Download PSW-201 Week 3 Integrating a Palliative Approach into Caregiving Exam 2023 and more Exams Public Health in PDF only on Docsity!
PSW-201 Week 3 Integrating a Palliative Approach into
Caregiving Exam 2023
The Beginning of Better Care for the Dying - ANSWER "It's not being dead but the dying I fear" Cicely Saunders heard and saw that the needs of the dying were not being met in acute care - ANSWER She took action She earned her MD and worked to create a hospice St Christopher's Hospice - ANSWER Founded in London, 1967_, by Dame Cicely Saunders Provided care for the unique needs of the dying Palliative care established 1974 - ANSWER In Montreal, Dr. Balfour Mount established "palliative care" after studying with Dame Saunders Coined term "palliative" "hospice" and "palliative" - ANSWER In Canada, these terms are often used together and may mean the same thing HPC = hospice palliative care Hospice Pallative Care (HPC) - ANSWER helps people manage symptoms People can benefit - ANSWER from HPC from time of diagnosis Palliative and curative care - ANSWER can occur together Principles: HPC is care that - ANSWER =Affirms life =Regards dying as a normal process =Considers the dying person and family to be the unit of care =Continues through death and bereavement HPC promotes care that - ANSWER =Improves quality of life
=Does not speed or delay death =Provides pain relief and manages distressing symptoms =Attends to the dying person in a holistic way BUT less than 30% of dying people receive HPC! - ANSWER WHY?
- Very few specialty HPC teams Most providers are in urban areas
- HPC is accessed most frequently by people with a steady, predictable decline (cancer) i.e. when the time of death can be predicted But remember: predictable deaths account for less than 20%! A solution? - ANSWER A Palliative Approach AUSTRALIA - ANSWER =integrated palliative care into primary health care Provided by ALL MEMBERS of the team Supported by input from specialists when necessary What is a PALLIATIVE APPROACH - ANSWER "Integrating the principles, practices and philosophy of HPC into the care of people with any life-threatening disease, early in the disease process, across all care settings" Integrating a palliative approach in LTC - ANSWER People enter LTC later in disease than previously -the length of stay is SHORTER -more people die in LTC each YEAR A palliative approach - ANSWER can improve care for those dying in long term care Reduces number of emergency room visits A palliative approach works well - ANSWER with dementia care principles People with dementia or multiple illnesses - ANSWER benefit from a pallative approach early on in their disease
- The team needs to communicate to be effective
- PSW communicates information from the dying person and family to the team
Care teams vary greatly - ANSWER Depending on
- Location - urban vs rural
- Care facility or home care
- Preferences of dying person and family
PSWs integrate a palliative approach by: - ANSWER 1. Holding the dying person and family at the centre of care
- Gathering information
- Considering the needs of the WHOLE PERSON
- Providing physical and psychosocial support by implementing the care plan and individualizing comfort measures.
- Communicates and advocates for the dying person and family
What is a good or bad death? - ANSWER Subjective terms Reflect personal preferences
Use instead "appropriate death" to include preferences of the person, dying with dignity
How do PSWs provide support? - ANSWER Create a nurturing place for the person and family by:
Being REAL
Expressing empathy Avoiding ROADBLOCKS to communication Offering a compassionate presence Supporting dignity Communicating
Being REAL? - ANSWER
Express empathy, not sympathy - ANSWER Empathy "It sounds really hard for you"
Sympathy "I am sorry for you"
Avoid communication roadblocks - ANSWER Communication roadblocks are phrases or responses that shut down communication.
Communication roadblocks will - ANSWER Minimize the problem Offer false reassurance, praise, platitudes or sympathy Include the risk of falling into the Fix-it Trap
You may be in a Fix-it Trap if... - ANSWER You feel it is your job to fix things BUT
... we cannot fix deep emotional and spiritual pain
In the Fix-it Trap we only hear what needs fixing - ANSWER We may avoid caring for someone when we cannot fix their problem
Silence is an important part of communicating - ANSWER Silence is full of presence Silence makes room for whatever needs to happen Present silence - trust that what needs to happen will happen
Supporting dignity - ANSWER The way a person see themselves is filtered by what they believe others see in them The person and family can judge their status in the health care system by the way you mirror their status Ask "the dignity question"
"What do I need to know about you as a person to give you the best care possible?
Ask the dignity question when: - ANSWER A person first arrives to care Care progresses Transitions occur
Ask yourself - ANSWER As care continues, ask yourself the dignity question to ensure that care reflects the person's needs
People need to communicate - ANSWER "Communicate or be eaten by your affliction"
People need to have the opportunity to express themselves - Verbally and non-verbally
Communication is the expression of a person's experiences and needs - ANSWER Communicating can bring change
PSWs that provide a safe place for communication - ANSWER will allow the person to grow as they die
Encouraging communication with open-ended questions - ANSWER "Can you tell me more?" "What is happening?" "Can you give me an example?" "What do you need right now?"
Why open-ended questions? - ANSWER Because they are not judgmental. This helps:
The person share their story You to see, hear and validate the person's experiences Prevent misunderstandings
Use open-ended responses - ANSWER You may encourage further exploration with a non-judgmental reflective response Helps gain clarity and understanding
Open-ended response - ANSWER "I wonder if what you are saying is..."
"So I get the sense that....is that right?"
=Right of all persons facing death and bereavement to receive consistent physical, emotional and SPIRITUAL SUPPORT =Effective care must be coordinated and consistent reflecting a common philosophy =Hospice caregivers have a commitment to PROFESSIONAL & PERSONAL GROWTH
GOALS OF PALLIATIVE CARE - ANSWER NOT to PROLONG LIFE life but to provide the BEST QUALITY of LIFE during the final days before death by:
=Assisting in CONTROLLING PAIN and symptoms of illness =Ensuring that death is a NATURAL PROCESS Providing COMPASSIONATE CARE
PALLIATIVE CARE & THE TEAM APPROACH - ANSWER =Mutual respect between team members as well as communication, accurate charting, and information sharing are all essential to ensure the best care.
CARE SHOULD BE: - ANSWER =MEANINGFUL =Strive to meet each person's expectations and needs =Outcome focused =Lead to consumer satisfaction
DEATH WITH DIGNITY - ANSWER ASSISTING THE PERSON WHO IS DYING
Can anyone identify the following? - ANSWER What are some ways to
prevent terminal illness? *Healthy lifestyles. exercises, seeking medical attention
THE DYING PERSON'S "BILL OF RIGHTS" - ANSWER =To be treated as a living human being until I die
=To maintain hopefulness and be cared for by people who maintain a sense of hope
=To be able to EXPRESS MY FEELINGS about my approaching death in my own unique way
=To participate in decisions concerning my care
=To expect continuing medical and nursing care of either "cure" or "comfort"
=To not DIE ALONE
=To be free from pain
=Have my questions answered HONESTLY
=Not to be DECEIVED
=To have individual and family help accepting my death
