palliative care Flashcards
what are the attitudes to death in Ireland?
-57% think we dont speak about death enough
-74% prefer a home death, 63% prefer home even in final days of life
why is the hospice favoured over hospital are for dying patients?
-lower pain levels
-reducing family distress
-controlling symptoms
-better communication
-better privacy
-long delays for services in hospital
why is there poor satisfaction with hospital care for dying patients?
-staff avoidance of dying patients
-inadequate symptom control
-focus on physical needs and not psychosocial needs
-too busy
-uncaring attitude
-lack of privacy
-use of medical language
define palliative care?
-the continuing active total care of patients and their families, at a time when the medical expectation is no longer a cure
-responds to physical, psychological, social and spiritual needs and extends to support bereavement
what does palliative care involve?
-affirms life and regards dying as a normal process
-provides relief from pain and other distressing symptoms
-offers a support system to help patients live as actively as possible until death
-uses a team approach to address the needs of patients and their families, including bereavement counselling if indicated
what is hospice care?
-describes the care offered to patients when the disease process is at an advanced stage
what are the 3 levels of palliative care services?
-level 1 - palliative care approach
-level 2 - general palliative care
-level 3- specialist palliative care
what is level 1 - palliative care approach?
-palliative care principles should be appropriately applied by all HCP’s
what is level 2 - general palliative care?
-at an intermediate level, a proportion of patients and families will benefit from the expertise of health care professionals who have some additional training & experience in palliative care
what is specialist palliative care?
-specialist palliative care services are those whose core activity is limited o the provision of palliative care, under the direction of a consultant in palliative medicine
what is rehabilitative palliative care?
-integrates rehab, enablement, self management and self care into the holistic model of palliative care
what are the aims of rehabilitative palliative care?
-aims to optimise peoples function and wellbeing and to enable them to live as independently and fully as possible
-supports people to live fully until they die
-optimise physical function & emotional wellbeing to the highest extent possible
describe 4 examples of rehab goals?
-restorative goals - return patients to previous level of function eg transferring from bed to chair
-preventative goals - prevent avoidable deterioration in function
-supportive goals - maximising function , independence etc
-palliative goals - involves supporting people to adapt to and come to terms with the irreversible changes in function etc
what % of cancer treatments need palliative care?
estimated at 70%
what are the affects of not making a diagnosis on the family and patient?
-patient & family are unaware that death is about to happen
-patient loses trust
-patient dies with controlled symptoms, leading to a distressing death
