Palliative Part 1 Flashcards
What is a hospice?
- Primarily a ‘concept’ of care - not always a specific place of care, but often combined
- E.g. specific philosophy of and/or approach to care rather than merely a type of building, service or both
What is palliative care?
- Approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness
- Prevention/relief of suffering by means of early identification, assessment, tx of pain and other physical, psycho-social and spiritual problems
- Guided by principles of primary healthcare
What are the principles of primary health care?
Accessible, participatory, inter-professional, health promoting, uses appropriate technology/skills
What does the Canadian Hospice Palliative Care Association consider palliative care to be?
- Affirms life, regards dying as a normal process
- Neither hastens nor postpones death
- Provides relief from pain/other symptoms
- Integrates psychological/spiritual aspects of care
- Offers ongoing support systems to dying pt’s and family members
What has brought forth the issue of palliative care as a human right?
An aging population, growing incidence and prevalence of cancer, and a growing HIV/AIDS epidemic, have all increased attention to palliative care as a public health issue and a human right
Describe the difference between curative focus and palliative focus:
CURATIVE: disease-specific, treatments
PALLIATIVE: comfort/supportive treatments
What is the focus of curative?
- Dx of disease and related symptoms
- Curing/tx of disease
- Alleviation of symptoms
What is the focus of palliative?
- Pt/family identify unique end-of-life goals
- Assess how symptoms, issues are helping/hindering reaching goals
- Interventions to assist in reaching end-of-life goals
- Quality of life closure
What are the ten guiding principles of hospice palliative care?
1) Person/family centered
2) Ethical
3) High quality
4) Team-based
5) Safe and effective
6) Accessible
7) Adequately resourced
8) Collaborative
9) Advocacy-based
10) Evidence-informed/knowledge-based
What are the goals of palliative care?
- Assure pt receives excellent pain control/other symptom/comfort measures
- Give pt information needed to participate in care decisions
- Offer ongoing emotional/spiritual support
- Obtain expert help in planning care outside the hospital (e.g. discharge planning)
What is evidence-based practice?
- The conscious decision to use current evidence in making decisions about the care of individual pt’s
- Those working in palliative care must use existing research through systematic reviews to maximize the value of data yielded in caring for pt’s/families
- Outcome and quality of life measures need to be sensitive to wider aspects of palliative care (not merely mortality, function, etc.)
- More difficult to measure quality of life and altered outcomes in pt’s/families whose illness or frailty make it difficult to collect data
What physical affects influence quality of life?
- Functional ability
- Strength/fatigue
- Sleep/rest
- n/v
- Appetite
- constipation
- pain
What psychological affects influence quality of life?
- Anxiety/depression
- Enjoyment/leisure
- Pain distress
- Happiness
- Fear
- Cognition/attention
What social affects influence quality of life?
- Financial burden
- Caregiver burden
- Roles/relationships
- Affection/sexual function
- Appearance
What spiritual affects influence quality of life?
- Hope
- Suffering
- Meaning of pain
- Religiosity
- Transcendence
