Palliative Medicine Flashcards

1
Q

where do most deaths occur nationally

A

hospital or nursing home

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2
Q

how does location of death vary?

A

by region

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3
Q

what are typical deaths

A

slow decline
associated with chronic disease and comorbidties
increased dependency needs

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4
Q

why is quality of life during dying poor

A

inadequate treatment of distress
fragmented care
strains on family/support system

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5
Q

what are the 3 tragectories of serious illness

A

steady decline, short terminal phase
slow decline, periodic crisis
prolonged dwindling

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6
Q

what diseases are steady decline, short terminal phase assocaited with

A

pancreatic, lung, breat cancer

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7
Q

what disease are slow decline periodic crisises associated with

A

CHF, COPD

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8
Q

what diseases are prolonged dwindling associated with

A

generalized frality, dementia

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9
Q

what is the 3 legged stool of medicine

A

diagnostics, prognostics, therapeutics

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10
Q

examples of life prolonging care

A

CPR, ventilation, dialysis

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11
Q

examples of limited medical care

A

hospitalization, antiboitics, but not CPR or MV

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12
Q

examples of comfort care

A

care in locus of choice

optimal pain management

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13
Q

difference between palliative medicine and hospice

A

palliative medicine is a subspeciality, hospice is a philosophy of car

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14
Q

when does palliative med take place

A

all stages of disease trajectory

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15
Q

when does hospice take place

A

last 6 mons of life

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16
Q

does a pt have to sign DRN to enroll in hospice services?

A

no

17
Q

what are common obstables to hospice

A

limited access
lack of family support
late referral
difficulties in determing prognosis

18
Q

palliative care services

A

etablish goals of care
treatment of symptoms
psychosocial support/spiritual care

19
Q

what are some hospital-based palliative care programs

A

consultation services
inpatient palliative care unit
comanagement

20
Q

what are 2 main barriers to referral to palliative care

A

lack of awareness among family

tendency of clinicians to equate palliative care with end of life