Wk: 3 Palliative approach, loss, grief and beravement

Question 1

What is the medical treatment planning and decision ACT 2016?

Answer 1

= a framework for decision making only applied when a person does not have the capacity to make treatment decisions for the selves.
- all regiestered health professionals are bound to seek consent before providing health (except in emergency situations)
*it is when consent no longer has the capacity be given that medicos use advanced care directives to guide care.
- involves completing an advanced care directive and appointing a decision maker.

Question 2

What is considered when determining capacity for decision making?

Answer 2

• must be able to understand the decision
• must be able to give their response
• must be able to weight up options

Question 3

What is an instructional directive?

Answer 3

Legally binding instructions that are clear and put in medical treatment planing and decision making act 2016.
Used if a person becomes unable to consent, then medical personal must follow these directives.

e.g. no CPD, i do not want to be tube fed

Question 4

What are values directives?

Answer 4

= wishes and requests.
e.g. if i get bed bound, i no longer want life-prolonging measures.

Question 5

What is the order of medical treatment decision making?

Answer 5

• patients
• spouse
• oldest adult child
• oldest parent
• oldest sibling

Question 6

How and where will voluntary assisted dying be recorded on the official death record?

Answer 6

• underlying disease/condition will be recorded as cause of death.
• at the Department of health and human services

Question 7

Define palliative care

Answer 7

= an approach that improves quality of life of patients and their families facing the problems associated with life threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain ain other problems, physical, psychosocial an spiritual.

Question 8

What can palliative care do??

Answer 8

• Provides relief from pain & other distressing symptoms;
• Affirms life & regards dying as a normal process;
• Intends to neither hasten or postpone death;
• Integrates the psychological & spiritual aspects of patient care;
• Offers a support system to help patients live as actively as possible until death;
• Offers a support system to help families cope during the illness & in their own bereavement;

Question 9

What is the palliative care approach?

Answer 9

• improve QOL for individuals and their family who have a life limiting illness. By reducing suffering, early identification, assessment and treatment of physical, cultural, psychological, social and spiritual needs.
  Thought
• positive attitude
• open discussion
• not confined to end stage care
• active comfort care
  facilitates understanding

Question 10

What are the elements of paliative care?

Answer 10

Palliative care should be strongly responsive to;
- the needs
- preferences
- values
of the
- People
- their families
- Carers

Question 11

What is in the criteria for VAD?

Answer 11

• over 18
• clearly dying of a disease/cause
• vic resident
• aus citizen
• decision making capacity
• diagnosed with an incurable disease or medical condition that is advanced or progressive that will cause death in less than 12 months.
• initated by you and no one else
• can be part of an advanced care directive

Question 12

What factors do not make you eligible for VAD?

Answer 12

• disability alone
• old age or mental illness alone

You are not excluded if you have decision making capacity and met all other criteria

Question 13

What is needed to initiate an advanced care directive?

Answer 13

• brought up by ther person
• 3 seperate requests, 2 verbal and one written.
• with a minimum of 10 days between the first. and final request
• independently assed by two doctors.
• if a medical practitioner objects, then you can go and get a second opinions.

Question 14

How does VAD lethal medication come?

Answer 14

• as a series of drinks
• in a locked box
• only for self administration

Question 15

What are three grief theories?

Answer 15

1. Worden’s tasks of Morning
2. Kubler-Ross’s Models of grieving
3. Stroebe and Shunt’s dual process model of coping

Question 16

Explain Worden’s tasks of mornig

Answer 16

= 4 tasks an individual needs to complete to adjust to their morning.
1. accept the reality of the loss
2. To work though 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.

That was different about Worden’s theory was that he acknowledged that the tasks were overlapping and that a bereaved person had to work through their emotional pain at the same time as they were adjusting to changes in their role, status and identity.

Question 17

Explain Kubler-Ross’s model of grieving

Answer 17

1. denial
2. anger
3. bargaining
4. depression
5. Acceptance

DABDA

• not leaner
• some may not experince all of them

Question 18

Explain what support is needed for someone grieving at each point of Kubler-Ross’s grief cycle

Answer 18

Denial + anger: information and communication

Depression: emotional support

Bargaining and acceptance: guidance and direction

Question 19

Explain Stroebe and Shut’s Dual Process Model of Coping model of grieving

Answer 19

• dual process model of coping accepts that grief can be both helpful and detrimental depending on the circumstances.
• expressing and controlling feelings are both important and oscillation between coping behaviours is perfectly acceptable as grief is viewed as a dynamic process in which the focous can shift from loss to restoration orientated.

Loss-orientated
- grief work
- intrusion of grief
- denial/avoidance

Restoration orientated
- attending to life changes
- doing new things
- distraction from grief
- new roles

Question 20

What are the two types of grief?

Answer 20

Complicated and uncomplicated