Week 3: Palliative approach, loss, grief and bereavement

Question 1

Medical Treatment and Planning and Decisions Act 2016

Answer 1

framework for decision making that is only applied when a person does not have the capacity to make treatment decisions for themselves.

Question 2

if patient can’t give consent which part of the ACP do they follow?

Answer 2

instructional dirctive

Question 3

difference between instructional and values directive

Answer 3

instructional is legally binding instructions as to what they do and don’t want
valuies preferences around what they do and dont want

Question 4

process of advance care directive

Answer 4

be signed by doctor witness adult by and signed by patient

Question 5

order of decision maker

Answer 5

appointed person
if vcat hasn’t appointed a guardian then:
spouse/ partner
primary carer
oldest adult child
oldest parent
oldest adult sibling
no advance care directive or anyone then gain consent from office of the public advocate

Question 6

where should the advance directive be stored?

Answer 6

medical file in clinical notes legal folder

Question 7

voluntary assisted dying eligable

Answer 7

end of life patient
vic resident
18 or over
Australian citizen
decision making capacity
incurable disease or medical condition that is advanced and progressive
death no longer than 12 months

Question 8

how to access VAD

Answer 8

a request for VAD made by patient can be initiated by them
two verbal and one written and witness with a minimum of 10 days of first and final request

Question 9

what happends after final request

Answer 9

medical coordinator must complete certificate for authorisation that all requirements are met assisted dying review board appoint contact details given to board to give back meds

Question 10

theoretical context

Answer 10

Loss, grief and bereavement theories that provide a framework for considering responses to loss, grief and dea

Question 11

emotional impact

Answer 11

of a patient death on healthcare staff: Symptoms and work performance may be affected by the quality and quantity of the relationship, age and other characteristics of the patient and or family.

Question 12

impact of culture

Answer 12

on the work environment: Patterns of behaviour, customs and beliefs of a group- in this case, nurses.

Question 13

impact of personal

Answer 13

situations and life experiences: Socio-cultural, personal, role expectation, previous losses that may impact on responses to the death of a patient.

Question 14

grief support

Answer 14

and education: Debriefing, education, formal and individual support systems contributed to professional wellbeing.

Question 15

grief theories: Worden’s Tasks of Mourning

Answer 15

To accept the reality of the loss
To work through the pain and grief of the loss
To adjust to an environment in which the deceased is missing
To relocate the deceased and move on

Question 16

Kubler-Ross’s Model of Grieving

Answer 16

denial, anger, bargaining, depression and acceptance

Question 17

Stroebe and Shut’s Dual Process Model of Coping

Answer 17

oscillation between coping behaviours, as grief is viewed as a dynamic process in which the focus can shift from a loss orientation or a restoration orientation.

Question 18

elements of palliative care

Answer 18

strongly responsive to the needs,
preferences and values of people, their families and carers. A
person and family-centred approach to palliative care is
based on effective communication, shared decision-making
and personal autonomy

Question 19

What does Palliative Care do?

Answer 19

Provides relief from pain & other distressing symptoms;
* Affirms life & regards dying as a normal process;
* Intends to neither hasten or postpone death;
* Integrates the psychological & 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 families cope during the illness
& in their own bereavement;