Week 4: Palliative and end of life care Flashcards
Models of Palliative Care
community based support: home, RAC, general practices
hospital based support: inpatient, outpatient services, emergency departments
National Palliative Care Strategy
people affected by a life-limiting illnesses, including carers and families, may benefit from the varied support available through palliative care. Helping people to live as well as possible for as long as possible is ultimately what palliative care is seeking to achieve.
palliative care standards
assessment of needs,
develop the care plan
caring for carers,
providing care,
transitions within services,
grief support
service to culture
quality improvement
staff qualification and training
standard 1 criteria
needs assessment carried out by qualified interdisciplinary staff
person’s needs are regularly reassessed
documented in the person’s clinical record
standard 2 criteria
Care planning is based on assessment process and reflects a person-centred, holistic approach
up to date information appropriate to meet their needs
substitute decision maker if a person does not have the capacity
standard 3 criteria
works with the family and carers to understand their needs and desired level of involvement in care
There are systems in place to ensure that the person’s nominated family and carers are supported to
participate
The family and carers are provided with information about the signs and symptoms of approaching death
and the steps to take following death
standard 4 criteria
Care is delivered promptly, in accordance with the changing needs
uses the best evidence to inform clinical practice.
Where care cannot be delivered in accordance with the goals and preferences of the person, this is discussed
standard 5 criteria
Care is integrated across the person’s experience to ensure seamless transitions within and
between services:
Care plans demonstrate appropriate actions for handover
Referrals from the specialist palliative care service are made to appropriate specialists or services that are able to meet needs
Services assist local community-based service providers to help home based palliative care
standard 6 criteria
risk assessment process begins on intake to the palliative care service and continues throughout the service’s involvement with the person and beyond.
Referrals to bereavement, specialist mental health and/or counselling professionals are made when
clinically indicated.
provides education about loss, grief and bereavement to staff, volunteers and other community providers.
Principles of symptom management
Evaluation
Explanation
Discussion
Individualised treatment
Monitoring
Dose escalation
common symptoms
Dyspneoa (reassure, reposition, oxygen)
Nausea and vomiting (anti nausea, small fluid & food, vomit bag in place)
Dehydration (rehydrate, keep mouth moist, offer icy poles)
Xerostomia is?
Dry, painful mouth
Caused by radiotherapy to head and neck
Some medications like tricyclic anti-depressants, antihistamines and anti-cholenergics
Can you think of 2 ways to help manage this?
1. Small frequent sips
2. General mouth care; water; sprays; oral balance; lip balm
last day of life toolkit?
- Recognition and Management Planning (standardise prescribing guideline, 5 symptoms management flowchart)
- Medication Management
- Transfer to Die at Home Plan (back up plan if tough for carer at home, med cert cause of death)
Anticipatory medicines
are injectable or sublingual medications prescribed to a person with a life-limiting illness. These medications are prescribed and dispensed in preparation for a time when a person needs them to manage symptoms
After death occurs
notify your palliative care service or can directly contact the funeral director of your choice. Nurse from the service will visit to support your carer, family, friend or support person.
Doctor can fill out the Medical Certificate of Cause of Death as long as they know your medical history within 48 hours of death. The doctor will also notify the Registrar of Births, Deaths and Marriages.