Perspectives on End-of-Life Care Flashcards

Question

Hospice and palliative care What is hospice specifically?

Answer 1

Hospice is comfort care without curative intent.

Answer 2

Palliative care is comfort care with or without curative intent.

Answer 3

Because more than 90 percent of hospice care is paid for through the Medicare hospice benefit,

Answer 4

Because more than 90 percent of hospice care is paid for through the Medicare hospice benefit, hospice patients must meet Medicare’s eligibility requirements; palliative care patients do not have to meet the same requirements ( private insurance/private pay)

Answer 5

Hospice Care Definition Compassionate comfort care (as opposed to curative care) for people facing a terminal illness with a prognosis of six months or less, based on their physician’s estimate if the disease runs its course as expected.

Answer 6

philosophy of care that seeks to support dignified dying for the person and their families and caregivers

Answer 7

Hospice treats the person not the disease; cost-effective alternative

Answer 8

Nursing Treatment during Hospice Care –no extending life treatment is provided ( no TPN, no chemo, no special assessments, PT /OT for hoyer transfer only.

Answer 9

PT /OT for hoyer transfer only.

Answer 10

The only intervention is providing an opioid analgesic.

Answer 11

* improving quality of care at end of life and cutting costs

Answer 12

Eligibility Criteria: requires that two physicians certify that the patient has less than six months to live if the disease follows its usual course

Answer 13

Hospice care is available for patients considering stopping curative treatments because they aren’t working or the side effects outweigh the benefits.

Answer 14

compassionate comfort care that provides relief from the symptoms and physical and mental stress of a serious or life-limiting illness.

Answer 15

Palliative care can be pursued at diagnosis, during curative treatment and follow-up, and at the end of life.

Answer 16

Palliative care: patient and family-centered care optimizing quality of life by anticipating, preventing, and treating suffering;

Answer 17

method that improves quality of life of older adults and their families facing the issue associated with life-threatening illness, through prevention and relief of suffering by means of early identification, assessment, treatment of pain, and other physical, psychosocial, and spiritual difficulties

Answer 18

“Stepping-stone” to hospice

Answer 19

The desired outcome of palliative care is always comfort

Answer 20

broad; addresses physical, intellectual, emotional, social, and spiritual needs; and facilitates older adult’s choice, autonomy, and access to information.

Answer 21

Eligibility Criteria: Palliative care is begun at the discretion of the physician and patient at any time, at any stage of illness, terminal or not.

Answer 22

People are eligible for palliative care if they are living with a serious illness – at any stage — and need solutions for pain, symptoms, and stress due to the serious illness, or the treatments to cure or manage it.

Answer 23

Palliative care can be provided to someone who may be cured of their disease, a person who will live with their condition for a long time, a person who has a progressive illness , or to a family needing explanations and support in order to make difficult care decisions during routine hospitalizations or times of crisis in the Emergency Department or Intensive Care Unit.

Answer 24

True Hospice services are provided by public and private agencies in home or facility-based settings or in freestanding, short-term residential facilities

Answer 25

Wellness at the end of life connected to a “good death”

Answer 26

Dignified death = dignified care

Answer 27

Nursing: Empower the client and family to maintain as much control as possible.

Answer 28

Treated as individual and with respect Maintain personal independence by assisting with meeting basic needs Involved in decision making regarding treatment or the choice to stop treatment Safe and private environment Good communication Absence of anxiety

Answer 29

preferences for specific dying process, pain free status, religiosity and spirituality emotional well being, quality of life, life completion, treatment preferences, dignity, presence of family, and relationship with health care providers

Answer 30

Aggressive and comprehensive symptom management Open and honest communication about prognosis, treatment, and dying process Ongoing discussion of patient’s goals of care Psychological and spiritual support for patients and families- is essential

Answer 31

Assessment of Spirituality in Older Adults: FICA Spiritual History Tool (on classes) Bereavement services

Answer 32

F FAITH AND BELIEF I IMPORTANCE C COMMUNITY A ADDRESS IN CARE

Answer 33

* Do you consider yourself spiritual or religious? * Do you have spiritual beliefs that help you cope with stress? If the patient answers “No,” the health care provider might ask, * What gives your life meaning?

Answer 34

Sometimes patients respond with answers such as family, career, or nature.

Answer 35

* What importance does your faith or belief have in your life? * Have your beliefs influenced how you take care of yourself in this illness? * What role do your beliefs play in regaining your health?

Answer 36

* Are you part of a spiritual or religious community? * Is this of support to you and how? * Is there a group of people you really love or who are important to you?

Answer 37

* How would you like me, your healthcare provider, to address these issues in your healthcare?

Answer 38

Communication: critical for all involved

Answer 39

Importance magnified due to complexity and uncertainty of situation

Answer 40

Listen reflectively to both the patient and family with compassionate presence

Answer 41

Demonstrate empathy and ability to journey in suffering Offer sensitivity

Answer 42

Addressing needs of the family

Answer 43

Be aware of the decisions a person has made about his or her current and future medical care.

Answer 44

Help protect the patient’s right to make his or her own health-care choices.

Answer 45

Written documents that outline patient’s wishes about life-sustaining treatments

Answer 46

Nurses have an obligation to know the legal requirements in their jurisdictions and then work with the older adult and the family to determine how the local laws can fit with their cultural patterns and needs related to end-of-life decisions.

Answer 47

* Distrust of the health care system (especially in groups who have experienced violence or discrimination in the United States or their country of origin)

Answer 48

Family rather than individual is “decision-maker”

Answer 49

* Preference for physician, as expert, to make the decision

Answer 50

* Taboo to talk about death or dying

Answer 51

* Influence of faith and spirituality: Illness as a test of faith

Answer 52

* Belief that life is a gift from God that must be protected * Death as a part of the cycle of life and must not be disturbed

Answer 53

* Dying away from home may lead to a disturbance of the spirits

Answer 54

* Cannot die at home because the spirit will linger

Answer 55

Correct answer is A. The priority action is to give the family as much time with the client as they need. Holistic care should be provided for the client and the family. It would be presumptuous of the nurse to assume that anger would be the family's most immediate emotion. Rest is important but quality time with the ill family member is a priority. Collecting belongings does not address the family's emotional needs.

Answer 56

Fatigue Constipation Dyspnea Nausea/Vomiting Dehydration Anorexia/cachexia

Answer 57

Breathing changes (dyspnea with apneic periods) Audible congestion (death rattle) Decreased level of consciousness/terminal delirium Extremity cooling, pallor, mottling Decreased food and fluid intake Urinary and fecal incontinence

Answer 58

Breathing changes (dyspnea with apneic periods) Audible congestion (death rattle)

Answer 59

Decreased level of consciousness/terminal delirium

Answer 60

Extremity cooling, pallor, mottling Decreased food and fluid intake

Answer 61

Have ability to talk to patients and families about dying. * Be knowledgeable about pain and symptom control. * Have ability to provide comfort-oriented nursing interventions. * Recognize physical changes that precede imminent death. * Deal with own feelings. * Deal with angry patients and families. * Be knowledgeable and deal with the ethical issues in administering end-of-life palliative therapies. * Be knowledgeable and inform patients about advance directives. * Be knowledgeable of the legal issues in administering end-of-life palliative care

Answer 62

True Beneficial aspects of end-of-life care are nursing interventions that include families as well as the patient, as nurses assist patients and families with end-of-life tasks and teach families about the signs of imminent death and management of the dying process

Answer 63

Anyone can ask to do this following a code/death.. “Could we take a moment just to Pause and honor this person in the bed. This was someone who was alive and now has passed away. They were someone who loved and was loved. They were someone’s friend and family member. In our own way and in silence let us stand and take a moment to honor both this person in the bed and all the valiant efforts that were made on their behalf.” 45 seconds to a minute of silence. “Thank you everyone.”

Perspectives on End-of-Life Care Flashcards

Exam 4 (Final)