Palliative Care Flashcards
Seriously ill, hospitalized patients report that what things are worse than death?
- Incontinence
- Requiring a ventilator
- Persistent mental confusion
Doctors are more likely to opt for dying at ____________.
home
What proportion of medicare beneficiaries have the following in the last month of life?
•ED visit
• ICU admission
• Inpatient surgery
- ED: 1 in 2
- ICU: 1 in 3
- Inpatient surgery: 1 in 5
What is the GAPS mnemonic?
- Goals at the end of life
- Advanced directive
- Psycho-spiritual support
- Symptom control
What is necessary for hospice care?
A prognosis of six months or less
Note: palliative care does not require this. PC is primarily a symptom-management team for people with serious illness.
Over the last thirty years, more people are dying in _____________ and fewer are dying in ____________.
their homes or in nursing homes; as inpatients
List six things that dying people often want.
- A dedicated decision maker
- Financial life in order
- Knowing prognosis
- Knowing what physical changes to expect
- Pain control
- Maintain dignity
How adept are doctors at recognizing the dying process?
- 49% can diagnose it in the last 24 hours
* 21% can diagnose it in the last 72 hours
The cardiac system often goes from _________ to ___________ during the dying process.
tachycardic; bradycardic
_____________ often need to be discontinued when dying people start struggling to breath.
IV fluids (which can worsen pulmonary edema)
_____________ are often given to treat dyspnea. There is no evidence that this hastens death.
Opioids
Three systems need to be checked to determine death: ________________.
- Neurologic: no cranial reflexes; nonresponsive
- Cardiac: no pulse
- Pulmonary: no respirations