PALLIATIVE CARE EVALUATION EXAM 2025/2026 ALL
QUESTIONS AND SOLUTIONS GRADED A+ TIP
✔✔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
3. fear of loneliness/rejection/isolation
4. fear leaving loved ones
5. fear finality of death
✔✔Elements of death anxiety - other - ✔✔1. financial burdens
2. ability to cope
3. fear of losing loved ones
4. afterlife concerns
5. fear of dead objects
✔✔Denial of death - ✔✔Smith.
stage 1 - normalization of death: recognize role captivity, resolving prior grief and fear .
stage 2 - faith in the existential self: discover personal meaning in life, identify with the
will
stage 3 - ego disattachment: discovering ones meaning in death, disidentification with
the ego.
stage 4 - self transcendence: acknowledging the transpersonal self and self redefintion,
discovering ones transpersonal mission and meaning for life after death
✔✔death viewed as - ✔✔1. absence or nonbeing
2. merger, oneness, loss of identity or transcendence
3. death as place ( location, heaven/hell)
QUESTIONS AND SOLUTIONS GRADED A+ TIP
✔✔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
3. fear of loneliness/rejection/isolation
4. fear leaving loved ones
5. fear finality of death
✔✔Elements of death anxiety - other - ✔✔1. financial burdens
2. ability to cope
3. fear of losing loved ones
4. afterlife concerns
5. fear of dead objects
✔✔Denial of death - ✔✔Smith.
stage 1 - normalization of death: recognize role captivity, resolving prior grief and fear .
stage 2 - faith in the existential self: discover personal meaning in life, identify with the
will
stage 3 - ego disattachment: discovering ones meaning in death, disidentification with
the ego.
stage 4 - self transcendence: acknowledging the transpersonal self and self redefintion,
discovering ones transpersonal mission and meaning for life after death
✔✔death viewed as - ✔✔1. absence or nonbeing
2. merger, oneness, loss of identity or transcendence
3. death as place ( location, heaven/hell)
