palliative & end of life care

Palliative & End of Life CarePalliative & End of Life Care

Practical Guidelines

Current TrendsCurrent Trends

• In 2010 the Baby Boomers will reach age 65. • The old will outnumber the young for the 1st

time in history.

The FutureThe Future

• The Focus of Palliative Care• Prevention of symptoms• Coordinating care services• Reducing unnecessary tests & medications • Ongoing Conversations with patient & family

• Allow Natural Death (AND)

• Support the patient to “Live Until They Die”

The Dying ProcessThe Dying Process

• Freedom from Pain• Being at Peace• Presence of Family• Being Aware• Honored Choices

Care At End-of-LifeCare At End-of-Life

• Medications• Dehydration• Asthenia

(Weakness)• Pain• Variable Awareness• Circulatory Changes

• Urine Output & Food Interest Reduced

• Breathing Patterns• Nearing Death

Awareness• Inability to Close

Eyes• Changes in Sensory

Perception

Care At The Time of DeathCare At The Time of Death

• Gentle Guidance of Family Members

• Listening to Stories• Facilitating Rituals• Participation as

Desired• Solitude

Care of the BereavedCare of the Bereaved

• Accept the reality of the loss

• Work through the pain of grief

• Adjust to the new environment

• Discover an emotional place for the loved one

• Go on Living

Advance Care PlanningAdvance Care Planning

• A Process• Communication• Clarification of Values• Discussion of Goals

• Advanced Directives• Surrogates

• End-of-Life Decisions

The most painful sight we ever confront is that of beauty yielding to

impermanence.

~~Arthur Frank, At the Will of the Body: Reflections on ~~Arthur Frank, At the Will of the Body: Reflections on

IllnessIllness

Ethical IssuesEthical Issues

• Patient Self-Determination• Relationships• Decision Making• Benefits & Burdens

Care of the SpiritCare of the Spirit

• Growth & Fulfillment• Finding Meaning• Forgiveness• Acceptance• Going Beyond Oneself & Circumstance