Week 6

Question 1

Define palliative care?

Answer 1

• Palliative care is treatment, care and support for people living with a life-limiting illness
• also support family and friends
• aim is to help you have a good quality of life

Question 2

Is palliative care the same as end-of-life care?

Answer 2

No:

• you can receive palliative care at any stage of your illness
• can also continue treatment while having palliative care

Question 3

what is the goal of palliative care?

Answer 3

to optimise quality not quantity of life

Question 4

What can palliative care include?

Answer 4

treatment of physical, emotional, spiritual or social issues

include:

• relieving physical symptoms
• resourcing equipment required at home
• assistance for family
• links to other services

Question 5

Where can palliative care take place?

Answer 5

• home
• hospital
• hospice
• residential care facility

Question 6

What factors determine where a person can choose to die?

Answer 6

• nature of illness and amount of care required

- sufficient family and community support

Question 7

What is included in an Advanced care directive?

Answer 7

Instructional directive:
- statement of medical decisions for specific treatments

Values directive:

• Statement of values and preferences for treatment
• > when a person no longer has decision making capacity and has not made an instructional directive

Question 8

WHo needs to sign off an advanced care directive?

Answer 8

Does not require legal unput

Requires witnessing

• 2 witnesses
• 1 must be medical practitioner
• witness cant be the medical treatment decision maker

Question 9

why might some palliative patients report less pain?

Answer 9

• religions urge to reject pain killers
• pain might be a sign. of worsening condition
• worry if they have strong pain killers now, nothing will work for them later

Question 10

What are the considerations for opioid use as analgesic?

Answer 10

Onset: Immediate v delayed
Duration: Short acting v long acting
Route: oral/patch/injection (sub-cut, IM, IV)

Question 11

What is cancer and what happens with its treatment?

Answer 11

uncontrolled cell growth

- treatments aim at killining dividing cells, leads to reduction of WCC - Neutrophile

Question 12

What is Febrile Neutropenia?

Answer 12

Fever plus low WCC

- occurs with infection in host with limited immune functions

Question 13

What happens with breathing during the dying process?

Answer 13

Gradual slowing down

Breathing

• altered breathing effort
• coughing and swallowing reflexes slow
• > saliva and mucous accumulate
• > breathing noises

Question 14

What happens with the heart rate during the dying process?

Answer 14

Could be tachy or brady or fluctuating

• eventually stop
• not painful

Question 15

What happens with blood glucose during the dying process?

Answer 15

not uncommon. to see high BGL

• reduction of insulin release
• can trigger other symptoms (thirst etc)

Question 16

What happens with apetitie and thirst during the dying process?

Answer 16

may decrease

• sips of water, moist mouth swabs
• natural process

Question 17

What happens with sleep and drowsiness during the dying process?

Answer 17

• maybe drowsy and difficult to wake
• might sleep a lot
• no need to wake patient up
• speak softly and naturally

Question 18

What happens with temp during the dying process?

Answer 18

can be cold at one time and hot another
- thermoregulator not working well

• body can become blotchy and darker in colour

Can be incontinent

Question 19

What happens with restlessness during the dying process?

Answer 19

• poorer cerebral circulation
• accumulation of toxins
• talk to person
• familiar music

Question 20

what is grief?

Answer 20

how we respond when we experience loss

Question 21

what are the kubler ross 5 stages of grief?

Answer 21

Denial
Anger
Bargaining
Depression
Acceptance