WEEK 3 Palliative Care Nursing Flashcards
What is palliative care?
An approach that improves the quality of life of patients and their families when facing life threatening illness
Describe what is meant by a palliative care approach
Early identification, Impeccable assessment, Treatment of pain and other physical/psychological issues
List 5 places where palliative care is provided
Peoples homes
Aged care facilities
Inpatient units
Outpatient services
Emergency departments
What is the legal framework used for when a person no longer hold capacity to make medical decisions?
Medical Treatment and Planning and Decisions Act 2016
Describe the Medical Treatment and Planning and Decisions Act 2016
Framework for decision making used only when a person does not have the capacity to make treatment decisions for themselves
What happens in the absence of an appointed substitute decision maker (SDM)?
The law sets out an order to determine the SDM with whomever has a close or continuing relationship with:
- Spouse or domestic partner
- Primary unpaid carer
- Oldest adult child
- Oldest parent
- Oldest adult sibling
Do health practitioners require consent to administer palliative care to a patient?
Health practitioners do not require consent to administer palliative care to a patient who does not have capacity to do so regardless of SDM
Can patients refuse palliative care?
A person cannot refuse palliative care in an instructional directive and nor can the SDM. A person can include statements about palliative care in their values directive
Define advanced care planning
Planning for future health and personal care, whereby the persons values and preferences are made known so that they can guide decision making at a future time when they do not have capacity
Identify the 4 principles of advanced care planning
Person centred
Ongoing process (Early intervention)
Goals, values and beliefs clarification
Legal framework
Identify the 6 components of advanced care planning
Reflection
Discussion
Decision making
Documentation
Review
Activation
Identify the 2 forms of advanced care directives in victoria
Instructional ACD
Values based ACD
Describe an instructional ACD
A legally binding statement in which you consent to, or refuse future medical treatment
Describe a values based ACD
Is a statement of you values, beliefs and preferences to be able to guide future medical treatment
Describe voluntary assisted dying
The Voluntary Assisted Dying Act 2017 is a law intended to limit suffering only for those who are clearly dying
What is the main criterion you have to meet for voluntary assisted dying
Must be diagnosed with an incurable disease, illness or medical condition that is advanced and progressive, that will cause death within weeks or months, but no longer than 12 months
What are the 5 criteria you have to meet for voluntary assisted dying?
- Over 18
- Victorian resident
- Australian citizen
- Must have decision making capacity
- Must be diagnosed with an incurable disease, illness or medical condition that is advanced and progressive, that will cause death within weeks or months, but no longer than 12 months
Identify the 3 theories used to describe grief
- Worden 1977
- Kubler-Ross
- Stroebe and Schut
Describe Worden’s grief theory
4 tasks of mourning that a person needs to complete in order to make an adjustment to their loss
1. To accept the reality of the loss
2. To work through the pain and grief of the loss
3. To adjust to an environment in which the deceased is missing
4. To relocate the deceased and move on
Describe Kubler-Ross’s model for grief
Stage 1: Denial
Stage 2: Anger
Stage 3: Bargaining
Stage 4: Depression
Stage 5: Acceptance
Describe Stroebe and Schuts model for grief
Dual process model of coping accepts that grief can be both helpful and detrimental depending on circumstances
Identify the 2 stages of the Stroebe and Schut model
- Loss Orientation: Grief work, intrusion of grief, denial/avoidance of restoration changes
- Restoration Orientation: Attending to life changes, doing new things, distraction from grief, avoidance of grief
Identify the 4 main impacts of patient deaths
- Emotional impact of a patient death on healthcare staff
- Impact of culture on the work environment
- Impact of personal situations and life experience
- Grief support and education
Describe the emotional impact of a patient death on healthcare staff
Symptoms and work performance may be effected by the quality and quantity of the relationship, age etc.
Describe the impact of culture on work environment
Patterns of behaviour, customs and beliefs of a group
Describe the impact of personal situations and life experience
Socio-cultural, personal, role expectation, previous losses that may impact responses to the death
Describe grief support and education
Debriefing, education, formal and individual support systems contributed to professional wellbeing
Describe the aspects of a communicative palliative approach
Positive attitude to death and dying
Open discussion about death and dying
Not confined to end stage care
Active comfort care - Positive approach to reducing symptoms
Facilitates understanding through active support
Define grief
An expected response to a painful life event, where the symptoms and duration of which can vary from person to person e.g. death of a loved one
What is uncomplicated grief?
When a person is processing their feelings in a typical way in the following days, weeks and months
What are 5 symptoms of uncomplicated grief
Crying/sobbing
Sleep problems
Persistent lack of energy
Changes in appetite
Difficulty concentrating
What is complicated grief?
Occurs when the response to a loss or death does not fade over time and keeps a person from getting back to their normal lives
Identify 5 symptoms of complicated grief
Includes the symptoms of uncomplicated grief, along with:
Persistent anger
Inability to focus on anything but the loss
Problems accepting the reality of the loss
Excessive avoidance of reminders
Intense feelings of sadness/pain/hopelessness
Sucicidal thoughts/actions
