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31 Cards in this Set
- Front
- Back
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How do people in america die?
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Chronic illnesses (more)
Acute illnesses (less) |
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For which type of death can we more impact the end of life?
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Chronic
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What are 4 patterns of death to look at?
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1. Acute
2. Terminal illness (cancer) 3. Organ failure 4. Frailty |
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Which can you have an impact on end of life?
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The last three
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What do you have to do to be able to make an impact on the end of life quality?
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ASK THE QUESTIONS - how have things been going lately?
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What is Comfort Care?
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Not palliative care
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What is end of life care?
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Not palliative care; it is just caring for a patient who is dying.
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Do patients who are in palliative or hospice care need to be on DNR?
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NO
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What is terminal care?
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part of an airport
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What is hospice care really?
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An insurance benefit available to patients who have a prognosis of 6 months or less
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How are palliative and hospice care similar?
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In philosophies
-Good biopsychosocial care -Care for the patient AND family |
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How is palliative care different from hospice care?
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It is available to the patient at any time in his/her illness, not only in the last 6 months.
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What are 2 ways that physicians view death?
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-As disease
-As part of life |
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What are 3 skills that are necessary to develop for caring for dying patients?
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-Communicating prognosis
-Symptom management -Communication skills |
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What are 4 types of knowledge that you need to be able to care for dying patients?
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1. Is it ethical
2. Are we hastening death 3. Will I get sued 4. Cultural differences |
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How do you develop your attitude to prepare for caring for dying patients?
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Through discussion, reflection, journal writing, ethics and palliative care, and personal experience.
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What do you have to do to be able to develop the skill of Recognition in caring for dying patients?
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Learn to recognize warning signs
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What are 4 warning signs that a dying patient is not doing well?
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1. Common sense - trust your geschtalt
2. When you're running many tests, but getting few answers 3. When the patient and family feel uninformed 4. When the family wishes to talk away from the patient |
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Who is at risk for warning signs?
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-Patients with chronic disease
-Metastic cancer patients -Chronic renal failure patients -ICU patients with an underlying fatal illness |
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Why are we bad at treating chronic renal failure patients like they are dying?
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Because dialysis can keep them going longer than they normally would.
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When you do recognize warning signs, what other skill do you have to use in caring for dying patients?
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Communication
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What is the #1 thing to do in communication?
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Ask open ended questions
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What should you NOT do in communication?
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Talk about what you yourself understand
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What are 3 things you should do after asking questions and letting the patient talk?
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-Help define their questions
-Facilitate family discussions -Facilitate community |
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What do you need to tell the dying patient about distressing physical symptoms?
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They can almost always be managed
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What should symptoms NEVER be allowed to be?
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A cause for suicide or the request for physician assisted suicide.
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What are the 3 stages in the Syndrome of Imminent Death?
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1. Early stage
2. Mid stage 3. Late stage |
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What is seen in Early stage SID?
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Bedbound
loss of food interest delirium |
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What is seen in Mid stage SID?
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Further decline in mental status
Death rattle (darth vadar) Fever |
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What is seen in Late Stage SID?
How soon will death typically occur? |
Coma
Cool extremities Altered respiration Death - usually w/in 36-48 hrs |
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What is considered a good death? (5 components)
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1. On patient's terms
2. Minimal trauma to family 3. Minimal distressful symptoms 4. Cultural customs honored 5. Community norms honored |
