Wk 4: palliative and end of life care Flashcards
What are the three strategic palliative care priorities for the the coming three years?
- Growing the health care, aged care and community care workforce
- Innovate in models of care, and
- Increase accessibility
What are the two types of palliative care?
- community based
- hospital based
What are the 9 national palliative care standards?
- Assessment of needs
- developing the care plan
- caring for carers
- providing care
- transition within and between services
- grief support
- service culture
- quality improvement
- staff qualifications and training
What are the principles of symptoms management?
- evaluation
- explanation
- discussion
- individualised treatment
- monitoring
dose escilation
Explain some key practice points of symptom assessment
Assessment should be completed;
- on admission
- every 4/24
- when a condition change is noticed
- after giving medication or tretment
Explain the symptom of xerostomia
= mouth dryness or pain
Cause: radiation which damages salivary glands, meds including antidepressants, antihistamines and anticholergics.
Explain the symptom of sialadentitis
= Inflammation of salivary galds
Usually when salivary flow is interrupted by;
- dehydration causing thickened saliva
- Infection
- Salivary duct stones
- Tumor or other obstruction
Explain the symptom of dyspnoea/breathlessness
Causes: disease of lung, asthma, chest infection, anxiety
Management:
- treat underlying condition if appropriate
- cool air
- elevate bed position
- opoids for pain and reduce anxiety
- reassurance ++
- assemment
Why are breathing patter changes significant in palliative care?
- indicate decreased circulation in the internal organs.
- Groan on exhalation is not distress but air passing over lax vocal cords
- gurgling
What to do if a patient is gurgling?
- can be quite distressing
- elevate bed
- turn head to side
- educate family
- consider medication
Explain the palliative symptom of N + V
Cause: the disease itself, medications, constipation, chemical imbalance, anxiety or fear.
Management
- PRN medications e.g. metaclopramide (nausea)
- check they are taking meds before meals
- small frequent meals
- bed positioning
- consider when last bowel movement was
- relaxation exercise
Explain the palliative symptom of fatigue
= extreeme tiredness related to factors such as lack of sleep, low O2, poor diet, depression, effects of chemo or radio, infection
- more common in advanced cancers
- can relate to nausea and vomiting
Management
- tend to causes
- do tiering activities such as showers when pt well related
- consider individual exercise programs
- encourage the person to practice
- minimise visitors
Explain the palliative symptom of pruritis
= itching and scratching are protective measures which can be caused by systemic disease such as sever liver or renal disease or failure.
- often cause can not be treated
Management
- Increase fluid intake
- Reduce frequency of bathing
- Reduce soaps and consider oils
- consider reducing vasodilators such as coffee and alcohol
- antihistamines may help
- loose fitting clothes
pine tarsal may help
What is the way we measure symptoms?
Comfort observation and symptoms assessment char5t- adults
- pain
- N + V
- restlessness or agitation
- distress/breathlessness
- family/carer distress
rates as mild, moderate or sever or absent/not witnessed and asked if action is required
What are some considerate we must take in the last days of life?
- returning of unused medications
- carer support
- anticipation medicines
