Palliative Medicine Flashcards
where do most deaths occur nationally
hospital or nursing home
how does location of death vary?
by region
what are typical deaths
slow decline
associated with chronic disease and comorbidties
increased dependency needs
why is quality of life during dying poor
inadequate treatment of distress
fragmented care
strains on family/support system
what are the 3 tragectories of serious illness
steady decline, short terminal phase
slow decline, periodic crisis
prolonged dwindling
what diseases are steady decline, short terminal phase assocaited with
pancreatic, lung, breat cancer
what disease are slow decline periodic crisises associated with
CHF, COPD
what diseases are prolonged dwindling associated with
generalized frality, dementia
what is the 3 legged stool of medicine
diagnostics, prognostics, therapeutics
examples of life prolonging care
CPR, ventilation, dialysis
examples of limited medical care
hospitalization, antiboitics, but not CPR or MV
examples of comfort care
care in locus of choice
optimal pain management
difference between palliative medicine and hospice
palliative medicine is a subspeciality, hospice is a philosophy of car
when does palliative med take place
all stages of disease trajectory
when does hospice take place
last 6 mons of life
does a pt have to sign DRN to enroll in hospice services?
no
what are common obstables to hospice
limited access
lack of family support
late referral
difficulties in determing prognosis
palliative care services
etablish goals of care
treatment of symptoms
psychosocial support/spiritual care
what are some hospital-based palliative care programs
consultation services
inpatient palliative care unit
comanagement
what are 2 main barriers to referral to palliative care
lack of awareness among family
tendency of clinicians to equate palliative care with end of life
