KONSEP DASAR & MODEL

PERAWATAN PALIATIF

Maria A. Witjaksono

Lampung, 1 Mei 2016

KASUS

 Wanita 42 th,
 Tidak menikah, hidup dengan 16 orang
di rumah sederhana
 Terbaring sejak beberapa bulan
 Ibu, 72 th seorang janda, hidup dengan
berjualan di rumah tidak laku karena
tetangga takut tertular
 Ibu tidak sanggup merawat
Latar Belakang

 Pasien dengan penyakit yang dapat mengancam jiwa mengalami

penderitaan yang muncul akibat masalah fisik, gangguan
psikologis, kesulitan sosial dan problem spiritual
 Penderitaan pasien menjadi beban keluarga
 Diperlukan pendekatan komprehensif dan berkelanjutan untuk
mencegah dan mengatasi penderitaan pasien sehingga tercapai
kualitas hidup yang lebih baik dan untuk mengurangi beban
keluarga PALLIATIVE CARE
 Rumah menjadi tempat yang paling banyak dipilih untuk
perawatan pasien terminal
 Perawat memiliki peranan besar dalam Perawatan Paliatif
PENDERITAAN: FISIK, PSIKOLOGIS, SOSIAL,
SPIRITUAL
MEMAHAMI PENDERITAAN PASIEN

PETUGAS KESEHATAN PASIEN

 Nyeri  Menjadi beban
 Tidak bisa makan  Tergantung keluarga
 Hipersekresi  Tidak bisa
 Bau
menyampaikan
kebutuhan dan
perasaannya: malu,
kasihan mama
 Imobilitas
 Disfigurement
“The relief of suffering when cure is impossible should become the
heart of all medical services. It is what every patient and family
hopes for and has a right to expect. Therefore, each health care
professional has responsibility to provide it when it is indicated”.

Derek Doyle, 1999

 To have information presented that is easy to
understand
 To have input into the type of their medical care
 To make medical decision with their family if they
choose to
 To use health information to make longer term
decisions about end of life care
 For pain relief and relief of suffering
 To access palliative care
 To know they are in terminal illness
 To have a dignified death
Something to Ponder about:
 The Dying Patient is a Living Person -
Saunders had a revelation:
 “I realized that we needed not only
better pain control but better overall
care. People needed the space to be
themselves. I coined the term ‘total
pain,’ from my understanding that dying
people have physical, spiritual,
psychological, and social pain that must
be treated. I have been working on that
ever since.”
Definition

 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)

 PC is an integrated system of care that improves QoL by

providing pain & symptoms relief, spiritual and psychosocial
support from diagnosis to the end of life and bereavement
(WHO 2005)