Palliative care

Question 1

what are the 10 key elements in the care of the dying?

Answer 1

1. recognise patient is dying
2. communicate with patients and fam/loved ones
3. spiritual care
4. anticipatory prescribing for symptoms of pain, resp tract secretions, agitation, nausea and vomiting, dyspnoea
5. review of clinical interventions- should be in the patients best interests
6. hydration review
7. nutritional review
8. full discussion of care plan with the patient and relative/carer
9. regular reassessment of the patient
10. dignified and respectful care after death

Question 2

how (widely speaking) is dying diagnosed?

Answer 2

worsening weakens and performance status, worsening physiological status with no reversibility
struggling to manage oral meds
losing interest in food and fluid
sleeping more –> unconsciousness

Question 3

what meds would be used for the following palliative problems?

1. Pain/SOB
2. Distress
3. Nausea/agitation
4. Resp secretions

Answer 3

1. morphine
2. midazolam
3. levomepromazine
4. Buscopan