Week 14: End of Life

Question 1

What skills are associated with EoLC?

Answer 1

• emotional resilience
• decision- making
• communication death
• recognising dying patients
• death education

Question 2

What is involved in palliative care?

Answer 2

• focuses on symptom management
• provides emotional, spiritual and psychological support
• offered practical support
• maintains good quality of life
• not a curative case
• can be long term

Question 3

What is involved in end of life care?

Answer 3

• recognition the patient is in last year of life
• aim to provide a dignified death
• advanced directives
• focus in symptom management and pain relief

Question 4

What are the 4 signs of the dying stage?

Answer 4

• neurological
• gastrointestinal
• respiratory
• cardiovascular

Question 5

What are examples of neurological change?

Answer 5

• confusion
• delirium
• hallucinations
• mood changes
• sleep disruption

Question 6

What are examples of gastrointestinal changes?

Answer 6

• rapid decline in appetite
• reduced fluid intake
• reduced urine and stool output
• new incontinence
• moves from anabolic to catabolic state
• raised ketones suppress hunger, pain, thirst

Question 7

What are examples of respiratory changes?

Answer 7

• muscle atrophy and unconscious state relax airway
• increase in secretions produce death rattle
• increased resp rate and shallow reps
• oxygen therapy not advised to reduced breathlessness

Question 8

What are examples of cardiovascular change?

Answer 8

• reduced blood pressure and heart rate
• reduced peripheral circulation
• may cause blood to pool

Question 9

What are symptoms of impending death?

Answer 9

• hyperextension of neck
• drooping of the nasolabial fold
• grunting
• unresponsive pupils
• cheyne stokes breathing
• unable to close eyes

Question 10

What are anticipatory medications?

Answer 10

Reduced distressing symptoms for the patient and the family, administer via submit injection

Question 11

What is the importance of communication?

Answer 11

• develop therapeutic relationships
• maintain trust
• establish realistic hope
• reduce uncertainty
• promote patient choices

Question 12

What is the art of silence?

Answer 12

Trying t hold silence for up to 90 seconds, if patient has not said anything in this time, probe by asking what they are thinking abt

Question 13

How can you plan and prepare for EoLC?

Answer 13

• talk to their gp
• helplines/services/charities
• educate and involve support network
• ensure wished and preferences are known and discussed
• prepare documentation
• JRCALC