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Hospice Palliative Care – Tips for Primary care

Hospice Palliative Care – Tips for Primary care. A Babber GPST - Windsor VTS 3 rd July 2018. 1. Hospice Palliative care support. Inpatient unit End of Life Care ( EoLC ) Symptomatic Control (SC) Respite Care (RC ) - support for family and carers Day therapy unit (DTU)

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Hospice Palliative Care – Tips for Primary care

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  1. Hospice Palliative Care – Tips for Primary care A Babber GPST - Windsor VTS 3rd July 2018

  2. 1. Hospice Palliative care support • Inpatient unit • End of Life Care (EoLC) • Symptomatic Control (SC) • Respite Care (RC) - support for family and carers • Day therapy unit (DTU) • Weekly activities – 6 week program • Respite for carer, symptom review by specialists and sign-posting • Complementary therapies • Physiotherapy

  3. 2. Community Palliative care support • District nurse • Clinical Nurse Specialist (CNS) • Macmillan Cancer Support Services • Marie Curie Cancer Care • Rapid Response Team (RRT) • Help the Hospices • Hospice UK

  4. 3. Proactive Indicator Guidance – GSF PC • 1% population die/yr (30% hospital pts, 80% care home pts) • Unexpected deaths: 10% • Tool for early identification of patients nearing end of life (EoL) • Surprise question – prognosis likely death within 12 months • If unsure - General/Specific indicators of decline • Cancer and non-cancer diseases • GSF Process • Identfy – Assess – Plan • Advance Care Planning (ACP) • GSF PIG 2016 online link

  5. 4. Common Symptoms • Pain • Nausea and vomiting • Shortness of breath • Agitation/anxiety or Confusion • Constipation • dysphagia • Disease progression, treatment or medication side effects related • Refer difficult to control symptoms for specialist palliative input

  6. 5. Palliative Emergencies • Likely to need hospital specialist and/or palliative care input • Spinal cord compression • Neutropenic sepsis / Pancytopenic crisis • Bone fractures • Hypercalceamia • Superior Vena Cava Obstruction (SVCO) • Major Haemorrhage

  7. 6. Complementary therapies • Holistic approach to patient-centred care • Massage – pain, lymphoedema, anxiety, • Acupuncture – emotional/physical stress, pain, N&V, breathlessness • Reiki – energy healing • Reflexology – pain, N&V, anxiety, constipation

  8. 7. DS1500 and continuing care • DS 1500 • Doctors report for Disability Allowance, Attendance Allowance or Incapacity Benefit under special rules • Prognosis <6 months • Fast track - override qualifying periods • tax free benefits due to terminal illness at higher rates • Continuing care • Application requires doctors report on disease and expected progression • Package of care arranged/funded by NHS for adults NOT Local Authority • For priority patients (terminal phase of illness) • Initial screening process and full assessment • Fast track process preventing delay

  9. 8. Useful guidance - links • Gold Standards Framework in Palliative Care Proactive Identification Guidance 2016 – RCGP supported document • Advanced Care Planning Discussion from – GSF • GMC Guidance on End of Life Care • NICE quality standards for End of Life Care • Palliative Care Assessment Tools – CAGE, MMSE, Performance Status, Constipation score • GMC Mental Capacity Aseessment Online Tool

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