Y3 End of Life Care

Question 1

What is terminal care?

Answer 1

The last phase of care when a patient’s condition is deteriorating and death is close

Question 2

What is palliative care?

Answer 2

A philosophy of care that emphasises quality of life and is performed by a multi-disciplinary team
Focuses on the person, not the disease, applies a holistic approach to the needs of patients and carers

Question 3

How do you determine when a patient needs palliative care?

Answer 3

Use the Supportive and Palliative Care Indicators Tool
A guide for doctors to consider patients who have a life-limiting diagnosis, or worsening medical condition, and highlight if they are at the stage where palliative care should take place
Can also use the palliative performance scale to determine the patient’s current functional level and have prognostic value

Question 4

WHO aims of palliative care

Answer 4

• Provides relief from pain and other distressing symptoms
• Affirms life and regards dying as a normal process
• Intends neither to hasten nor postpone death
• Integrates the psychological and 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 the family cope during the patients illness and in their own bereavement
• Use a team approach to address the needs of the patients and their families, including bereavement counselling if indicated

Question 5

How is a “good death” described?

Answer 5

• Pain-free death
• Open acknowledgement of the imminence of death
• Death at home surrounded by family and friends
• An ‘aware’ death, in which personal conflicts and unfinished business are resolved
• Death as personal growth
• Death according to personal preference and in a manner that resonates with the person’s individuality

Question 6

What are the stages of grief? (Elizabeth Kubler Ross Grief Cycle)

Answer 6

Stability
Immobilisation
Denial
Anger
Bargaining
Depression
Testing
Acceptance

Question 7

Possible reactions to bad news?

Answer 7

Shock
Anger
Denial
Bargaining
Relief
Sadness
Fear
Guilt
Anxiety
Distress

Question 8

What is euthanasia and the types of it?

Answer 8

Means ‘gentle’ or ‘easy’ death
Has now come to mean the deliberate ending of a person’s life with or without their request
- Voluntary euthanasia (at patient’s request)
- Non-voluntary (no request)
- Physician assisted suicide (physician provides the means and the advice for suicide)

Question 9

How can you respond when someone requests euthanasia?

Answer 9

Listen
Acknowledge the issue
Explore the reasons for the request
Explore ways of giving more control to the patient
Look for treatable problems
Remember spiritual issues
Admit powerlessness

Question 10

Other than the Health and Social Care Partnership team, who else may be involved in palliative care?

Answer 10

MacMillan Nurses
CLAN
Marie Curie nurses
Religious or cultural groups