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PALLIATIVE CARE

What is palliative care?. Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and trea

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PALLIATIVE CARE

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    1. PALLIATIVE CARE Dr Catherine O’Doherty Consultant in Palliative Medicine, BTUH

    2. What is palliative care? “Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems; physical, psychosocial and spiritual.” WHO, 2002

    3. Palliative care (1): Provides relief from pain and other distressing symptoms Affirms life and regards dying as a normal process Intends neither to hasten nor postpone death Integrates the psychological and spiritual aspects of patient care

    4. Palliative care (2): Offers a support system to help patients live as actively as possible until death Offers a support system to help the family cope during the patient’s illness and in their own bereavement Uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated

    5. Palliative care (3) Is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing complications

    6. Generic palliative care Provided by all health care professionals adopting the palliative care approach Focus on quality of life Whole person approach Care encompassing person and those that matter to them Respect for autonomy and choice Emphasis on open and honest communication

    7. Specialist palliative care The specialist palliative care team becomes involved with patients with an extraordinary need. This often reflects an intensity or complexity of problems across the physical, psychological, social or spiritual domains

    8. Principles of palliative care provision It is the right of every person with a life-threatening illness to receive appropriate palliative care wherever they are It is the responsibility of every health care professional to practise the palliative care approach, and to call in specialist colleagues if the need arises, as an integral component of good clinical practice, whatever the illness or its stage

    9. Palliative care services Voluntary hospices and private foundations Palliative care units maintained by the NHS Hospital in-patient beds Hospital support teams Day care facilities Community palliative care teams Hospice at home services Bereavement services

    10. Palliative care services at BTUH In-patient beds for general and specialist palliative care (Orsett ward) Out-patient clinic in palliative medicine Hospital support team Clinical nurse specialists in palliative care Consultant in palliative medicine Specialist registrar in palliative medicine Medical secretaries

    11. Counselling service for people affected by cancer Macmillan Welfare Benefits Service surgeries

    12. St Luke’s Hospice in-patient services 8 beds Admission criteria: Patients with acute specialist palliative care needs Reasons for admission: Assessment/symptom control/terminal care/respite/rehabilitation

    13. Day hospice services Enhance quality of life through activities which include Social interaction, mutual support and friendship Creative and therapeutic activities Clinical surveillance Physical care Respite to home carers

    14. Community palliative care team A core team of clinical nurse specialists in palliative care (Macmillan Nurses) Supported by a consultant in palliative medicine Other team members eg OT, lymphoedema therapist Work with and as a resource for the primary health care team

    15. Other community palliative care services Hospice-at-home Marie Curie nurses Macmillan Welfare Benefits Service

    16. End of Life Care Strategy Published July 2008 To promote high quality care for all adults at the end of life ‘How people die lives on in the memory of those who live on’ (Dame Cicely Saunders)

    17. Implications for general practice Register of palliative care patients (QOF measure) Enhanced co-ordination of care using Gold Standards Framework Patients encouraged to complete Preferred Priorities for Care document Expected deaths in the community should be guided by an Integrated Care pathway (LCP)

    18. ‘The care of all dying patients is raised to the level of the best’

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