Palliative care introduction Flashcards
What is palliative care?
An approach that improves quality of life of patients and families facing the problems associated with life threatening illness.
This is through the prevention and relief of suffering by means of:
- early identification
- impeccable assessment
- the treatment of pain and other problmes, physical, psychosocial and spiritual
How can palliative care make an individual comfortable as possible?
What us the aim?
What approach?
referred to as? (sometimes)
aim of palliative care is to help individual to have a good quality of life
includes being as well and act as possible for the time left
involves holisitc approach to managing sx and improving qol
referred to as “supportive care”
palliative care does include caring for people near the end of their life
Who is palliative care for?
improves qol for patients and families facing problems ass. with life threatening illness.
What does life limiting/ life threatening mean?
what might you hear it being referred to as?
what are some examples?
Life limiting illness is an illness that cannot be cured/ that you are likely to die from
may hear this illness called life threatening or terminal
people also use the term progressive (gets worse over time) or advanced (is at a serious stage)
e.g. cancer, motor neuron disease, dementia
What is a holistic approach?
EDIT
Holisitc approach –> deals with a person as a “whole” person, not just symptoms or illness.
T`akes into account the social, physical, psychological and spiritual side of a persons life.
What is end of life care?
Definitino varies, some individuals count last year of life, others count last few weeks of life.
End of life care involves treatment, care and support for people who are nearing the end of their life. An important part of palliative care.
For people thought to be in last year of life but timeframe difficult to predict.
therefore some people may only receive end of life care in last weeks/ days
How to we prevent and relieve suffering?
By early identification –> need to manage pain/ sx/ support family and carers/ holistic appraoch. Importantly, once recognised doctors need to initiate the conversation about prognosis early.
Patients may receive palliative care earlier in their illness whilst receiving other therapy.
Do we always give a prognosis even if the outlook is not good?
Majority of patients will want to know prognosis even if difficult (e.g. only 6 months left to live). Allows patients to get affairs in order.
Obviously not all patients will want to know but better to ask.
What diseases does palliative care tend to interact with?
What are the timeline/ prognostic timelines for these diseases?
1) Cancer, organ failure, physical and cognitive frailty.
- Often a patient diagnosed with cancer will remain at a good performance level before a major decline.
- Organ failure often is harder to recognise early, and functioning already low when diagnosed.
- Frailty often recognised at a low function and the decline is very slow, and may not even be recognised. Ask about significant events (e.g. how were you over summer/ xmas then compare).
What sort of assessment approach is taken in palliative care?
Person centred approach
- what matters to you?
- what are your main concerns?
- what cant you do that you’d like to be able to do?
- what are your goals?
Can use tools to help to identify what is important to a person –> person centred template, IPOS scale (integrate palliative care outcome scale) or SPICT tool
IPOS includes things like rating appetite, sore mouth as well as other aspects, used as part of the MDT.
What is the concept of total pain?
total pain = suffering that encompasses all of the person’s physical, pscyhological, social, spiritual and practical struggles.
e.g. individual with cancer when feeling pain worries that when they feel the pain the cancer is growing –> therefore have both the physical pain and psychological aspect.
Who are part of the palliative care MDT?
- Consultants in palliative medicine
- nurse specialists in palliative care –> level of clinical nurse specialist in palliative care
- Often other input:
- physiotherapists
- occupational therapist
- social workers
- practitioners in psychological care and spiritual care qualification
- dietician
- Speech and language
- pharmacists
- specialists in interventional pain management
