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Palliative Care & Hospice Care

Palliative Care

care for the seriously ill which is part of cancer care expanded to address comprehensive symptom management, psychosocial care and spiritual support to enhance quality of life focus COMFORT

Hospice palliative care that is delivered at home or a special facility who are approaching the end of life focus QUALITY OF LIFE Both aims to prevent and relieve

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HOSPICE CARE

PALLIATIVE CARE

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5 Stages of Grief

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5 Stages of Grief Denial

-"this can't be happening to me", looking for the former spouse in familiar places, or if it is death, setting the table for the person or acting as if they are still in living there. No crying. Not accepting or even acknowledging the loss.

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Anger-"why me?", feelings of wanting to fight back or get even with spouse of divorce, for death, anger at the

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Bargaining-bargaining often takes place before the loss. Attempting to make deals with the spouse who is leaving, or attempting to make deals with God to stop or change the loss. DepressionBegging, wishing, praying for overwhelmingcome back them to feelings of hopelessness, frustration, bitterness, self pity, mourning loss of person as well as the hopes, dreams and plans for the future. Feeling lack of control, feeling numb. Perhaps feeling suicidal.

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Acceptance-there is a difference between resignation and acceptance. You have to accept the loss, not just try to bear it quietly. Realization that it takes two to make or break a marriage. Realization that the person is gone (in death) that it is not their fault, they didn't leave you on purpose. (even in cases of suicide, often the deceased person, was not in their right frame of mind)

Principles of Palliative 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 psychological, ethical, legal and spiritual aspects of care

Offers a support system to help patients live as actively as possible until death Offers a support system to help patients families cope during the patients illness and in their own bereavement

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Models of CarePalliative Care Services operate in one or more of the following ways, reflecting local practice and needs, but there is no right or wrong type of service.

In-patient beds

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Cont.. an in-patient palliative care unit may be part of a hospital or an independent free-standing unit a hospital unit may be either a special ward within the hospital or a separate unit built in the hospital grounds a free-standing unit is physically separate from the hospital, but should still be able to access its staff and services patients may be admitted for symptom management (physical or psychosocial) terminal care short duration rehabilitation/convalescence 4/14/12 to provide a period of respite for family

MODELS OF CARE

Community services there are various models for community basedpalliative care serviceso

services providing specialist advice and support for the family doctors and community nurses managing the patients services providing hands-on nursing and allied health services to patients at home, in co-operation with the patients own doctor

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MODELS OF CARE

Day units

known as Day Care, Day Hospice, Day Palliative Care Unito

usually form part of a hospital or in-patient palliative care unito

provide care, rehabilitation, support and respite during the day for peopleo

under care at home, who are still well enough to be transported to and from the Day Care Unit, often by 4/14/12 volunteer transporto

Hospital palliative care teamsoperate in general and specialist hospitals are staffed by doctors and palliative care nurses o some also have a social worker or a pastoral care specialist provide consultative advice on patients referred to them in any department of the hospital o to advise on every aspect of palliation o provide support for family member o provide support and education for the staff4/14/12

MODELS OF CARE

Bio-Ethical and Cultural beliefs and practicesCultural Competence continuous A dynamic fluid,o

process of awareness, knowledge, skill, interaction and sensitivityo

Has four components to be culturally competent; cultural awareness, cultural knowledge, cultural skill and cultural encounter4/14/12

Bio-Ethical and Cultural beliefs and practices

Cultural Awarenessexamination of ones own heritage, practices, experiences, religious and spiritual beliefso

essential to identify and acknowledge the role of ones own beliefo

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example: to what extent do you believe in life after death?, what kind of deatho

Bio-Ethical and Cultural beliefs and practices

Cultural knowledge different Knowledge about gain cultural groups too

cultural competenceo

serves as a guide to assist hospice/palliative in providing quality care be careful with assumptions stereotypingo

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o

example: first gen.

Bio-Ethical and Cultural beliefs and practices

cultural communication, cultural interpretation and appropriate interventions are required skills tools used focuses on cultural affiliation, values orientation, health-related beliefs and practices, etc.

Cultural Skills cultural assessment, cross-

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example: where was the

Overview of Religious and Cultural Beliefs on Death and Dying

HINDUISMo

Transition between previous life and the next Bodies are cremated, during the first 10 days relatives must create a new ethereal body A good death is timely in the right place and

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Overview of Religious and Cultural Beliefs on Death and Dying

JUDAIS Human beings are M bodies belong mortal,o

to Godo

Jewish are obligated to visit the sick Most rabbis allow Jews may enroll to hospice

o

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Overview of Religious and Cultural Beliefs on Death and Dying

BUDDHI SM No central authorityo o

Religious law imposes no special requirement for medical treatment Buddhists may refuse pain relievers, believed that an unclouded mind leads to a better

o

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Overview of Religious and Cultural Beliefs on Death and Dying

o

ISLA Muslims may wish to M engage in ritualprayer, five times a day Fasting during month of Ramadan Pain is a cleansing instrument of God Killing of terminally ill person is an act of disobedience

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Overview of Religious and Cultural Beliefs on Death and Dying

Traditional Christians God Believe in oneo o

No obligation to postpone death, the attempt to save life is forbidden Impending death is offers a chance to reconcile and ask for Gods forgiveness

o

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