Principles of Palliative care

Mamon, Joryl M. Maddas, Emir Rafi

Palliative

derives from the Latin Pallium which means to cloak. not

Palliation means to cloak over, to

address the underlying causes, but to eliminate the effects.

Palliative care (WHO, 2002)

Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with lifethreatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychological and spiritual.

Palliative Care for Children (WHO, 2002)

The

active total care of the childs body, mind, and spirit and also involves giving support to the family. It begins when the illness is diagnosed, and continues regardless of whether or not a child receives treatment direct at the disease.

Quality of Life
Hopes, Ambitions, Desires

Present reality

Modified expectations

Improved circumstances

Spiritual

Symptom

Bereavement

Control
Emotional

Physical

Psychosocial

General Palliative Care Patients with less complexed needs Nursing Homes, PC approach, Specialist Patients with complexed needs. Multi-professional team with specialist PC training. Medical, Nursing, Social Work, Spiritual, Physio, OT, Pharmacy Supportive Provided from pre-diagnosis onwards. Umbrella term for general & specialist services. Responsibility of all Health & Social care professionals

The Palliative Care Approach NCPC (1997)

Vital and integral part of all clinical practice. Informed by a knowledge of and practice of palliative care principals and supported by specialist palliative care Quality of life A whole person approach Care for both the dying person and those that matter to the person Patient autonomy and choice

Principles underlying palliative care provision

1997)

(NCPC

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 practice the

palliative care approach, and to call in specialist palliative care colleagues if the need arises, as an integral part of good clinical practice whatever the illness or stage.

Palliative care nursing

VALUING
connecting empowering

Doing for
Preserving integrity
Finding meaning

Palliative care nursing

Connecting

Making a connection
establishing a rapport

building up trust

Maintaining a connection
being available, spending time, sharing secrets, sharing self, maintaining trust.

Breaking the connection

usually as a result of the patients death

Empowering.....

facilitating
recognises patient autonomy

encouraging

defusing
dealing with negative feelings

mending
facilitating healing

giving information

Palliative care nursing

Doing for......

Finding meaning

Taking charge symptom control making arrangements

Focusing on living - helping the patient to live as fully as possible Acknowledging death giving or reiterating bad news talking about death and the time left

Team playing

acting as the patients

advocate

Preserving Integrity
Confronting

mortality Burnout Supporting Colleagues

own

Principles of Palliative Care

Palliative care is a philosophy of care that is applicable from diagnosis until death and then into bereavement care for the family. Often palliative care is seen as focusing on end-of-life care only, and while this is an important aspect of palliative care, it is only one component of the continuum of care that should be provided.

It is focused on the needs of the patient, their families and caregivers. It is the provision of comprehensive holistic care with the patient at the center of that care, and is dependent on attitudes, expertise, and understanding.

It is a philosophy that can be applied anywhere across a range of skills, settings, and diseases.

The WHO has outlined several principles that underpin the provision of palliative care,including statements that palliative care:

Affirms life & regards dying as a normal process; Intends neither to hasten nor postpone death; Integrate the psychological & spiritual aspects of patient care; Offers support system to help patients live as actively as possible until death; Offers a support system to help the family cope during the patients illness and in their own bereavement