Exam (elaborations)
N450 Final Palliative care (1).
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N450 Final Palliative care (1).
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N450 Final Palliative carePalliative Care - ANS-Focus is to improve the quality of life
Initiated when a life-threatening illness is diagnose
There are no time restrictions
Includes hospice and end-of-life care, but is broader
Symptom Management = Comfort Care - ANS-Symptom Management = Comfort Care
Hospice - ANS-Emphasize palliative rather than curative care
Hospice- The team usually consists of: - ANS-Clergy or other counselors
Home health aides
Hospice physician (or medical director)
Nurses
Social workers
Trained volunteers
Speech, physical, and occupational therapists, if needed
The person's personal physician may also be included
Criteria for hospice - ANS-Patient must desire services
Two physicians must certify patient has
6 months or less to live
What is hospice involved in? - ANS-Care that focuses on providing compassion, concern, and
support for the dying patients and their families
Hospice care is provided once a person decides to not continue with curative treatments
Aims to provide care and comfort for people in the final phases of a terminal disease
End of Life Care - ANS-Refers to the final phase of a patient's illness, when death is imminent
Period of time from diagnosis of a terminal illness to actual death varies considerably,
depending on the patient's diagnosis and extent of disease
Term used for issues and services related to death and dying
Focuses on physical and psychosocial needs of patient and family
End-of-Life Care - What We Know - ANS-Preparing for Death
There is no typical death. Every person dies in their own way, own time, with their own culture,
belief system, values and unique relationships with others.
Time cannot be predicted
Some patients instinctively know when death will occur
Signs and symptoms are only guidelines
Dying is a natural slowing down process
, Signs and symptoms can last weeks or may be present only hours or minutes prior to death
End-of-Life Care - Psychological and Spiritual Signs of Active Dying - Center to Advance
Palliative Care - ANS-Fear of dying
Fear of abandonment
Fear of the unknown
Dreams and visions with powerful themes or symbols
Withdrawal from family and friends
Increased focus on spiritual issues
Terminal anguish - state prior to death where patient is unable to suppress or repress painful,
unresolved psychological issues
Physical Manifestations- Death - ANS-Death occurs when all vital organs and systems cease to
function
The "usual road" to death - ANS-- experience increasing drowsiness and eventually become
unarousable.
Sleepy, lethargic, semicomatose, comatose, death
The "difficult road" to death - due to nervous system agitation prior to entering semicomatose
state.
Restlessness, confusion, tremors, hallucinations, delirium, muscle jerking, seizures - ANS-due
to nervous system agitation prior to entering semicomatose state.
Restlessness, confusion, tremors, hallucinations, delirium, muscle jerking, seizures
Physical Manifestations
Sensory System - Hearing, Touch, Taste, Smell, & Sight - ANS-All senses will decrease but
hearing is usually last sense to disappear
Decreased sensation, frequent assessment of pain control methods
How do you know if they are in pain?
Blurring of vision
Sinking and gazing of eyes
Blink reflex absent
Eyelids remain half-open
Sensitivity to light may remain
Physical Manifestations
Pain - ANS-Rigor of pain control must continue at any point in illness
Pain assessment in cancer patients
Location
Intensity
Quality
Pattern
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