MODULE 12 - PALLIATIVE CARE Flashcards
(8 cards)
What are the core values and principles of palliative care?
- To show empathy and compassion
- To respect each individual’s personal and social circumstances, preferences and choices.
- To optimise the individual’s sense of control and personal resources
- To provide holistic care
- To provide interdisciplinary approach to meeting a person’s needs
- To ensure excellence in care, being accountable to individuals and the community
What are the ABCD’s of dignity in care?
ATTITUDE
BEHAVIOUR
COMPASSION
DIALOGUE
What does the acronym PREPARED stand for? and why is it used?
Key strategies that can be used when communicating with a person with a life limiting illness and their family
P - preparation for the discussion, where possible
R - relate to the person
E - elicit patient and caregiver preferences
P - provide information tailored to the individual needs to both patients and their families
A - acknowledge emotions and concerns
R - (foster) realistic hope
E - encourage questions and further discussions
D - document
What are some support strategies?
Know the signs of dying including:
Extreme fatigue
Increasing drowsiness
Sleeping most of time/coma
Becoming un-rousable
Cheyne-stoke breathing pattern
Absence of eyelash reflex – profound coma
Always assume though the unconscious patient hears everything!
This way you can communicate the end is near.
What are some strategies for family/significant others?
If family are present the nurse may:
encourage goodbyes,
the massaging of limbs or feet and hands,
playing of favourite music,
sharing life stories.
This gives everyone the opportunity to participate in end of life care as able.
When someone dies, what happens?
Processes may vary from hospital to hospital and nurse actions may be dictated legally e.g.. If death is to be investigated for Coroners Inquiry the patient must remain with airway, catheters, IV etc. left insitu.
Under general circumstances:
Time needs to be made for relatives to say goodbye / grieve if able to stay in the ward/room. Alternatively, a viewing can be arranged at an alternative location.
The patient is cleaned of body secretions (Nurses do not tend to do full wash / sponge or place in shroud as has been done in the past)
The patient is then placed in a body bag, relevant identity tags placed on the body and is either taken to the hospital morgue and collected by the undertaker. In some circumstances the patient can be collected by the undertaker from the room.
Facility policies & procedures should be adhered to.
Who notifies the undertaker?
In the residential aged care setting the RN fills out a ‘life extinct form’ and notifies the doctor who will sign a death certificate and then the RN notifies the undertaker
In the hospital the doctor is notified – they pronounce death and fill out a death certificate & relatives are notified
In a private hospital you will need to find out (from relatives) which funeral director will be used (ASAP) (death cert needs to be filled out within 24 hours)
In regards to notification, who is to be notified?
Who is to be notified?
How do you identify this person (NOK) over the phone?
If over the phone: don’t use words such as ‘passed on’ * better to say ‘died’ – use clear, direct language (no jargon)
Identify who you are on the phone… ’It is (name) the Registered Nurse from the hospital ringing about….., can I please speak to…..’
Use a warning shot e.g. ‘I’m afraid I have some bad news…’
