y3 tutorial 5

Question 1

What indicators are used to decide whether a patient is suitable for palliative care?

Answer 1

Not be expected to be alive in 6 - 12 months
General health indicators:
- spends >50% day in bed/chair
- weight loss >10% body weight over past 6 months
- in a nursing home/NHS continuing care unit
- 2 or more unplanned hospital admissions in last 6 months
Disease-specific indicators, e.g:
- breathless at rest/min exertion
- FEV1 <30%

Question 2

What are the uses of the palliative performance scale?

Answer 2

Communicating a patient’s current functional level
Workload assessment
Prognostic value

Question 3

What aspects are assessed as part of the palliative performance scale?

Answer 3

Ambulation (to what extent patient is bedbound or not)
Activity and evidence of disease
Self-care
Intake
Conscious level

Question 4

How is “evidence of disease” described on the PPS?

Answer 4

Some
Significant
Extensive

Question 5

How does the WHO describe palliative care?

Answer 5

Provides relief from pain and other unpleasant sx
Affirms life, and regards dying as a normal process
Neither hastens nor postpones death
Psych and spiritual aspect of patient care
Support system for family
Team approach including bereavement counselling

Question 6

What makes a “good death”?

Answer 6

Pain-free
Open acknowledgement of the iminence of death
At home with famil/friends
“Aware” - conflicts and unfinished business has been resolved
Personal growth - acceptance and moving on
Death according to personal preference

Question 7

Describe the cycle of grief

Answer 7

Stability
Immobilisation
Denial
Anger
Bargaining
Depression
Testing
Acceptance

Question 8

How may a person react to bad news?

Answer 8

Shock
Anger
Denial
Bargaining
Relief
Sadness
Fear
Guilt
Anxiety
Distress