What is the most common cause of death?
Most common causes of death are cancer and IHD.
Since 1995 cancer has outstripped IHD.
What is the emphasis of palliative care?
Improving quality of life
pain and symptom relief, spiritual and psychosocial support
Who provides palliative care?
Primary care mostly - palliative care units (hospices)
What might be in anticipatory care planning?
Where do they want to be cared for?
Do they want to be resuscitated in the event of cardiac arrest? Or do they want to be allowed to die naturally?
Who do they want to be informed of their care and any changes in their condition?
Are they fully aware of their prognosis?
Is their family aware of their prognosis?
How is the anticipatory care plan inmplemented?
Patient is placed on the palliative care register
Plan should be sent ot hte out of hours service - so that anyone who is involved in the patients care is aware of the patients wishes.
What are the domains of the palliative performance scale?
Activity and evidence of disease
Self - care
What are the goals of palliative care according to WHO?
Affirms life and regards dying as a normal process
Intends neither to hasten nor postpone death
Integrates the psychological and spiritual aspects of patient care
Offers a support system to help patients live as actively as possible until death
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.
Which professionals might be involved in palliative care situations?
Macmillan Nurses (liase with palliative medicine and provide support to patient and family)
Marie Curie Nurses
Religious or Cultural Groups amongst other support networks.
What makes a good death?
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
Death according to personal preference and in a manner that resonates with the person's individuality
What might help GP's offer end of life care at their homes?
Gold Standards Framework
Important pointers for breaking bad news
Set the Scene
Find out what the patient understands
Find out how much the patient wants to know
Share information using a common language
Review and summarise
Allow opportunities for questions
Agree follow up and support
What are the different reactions to bad news?
What is the definition of voluntary euthanasia, non-voluntarty euthanasia and physician assisted suicide?
Voluntary Euthanasia – patients request
Non Voluntary Euthanasia – no request
Physician assisted suicide – Physician provides the means and the advice for suicide.
If someone expresses the wish to die, how should you respond?
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