Palliative Care

Question 1

What are the goals of palliative care?

Answer 1

1. To provide the best possible quality of life for patients and their family
2. To address the biological, psychosocial, and spiritual dimensions of suffering
3. To emphasizing state-of-the-art pain and symptom management
4. Not to give up on aggressive treatment
5. To examine the goals of treatment
6. To provide an opportunity of a much broader range of patients reflection on issues of life closure

Question 2

How is quality of life improved through palliative care?

Answer 2

1. Palliative care provided alongside aggressive treatment

2. As patient becomes sicker and closer to death, palliation becomes the primary objective

Question 3

What is the “both/and” approach?

Answer 3

1. “Hope for the best” (such as experimental treatment)
2. “Prepare for the worst” (financial planning/religious beliefs)
3. Makes transition to hospice easier for patients when using this approach

Question 4

Define palliative care

Answer 4

Pain and symptom management, Enhancing the quality of life, Finding the meaning in the face of death

Question 5

Define hospice care

Answer 5

1. Comprehensive care given to dying patients by a multidisciplinary team of nurses, physicians, social workers, volunteers, and clergy
2. pts will most likely die in the next 6 months

Question 6

Where can hospice care be provided?

Answer 6

Care can be given in the home, acute-care hospitals, or skilled nursing facilities

Question 7

What End-of-Life Issues need to be Discussed with Patients?

Answer 7

1. Life Support
2. Personal Beliefs
3. Long Term care and support systems

Question 8

What life support issues need to be discussed?

Answer 8

1. Do you have an advanced directive?
2. Do you know what CPR is?
3. In the event an illness led to your being unable to eat or drink on a permanent basis, would you want to be fed with feeding tubes?
4. Do you want your medical care primarily geared to prolonging your life, or is improving or maintaining your quality of life more important?

Question 9

What personal belief issues need to be discussed?

Answer 9

1. What life experiences have you had around death or dying?
2. How have these experiences affected your own attitudes about death?
3. What are your worst fears about dying? What are your biggest hopes?
4. What would be a “good death” for you?
5. What do you believe happens to you when you die?
6. If you were to die sooner rather than later, what would be left undone?

Question 10

What long term care and support systems need to be established with pts?

Answer 10

1. If you become too ill to take care of yourself, who will take care of you?
2. Who would you want to make health care decisions for you if you became unable to do so?
3. If you were dying, would you prefer to be at home or in an institution such as a hospital or nursing home?
4. Do you know what hospice care is? Would you want that kind of care if you were terminally ill?
5. Who would you want to be present at the time of your dying and death?
6. Is there anything you need to get done before you die?

Question 11

What are last resort interventions?

Answer 11

1. Double effect
2. Witholding or withdrawing life sustaining treatment
3. Palliative sedation to unconsciousness (terminal sedation)
4. Physician aid-in-dying (Physician assisted suicide)
5. Active Euthanasia