Professional Documents
Culture Documents
Nursing Needs For Older Person - Palliative and EOL - PPSX
Nursing Needs For Older Person - Palliative and EOL - PPSX
Curative Palliative
Treatment Care
Hospice
ELNEC Core Curriculum
Continuum of Care
Death
Disease-Modifying
Treatment
Hospice
Care
Palliative Care Bereavement
Support
Terminal Phase of
Illness
Palliative Background
• International
–World Health Organization
• Palliative care, while still a relatively new
component to modern healthcare, is
increasingly recognized as an essential
part of all healthcare systems.
Palliative Background
provision. characterized
by:
– the development of palliative
care activism that is patchy in
scope and not well
supported; sourcing of
funding that is often heavily
donor dependent;
– limited availability of
morphine; and a small
number of hospice-palliative
care services that are often
home-based in nature and
relatively limited to the size of
the population.
Background: PALLIATIVE CARE
• National
Palliative Background
– “The Palliative and Hospice Care Act of 2013”
• House Bill Act 49 during the 15 Congress, no further action was
taken due to time constraints
• Highlight the following section:
– Services and Site of Care
– Compassionate Care Leave Benefits
– Mandatory Palliative Care and Hospice Services
– Accreditation
– Education and Training Health care Professional
– Continuing Research
– Designation of National Palliative and Hospice Care Council of the
Philippines
• PROCLAMATION 1110 by GMA
– 1st week of October of each year as
Palliative Background
“National Hospice and Palliative Care
Week“
• PROCLAMATION 936 by GMA
– National hospice and palliative care
council of the Philippines ( HOSPICE
PHILIPPINES) as one of the major
conduits of the department of heath
in the distribution of morphine
Background: PALLIATIVE CARE
• Joint Commission International
Palliative Background
requirement
– Standard ACC.2.1 Patient needs for
preventive, palliative, curative, and
rehabilitative services are prioritized
based on the patient’s condition at the
time of admission as an inpatient to
the hospital.
– Standard COP.7 The hospital addresses
end-of-life care.
– Standard COP.7.1 Care of the dying
patient optimizes his or her comfort
and dignity.
Background: EOL
• Dying patients frequently do not receive
basic nursing care or assistance with
eating and drinking (Rogers, 2003)
• Alternatively staff may focus on meeting
physical needs at the expense of
psychological and spiritual care
• Comorbidity and drug reactions make
symptom control more difficult
Background: EOL
• Older people are less likely to receive
appropriate pain control than their
younger counterparts.
• Older people are less likely to receive
hospice care
• In care homes end of life care may be
impeded by inadequate staff training,
poor symptom control and lack of
psychological and emotional support
Types of Dying Awareness
Closed Suspicion
awareness awareness
Mutual Open
pretense Awareness-
Types of awareness of dying
• Closed awareness- the patient is
unaware of impending death while the
staff and/or family engage in tactics to
avoid disclosure
• Continuity and
coordination of care
that responds to
episodic and long
term chronic
illnesses and
transitioning
between levels of
care
Needs of Older Person in Palliative Care
• Decision making
regarding care and
treatment
decisions
• Pain and
symptoms control
Needs of Older Person in Palliative Care
• Determining risk
versus benefits of
treatment
• Home support for
family and care
givers
• Community
Resource
information and
access assistance.
Needs of Older Person in the FINAL
Hours (End-of-Life Nursing)
Difficult
road
Two Roads to Death
THE DIFFICULT
Tremulous ROAD
Confused Hallucinations
Restless Mumbling Delirium
NORMAL
Myoclonic Jerks
Sleepy
Lethargic Seizures
Obtunded
THE USUAL Semicomatose
ROAD
Comatose
• Death rites
• Rituals
Lipson & Dibble, 2005
What can each of you do?
1. Recognize patients who may benefit from
palliative care
2. Start interdisciplinary discussion about palliative
and end-of-life care
3. Ask about symptoms, physical and emotional
(holistic approach)
4. Talk with patient and family about concept of
palliative/supportive care
5. Know the available palliative care resources in
your institutions
Any Question ?
Final Thoughts
• Quality palliative care addresses quality-of-life
concerns
• Increased HCP knowledge is essential
• “Being with” – one care needs of older patient
• Importance of interdisciplinary approach to
care
• Nurses play a big role in addressing the needs
and supporting dying patient and their
significant others.
THANK YOU VERY MUCH!