Week 12 End of Life

Question 1

What are the steps for breaking bad news?

Answer 1

• plan the meeting: who will attend? where?
• explore what the patient knows
• what does the patient want to know?
• give the news: no medical jargon
• stop. respond to emotions
• make a plan: include follow up!

Question 2

Skills for responding to emotions

NURSE

Answer 2

• name the emotion
• understanding: of course this is devastating
• respect: i can see how much you love xxx”
• support: i will be here with you through this
• exploring: tell me what you’re thinking

Question 3

what 3 impairments in physical function are linked with impaired driving?

Answer 3

• impaired vision
• impaired neck ROM
• inability to walk 10 feet and back in <9 seconds

Question 4

what MoCA score correlates with prediction of impaired driving safety?

Answer 4

18 and under

Question 5

in BC, what are the conditions under which a driver’s medical might be needed?

Answer 5

• Age (80+ every 2 years)
• Commercial drivers
• Known medical condition
• if report received that person has condition that affects their ability to drive

Question 6

first line treatment of dyspnea in palliative care?

Answer 6

first line: opioids

benzos for anxiety only in moderate to severe dyspnea as second-line agent if opioids not effective

Question 7

non-pharm for treatment of dyspnea in palliative care?

Answer 7

• Pacing
• Breath control
• Small frequent meal
• Positioning: upright, semi Fowler
• position poor lung side down when lying on side
• Support with pillows, lean forward
• COPD: pulmonary rehab
• Ask yes/no questions instead of open ended
• Relaxation
• Stay calm
• Fans to help with airflow for minimum 5 min
• Walking aids
• O2 generally only helpful for hypoxic patients
If non-hypoxic: limit trial of O2