YR3 Tutorial 1 - End of Life Care

Question 1

Nowadays most people die from … or …

Answer 1

Cancer or

ischaemic heart disease

Question 2

regarding death what causes a profound sense of shock?

Answer 2

an unexpected death

Question 3

what causes an even more profound sense of shock than an unexpected death?

Answer 3

deaths of children

Question 4

What is terminal care?

Answer 4

the last phase of care when a patients condition is deteriorating and death is close

Question 5

What is palliative care?

A more helpful term than terminal care for the….

Answer 5

management of conditions until the terminal phase is reached

Question 6

Palliative care is a philosophy of care that emphasises…

Answer 6

quality of life

Question 7

Who is palliative care performed by?

Answer 7

multi disciplinary team

Question 8

In palliative care what is essential between members of the MDT?

Answer 8

communication

Question 9

Where is most of palliative care provided?

Answer 9

in primary care

Question 10

who supports primary care in delivering palliative care?

Answer 10

specialist practitioners and specialist care units (or hospices)

Question 11

What is the Supportive and Palliative Care Indicators Tool?

Answer 11

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.

Question 12

What is the palliative performance scale (PPS) used for?

Answer 12

quickly describes a patient’s current functional level

Question 13

list as many different points to the WHO definition of palliative care

Answer 13

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

Question 14

apart from the health and social care partnership team who else is involved (what other professionals) in palliative care situations?

Answer 14

Macmillan nurses, CLAN, Marie Curie Nurses, religious or Cultural groups

Question 15

what is a ‘good’ death?

Answer 15

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

Question 16

what model is used to break bad news?

Answer 16

SPIKES

Question 17

what do the letters in the SPIKES model stand for?

Answer 17

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

Question 18

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…..

Answer 18

individual
months or years
reassured
help

Question 19

how to respond to a euthanasia request

Answer 19

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