Palliative Care Flashcards
Palliative Care models compare to the chronic care model are more:
Palliative care models are more focused then chronic care model.
Palliative care is
- an approach that improve the quality life of patients and families facing problems associated with illness
- Includes the prevention and reliefs of suffering through early identification, assessment and tx of symptoms (physical, psychosocial and spiritual issues)
- Should be received EARLY and conjunction with others therapies that are intended to prolong life.
Patient does not like the name of Palliative Care, but this model is therapeutic due to:
- The focus of maintaining optimal quality of life
- Intensifies as death approaches with comfort as priority
- Values and decisions are respected; opportunities for closure and growth enhanced.
2 type of palliative care model:
- Mobile palliative care within hospitals
2. Community palliative care
Early Models of Palliative Care was focused on:
Curative first then palliative after.
Canada is one of the pioneer of Palliative care model by
integrating active tx and palliative together.
Bow Tie Model is:
- A palliative care model, focusing on disease management, pain and symptom management and Palliative care leading to rehabilitation (survivorship) or End-of-life care (Bereavement)
- Autor: Hawley P.
- Extended to patient’s families and other caregivers (patient-centered)
Palliative Care needs is
- Australia palliative care model
- Are very proactive
Important issues to remember about palliative care:
- VARIATION in patient need’s throughout the illness trajectory
- Needs and illness trajectories can be UNPREDICTABLE
- The complexity of needs does not determine the setting of care. (even if complex needs, doesn’t mean they have to be in hospitals)
Model of Care Matrix:
- Stages of a condition, injury or event with the needs (movement in the 2 ways leading to bereavement or well community)
- Level of the healthcare systems (policy, organizational and individual level)
Priority Areas for effective health care systems:
- Integrating Palliative care as early as possible
- Provide acute hospital-based care only when necessary
- Focusing on PC and appropriate tx at end of life
- Ensuring equitable access to PC and end-of-care.
Finding related to the priority areas for effective health care systems:
- Some patients receiving Palliative care designation only near end of life
- Oversure of or over-reliance on acute-care hospital services near end of life.
- Palliative radiation for pt with prostate and breast cancer underused
- Rural residents, younger pts and those with certain cancers have different end-of-life care experiences than the general cancer population.
Barriers contributing to care deficiencies on integrating PC as early as possible:
- Misperceptions that Palliative care equates end-of-care
- Concerns that use of Palliative care signals that clinicians are ‘‘giving up’’
Barriers contributing to care deficiencies on providing acute hospital-based care only when necessary:
- Inadequate access to primary care and community-based services
- Lack of people at home to care for the patient
- Cost of medications
- Lack of planning for impending death
Barriers contributing to care deficiencies on focusing on PC and appropriate tx at end-of-life:
-Physician referral practices and awareness of palliative tx ay influence uptake.
