palliative care

Question 1

what are the attitudes to death in Ireland?

Answer 1

-57% think we dont speak about death enough
-74% prefer a home death, 63% prefer home even in final days of life

Question 2

why is the hospice favoured over hospital are for dying patients?

Answer 2

-lower pain levels
-reducing family distress
-controlling symptoms
-better communication
-better privacy
-long delays for services in hospital

Question 3

why is there poor satisfaction with hospital care for dying patients?

Answer 3

-staff avoidance of dying patients
-inadequate symptom control
-focus on physical needs and not psychosocial needs
-too busy
-uncaring attitude
-lack of privacy
-use of medical language

Question 4

define palliative care?

Answer 4

-the continuing active total care of patients and their families, at a time when the medical expectation is no longer a cure
-responds to physical, psychological, social and spiritual needs and extends to support bereavement

Question 5

what does palliative care involve?

Answer 5

-affirms life and regards dying as a normal process
-provides relief from pain and other distressing symptoms
-offers a support system to help patients live as actively as possible until death
-uses a team approach to address the needs of patients and their families, including bereavement counselling if indicated

Question 6

what is hospice care?

Answer 6

-describes the care offered to patients when the disease process is at an advanced stage

Question 7

what are the 3 levels of palliative care services?

Answer 7

-level 1 - palliative care approach
-level 2 - general palliative care
-level 3- specialist palliative care

Question 8

what is level 1 - palliative care approach?

Answer 8

-palliative care principles should be appropriately applied by all HCP’s

Question 9

what is level 2 - general palliative care?

Answer 9

-at an intermediate level, a proportion of patients and families will benefit from the expertise of health care professionals who have some additional training & experience in palliative care

Question 10

what is specialist palliative care?

Answer 10

-specialist palliative care services are those whose core activity is limited o the provision of palliative care, under the direction of a consultant in palliative medicine

Question 11

what is rehabilitative palliative care?

Answer 11

-integrates rehab, enablement, self management and self care into the holistic model of palliative care

Question 12

what are the aims of rehabilitative palliative care?

Answer 12

-aims to optimise peoples function and wellbeing and to enable them to live as independently and fully as possible
-supports people to live fully until they die
-optimise physical function & emotional wellbeing to the highest extent possible

Question 13

describe 4 examples of rehab goals?

Answer 13

-restorative goals - return patients to previous level of function eg transferring from bed to chair
-preventative goals - prevent avoidable deterioration in function
-supportive goals - maximising function , independence etc
-palliative goals - involves supporting people to adapt to and come to terms with the irreversible changes in function etc

Question 14

what % of cancer treatments need palliative care?

Answer 14

estimated at 70%

Question 15

what are the affects of not making a diagnosis on the family and patient?

Answer 15

-patient & family are unaware that death is about to happen
-patient loses trust
-patient dies with controlled symptoms, leading to a distressing death