Test 1 Flashcards
palliative care
services offered to clients and their families living with and/or dying from a progressive, life-threatening illness
goals of palliative care
relieve pain, suffering, improve comfort, promote dignity (NOT to cure illness or prolong life)
5 areas of holistic focus
- physical
- emotional
- spiritual
- social
- intellectual
MAID
medical assistance in dying
medically assisted death
aided by providing client with means/information necessary to end their life
euthanasia
act of putting another person painlessly to death
stage 1 of MAID
determine eligibility
- 18 yrs
- capable of making health decisions
- grievous + irremediable med condition
- voluntarily request
- give informed consent
- eligible to receive health services funded by Can gov.
what type of illness is excluded by MAID
mental illness
stage 2 of MAID
ensure safeguards are met
(when a patients natural death is reasonably foreseeable)
- written request signed by one independent witness
- eligibility provided by two independent practitioners (one must be expert in client illness)
- can withdraw consent at any time
- all necessary measures taken to provide reliable means for patients difficulty communicating to understand and communicate their decision
- immediately before providing MAID , patient is given opportunity to withdraw their request and ensure patient gives express consent to receive MAID
(when a patients natural death is NOT reasonably foreseeable)
Everything above^^^ and…
- 90 day assessment period observed
- patient informed about means available to relieve their suffering
- eligibility provided by two independent practitioners but one must be expert in client illness
Stage 3 of MAID
Obtain consent
type of consent when a patient’s natural death is reasonably foreseeable
- General consent
- advanced consent
- express consent (final)
type of consent when a patient’s natural death is NOT reasonably foreseeable
- General consent
- express consent (final)
Stage 4 of MAID
Provide MAID
- prescribing, providing, or administering medications that cause death
- reporting requirement
PSW responsibilities related to Medically Assisted Death
- perform activties/ADL’s
- provide comfort measures
- educate clients
- provide support to clients and family
- do not encourage client to choose medical assistance in dying (it is a CRIME)
factors required for home palliative care
- desire to die at home
- the caregiver’s desire to have client at home
- good family/physician support w/ available medical support 24 hr/day
- available caregivers
- financial resources
- cost of medications/medical equipment
- compassionate leave
home care challenges
- less structured
- more physical demands
- financially more expensive
home care benefits
- more privacy
- less intrusiveness
- more sleep
hospital care benefits
- more sleep
- more structure
- less expensive
hospital care challenges
- more intrusiveness
- less privacy
- decreased access to client for family
capable
understanding information and consequences of a situation
incapable
no understanding of consequences of choices of activities of daily living
advanced directive
making choice while you are capable about how you wish to be cared for in the future in you become incapable of making those decisions
ex: designating Power of Attorney or Substitute Decision Maker
Power of Attorney
A document that gives a designated family member or another trusted friend the right to make legal decisions in situations where the client cannot decide for themselves
2 types of Power of Attorney
Personal - ADL’s, where to live, what kind of treatment to receive
Financial - Property, money, paying bills…
Living Will
- document that speaks for the person in special situations when they cannot speak for themselves
- puts in writing more specific medical interventions in special circumstances
Last Will and Testament
Is an “after death document” that specifies your estate distribution
Hierarchy of Substitutes
- substitute decision maker (POA)
- spouse, common-law or partner
- child (if 16 or older) or parent
- brothers and sisters, any other relative (may share decision-making responsibility)
if no living relatives:
- office of public guardian and trustee
- consent and capacity board appoints a “Board Appointed Representative”
DNR
Do Not Resuscitate - instructions not to perform any heroic measures to keep someone alive
4 reasons why communication is important
- promotes safe/effective care
- establishes client’s needs
- builds relationships
- provides advocacy
tips for effective communication
- use verbal and non verbal
- use simple, clear language
- ask open-ended questions
- give broad openings
- use silence
- active listening
- paraphrase to clarify meaning
- acceptance
barriers to communication
- ease of communication = job satisfaction
- condition of client
- time
- pressure from colleagues + supervisors
- fear
- over-identification with patients and families
- interrupting
- jumping to conclusions
- becoming impatient
- becoming bored
- answering own questions
- hurrying, focusing not on client
tips for communicating w/ unconscious client
- do not shout “can you hear me?”
- speak as if they can hear you
- describe what you are going to do
- make physical contact if culturally appropriate
what is grief
- internal part of loss
- how we feel
- it is real
- leaves its imprint
- reflection of the connection we had with the person who has died
- healing process that brings us comfort
factors that influence grief
- time
- attachments/connection
- religion
- culture
- past experience
- dying person’s role in family
- length of illness
- presence of social supports
- cultural differences
public grief
- gathering of people to share a loss in villages, town, cities
- funeral, memorial, vigil, wake are NA examples
- normal and healthy
time after learning of a fatal illness, when one experiences all of the emotions of grief in ‘anticipation of the loss of a loved one’
anticipatory grieving, normal grief reaction
mourning
external part of loss: actions, rituals, customs
who noticed that when people were dying they were “shunned and abused and no one wanted to be honest with them?
dr. elisabeth kubler-ross
