PALLIATIVE CARE. Palliative Care Team Heart of England NHS Foundation Trust. AIMS:-. To define what we mean by palliative care To define what we mean by end of life care To identify the needs of patients that are dying To highlight what the needs of the family are when a patient is dying
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Palliative Care Team
Heart of England NHS Foundation Trust
At the end of the session HCA’s should be able to:-
The goal of palliative care is the achievement of the best possible quality of life for the patients and their families.
(WHO 1990)Aim of palliative Care
………to achieve the best quality of life for individuals with any advanced, progressive illness, and their families, by the management of their physical symptoms and the provision of psychological, social and spiritual support.
World Health Organisation 2002
50% of complaints are related to end of life care in some way.
Of 50 cases looked at relating to end of life care the complaints were around poor communication, lack of basic comfort, privacy and psychological care, and late or no referral to palliative care
Relatives are often the 1st to notice a patient is dying!
‘If the patient has a progressive incurable disease, if reversible causes of deterioration have been excluded (eg infection, hypercalcaemia) and if they are very weak and drowsy and getting weaker every day, then they are dying.’
“all the care she received before meant nothing, because she died the way she died”
Husband of 43yr old lady who died in hospital
NB:- Think of caring for that person as you would wish a loved one to be cared for!
With dying patients and their relatives
Believe Doctors/nurses primarily concerned about physical care
Don’t want to burden them with their worries
Think their perspectives may depend on treatments so don’t want to complainBarriers perceived by patients
Think their worries are silly or trivial or that professionals will think that.
Fear of admitting being unable to cope, breaking down, losing control.
Not being able to find the words to explain how they feel.
Anxiety about having their worse fears confirmed.Continued . . .
Being frightened of
When you think you want to say: professionals will think that.
You are going to be just fine.
Don't talk like that! You can beat this!
I can't see how anyone can help.
What do the doctors know? You might live forever.
Don't be glum. You will get well.
Try this instead:
Are there some things that worry you?
This must be hard to come to terms with
We will work with you.
Do you think the doctors are right? How does it seem to you?
It must be hard. Can I just sit with you for a while.Words to try