Tutorial 1

Question 1

Define Palliative Care

Answer 1

Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with 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.

Question 2

Principles of palliative care

Answer 2

*provides relief from pain and other distressing symptoms;
*affirms life and regards dying as a normal process;
*intends neither to hasten or postpone death;
*integrates the psychological and spiritual aspects of patient care;
*offers a support system to help patients live as actively as possible until death;
*offers a support system to help the family cope during the patient’s illness and in their own bereavement;
*uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated;
*will enhance quality of life, and may also positively influence the course of illness;
*is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications

Question 3

total pain

Answer 3

*physical pain
* social
*emotional
*spiritual

Question 4

stages of palliative care

Answer 4

curative care
palliative care
end of life care
bereavement care
care of vulnerable children

Question 5

classical disease trajectory 1

Answer 5

cancer

Question 6

classical disease trajectory 2

Answer 6

organ system failure

Question 7

classical trajectory 3

Answer 7

dementia/ frailty

Question 8

why is palliative medicine part of primary care?

Answer 8

World death rate is holding steady at 100%

-Patients seek help at the primary care level
-The primary care approach meets these needs
-Patients want end of life care in their homes
-Primary palliative care can offer this

Question 9

Approaches of Palliative care

Answer 9

Symptom management
Psychosocial care Spiritual care

Question 10

Approach to symptom management

Answer 10

COMMUNICATE to patient about problem and offer and psychological support

correct REVERSIBLE factors

provide DISEASE SPECIFIC treatment

consider NON-DRUG measures (non-pharmacological)

MEDICATION as needed (pharmacological)
TEAM approach
REVIEW

REFER

Question 11

Approach to pain management

Answer 11

IN ADDTION TO APPROACH TO SYMPTOM MANAGEMENT
- Address each source of pain in the patient individually

-characterise type of pain (SOCRATES)

• use WHO pain Ladder to asses medication needs according to severity