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Running Head: Palliative Care

Palliative Care

Michael Turnbull

NURS 3746 Geriatric Health

Dr. Amy Weaver

Fall 2016
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Running Head: Palliative Care

Abstract:

The purpose of this research is to describe what palliative care is and why it is

essential to the adult population. The research paper is going to discuss the different parts of

palliative care and different situations where it is optimal to give this treatment for the patient

suffering. This paper will explain the treatments of palliative care and the medical management

of various diseases and a portion focusing on cancer care. This paper is geared to assist the

importance of palliative care with the elderly population. Through PowerPoint presentation, I

will share current knowledge about palliative care and how it is implemented on being a

synergist to promoting comfortability throughout the disease process.

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Running Head: Palliative Care

What is Palliative Care and how is essential to the elderly population?

Palliative care is care given to improve the patients comfortability in life combating their

chronic, life threatening or cancer disease process. As it combats the disease process, it is a

synergist to increase their quality of life masking the signs and symptoms of their disease.

Palliative care is not a means to cure a disease process (Feature, Katherine KamWebMD).

Palliative care is used to help the person holistically and it is multiple factorial engaging the

patients family and environment. This is essential for the elderly population because as they

near the end of life they have more issues and disease processes that alter their level of

functioning. The palliative care is used support them manage their symptoms and make sure

they are comfortable as possible. This will help them preform their activities of daily living for a

prolonged period of time before the disease process completely diminishes their level of

functioning and if implemented in advance help them die peacefully.

How is Palliative Care implemented to the different disease processes?

Palliative care is implemented interdisciplinary by a specialized team of doctors, nurses, social

workers and other specialists that are referred to a specific patient. When a person decides to

receive palliative care, they use the care from primary physicians about the management of

their pain. Palliative care is treated by medical professionals but another facet of care is

through a religious standpoint where a priest or rabbi can help the person psychosocially and

prepare them for the end of life so that they can have a peaceful death. It is essential for proper

communication throughout the team so that care is fluent throughout the total term of the

applied treatment. It is appropriate at any age and they level of palliative care is specific to each
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Running Head: Palliative Care

person. The illnesses that are common in the treatment of palliative care are cancer, congestive

heart failure, chronic obstructive pulmonary disease, kidney disease, Alzheimer’s disease,

Parkinson’s disease, amyotrophic lateral sclerosis, and many more (CAPP). These chronic

debilitating diseases have symptoms that alter life such as depression, pain, shortness of

breath, fatigue, constipation, nausea, loss of appetite, difficulty sleeping and symptoms directly

associated with the disease process that is attacking their body. As soon as you find out that

you have one of these chronic diseases, palliative care needs to be implemented.

How is cancer management effected by Palliative Care?

Palliative care should be given to a cancer patient upon diagnosis, throughout the treatment,

follow up care all the way through the end of life care. Palliative care is given in correlation to

the cancer care and is beneficial if the patient has to take the end of life route (NIH).

How does hospice care effect Palliative Care?

The difference between hospice care and palliative care is that hospice care is implemented

when the person is no longer able to control the debilitating progressive disease (patient only

has six months or less to live), whereas the palliative care is promoting comfortability during

the fight against the disease process. So when we decide to proceed with palliative care and

hospice care we need to know what the patients goals are as well as their advanced directives.

We need to make sure that the patient’s goals are realistic and obtainable. The family should be

involved in setting these goals because they play a major part in both treatments (AHRQ). One

holistic approach found useful for implementing both hospice care and palliative care based

upon the nurse patient relationship and communication is the “ABCDE”:

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Running Head: Palliative Care

Advanced Preparation: Being ready for what can happen next while treating the

signs and symptoms of the disease process. This also includes potentially dealing with death.

Knowing what to say and how to say it to the patient and family.

Building a Therapeutic Relationship/Environment: This is important so that the

patient feels comfortable relating to their thoughts and feelings. This will promote their

comfortability.

Communicating Well: This is the actual communication part of the palliative

process. This is promoted by the therapeutic relationship/environment.

Deal with the Patient and Family: This is important because everyone needs to be

involved for the best outcomes. This is a difficult part of the care because you need to feel out

how the family is taking the process. (CAPP)

Encourage and Validate Emotions: You need to know how the patient their self is

feeling about their situation and help them though the process. It is important to make sure the

patient understands you clearly and that you are there to help as much as you can.

Some suggestions for communication during this phase of life are use nonverbal forms of

education, understand that not all tools are universal such as pain scales, avoid using humor

that can be considered offensive, be sensitive of the roles that play into the patient

communication, include the family, always address the patient formally so they fel respected,

ask open ended questions to gain as much info from them as possible, review information

about the patient’s culture and diversity, address their food and dietary preferences, and we

need to address the end of life planning for whichever ritual they decide. As the disease
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Running Head: Palliative Care

progresses it is important to take considerations of the patient’s end of life wishes and to make

sure the patient is living an optimal level of life to a more palliative level of life. So while they

can, you want to take them shopping and keep them upbeat with things that the patient

personally likes to do. As the disease becomes debilitating that is when you rely on other

methods such as medicine administration to make sure that they die peacefully. We need to

take into consideration that pain is subjective and we all experience different levels of it. Other

factors that can effect pain are culturally, if they have had prior addiction to opiates/pain

analgesics.

How is Palliative Care taken out during the preparation of the dying process?

Palliative care continues to promote comfortability as the dying process runs its course. It is

extremely important to know the advance directives, and if appropriate the continual care of

hospice care. As they are approaching death it is important to know what they want when they

pass such as a funeral, or whichever ritual they choose. Before death you also want to make

sure that they have a will. This will make things easier as the process occurs so the family knows

exactly what to do. Some signs and symptoms that indicate death are delirium, withdrawal

from social activities, they are lethargic, decreased intake, periods of apnea with Cheyne-Stokes

respirations, patient reports seeing persons who have already dies, patient states they are

dying, patient requests to see family to tie up loose ends of unfinished business, they cannot

recover from infections, increased edema, they go into a coma or they are easily agitated, they

are seeing hallucinations, they become incontinent, blood pressure drops, patient becomes

cold with numbness in their extremities, and the patient’s body is held in a rigid unchanging

position. (AHRQ)
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Running Head: Palliative Care

Conclusion:

Palliative care is a major component of healthcare and is extremely important for the patient to

receive to promote their comfortability. This comfortability will help them maintain a higher

level of function throughout their disease process. It also eases the family into the dying

process if the disease runs its course completely.

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Running Head: Palliative Care

Works Cited

AHRQ. "Palliative Care for Adults." Home. USDHHS, 2016. Web. 14 Nov. 2016.

CAPP. "What Is Palliative Care?" Get Palliative Care What Is Palliative Care Comments. Center to

Advance Palliative Care, 28 Apr. 2016. Web. 14 Nov. 2016.

Feature, Katherine KamWebMD. "What Is Palliative Care?" WebMD. WebMD, 2016. Web. 14

Nov. 2016.

NIH. "Palliative Care in Cancer." National Cancer Institute. National Institute of Health, 16 Mar.

2010. Web. 14 Nov. 2016.