palliative care A Graded Exam with Questions
and Answers| Already Passed
Issues of PC - ✔✔1. Province in charge of health care however Federal government is in charge
of veterans/aboriginals/corrections
2. Voices of the dying go unheard
3. Aging population - 1/4 will be over 65 in 2031
4. Only about 30% of Canadians have access to PC
General Assumptions/Principles for the terminally ill - ✔✔patient, family, caregivers.
care is compromised when needs go ignored and when the environment for these services is not
reassuring/soothing
Patient Oriented Assumptions/Principles - ✔✔lack of curative treatment regimens dow not mean
the person is to be abandoned to pain, distress and isolation - efforts must be made to keep the person
comfortable
PC efforts need to shift over time as the person's needs may change
Family Oriented Assumptions/Principles - ✔✔unit of care = patient and family.
include
provide space, time, privacy
,continue care after death
Staff Oriented Assumptions/Principles - ✔✔knowledgable, ongoing orientations, care must be taken
to help caregivers deal with results of emotional overload (burnout/compassion fatigue)
Losses associated with End-Of-Life - ✔✔1. Health
2. Sex
3. Future
4. Work
5. Independence
Illness viewed as a ... - ✔✔1. challenge/battle
2. enemy
3. punishment
Stages of disease - ✔✔1. pre-diagnosis
2. acute
3. chronic
4. recovery/rehab
5. terminal
Needs of the dying - ✔✔1. Hope
2. Control
3. Forgiveness
4. resolution
5. symptom relief
Dying Trajectories - ✔✔1. Sudden death example: car accident
,2. Slow/Steady decline with predictable time of death example: terminal form of cancer
3. Slow/Ambiguous decline where time of death is uncertain ex: Alzheimer's
disease ^^ most dealt with in PC (2&3)
4. Life threatening condition. three conditions: recovery and continued health, deterioration and
continued decline in health, or death ex: aftermath of serious head trauma
Main causes of death - World Health Organization - ✔✔1. disease / illness
more deaths due to diseases of the circulatory system and heart diseases than to any other
2. accidents
3. homicide
4. suicide
Gender differences in death - ✔✔- more likely for males than females to die from
accidents, homicide, suicide or other violent causes
- females more likely to die than males of disease/illness
Awareness Contexts: how people respond once they become aware someone is dying -
✔✔Glaser and Strauss four forms of awareness:
1. Closed awareness
2. Suspected Awareness
3. Mutual Pretense (knows person is dying but pretend everything is fine)
4. Open Awareness
Awareness of dying - Charles Corr - ✔✔four primary areas of tasks to engage in: physical,
psychological, social and spiritual. Need to complete basic tasks that need to be completed when
a person is dying
, What factors influence dying? - ✔✔1. age
2. gender
3. interpersonal relationships
4. place of death (hospital versus home)
Who can provide PC? - ✔✔interdisciplinary
team, knowledgable & skilled,
trained volunteers, social workers, nurses, physicians,
many others provide support: dietary aid, housekeeping
staff, the family and friends
Settings of Palliative Care - ✔✔1. Acute care settings Example: ER, ICU
2. Chronic Care Settings Example: persons home, hospices, 3. Respite care... may be needed when
families need a break example: nursing home
4. end of life care
5. bereavement care
Respite Care - ✔✔appropriate when there are no major changes in the patients overall condition,
usual caregivers require a break.
Options - nursing home, hospital, patients home
Ambulatory Outpatient Care - ✔✔may be incorporated into clinic and offer a range of
services including ongoing pain and symptom management
examples: social workers, 24 hour call service
Elements of death anxiety - self - ✔✔1. fear of
dependency 2. fear of pain
and Answers| Already Passed
Issues of PC - ✔✔1. Province in charge of health care however Federal government is in charge
of veterans/aboriginals/corrections
2. Voices of the dying go unheard
3. Aging population - 1/4 will be over 65 in 2031
4. Only about 30% of Canadians have access to PC
General Assumptions/Principles for the terminally ill - ✔✔patient, family, caregivers.
care is compromised when needs go ignored and when the environment for these services is not
reassuring/soothing
Patient Oriented Assumptions/Principles - ✔✔lack of curative treatment regimens dow not mean
the person is to be abandoned to pain, distress and isolation - efforts must be made to keep the person
comfortable
PC efforts need to shift over time as the person's needs may change
Family Oriented Assumptions/Principles - ✔✔unit of care = patient and family.
include
provide space, time, privacy
,continue care after death
Staff Oriented Assumptions/Principles - ✔✔knowledgable, ongoing orientations, care must be taken
to help caregivers deal with results of emotional overload (burnout/compassion fatigue)
Losses associated with End-Of-Life - ✔✔1. Health
2. Sex
3. Future
4. Work
5. Independence
Illness viewed as a ... - ✔✔1. challenge/battle
2. enemy
3. punishment
Stages of disease - ✔✔1. pre-diagnosis
2. acute
3. chronic
4. recovery/rehab
5. terminal
Needs of the dying - ✔✔1. Hope
2. Control
3. Forgiveness
4. resolution
5. symptom relief
Dying Trajectories - ✔✔1. Sudden death example: car accident
,2. Slow/Steady decline with predictable time of death example: terminal form of cancer
3. Slow/Ambiguous decline where time of death is uncertain ex: Alzheimer's
disease ^^ most dealt with in PC (2&3)
4. Life threatening condition. three conditions: recovery and continued health, deterioration and
continued decline in health, or death ex: aftermath of serious head trauma
Main causes of death - World Health Organization - ✔✔1. disease / illness
more deaths due to diseases of the circulatory system and heart diseases than to any other
2. accidents
3. homicide
4. suicide
Gender differences in death - ✔✔- more likely for males than females to die from
accidents, homicide, suicide or other violent causes
- females more likely to die than males of disease/illness
Awareness Contexts: how people respond once they become aware someone is dying -
✔✔Glaser and Strauss four forms of awareness:
1. Closed awareness
2. Suspected Awareness
3. Mutual Pretense (knows person is dying but pretend everything is fine)
4. Open Awareness
Awareness of dying - Charles Corr - ✔✔four primary areas of tasks to engage in: physical,
psychological, social and spiritual. Need to complete basic tasks that need to be completed when
a person is dying
, What factors influence dying? - ✔✔1. age
2. gender
3. interpersonal relationships
4. place of death (hospital versus home)
Who can provide PC? - ✔✔interdisciplinary
team, knowledgable & skilled,
trained volunteers, social workers, nurses, physicians,
many others provide support: dietary aid, housekeeping
staff, the family and friends
Settings of Palliative Care - ✔✔1. Acute care settings Example: ER, ICU
2. Chronic Care Settings Example: persons home, hospices, 3. Respite care... may be needed when
families need a break example: nursing home
4. end of life care
5. bereavement care
Respite Care - ✔✔appropriate when there are no major changes in the patients overall condition,
usual caregivers require a break.
Options - nursing home, hospital, patients home
Ambulatory Outpatient Care - ✔✔may be incorporated into clinic and offer a range of
services including ongoing pain and symptom management
examples: social workers, 24 hour call service
Elements of death anxiety - self - ✔✔1. fear of
dependency 2. fear of pain
