Week 4 Flashcards
what is a chronic progressive illness
- condition that lasts for more than 1 year
- worsens over time
- requires ongoing medical attention
what is curative care
- care that is diseased focused
- focuses on 1 illness or organ
- focus is to treat or fix illness
what is palliative care
- care that considers the whole person (4 domains)
- focuses on increases quality of life
- abt helping people live as best as possible for however long that may be
describe the difference in treatment for curative vs palliative care
- curative = decided by HCP
- palliative = tailored to pts values and preferences, includes shared decision making
what does palliative care do? (2)
- affirms life & regards dying as a normal process
- intends to neither hasten or prolong death
those with ___ receive majority of specialized palliative care services
cancer
who typically delivers most of the palliative care in Canada today
- family caregives (however they are not well supporte
when considered palliative care in Canada today, where do most pts want to die vs where they actuall do?
- many want to die in own home
- majority die in institutions
what is an integrated approach to palliative care
- focuses on meeting full range of needs (4 domains) at all stages of fratily or chronic illness
- makes key aspects of palliative care available at appropriate times and in all care setting (not just specializaed teams)
what does integrated approach to palliative care reinforce (3)
- autonomy
- right to be actively involved in ur own care
- greater sense of care for pts and their families
who is an integrated approach to palliative acre for?
- across the lifespan (neonates to older adults)
- individuals & their families living with:
- -> fratily
- -> chronic progressive illness
- -> neurodegenerative disease
- -> cancer
when is an integrated approach to palliative care appropriate
- not just end of life
- appropriate from time of diagnosis
- close to death should no longer be the trigger for palliative care
describe the relationship between palliative acre & end of life care
- palliative acre = umbrella term
- end of life care = small piece of palliative care
NOT the same thing
what is an additional layer (other than time of diagnosis) that can be used to ensure palliative care is given before end of life
ask the surprise question
what is the surprise question
“would i be surprised if this pt died in the next year”
- if no = would benefit from palliative care
why is an integrated approach to palliative acre important?
- only 15% of people will need complex specialized palliative care services
- while 85% can have needs met by integrating a palliative approach into the care received in any setting
what are some benefits of an integrated approach to palliative care (7)
- considers whole person
- improves QOL
- patient-centeredness broadens focus of care
- combines curative, disease-specific, and comfort/supportive therapies
- more autonomy & control for the pt
- more effective use of health resources (cost effective)
- seamless transitions
who delivers an integrated approach to palliative care
- all HCP
where is an integrated approach to palliative care provided
- all settings in community where the person lives or is receiving care
- can be urban, rural, remote setting, hospital, long-term care, etc.
what is specialized palliative care
- delivered by HCP with specialized training
when might specialized palliative care be required (3)
if any of the following become particularly complex:
- pain and/or symptom management
- family dynamics
- decision-making
how can we provide an integrated approach to palliative care (9)
- open communication about prognosis & illness trajectory
- ACP
- total, active, individualized care
- support for the family
- deliver with pt’s other care in the setting of their choice
- consistent, seamless care if/when pt changes settings
- ICP approach
- effective communication
- referrals to specialized palliative care services if requires
palliative care is not.. (4)
- just for individuals nearing death
- only delivered in specialized location
- provided only by specialized team
- hands-off care
what is the role of the nurse in integrated approach to palliative care (10)
- responsible for providing and advocating for palliative and end-of-life care
- talk about it
- work together
- make it happen, no matter what setting
- initiate communication that reflect pt’s values and healthcare wishes
- honour their values and wishes
- advocate for and support persons in their experiences of living & dying
- attend to pain & symptoms relief & to psychosocial, grief, and bereavement support to maximize QOL
- provide compassionate, therapeutic presence
- advocate for resources that supports individuals choosing their preferred enviro for a dignified death
palliative and end-of-life care should be (5)
- safe
- compassionate
- competent
- ethical
- evidence informed
what is the criteria for a formal paliative care program (3)
- has an illness that is likely to take the pt’s life in next 6 mo
- no longer receiving aggressive disease/focused treatment (ex. chemo) or requiring monitoring for and treatment of potentially serious complication
- has chosen a comfort approach including a decision to decline attempted resuscitation
what are soms cons to the criteria for the formal palliative programs (2)
- focuses on dying
- someone could benefit from a palliative approach even if dont meet the criters
why is palliative care not currently being delivered well in healthcare (5)
- death denying society
- way we live & die is changing
- misconceptions about palliative care
- lack of education, skills, researching training & funding
- lack of specialized resources
what are some strategies for improving palliative care (5)
- public awareness
- effective attitude/philosophy
- education
- professional practice
- improve service availability
a palliative approach to care is about…
- helping people live well and improving quality of life
when should goals of care discussions occur
- not just once! throughout the illness trajectory
what is important to tell pt and their families about grieving
- no right or wrong way to grief
- no proper timeline
what is the foundation of a palliative approach to care (4)
- person-centered care
- honours people’s values & health care wishes
- promotes autonomy, dignity, and control
- promotes shared decision making
what are the responsibilities of nurses r/t palliative care
- provide and advocate for safe, compassion, competent, ethical, and evidence informed palliative & end of life care
what is the responsibility of nurse educators r/t palliative care
- teach students and nurses abt palliative care
nursing regulators are responsible for …. r/t palliative caree
- ensuring that professional standards of practice are followed in palliative care
what is the responsibility of nursing policy makers r/t palliative care
- developing, promoting, and advocate for proactive policy on palliative and end of life issues
what is the responsibility of nurse leaders r/t palliative care
- demonstrating, promoting, and advocating for a palliative approach to care
what is the governments responsibility r/t palliative care
- supplying adequate resources (financial and human) to provide quality palliative care
what is palliative care
- seeks to improve a persons QOL once a chronic, life limiting condition is diagnosed
- continues til death, into family bereavement and care of the body
where is palliative care provided
- all primary care settings (homes, ambulatory clinics, community settings)
- all tertiary care settings (hospitals, hospices, long term care facilities)
what is the palliative approach
- uses palliative care principles (dignity, hope, comfort, QOL, relief of suffering) with people facing chronic, life-limiting conditions at all stages, not just at end of life
what does a palliative approach reinforce (3)
- personal autonomy
- right for person’s to be actively involved in their own care
- greater sense of control
the palliative approch does not _____ but rather…
- does not link the provision of care too closely w prognosis
- focuses more broadly on conversations abt their needs and wishes
what is specialized palliative care
- involves a specialist palliative care team or health profressional to augment palliative care
in what 2 ways does specialized palliative care augment palliative cate
- assessing & treating complex situation
- providing info and advice to staff abt complex issues
what are some complex issues the specialized palliative care team can provide info & advice on (3)
- ethical challenges
- family issues
- psychological or existential distress
what is end of life care (3)
- care that starts in the final stage of dying
- continues until death and into family bereavement and care of the body
- relieves suffering and improves quality of living until death
what is palliative care
- seeks to improve a persons QOL once a chronic, life limiting condition is diagnosed
- continues til death, into family bereavement and care of the body
what is the first step in achieving an effective palliative approach
- starting the convo about end-of-life care early (ACP) and periodically revisiting it
