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34 Cards in this Set
- Front
- Back
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What changes to healthcare were most noted in the 1900's?
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Sanitation, disease Prevention, Curing diseases, antibiotics, anesthesia, CPR
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When was CPR accurate?
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1960
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What were the causes of the changes associated with death in the 1900's?
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The invention of PCN
The Idea that Sanitation was necessary to control the spread of disease |
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Where did the shift in where to die move to?
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Home --> Institution
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What direction did the shift in who provided care for dying people move from?
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Family -->Staff
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What results did the changes in the 1900's in reguards to death and dying have?
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Increased Life Expectancy
Aging of the population |
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Name some trends associated with the 1900's on death and dying
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Family Members live further apaprt
Death might not be experienced until middle adulthood End of life care is focused on medical aspects Concept of therapeutic optimism was created It was considered a failure of HCP if a patient died |
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Where do most Adults prefer to be cared for if they are terminally ill?
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At home
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What are the two greatest fears associated with death?
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Being a burden to the family and being in pain
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Name some other fears associated with dying?
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"Over-treatment"
Abandonment Dying in pain the way so and so did |
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Discuss the imapct of a dying loved one on the family
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How to provide care and adjust to role changes
Financial issues of paying for care of a dying loved one |
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Name some barriers to quality of care at the end of life?
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Failure to acknowledge limits of medicine
Inappropriate use of aggressive curative treatments |
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Discuss how professionals lack the training required to deal with EOL issues.
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There is little education about how to communicate "Bad News"
Health providers cannot practice what they don't know |
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Discuss some lacking concepts related to access and knowledge in palliative care?
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Miscommunication on what EOL programs can offer
only 38% of terminally ill patients enroll in hospice programs Some people believe hospice is only available for cancer patients |
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Explain how hospital and state regulations make dying difficult for patients and families
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Restrictive visiting hours
inadequate policies on pain and symptom management |
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Explain how government Regulations has led to fear in doctors and nurses when it comes to adequately controlling a dying patients pain and symtoms
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Regulation of contolled substances has led to fear of prosecution for prescribing and administering meds to relieve pain and other symtoms
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What financial barriers to care do dying patients and families face
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Inadequate Insurance coverage
Possibility of hiring a caregiver to come inside the home |
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Why is there apprehension in staff when discussing EOL programs with doctors or families?
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Denial of death
Reluctance to take away hope |
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What effect can poor communication have on getting a dying patient to comprehensive EOL services?
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It can impede timely referrals
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What documents are available to protect the wishes of a person should they become deathly or unable to make their wishes known?
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Advance Directives
Living will Medical Power of Attorney DNR's |
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What is an Advance Directive?
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A general term that describes two types of legal documents
Living wills Medical Power of Attorney |
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What is a living will?
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A type of advanced directive that lets a person put in their own writing their wishes about medical treatment for the end of life in the event the person cannot communicate these wishes directly
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What is a Medical Power of Attorney or "Health Care Proxy"?
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A document that lets a person appoint someone the person trusts to make decisions about their medical care if the person cannot make the decisions themselves
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How old does someone have to be to sign a medical legal document (witness too!)
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18 years old
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Are advance directives still in effect if a person becomes pregnant?
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No
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Can you revoke your Advance Directive at anytime?
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Yes
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What does an Oklahoma Advance Directive Include?
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A living Will section
An Appointment of health care proxy section An Anatomical Gift Section |
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What is Hospice?
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A program of care provided across a variety of settings and based on the understanding that dying is a normal part of life
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What are the conditions for Medicare Hospice Benefits?
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Eligible for Medicare part A
Physician and hospice director must certify that the patient is terminally ill and has less than six months to live if the illness runs it's normal course Patient must sign a statement choosing hospice care instead of other Medicare covered benefits Patient must get care from a Medicare approved hospice program |
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What does Medicare hospice pay for?
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Physician Services
Nursing Care Medical equipment Medical Supplies Drugs for symptom control/pain relief Home health aide/homemaker services Physical and occupational therapy Speech Therapy Dietary Counseling Grief and loss counseling for the patient and the family Short-term inpatient care Short-term respite care And many more |
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What won't Medicare pay for on Hospice?
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Treatment Intended to cure terminal illness
Presciption drugs to cure the illness Care from any provider that wasn't set up by the hospice team Room and Board (in a hospice facility or nursing home) Care in an ER unless it was arranged by the hospice team Care in an impatient Unit unless it was arranged by the hospice team Ambulance transport, unless it was arranged by the hospice team |
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How long is hospice coverage?
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two 90 days, --> unlimited 60 day periods
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Do patients ever get out of Hospice?
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Yes, sometimes they get better
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What does a patient need to do to get out of hospice?
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Sign a piece of paper. This can happen at any time during care
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