Palliative unit 0 Flashcards

1
Q

Definition of Palliative

A

mproves the quality of life of patients and their families facing the problem associated with a life-threatening
illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical,
psychosocial and spiritual

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2
Q

Palliative care concepts (8)

A

Provides relief from pain and other distressing symptoms

Affirms life and regards dying as a normal process

Intents neither hasten nor postpone death

Applicable early in the early stage of illness

Integrates psychological and spiritual aspect of patient care

Support patient to live as actively as possible until death

Support family to cope during patient’s illness and their own bereavement

Is applicable early in the course if illness, in conjunction with other therapies

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3
Q

Defintion of End of Care life

A

Care given to people who are near the end of life and have stopped treatment to cure or control their disease.

End-of-life care includes physical, emotional, social, and spiritual support for patients and their families.

The goal of end-of-life care is to control pain and other
symptoms so the patient can be as comfortable as possible.

End-of-life care may include palliative care, supportive care, and
hospice care

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4
Q

Definition of Terminally Ill

A

Life expectancy of 6 months or less

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5
Q

Hospice

A

a place where a warm feeling between
the host and guest experienced

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6
Q

Eastern Cooperative Oncology Group (ECOG)

A

Scale used to assess performance status and
determine future treatment options.

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7
Q

ECOG performance status

A

Refer to Slide

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8
Q

types of Palliative and Hospice Care Services
(Singapore)

A

Hospital Palliative Care Services

Subacute Palliative Care Services

Inpatient Hospice Services

Palliative Day Care Services

Home Hospice Services

Caregiver Services

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9
Q

Hospital Palliative Care Services

A

symptoms control, psychosocial and spiritual support; and end-of-life care

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10
Q

Subacute Palliative Care Services

A

patients with life-limiting illnesses, who require a period of hospitalization for subacute treatment (e.g. complex wound care or symptom control).

  • Example: AMK Thye Hua Kwan Hospital, Yishun Community Hospital
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11
Q

Inpatient Hospice Services

A

patients with life-limiting illnesses, with prognosis of less than 3 months.

When care at home becomes difficult, option of inpatient hospice can be considered.

  • Pain and symptom control, Psychosocial and spiritual support, respite Care and end of life care
  • Example: Assisi Hospice, Dover Park Hospice, Bright Vision Hospital, St. Joseph’s
    Home
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12
Q

Palliative Day Care Services

A

patients who are diagnosed with life-limiting illness but are stable
and slowly deteriorating. Patients go to day hospice in the day and
return by evening. Meals and transport are provided for a small fee.

Physiotherapy, occupational therapy, art/music therapy; recreational activities (e.g. music, art and art, grooming, cooking, outings); pain
and symptom control; psychosocial and spiritual support; respite care
in the day.

  • Example: Assisi Hospice, HCA Hospice
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13
Q

Home Hospice Services

A

patients diagnosed with life-limiting illnesses and have caregivers at home.

Home visits are conducted by doctors, nurses, counsellors/medical social workers and therapists.

Frequency of visits depends on clinical needs.

Caregiving is done by patient’s caregivers, not the home hospice team.

  • Pain and symptom control; psychosocial and spiritual support; end-of-life care; caregiver training; equipment loan; 24hour coverage with hotline and after office hours visits as needed.
  • Example: HCA hospice, Dover Park Home Care, Agape Care, Singapore
    Cancer Society Home Care, Assisi Hospice
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14
Q

Caregiver Services

A

Caregiver training and grant; counselling; bereavement support

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15
Q

Concepts of Palliative and End-of-life Care

  • Interdisciplinary involvement (10)
A

Doctor
* Nurse
* Medical Social Worker/ Counselor
* Therapist – Speech, Occupational Therapist,
Physiotherapists
* Pharmacist
* Dietician
* Music, Art Therapist
* Complementary/Alternative Therapy
* Religious representatives
* Caregivers/family members

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16
Q

Patient ->

A
  1. Symptom control
  2. Disease management
  3. Psychosocial and
    spiritual care
17
Q

Palliative and End-of-life Care, care plan should include (5)

A

Pain and other symptoms management

Psychological and psychiatric issues assessment and management

Social needs of patients and family members

Spiritual, religion and existential aspects of care

Culture-specific needs of patient and family

18
Q

Palliative and End-of-life Care

A

Comprehensive interdisciplinary assessment of the patient and
family members

Respect patient’s goals, preferences and choices (within the limit of ethical and legal boundaries)

Recognize the signs and symptoms of impending death

19
Q

Concepts of Palliative and End-of-life Care

Respect Patient’s Goals, Preferences and Choices

A
  • Advanced Care Planning (ACP)
  • Disease Specific
  • Preferred Plan of Care (PPC)
20
Q

Illness
Trajectories

A

Refer to slides

21
Q

ECOG GRADE 0

A

Fully active, able to carry on all prediseases performance without restriction

22
Q

ECOG GRADE 1

A

Restricted in physically strenuous activity but ambulatory and able to carry out any work activities; up and about more than 50% of waking hours

23
Q

ECOG GRADE 2

A

Ambulatory and capable of all self-care but unable to carry out any activities; up and about more than 50% of waking hours

24
Q

ECOG GRADE 3

A

Capable of only limited self care , confined to bed or chair more than 50% of working hours

25
Q

ECOG GRADE 4

A

Completely disabled, cannot carry on any self-care, totally confined to the bed or chair

26
Q

ECOG GRADE 5

A

Dead

27
Q
A