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DIALOGUE OF PALLIATIVE CARE

Learn the essence of quality dialogue in palliative care to enhance trust, ease uncertainties, and provide support for Cancer Patients. Explore skills, barriers, and importance of dialogue.

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DIALOGUE OF PALLIATIVE CARE

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  1. DIALOGUE OFPALLIATIVE CARE MS. IVA ATHAVIA Cancer Patients Aid Association Mumbai, India Email: ivathavia_17@yahoo.co.in www.cancer.org.in

  2. MEANING OF PALLIATIVECARE • To give or hand on. • Be connected. • Being in a close relationship.

  3. CHARACTERISTICS OF PALLIATIVE CARE • Patient-centred, not disease-focused • Total care: physical, psychological, social and spiritual • Death accepting, but also life enhancing • Concerned with healing, not curing • Multi-professional teamwork • Partnership with & empowerment of the patient & family

  4. Palliative Ovary cancer + Heart Patient at Hospice

  5. OPENING DIALOGUE • ‘Do you like to meet me ?’ • ‘How can I help you ?’ • ‘What are you hoping ? • ‘Will it effect you on positive way?’

  6. IMPORTANCE OF GOOD DIALOGUE • To maintain trust • To reduce uncertainty • To prevent unrealistic expectations • To allow the person to adjust • To prevent a conspiracy of silence • To devotion on patients • To sustain interest • To willingness to listen • To keep patience • To maintain good expression

  7. Palliative Stomach Cancer Patient

  8. BAD DIALOGUE WITH PATIENTS • Confusion or chaos • Hampers interpersonal relationship • Spoils atmosphere • Hampers quality and quantity of services • Brings stress/tension/anxiety • Leads to dissatisfaction, burn out.

  9. Lack of experience Personal inhibitions or limitations Fear of blame or criticism Fear of reaction Avoiding problems or crisis situation Dealing only with positive Lack of acceptance BARRIERS IN DIALOGUE

  10. DON’Ts in the case of PALLIATIVE Patients • Avoiding the patient • Ignoring cues • Small talk • Switching the topic • Use of medical jargon • Dealing with negatives, if any • False hope & assurance

  11. ‘HEAD & NECK’ PALLIATIVE CANCER PATIENT

  12. DIALOGUE SKILLS • Appropriate eye contact • Ask open ended questions • Enquire about feelings • Encourage the expression of emotions • Use sensitive prompting, summarizing, and clarifying • Feel comfortable with silence • Ask questions about mood and fears • Appropriate use of touch • Allow appropriate use of your own emotion

  13. Pain Fear Anger Anxiety Depression Loss Confusion Worthlessness Important ISSUES of Palliative Care

  14. TONGUE CANCER PATIENT

  15. “H & N” Palliative Cancer Patients Face with the Common Problems • Trouble in swallowing • Persistent sore throat • New lump origin in every week • Ear pain, especially when swallowing • Mouth sore that do not heal • Hoarseness or difficulty in speaking ……………..2

  16. Spitting up blood & Change in skin appearance • Chronic sinus infections, which do not respond • Frequent headaches • Facial pain that does not go away • Trouble in breathing through the nose.

  17. Palliative Lung Cancer + HIV.Aids Patient’s Home Visit

  18. WHY TO BREAK “BAD NEWS” IN PALLIATIVE CARE • To reduce fear and stress • To allow some time for the adjustment • To utilise available support system

  19. Why it is difficult? • Denial • Lack of time • Lack of privacy • Family collusion • Socio economic conditions • Lack of knowledge • Fear of facing the unexpected situation

  20. Sympathy/ Empathy Encourage expression Sharing - Interpersonal /group Prevent unrealistic expectations Reduce uncertainty Offer continued support and availability Acknowledgement and appreciation TO IMPROVE PATIENT’S QUALITY OF LIFE

  21. “H & N” Palliative Patients Face with different Psychological Problems • They do not have any outlet for their emotions, • Many unresolved issues as – loss of facial values, loss of speech, • Differences with the spouse attitude (if young couple), availability of relatives. • The Patients last wish to speak but cannot speak and relatives do not keep patience to understand patient’s psychology.

  22. Palliative Mouth Cancer Patient

  23. "H&N" Palliative Pts.in Grief

  24. PEDIATRIC PALLIATIVE CANCER PATIENT

  25. “The woods are lovely dark and deep,And I have promises to keep,And miles to go before I sleepAnd miles to go before I sleep”…………………………… A ROLE PLAY

  26. Data has been collected from the following Hospitals B.Y.L. NAIR Charitable Hospital Mumbai, India. & Cama & Allbless Hospital Mumbai, India.

  27. THANK YOU

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