Week 7 - Palliative, Hospice, Advanced Care Planning, Death and Dying Flashcards
Palliative care
healthcare for people with serious illness which focuses on relief from symptoms and stress, and improving quality of life and comfort for the patient and their family.
Functions of palliative care
- Symptom assessment and treatment
- Assistance with decision making
- Help with establishing goals of care
- Collaborative transitions in care
When to refer to palliative care
- Needs cannot be met with existing resources
- Refractory symptoms
- Difficulty with decision making
- Healthcare team burnout
- Patient/family distress
Hospice
Offered once lift prolonging treatments are no longer appropriate.
- Optimize symptom management and psychosocial support while not prolonging life
Advanced Directives
- Durable power of attorney for healthcare
- Medical orders for life sustaining treatment
POLST form
Physician orders for life-sustaining treatment (POLST)
- Orders directing how care should be provided in event of acute injury or illness
- Patient’s goals for treatment (aggressive, limited, comfort focused), CPR, hospitalization, antibiotics, hydration, nutrition
SPIKES protocol
Strategy for communicating sensitive information about Advanced Care Plan while focusing on patient emotions
- Setting
- Perception – what the patient already knows
- Invitation – clarify information preferences
- Knowledge – Give the information
- Empathy – respond to emotion
- Summary – next steps and follow up
Kübler-Ross’s stages of death and dying
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
Types of grief
- Normal
- Anticipatory
- Disenfranchised
- Prolonged
Normal grief
Sadness, guilt, loneliness, crying, sleep changes, lack of energy, appetite changes, temp withdrawal from normal activities
Anticipatory grief
Response to an expected loss occurs before the actual death
Disenfranchised grief
Loss cannot be socially acknowledged – no recognition by others (miscarriage)
Prolonged grief
Grief symptoms like sadness, anger, bitterness, and guilt, are disabling, limiting day-to-day functioning.
Prolonged grief may involve difficulty accepting the reality of a loss, self-destructive behavior, or suicidal thoughts.