Week 4 Flashcards
(50 cards)
1
Q
what is a chronic progressive illness
A
- condition that lasts for more than 1 year
- worsens over time
- requires ongoing medical attention
2
Q
what is curative care
A
- care that is diseased focused
- focuses on 1 illness or organ
- focus is to treat or fix illness
3
Q
what is palliative care
A
- care that considers the whole person (4 domains)
- focuses on increases quality of life
- abt helping people live as best as possible for however long that may be
4
Q
describe the difference in treatment for curative vs palliative care
A
- curative = decided by HCP
- palliative = tailored to pts values and preferences, includes shared decision making
5
Q
what does palliative care do? (2)
A
- affirms life & regards dying as a normal process
- intends to neither hasten or prolong death
6
Q
those with ___ receive majority of specialized palliative care services
A
cancer
7
Q
who typically delivers most of the palliative care in Canada today
A
- family caregives (however they are not well supporte
8
Q
when considered palliative care in Canada today, where do most pts want to die vs where they actuall do?
A
- many want to die in own home
- majority die in institutions
9
Q
what is an integrated approach to palliative care
A
- focuses on meeting full range of needs (4 domains) at all stages of fratily or chronic illness
- makes key aspects of palliative care available at appropriate times and in all care setting (not just specializaed teams)
10
Q
what does integrated approach to palliative care reinforce (3)
A
- autonomy
- right to be actively involved in ur own care
- greater sense of care for pts and their families
11
Q
who is an integrated approach to palliative acre for?
A
- across the lifespan (neonates to older adults)
- individuals & their families living with:
- -> fratily
- -> chronic progressive illness
- -> neurodegenerative disease
- -> cancer
12
Q
when is an integrated approach to palliative care appropriate
A
- not just end of life
- appropriate from time of diagnosis
- close to death should no longer be the trigger for palliative care
13
Q
describe the relationship between palliative acre & end of life care
A
- palliative acre = umbrella term
- end of life care = small piece of palliative care
NOT the same thing
14
Q
what is an additional layer (other than time of diagnosis) that can be used to ensure palliative care is given before end of life
A
ask the surprise question
15
Q
what is the surprise question
A
“would i be surprised if this pt died in the next year”
- if no = would benefit from palliative care
16
Q
why is an integrated approach to palliative acre important?
A
- only 15% of people will need complex specialized palliative care services
- while 85% can have needs met by integrating a palliative approach into the care received in any setting
17
Q
what are some benefits of an integrated approach to palliative care (7)
A
- considers whole person
- improves QOL
- patient-centeredness broadens focus of care
- combines curative, disease-specific, and comfort/supportive therapies
- more autonomy & control for the pt
- more effective use of health resources (cost effective)
- seamless transitions
18
Q
who delivers an integrated approach to palliative care
A
- all HCP
19
Q
where is an integrated approach to palliative care provided
A
- all settings in community where the person lives or is receiving care
- can be urban, rural, remote setting, hospital, long-term care, etc.
20
Q
what is specialized palliative care
A
- delivered by HCP with specialized training
21
Q
when might specialized palliative care be required (3)
A
if any of the following become particularly complex:
- pain and/or symptom management
- family dynamics
- decision-making
22
Q
how can we provide an integrated approach to palliative care (9)
A
- open communication about prognosis & illness trajectory
- ACP
- total, active, individualized care
- support for the family
- deliver with pt’s other care in the setting of their choice
- consistent, seamless care if/when pt changes settings
- ICP approach
- effective communication
- referrals to specialized palliative care services if requires
23
Q
palliative care is not.. (4)
A
- just for individuals nearing death
- only delivered in specialized location
- provided only by specialized team
- hands-off care
24
Q
what is the role of the nurse in integrated approach to palliative care (10)
A
- responsible for providing and advocating for palliative and end-of-life care
- talk about it
- work together
- make it happen, no matter what setting
- initiate communication that reflect pt’s values and healthcare wishes
- honour their values and wishes
- advocate for and support persons in their experiences of living & dying
- attend to pain & symptoms relief & to psychosocial, grief, and bereavement support to maximize QOL
- provide compassionate, therapeutic presence
- advocate for resources that supports individuals choosing their preferred enviro for a dignified death
25
palliative and end-of-life care should be (5)
- safe
- compassionate
- competent
- ethical
- evidence informed
26
what is the criteria for a formal paliative care program (3)
- has an illness that is likely to take the pt's life in next 6 mo
- no longer receiving aggressive disease/focused treatment (ex. chemo) or requiring monitoring for and treatment of potentially serious complication
- has chosen a comfort approach including a decision to decline attempted resuscitation
27
what are soms cons to the criteria for the formal palliative programs (2)
- focuses on dying
| - someone could benefit from a palliative approach even if dont meet the criters
28
why is palliative care not currently being delivered well in healthcare (5)
- death denying society
- way we live & die is changing
- misconceptions about palliative care
- lack of education, skills, researching training & funding
- lack of specialized resources
29
what are some strategies for improving palliative care (5)
- public awareness
- effective attitude/philosophy
- education
- professional practice
- improve service availability
30
a palliative approach to care is about...
- helping people live well and improving quality of life
31
when should goals of care discussions occur
- not just once! throughout the illness trajectory
32
what is important to tell pt and their families about grieving
- no right or wrong way to grief
| - no proper timeline
33
what is the foundation of a palliative approach to care (4)
- person-centered care
- honours people's values & health care wishes
- promotes autonomy, dignity, and control
- promotes shared decision making
34
what are the responsibilities of nurses r/t palliative care
- provide and advocate for safe, compassion, competent, ethical, and evidence informed palliative & end of life care
35
what is the responsibility of nurse educators r/t palliative care
- teach students and nurses abt palliative care
36
nursing regulators are responsible for .... r/t palliative caree
- ensuring that professional standards of practice are followed in palliative care
37
what is the responsibility of nursing policy makers r/t palliative care
- developing, promoting, and advocate for proactive policy on palliative and end of life issues
38
what is the responsibility of nurse leaders r/t palliative care
- demonstrating, promoting, and advocating for a palliative approach to care
39
what is the governments responsibility r/t palliative care
- supplying adequate resources (financial and human) to provide quality palliative care
40
what is palliative care
- seeks to improve a persons QOL once a chronic, life limiting condition is diagnosed
- continues til death, into family bereavement and care of the body
41
where is palliative care provided
- all primary care settings (homes, ambulatory clinics, community settings)
- all tertiary care settings (hospitals, hospices, long term care facilities)
42
what is the palliative approach
- uses palliative care principles (dignity, hope, comfort, QOL, relief of suffering) with people facing chronic, life-limiting conditions at all stages, not just at end of life
43
what does a palliative approach reinforce (3)
- personal autonomy
- right for person's to be actively involved in their own care
- greater sense of control
44
the palliative approch does not _____ but rather...
- does not link the provision of care too closely w prognosis
- focuses more broadly on conversations abt their needs and wishes
45
what is specialized palliative care
- involves a specialist palliative care team or health profressional to augment palliative care
46
in what 2 ways does specialized palliative care augment palliative cate
- assessing & treating complex situation
| - providing info and advice to staff abt complex issues
47
what are some complex issues the specialized palliative care team can provide info & advice on (3)
- ethical challenges
- family issues
- psychological or existential distress
48
what is end of life care (3)
- care that starts in the final stage of dying
- continues until death and into family bereavement and care of the body
- relieves suffering and improves quality of living until death
49
what is palliative care
- seeks to improve a persons QOL once a chronic, life limiting condition is diagnosed
- continues til death, into family bereavement and care of the body
50
what is the first step in achieving an effective palliative approach
- starting the convo about end-of-life care early (ACP) and periodically revisiting it
