Hospice, Palliative, And End of Life Nursing Care –
Questions With Solutions
Why are home & community-based palliative & hospice services so
important? Right Ans - -more adults and children living with chronic,
progressive diseases at home
-aging populations
-people want to die at home
-caregivers strained and need support
-decrease health care costs
-less aggressive tx, less use of futile care
-better ability to meet patients where they are
Why are nurses important for palliative & end-of-life care? Right Ans -
holitstic approach
spend the most time with patients and families
teaching
support & guide
advocacy
nurses in all settings provide this care
Trajectory of chronic illness Right Ans - steady decline, periodic crisis,
aggressive treatments, death
Chronically ill individuals may lack coordinated care Right Ans - -multiple
unplanned ER and hospital trips, quick diagnosis, stabilized, return to home
-leads to polypharmacy, falls, inability to remain at home
-specialized care for peple living with a serious, life-threatening illness
-goal is to improve quality of life for both the patient and the family
-based on the needs of the patient, not the patient's prognosis
-is appropriate at any age and at any stage in a serious illness
-can be provided along with curative tx Right Ans - palliative care
How does palliative care improve quality of life and lower sx burden? Right
Ans - -person is more than disease
-time to devote to intensive family meetings and patient/family counseling
-communication what to expect
, -supports caregivers
-expert management of complex physical and emotional sx
-large piece of palliative and hospice care is caring for the caregiver
-heavy, burdensome role and many caregivers put their own needs aside
-many of us will take on the caregiver role at some point in our lives Right
Ans - caregiver support
3 main goals of medical care Right Ans - cure
stabilization to prolong life
comfort
identify and align care with the client's goals
5 questions to understand your patient's wishes for care Right Ans - -What
is your understanding of your current health or condition?
-If your condition worsens, what are your goal?
-What are your fears or worries for the future?
-Are there any tradeoff you are willing to make or not?
-What does a good day look like?
general term for decisions made about treatments to prolong or sustain life
before a decision needs to be made (in advance!) Right Ans - advance care
planning (advanced directives)
examples of advance directives Right Ans - living will
power of attorney for health care
DNR
organ and tissue donation status
POLST or MOLST form
-legal form with patient designating an agent to act and make medical
decisions on their behalf if they are unable to (not only during end or life)
-the idea is that they will make decisions consistent with the client's wishes
and values not their own
-does not go into effect until the patient is unable to communicate their wishes
-best when appointed in combination with documentation of a living will
- Right Ans - power of attorney for health care
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