End of Life Care Flashcards
Define Terminal Care?
Terminal care = last phase of care when patient’s condition is deteriorating, often misleadingly associated with cancer.
Define Palliative care?
and
WHO definition of Palliative care?
Palliative care = management of conditions until terminal phase is reached
WHO state: palliative care improves QoL of patients and families who face life threatening illness by providing pain and symptom relief, spiritual and psychosocial support, from diagnosis to end of life and bereavement
What does palliative care focuses on (the holistic approach)?
- Physical needs
- Practical needs
- Functional needs
- Social needs
- Emotional needs
- Spiritual needs
How do you know if a patient is at the palliative stage?
Supportive and Palliative Care Indicators Tool (SPCIT) is a guide for doctors if patient has a life-limiting diagnosis and worsening chronic disease e.g. cancer, COPD…and highlights if patient is at stage for palliative care
What is a Anticipatory Care Plan?
ACP helps you make informed choices about how and where you want to be treated and supported in the future
What answers does an anticipatory care plan answer?
- Where do they want to be cared for?
- Do they want to be resuscitated in event of cardiac arrest? Or die naturally?
- Who do they want to be informed about their condition/ changes to condition?
- Are they fully aware of their prognosis?
- Is family aware of prognosis?
Once ACP is established, which list should the patient be included in?
The practice’s Palliative Care Register and out of hour services
What is the Palliative Care Performance Scale ?
It is used to evaluate how quickly the situation is changing for patient and see if care needs to be re-evaluated.
What are the goals of palliative care?
- Provides relief from pain and other distressing symptoms
- Affirms life and regards dying as normal process
- Intends to neither hasten/hurry nor postpone death
- Integrates psychological and spiritual aspects of patient care
- Offers support system to help PATIENT live as actively as possible until death
- Offers support system to help FAMILY cope during patient’s illness and bereavement
- Uses team approach to address patient needs and families including bereavement counselling if needed
Name some members of the palliative care team (apart from doctors)
- MacMillan nurses
- CLAN
- Marie Curie nurses
- Religious or cultural groups
What are the aspects of a ‘good death’? (6 key aspect)
- Pain-free death
- Open acknowledgement of imminence/proximity of death
- Death at home surrounded by family and friends
- An aware death where personal conflicts and unfinished business are resolved
- Death as personal growth
Death according to personal preference and in a manner that resonates with person’s individuality
What are the 8 stages of breaking bad news (According to the FoPC notes- NOT SPIKES :( )
- Listen
- Set the scene
- Find out what the patient understands
- Find out how much patient wants to know
- Share information using common language
- Review and summarise
- Allow opportunities for questions
- Agree follow up and support
What are the stages of grief?
- Stability
- Immobilisation
- Denial
- Anger
- Bargaining
- Depression
- Testing
- Acceptance
SIDAB DTA
What is euthanasia and the three different sub types?
It is deliberate ending of person’s life with or without their request; gentle or ‘easy’ death
- Voluntary euthanasia: patient’s request
- Non- voluntary euthanasia: with patient’s request
- Physician assisted suicide: physician provides means and advice for suicide
What are the different responses stages to an euthanasia request?
- Listen
- Acknowledge the issue
- Explore reasons for the request
- Explore ways of giving more control to the patient
- Look for treatable problems
- Remember spiritual issues
- Admit powerless
