YR3 Tutorial 1 - End of Life Care Flashcards
Nowadays most people die from … or …
Cancer or
ischaemic heart disease
regarding death what causes a profound sense of shock?
an unexpected death
what causes an even more profound sense of shock than an unexpected death?
deaths of children
What is terminal care?
the last phase of care when a patients condition is deteriorating and death is close
What is palliative care?
A more helpful term than terminal care for the….
management of conditions until the terminal phase is reached
Palliative care is a philosophy of care that emphasises…
quality of life
Who is palliative care performed by?
multi disciplinary team
In palliative care what is essential between members of the MDT?
communication
Where is most of palliative care provided?
in primary care
who supports primary care in delivering palliative care?
specialist practitioners and specialist care units (or hospices)
What is the Supportive and Palliative Care Indicators Tool?
a guide for doctors to consider their patients who have life-limiting diagnosis (cancer) or worsening chronic condition (COPD)
+
highlight if they are at a stage where supportive and palliative care should take place.
What is the palliative performance scale (PPS) used for?
quickly describes a patient’s current functional level
list as many different points to the WHO definition of palliative care
provides relief from pain and other distressing symptoms
affirms life and regards dying as a normal process
intends neither to hasten more postpone death
integrates the psychological and spiritual aspects of patient care
offers a support system to help the family cope during the patients illness and in their own bereavement
uses a team approach to address the needs of patients and their families, including bereavement counselling if indicated
apart from the health and social care partnership team who else is involved (what other professionals) in palliative care situations?
Macmillan nurses, CLAN, Marie Curie Nurses, religious or Cultural groups
what is a ‘good’ death?
death according to personal preference and in a manner that resonates with the persons individuality
Pain free
also:
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
what model is used to break bad news?
SPIKES
what do the letters in the SPIKES model stand for?
SPIKES Model
S. Setting and listening skills
P. Patient’s perception
(of current situation)
I. Invitation or Indication (warning shot)
heads up - this is not gonna be good
get a clear invitation to the patient to share information
K. Knowledge (in small chunks, check understanding, avoid jargon)
tell them whats up
E. Explore emotions and empathise
Give time to let it out
S. Strategy and summary - arrange the next step/ follow-up
Chat about future
grief is a … experience
it is a process that may take … or ….
patients may need to be ….. that they are normal
abnormal or distorted reactions may need more…..
individual
months or years
reassured
help
how to respond to a euthanasia request
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
