Palliative Care Powerpoints

Apply a Palliative
Approach in Nursing
Practice
Diploma of Nursing
Tricia O'Connor RN MN
 Palliative Care is a sensitive subject
 privacy and confidentiality are essential
 people's feelings and thoughts must be
respected
 people's right not to disclose feelings and
thoughts must be respected.
 Support
 Self Care
Learning Objectives
 To gain an understanding of what a palliative
care and a palliative approach to care is
 To investigate what quality of life may mean to
different clients
 Gain awareness of End of Life Care
 Gain awareness of After Death Care
A definition
Palliative care aims to improve the quality of
life of patients and the families of patients,
who face the problem associated with life-
threatening illness. It involves the early
identification and impeccable assessment and
treatment of pain and other physical,
psychosocial and spiritual problems. It both
prevents and relieves suffering (World Health
Organisation).
What is Quality of Life
????
???????????
????????????????????
???????????????????????????
?????????????????????????????????
W.H.O. definition for quality of life
“an individual’s perception of their position in
life in the context of the culture and value
systems in which they live and in relation to
their goals, expectations, standards and
concerns. It is a broad ranging concept
affected in a complex way by the person’s
physical health, psychological state, personal
beliefs, social relationships and their
relationship to salient features of their
environment”
What is a life-threatening illness?
Not just cancer,
can be
 Chronic renal failure/liver/cardiac ie organ

failure
 Emphysema
 Dementia
 COPD
 MND etc
…..definition alternative
……. life-threatening illness.
???? substitute with

…………progressive life limiting illness.
Definition by Palliative Care Australia
Palliative care is person and family-centred

care provided for a person with an active,
progressive, advanced disease, who has little
or no prospect of cure and who is expected to
die, and for whom the primary goal is to
optimise the quality of life.
https://palliativecare.org.au/
Holistic
spiritual
physical cultural
psychologic
social
al
emotional
Barriers and Misconceptions
Loss of hope
Fighting the good fight- never give up
Death and dying is sanitised in western culture
Fear
Associated with speeding up death
Should only happen at the last minute
Will always use morphine = addiction
May have past history of bad experience in the family.
Living in rural and remote areas
Cultural concerns
Lack of knowledge about palliative care
What it is not.......
Stopping all treatment
Telling the client that there is no more
to be done
Giving exact time frame in which
someone will die
Euthanasia
Euthanasia versus Palliation
What is the difference?
Euthanasia is the deliberate and illegal ending

of life
Palliation intends to end the suffering, not the
life of the person
The practice of palliative and end of life care,
does not include deliberate ending of life
through voluntary euthanasia or physician-
assisted suicide, even if the patient requests it
(Pall Care Org Position Statement 2010)
Important
If a person dies soon after medication is
given to relieve pain or symptoms during
palliative treatment – this is not euthanasia –
as the intention is to relieve suffering by
legal and ethical means
Palliative care
Palliative care is designed to relieve the symptoms
of a disease rather than to cure it.
May still receive treatment but the aim has changed
 It’s considered when a cure for a life-limiting illness
is not an option
When the client becomes so frail that death will be
the outcome.
There is no fixed point in a person’s life at which a
palliative approach should commence, as each client
will experience deterioration in their health
differently.
Palliative Care - Philosophy
The palliative approach comes early in the course of an
illness, not just as end-of-life care
Affirms life and regards dying as a normal process
Neither hastens nor postpones death
Provides relief from pain and other distressing symptoms
Integrates the physical, psychological, social, emotional and
spiritual aspects of care, with
Coordinated assessment and management of each persons needs
Offers a support system to help people live as actively as possible
until death
Offers a support system to help the family cope during the
persons illness
And in their bereavement.
Palliative care can be provided in three ways

palliative approach to care - promotes quality

of life
 specialist palliative care - assesses and
treats complex symptoms,
end-of-life care, at the terminal phase of the
illness.
GP
PCare
Hospic Specialis
e t
Patie
nt
OPD
HBPC
Recognising transition markers from
palliative approach to palliative care
(independent of disease)
Increase in dependence
Increased susceptibility to acute illness
Poor ability to recover stressors
 Increased cognitive impairment
Symptom distress
Increasing family support needs
http://www.caresearch.com.au/Caresearch/Portals/0/Documents/whatispalliativecare/nationalprogram/rural-agpn/82-Philosphy-and-
Meaning-ofPC.pdf
Indication for Specialist Consultation
Exacerbation of previously stable symptoms
Needs exceed the capacity of the facility
Client requires complex symptom
management
Risk of complications, physical - social -
emotional
Who and Where
Who?
Young Women
Aged Men
Disability
Where?
Home, Hospital, RACF, Group Home
Where?
Most patients who die an easily predictable
death from a diagnosed terminal illness want
to be cared for at home (>50%). However, only
about 16% are able to exercise this option, as
most patients now die in hospital; only 20% of
people die in hospices and 10% in nursing
homes. www.curriculum.racgp.org.au/statements/palliative-care/
When?
There is no fixed point in a person’s life at
which a palliative approach should
commence, as each client will experience
deterioration in their health differently.
Kaye's Story
Thoughts……?
Holistic Care
body
mind spirit
Holistic Care
spiritual
physical cultural
psychologic
social
al
emotional
The goals of end-of-life care
to maintain the comfort, choices, and quality of
life
to support their individuality
to care for the psychosocial and spiritual needs
of themselves and their families
support for families in bereavement (if required)
End-of-life care also aims to reduce inappropriate

and burdensome healthcare interventions and to
offer a choice of place of care when possible.
How people die remains
in the memories of
those who live on.
Saunders, C. M. & Baines, M. J. (1989). Living with dying: the management of terminal
disease (2nd ed.). Oxford, UK: Oxford University Press.
Care issues to consider
Comfortable positioning
Pain relief (other than oral)
Mouth care
Eye care
Elimination - retention
Breathing
Terminal restlessness
Delirium,
After Death
There is no need to hurry if family present
note time and
remain quiet, yet available
Console as you feel is appropriate to your
relationship.
Give the family time
friends and relatives may come and say their
goodbyes.
Telephone call if family not present
Listen more than you speak
Maintaining respectful support
• Give them the space to grieve in their own way and their own time.
• Be respectful of their privacy
• Try not to say things like “I know” or “I understand” unless you really do. • Don’t
make assumptions as to how they are feeling or what they need. Ask them.
• Listen to their needs, and try to assist in whatever ways you can.
• Appreciate that various cultures grieve and mourn in different ways – try not to
impose your own views and beliefs.
• Don’t avoid them. While there are no words that can heal their pain, to hear no
words and to feel isolated is far worse.
• Offer to spend time with them, but don’t commit to or suggest support that you
are unable or unwilling to follow through with.
• Avoid use of platitudes such as ‘They had a good innings’, ‘It was God’s will’ or ‘It
could be worse’
• Don’t take anger or strong emotions personally. Grief is an emotional
rollercoaster, and the reactions of the bereaved are not a personal attack on you.
• Avoid comparing their loss to other losses. Grief is as individual as a fingerprint,
and no loss is ever ‘the same’ as someone else’s www.grief.org.au
Practical after death care
RESPECT
DIGNITY
remove sources of heat
straighten limbs
replace dentures
Wash and dress : using Standard precautions as per
hospital policy. GLOVES
Incontinence pads
Paperwork and Funeral director
remove all medical lines (unless post mortem is
necessary then …)
Recap
What is a Palliative Care
What it is not
What is quality of life
and how can this concept be different for
different people,
 can it change
 Holistic care
 End of life care
 After death care
References
 Kaye’s story https://www.youtube.com/watch?v=-h5TyhYhjCE
 http://www.palliativecare.org.au/
 http://www.who.int/cancer/palliative/definition/en/
 http://www.who.int/mental_health/media/68.pdf
 http://cicelysaundersinternational.org/
 http://www.caresearch.com.au/Caresearch/Portals/0/Documents/whatispalliativ
ecare/nationalprogram/rural-agpn/82-Philosphy-and-Meaning-ofPC.pdf
 https://www.researchgate.net/figure/7306678_fig1_Figure-I-Three-General-Traje
ctories-of-Function-and-Well-Being-over-Time-in-Eventually
 http://www.intellectualdisability.info/physical-health/cancer-palliative-care-a
nd-intellectual-disabilities
 www.curriculum.racgp.org.au/statements/palliative-care/
 https://palliativecare.org.au/

Palliative Care Powerpoints

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Palliative Care Powerpoints

Uploaded by

Copyright:

Available Formats

Apply a Palliative

 Chronic renal failure/liver/cardiac ie organ

???? substitute with

Palliative care is person and family-centred

Euthanasia is the deliberate and illegal ending

palliative approach to care - promotes quality

Home, Hospital, RACF, Group Home

End-of-life care also aims to reduce inappropriate

You might also like