ELECTIVE 1: HOSPICE PALLIATIVE CARE

Course Description

This course includes the concepts, principles and theories of hospice palliative care.

Course Objectives1. Differentiate the stages of death and dying.2. Assess the needs of clients and family

members.3. Identify and prioritize nursing interventions of

the client and family at any stage of the life situation

4. Implement the client and family the most relevant intervention at the present time, taking into consideration the principles and techniques of desired action.

5. Follow with respect the bioethical and cultural beliefs and practices of the client and family

6. Relate effectively with clients, families and health care team members in fulfilling the quality of life

Course Content

• Introduction to Palliative Care: Overview of Nursing Developments

• Education and Development in Palliative Care

• Holistic Care• Symptom Management

Course Content

• Communication and Support in Palliative Care• Spirituality in Palliative Care• Sexuality and Palliative Care• Complementary Therapies in Palliative Care

Course Content• Supporting with Family and Carers• Stages of Death and Dying• Living with Loss • Care of the Dying Person• Ethical Issues in Palliative Care• Evidence-based Palliative Care

Definition• Hospice care is palliative care given to

individuals who are terminally ill with an expected survival of six months or less.

• The focus of hospice care is on meeting the physical, emotional, and spiritual needs of the dying individual, while fostering the highest quality of life possible.

Definition of Palliative Care

Palliative Care by WHO (2005) defined as an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.

Palliative Care:

• provides relief from pain and other distressing symptoms

• Affirms life and regards dying as a normal process

• Intends neither to hasten nor to postpone death

• Integrates the psychological and spiritual aspects of patient care

Palliative Care:• Offers a support system to help family cope

during the patient’s illness and their own bereavement

• Uses a team approach to address the needs of patient’s illness and their own bereavement counseling

Palliative Care:

• Will enhance quality of life and may also positively influence the course of illness

• Is applicable early in the course of illness in conjunctions with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications.

Principles of Palliative Care /NCPC Definition of Palliative care

• Affirms life and regards dying as a normal process

The emphasis is on quality of life, not quantity, and it affirms that dying is a normal life process, not a medical disease process. It forces us to think holistically and move away from a model focused on medical disease

• Neither hastens nor postpones death• Provides relief from pain and other distressing

symptoms

Principles of Palliative Care /

NCPC Definition of Palliative care

• Integrates the psychological 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 patient's illness and in their own bereavement

“Care does not end with the death of the patient

but continues through death pronouncement, family notification of the death, discussion of autopsy, and immediate bereavement support.”

Palliative Care in the Final Days of Life "They Were Expecting It at Any Time" James

Hallenbeck, MD

Focus of Care• The focus of hospice is not on treatment, but

on pain and symptom management, comfort measures, acknowledging that the individual will die, supporting the family, and trying to provide the best quality of life for

the time remaining.

Hospice functions under the philosophy that although some terminally ill patients may no longer receive treatment, they still require and deserve care.

Palliative Care Questions and Answers

Question Palliative Care Hospice Care Who can receive this care?

Anyone with a serious illness, regardless of life expectancy, can receive palliative care

Someone with an illness with a life expectancy measured in months not years

Can I continue to receive treatments to cure my illness?

You may receive palliative care and curative care at the same time

Treatments and medicines aimed at relieving symptoms are provided by hospice

Palliative Care Questions and Answers

Question Palliative Care Hospice Care Where are services provided?

Home Assisted living facility Nursing facility Hospital

Usually, wherever the patient resides, in their home, assisted living facility, nursing facility, or hospital. Some hospices have facilities where people can live, like a hospice residence, or receive care for short-term reasons, such as acute pain or symptom management.

Palliative Care Questions and Answers

Question Palliative Care Hospice Care Who provides these services?

It varies. However usually there is a team including doctors, nurses, social workers and chaplains, similar to the hospice team.

A team – doctor, nurse, social worker, chaplain, volunteer, home health aide and others.

• Some people mistakenly think hospice care is just about dying…that hospice is the place you call when there’s nothing more that can be done.

• Hospice helps patients and families focus on living.

• Hospice care brings comfort, dignity, and peace to help people with a life-limiting illness live every moment of life to the fullest.

• It also reaches out to provide support for the family and friends who love and care for them.

Ten Facts about Hospice Care You may not Know

1. Hospice is not a place; it’s high-quality medical care that helps the patient and family caregivers focus on comfort and quality of life.

2. Hospice is paid for by Medicare, Medicaid, most insurance plans, HMOs, and managed care plans. Fear of costs should never prevent a person from accessing hospice care.

3. Hospice serves anyone with a life-limiting illness, regardless of age or type of illness.

4. Hospice serves people of all backgrounds and traditions; the core values of hospice—allowing the patient to be with family, including spiritual and emotional support, treating pain—cut across all cultures.

5.Research has shown that the majority of Americans would prefer to be at home at the end of life’s journey—hospice makes this possible for most people.

6. Hospice serves people living in nursing homes and

assisted living facilities.

7. Hospice patients and families can receive care for six months or longer.

8. A person may keep his or her referring physician involved while receiving hospice care.

9. Hospice offers grief and bereavement services to family members and the community.

10. To get the most out of what hospice offers, it’s better to have care for more than just a few days.

• November is National Hospice/Palliative Care Month.

• A time for raising awareness about the compassionate care that hospice and palliative care provide to patients and families coping with serious and life-limiting illness. One of the most important things that people need to learn is that hospice [and palliative care depending on focus you want to give the piece] helps patients and families focus on living.