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NURS 3510 - Supportive and Palliative Care > Week 4 > Flashcards

Week 4 Flashcards

1
Q

what is a chronic progressive illness

A
  • condition that lasts for more than 1 year
  • worsens over time
  • requires ongoing medical attention
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2
Q

what is curative care

A
  • care that is diseased focused
  • focuses on 1 illness or organ
  • focus is to treat or fix illness
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3
Q

what is palliative care

A
  • 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
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4
Q

describe the difference in treatment for curative vs palliative care

A
  • curative = decided by HCP

- palliative = tailored to pts values and preferences, includes shared decision making

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5
Q

what does palliative care do? (2)

A
  • affirms life & regards dying as a normal process

- intends to neither hasten or prolong death

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6
Q

those with ___ receive majority of specialized palliative care services

A

cancer

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7
Q

who typically delivers most of the palliative care in Canada today

A
  • family caregives (however they are not well supporte
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8
Q

when considered palliative care in Canada today, where do most pts want to die vs where they actuall do?

A
  • many want to die in own home

- majority die in institutions

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9
Q

what is an integrated approach to palliative care

A
  • 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)
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10
Q

what does integrated approach to palliative care reinforce (3)

A
  • autonomy
  • right to be actively involved in ur own care
  • greater sense of care for pts and their families
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11
Q

who is an integrated approach to palliative acre for?

A
  • across the lifespan (neonates to older adults)
  • individuals & their families living with:
  • -> fratily
  • -> chronic progressive illness
  • -> neurodegenerative disease
  • -> cancer
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12
Q

when is an integrated approach to palliative care appropriate

A
  • not just end of life
  • appropriate from time of diagnosis
  • close to death should no longer be the trigger for palliative care
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13
Q

describe the relationship between palliative acre & end of life care

A
  • palliative acre = umbrella term
  • end of life care = small piece of palliative care
    NOT the same thing
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14
Q

what is an additional layer (other than time of diagnosis) that can be used to ensure palliative care is given before end of life

A

ask the surprise question

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15
Q

what is the surprise question

A

“would i be surprised if this pt died in the next year”

- if no = would benefit from palliative care

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16
Q

why is an integrated approach to palliative acre important?

A
  • 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
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17
Q

what are some benefits of an integrated approach to palliative care (7)

A
  • 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
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18
Q

who delivers an integrated approach to palliative care

A
  • all HCP
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19
Q

where is an integrated approach to palliative care provided

A
  • all settings in community where the person lives or is receiving care
  • can be urban, rural, remote setting, hospital, long-term care, etc.
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20
Q

what is specialized palliative care

A
  • delivered by HCP with specialized training
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21
Q

when might specialized palliative care be required (3)

A

if any of the following become particularly complex:

  • pain and/or symptom management
  • family dynamics
  • decision-making
22
Q

how can we provide an integrated approach to palliative care (9)

A
  • 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
23
Q

palliative care is not.. (4)

A
  • just for individuals nearing death
  • only delivered in specialized location
  • provided only by specialized team
  • hands-off care
24
Q

what is the role of the nurse in integrated approach to palliative care (10)

A
  • 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
25
Q

palliative and end-of-life care should be (5)

A
  • safe
  • compassionate
  • competent
  • ethical
  • evidence informed
26
Q

what is the criteria for a formal paliative care program (3)

A
  • 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
27
Q

what are soms cons to the criteria for the formal palliative programs (2)

A
  • focuses on dying

- someone could benefit from a palliative approach even if dont meet the criters

28
Q

why is palliative care not currently being delivered well in healthcare (5)

A
  • death denying society
  • way we live & die is changing
  • misconceptions about palliative care
  • lack of education, skills, researching training & funding
  • lack of specialized resources
29
Q

what are some strategies for improving palliative care (5)

A
  • public awareness
  • effective attitude/philosophy
  • education
  • professional practice
  • improve service availability
30
Q

a palliative approach to care is about…

A
  • helping people live well and improving quality of life
31
Q

when should goals of care discussions occur

A
  • not just once! throughout the illness trajectory
32
Q

what is important to tell pt and their families about grieving

A
  • no right or wrong way to grief

- no proper timeline

33
Q

what is the foundation of a palliative approach to care (4)

A
  • person-centered care
  • honours people’s values & health care wishes
  • promotes autonomy, dignity, and control
  • promotes shared decision making
34
Q

what are the responsibilities of nurses r/t palliative care

A
  • provide and advocate for safe, compassion, competent, ethical, and evidence informed palliative & end of life care
35
Q

what is the responsibility of nurse educators r/t palliative care

A
  • teach students and nurses abt palliative care
36
Q

nursing regulators are responsible for …. r/t palliative caree

A
  • ensuring that professional standards of practice are followed in palliative care
37
Q

what is the responsibility of nursing policy makers r/t palliative care

A
  • developing, promoting, and advocate for proactive policy on palliative and end of life issues
38
Q

what is the responsibility of nurse leaders r/t palliative care

A
  • demonstrating, promoting, and advocating for a palliative approach to care
39
Q

what is the governments responsibility r/t palliative care

A
  • supplying adequate resources (financial and human) to provide quality palliative care
40
Q

what is palliative care

A
  • 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
41
Q

where is palliative care provided

A
  • all primary care settings (homes, ambulatory clinics, community settings)
  • all tertiary care settings (hospitals, hospices, long term care facilities)
42
Q

what is the palliative approach

A
  • 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
43
Q

what does a palliative approach reinforce (3)

A
  • personal autonomy
  • right for person’s to be actively involved in their own care
  • greater sense of control
44
Q

the palliative approch does not _____ but rather…

A
  • does not link the provision of care too closely w prognosis
  • focuses more broadly on conversations abt their needs and wishes
45
Q

what is specialized palliative care

A
  • involves a specialist palliative care team or health profressional to augment palliative care
46
Q

in what 2 ways does specialized palliative care augment palliative cate

A
  • assessing & treating complex situation

- providing info and advice to staff abt complex issues

47
Q

what are some complex issues the specialized palliative care team can provide info & advice on (3)

A
  • ethical challenges
  • family issues
  • psychological or existential distress
48
Q

what is end of life care (3)

A
  • 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
49
Q

what is palliative care

A
  • 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
50
Q

what is the first step in achieving an effective palliative approach

A
  • starting the convo about end-of-life care early (ACP) and periodically revisiting it

NURS 3510 - Supportive and Palliative Care (11 decks)

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