palliative care 2b Flashcards
People with lifelimiting disease
have
complex needs, needing support from different health disciplines.
The benefits of Multidisciplinary
Care
Increased access to patient information, social
services and practical support.
Increased patient satisfaction.
Greater likelihood of implementing care according
to national standards and clinical practice
guidelines.
This leads to better outcomes for the patient.
Principles of Multidisciplinary
Care
Patient defined goals of care.
A team approach.
Ongoing information and communication between
team members.
Care is provided according to national standards of
care.
This includes patient and family involvement, care
co-ordination and continuity of care
Who and where? Providing Palliative
Care in NSW
majority of patients living with a life limiting illness
do so in their own homes.
They receive care from their primary carer, coworkers, families and friends.
They may have many carers, they may have none.
They may live in a nursing home, they may live in
remote communities, they may be homeless.
The Carer
Husband, wife, parent, grandparent, brother, sister,
son, daughter, niece, nephew, partner, friend.
Three quarters of carers have chronic health
problems as well.
Their health, both physical and psychological,
needs to be recognised and supported by the
palliative team.
Caring for the carer
Providing information about help and resources
available.
Providing education about symptom management
and control.
Emphasising the importance of the need for respite.
Educating about self care and manual handling.
Co-ordination of services
Factors to consider when looking
after a patient at home
Resources in community Patient’s level of function Stage of disease State of pain and symptom control Patient and family’s acceptance of stage of disease Patient’s social circumstances Personal finances Age of patient and age of carer.
Resources typical in a metropolitan area
Community Specialist Palliative Care Service and inpatient
palliative care beds (infrequent visits. Monitoring two to four
weekly)
Community Nursing: come for syringe driver change, dressing
change, etc.
Wide range of Residential Aged Care Facilities (RACFs)
Rehab hospitals: Lady Davidson/Mount Wilga/Arcadia have
palliative beds.
Equipment suppliers
Acute hospitals, like the Sydney Adventist, and subacute
hospitals, like Neringah, Greenwich palliative care unit , Manly
Waters Private, and the new Mona Vale PC
support services through My Aged
Care and Community Health
My Aged Care is a government programme which provides
services that support older people to stay at home and
remain independent in the community.
Community Options programs
Homecare- domestic and personal care
Chronic and Complex Care Co-ordinators
Hammond At Home (CommonWealth funded): 48 hours of
care offered when death is imminent: can be renewed.
RACF (Residential Aged Care
Facilities)
Nursing Homes and Hostels
Primary care sector- GP and nurses with palliative
approach
Can be linked to Community Palliative Care.
There is continuous State and Federal funding to
improve palliative care in these facilities:
PEPA, Hammond at Home, education on palliative
care in Nursing homes.
Currently Medibank Private and BUPA
are piloting a
trial with Hammondcare where they pay
HammondCare to provide services to patients
requiring palliative care.
The Palliative Care Outcomes
Collaborative (PCOC)
a national program that uses standardised tools
to measure and benchmark patient outcomes in
palliative care.
Based on the Standards for providing quality
palliative care for all Australians.
Provides evidence based tools to improve patient
outcomes.
How should palliative care be
delivered?
Goals of care are focussed on the patient’s
functions, e.g. how capable he/she is to function
day by day?
Medical goals relate back to functional goals, e.g.
will pain control allow him/her to function better?
The patient’s goals change day by day as the illness
progresses.
Where should palliative care
occur?
Wherever the patient and the family want it to be:
circumstances permitting.
Most people spend most of their time at home.
In the home.
In the nursing home.
In the hospital.
In a hospice.
