palliative & end of life care
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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