Transcript: Average daily costs to provide palliative care services could also be offset by inviting local groups, that offer volunteer services to nonprofit organizations. Volunteers could provide help with lawn maintenance, clean common areas, or stock supplies. Having volunteer assistance in the areas mentioned above, would save exponentially on cost because personnel would not have to be hired and paid to do those jobs. Palliative Care is specialized medical care for people with serious illnesses. It focuses on providing patients with relief from the symptoms and stress of a serious illness. The goal is to improve quality of life for both the patient and the family. Palliative care is NOT physician assisted suicide. Many people might confuse palliative care and physician suicide but palliative care is simply taking care of dying patients and making them comfortable. The patients also receive emotional support. What is palliative care? Some patients think that their only option is to only live out the last little bit of their life in the hospital or in their home. This is why physicians should be required to tell thier patients all their options including palliative care. Cost-Benefit: Physicians will take seminars at their hospital and will be trained to talk to their patient about their options. They will talk to all terminally ill patients about palliative care and other options that they have. Problem: By: Kendal Lee Physicians would start being required to tell their patients about palliative care. The physician can build a trusting relationship with them so they will become more comfortable and open to their plan of care. Cost-Benefit: Someone will be hired to teach seminars at the hospital so that physicians can learn how to communicate with their patients better. The sliding-scale payment plan would allow anyone who is interested in receiving palliative care find the necessary financial assistance needed to ensure that care is received and not solely based on their ability to pay. Palliative Care Solution: Problem: Palliative care is not often brought up when people are dying due to their terminal illness. Many patients do not receive this information on palliative care simply because their physician is not comfortable talking to them about it.
Transcript: PALLIATIVE CARE Heidi Korhonen Spring 2020 What is palliative care ? Palliative care Introduction Palliative care is 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, definition by WHO Definition continues.. provides relief from pain and other distressing symptoms affirms life and regards dying as a normal process intends neither to hasten or postpone death integrates the psychological and spiritual aspects of patient care offers a support system to help patients live as actively as possible until death Main content of palliative care offers a support system to help the family cope during the patients illness and in their own bereavement uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated will enhance quality of life, and may also positively influence the course of illness is applicable early in the course of illness, in conjunction 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. The content of palliative care Progressed illnessess for ex. cancer, neurological, heart, lung, liver or kidney diseases as well as a memory disease cause a need for palliative care WHO:n estimates that in the end of a life at least 30 000 people need palliative care in Finland Every two of them need a special consultation or treatment. Arviolta joka toinen heistä tarvitsee erityistason konsultaatiotukea tai hoitoa. Indication for palliative care Different illnesses Giving palliative care and (hospice care) is based on early made proactive care plan and hospice care decision. The goal of care plan can aim to the home based care till death or transferrence of pre decided hospice care unit (if patients and family members wish so) Care plan and hospice care decision Care plan and hospice care decision Palliative care path What is the care path of palliative patients ? Providing palliative treatment in Finland In February 2016, the Ministry of Social Affairs and Health assigned an expert working group a task of drafting a proposal for the provision of palliative treatment and end-of-life care to ensure equal access to palliative treatment and end-of-life care throughout the country The recommendation is based on a three-tier model for providing services at the 1.basic, 2.specialized and 3.intensive tertiary level. This will serve as a basis for the regional planning of service chains and agreeing upon the division of responsibilities in accordance with the Government Decree (582/2017) Providing palliative care in Finland Care plan and care alignments Bringing the palliative care into the discussion early and patient's early expressed will of treatment create a basis for planning good end of life care. The doctor and the treating team in charge of the care create an advanced care plan in mutual understanding with the patient, relatives, or legal representative. Such includes the alignments of care, required treatment methods and the restrictions of treatment. The care plan anticipates and outlines how to respond to the pain of the patient, other physical symptoms, as well as the mental, social, and spiritual needs. Care plan and care alignments The responsibility of realizing and updating the care plan belongs to the doctor responsible for the treatment. As the death approaches, the care plan is completed with the hospice care plan Palliative care is included in all stages of the disease. It is relevant, when care aimed to slow down the disease is no longer beneficial, and the disease causes pain or other physical, mental, or spiritual suffering. This is not abandoning care, but instead giving care with different aims. Care plan and care alignments Where is palliative care given at ? Care chains The care chains The care chain in Finland Lilia is a 80 year old lady and she has been diagnosed with lung cancer 2 years ago. She still lives at home by herself. Lately , the pain has been getting worse. In the cancer policlinic she was told after lab results that her cancer has spread out and progressed. Sytostates are not helping anymore. Doctor has suggested a palliative care offered at her home. Lilia feels motivated to this plan. She understands the situation. She wants to hear more about the care plan and treatments for her symptoms. However her children are not happy about the plan and insist active care to Lilia. They think palliative care is just hastening her death. Assignment Case Lilia Assignment Implement a care meeting where there are present: Lilia, Palliative care policlinic doctor, nurses, Lilia's children and social
Transcript: PALLIATIVE CARE EXPERIENCE By: SANTIAGO RUiZ DESCRIPTION Laura Baum is a palliative care doctor that works to control and reduce the pain of patients with a very bad disease. Besides this, her work is also related with helping patients to control the way the are feeling and prepare them for bad news. SWOT HOPE H O P E PALLIATIVE CARE DOCTOR PALLIATIVE CARE DOCTOR CANCER The most common types of cancer in USA are breast cancer, lung cancer and prostate cancer. These types of cancer are the most dangerous ones and they are so difficult to cure if they are discovered in a later stage of cancer. EFFEECT IN HER PERSONAL LIFE She don't want to combine her personal life with her career because all the things and experiences that she have got can change or affect her family in a bad way. FAMILY FAMILY CAREER WORK STAGES OF CANCER The chances of cure cancer are higher if the cancer is in the stage 1 because the cancer is not so developed yet. The chances of cure cancer are pretty low if the cancer is in the stage 4 because the cancer is more developed. citation: www.cancer.org STAGE 1 In stage 1 liver cancer, the single primary tumor (any size) has not grown into any blood vessels. The cancer has not spread to nearby lymph nodes or distant sites. STAGE 2 In stage 2, a single primary tumor (any size) has grown into the blood vessels, or there are several small tumors, all less than 2 inches (5 cm) in diameter. The cancer has not spread to nearby lymph nodes or distant sites STAGE 3 In stages 3,there are several tumors and, at least, one tumor is growing into a branch of the portal vein or the hepatic vein. The liver cancer has not spread to nearby lymph nodes or distant sites. STAGE 4 Stage 4 liver cancer is the most advanced form of the disease. In stage 4, the cancer has spread to nearby lymph nodes and may have grown into nearby blood vessels or organs. Advanced liver cancer does not often metastasize (or travel to distant organs), but when it does, it is most likely to spread to the lungs and bones. WHAT SHE WANTS She wanted to help the world in some way, so this career was the perfect option to her for help those people who need it. That’s what she is doing, trying to help her patients and giving the best that she can to let them know that they are not alone, that there is still hope. ADVICES FROM LAURA *Just try to find a way to improve the world. *Do not lose your hope. *Everything's gonna be alright.
Transcript: Comfort Level? Learning Outcomes MYTH Journal Entry Quality of Life People with: Concerns? Communication Between nurse and client/family Between nurse and interprofessional team Only patients benefit from palliative care Palliative care patients still receive treatment Palliative care is the same as euthanasia Palliative care is offered to cancer patients only Symptom Management What is the Role of the Nurse in Palliative Care? Cancer Chronic Lung Disease AIDS Alzheimers MS ALS More Palliative Care -Specialized medical care for people with serious illnesses considered to be chronic or incurable - Holistic approach that aimed towards relieving client suffering Coordinate Care Myths and Facts For Next Class... MYTH Implementation Work collaboratively to create a treatment plan Help clarify the treatment plan when necessary Initiate the treatment plan Core themes: What are the Goals of Palliative Care? Monitor and manage symptoms Achieving quality of life Maintaining an independent person Family support Client and family advocate Who's Eligible for Palliative Care? Understand what palliative care is Gain insight into the goals of palliative care and who can receive it Understand the role of the nurse when providing care for palliative patients What is Palliative Care? Caring for Palliative Patients FACT MYTH
Transcript: Prezi...an interactive presentation COMFORT Patient & Family An overview using Prezi Jill Ricke, BSN, RN, CMSRN University of Indianapolis Palliative Care: Primary Goal: Nursing http://www.prezi.com Get Palliative Care (2012). What is palliative care? Retrieved from http:// www.getpalliativecare.org/whatis/ Gifford Productions (Producer). (2008, Feb 21) Palliative Care: What is it and who is it for? Center to Advance Palliative Care. Video retrieved from: http:// www.youtube.com/watch?v=ttW8pxF__g4 Kemenczy, K. (Producer). (2010, April 13). What is Prezi?-The official intro video. Video podcast retrieved from http:// www.youtube.com/watch?v=pxhqD0hNx4Q Integrative Palliative is a form of care focused on comfort for patients in any stage of illness or health decline Social work Physicians Blank Canvas References Muti-discipline approach The learner will be able to give an example of a patient in need of Palliative Care. The learner will identify resources available for Palliative Care education. The learner will be able to describe the benefits of Prezi Presentation technology. Spiritual Care http://prezi.com Alleviate the various side effects of illness and treatments Use of supplemental therapies (i.e. music therapy) Providing comfort to enhance quality of life Blank Canvas
Transcript: Cost Avoidance Prevent Readmissions PRN Care Coordination What's important to Dave Unlikely to Provide Benefit: Lung transplant, CPR/Intubation, ICU admission, Enteral/Paraenteral nutrition Prevent Weekend Admissions Hospice Transitions STEP 2 PRE-OP Risk Assessment Inpatient Home Visit STEP 3 Dave's Goals Focus on Goals Compatible with the Prognosis/Treatment options: Spend time with family. Do everything that may help. Die peacefully at the end. Medical Plan to Achieve the Goals: Antibiotics if needed. Continue high flow of oxygen. Enroll in hospice, Forgo CPR Complete a POLST Friday Clinic Prevent Revocations and Admissions Inpatient Consults Triggers Palliative Care Pulminary and Cardiac General Likely to Provide Benefit: Oxygen, IV fluids, Hospice, Hospitalization, BiPAP, Anticoagulation, Antibiotics Advaced Care Planning (5% - 50%) Phone Support STEP 1 Oncology PRN Ambulatory Fight the illness. Stay positive. Spend time with family. Do everything that might help. Die peacefully at the end. Recommendation Treatment Options for Prognosis of 3-6 months Care Coordination CLINIC Care Coordination SMH Structural Heart (TAVR) SRS Palliative Care Across the Continuum
Transcript: Palliative care aims to promote quality of life while easing the symptoms of serious illness. It is care for patients who find themselves in the space between curative and hospice treatment. The World Health Organization (2012) defines palliative care as ‘an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering’. (Ivany, 2013) Education and Communication are Key Palliative care improves patient outcomes and decreases intensive care utilization resulting in better quality of life and lower health care costs (Youngwerth, et. al. 2016) "Palliative care is appropriate at any age and any stage of a serious illness." (Youngwerth, et. al., 2016) References Aldridge, M. D., Hasselaar, J., Garralda, E., van der Eerden, M., Stevenson, D., McKendrick, K., & ... Meier, D. E. (2016). Education, implementation, and policy barriers to greater integration of palliative care: A literature review. Palliative Medicine, 30(3), 224-239 16p. doi:10.1177/0269216315606645 Ivany, E., & While, A. (2013). Understanding the palliative care needs of heart failure patients. British Journal Of Community Nursing, 18(9), 441-445 5p. Ouimet Perrin, K., & Kazanowski, M. (2015). End-of-Life Care. Overcoming Barriers to Palliative Care Consultation. Critical Care Nurse, 35(5), 44-52 9p. doi:10.4037/ccn2015357 Youngwerth, J., Johnson, D. Palliative care: management of common physical and psychological symptoms. In: Glasheen JJ ed. Hospital medicine secrets. Philadelphia, PA: Elsevier Palliative Care Things to Consider Nursing The Intersection of Curative and Comfort for Quality of Life Patient and family Primary care provider Specialist Pharmacist Nutritionist/Dietician People are now living longer End result of chronic illnesses is now the leading cause of death Acute, intensive care is not always appropriate
Transcript: Reem Al Matrushi "We have enjoined on man kindness to parents" (8) Al-Ankaboot Palliative Care Death is the natural end to life, not a failure of medicine. Relieving physical, psychological & spiritual suffering Close multidisciplinary teamwork Promote the quality of life reduce unnecessary hospital admission specialized medical care for patients with life threatening illnesses & their families * Appropriate for those likely to die in < 12 months, which deaths are ‘predictable’ & follow a period of chronic illness. * Symptom control must be tailored to the needs of the individual. • Carefully diagnose the cause of the symptom • Explain the symptom to the patient • Discuss treatment options • Set realistic goals • Anticipate likely problems • Review regularly End Of Life Care EOLC Pain Pain & general debility * The cornerstone of palliative care * Acute & Chronic pain * Common symptoms : - Weakness - Fatigue - Drowsiness Reversible causes Causes • Drugs • Emotional problems • Biochemical abnormalities • Anaemia • Infection • Poor nutrition • Prolonged bed rest • Raised intracranial pressure * Treat reversible causes * Life style modification * Pain-relieving drugs * Modification of emotional response * Physiotherapy * Psychological support * Prevention * Review home care arrangements Strategies of Management Management * Persist Vomiting Review Medication Review Assess To decrease Nausea • Avoidance of food smells & unpleasant odours • Relaxation, diversion, anxiety management • Acupressure, acupuncture Non-drug measures Non-drug measures Administer antiemetics regularly rather than prn & choose an appropriate route of administration Choose Anti-emetic Bed Sores Mr. Daly, a terminally ill male in his late 80s, a known diabetic, with above-the-knee amputation of a gangrenous left foot & end-stage renal disease with an order for hemodialysis. Having multiple pressure ulcer. Case Scenario Management How would You Manage ! MCQs 65 years old male, presented with sever muscle pain since 4 days. The pain was mainly in the lower limp. On examination; the patient was stable . On inspection; no signs of inflammation or redness of the muscle . How would you manage this patient ? Thank You For Your Afternoon
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