ELECTIVE 1: HOSPICE

PALLIATIVE CARE
Course Description
This course includes the concepts, principles and theories of
hospice palliative care.
Course Objectives
1. Differentiate the stages of death and dying.
2. Assess the needs of clients and family members.
3. Identify and prioritize nursing interventions of the
client and family at any stage of the life situation
4. Implement the client and family the most relevant
intervention at the present time, taking into
consideration the principles and techniques of desired
action.
5. Follow with respect the bioethical and cultural beliefs
and practices of the client and family
6. Relate effectively with clients, families and health care
team members in fulfilling the quality of life
Course Content
Introduction to Palliative Care: Overview of Nursing
Developments
Education and Development in Palliative Care
Holistic Care
Symptom Management

Course Content
Communication and Support in Palliative Care
Spirituality in Palliative Care
Sexuality and Palliative Care
Complementary Therapies in Palliative Care

Course Content
Supporting with Family and Carers
Stages of Death and Dying
Living with Loss
Care of the Dying Person
Ethical Issues in Palliative Care
Evidence-based Palliative Care

Definition
Hospice care is palliative care given to individuals who
are terminally ill with an expected survival of six
months or less.

The focus of hospice care is on meeting the physical,
emotional, and spiritual needs of the dying individual,
while fostering the highest quality of life possible.
Definition of Palliative Care
Palliative Care by WHO (2005) defined as an approach
that improves the quality of life of patients and their
families facing the problem 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.
Palliative Care:
provides relief from pain and other distressing
symptoms
Affirms life and regards dying as a normal process
Intends neither to hasten nor to postpone death
Integrates the psychological and spiritual aspects of
patient care

Palliative Care:
Offers a support system to help family cope during the patients
illness and their own bereavement

Uses a team approach to address the needs of patients illness
and their own bereavement counseling

Palliative Care:
Will enhance quality of life and may also positively
influence the course of illness

Is applicable early in the course of illness in
conjunctions 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 clinical
complications.


Principles of Palliative Care /
NCPC Definition of Palliative care

Affirms life and regards dying as a normal process
The emphasis is on quality of life, not quantity, and it affirms
that dying is a normal life process, not a medical disease process. It
forces us to think holistically and move away from a model focused on
medical disease
Neither hastens nor postpones death
Provides relief from pain and other distressing symptoms


Principles of Palliative Care /
NCPC Definition of Palliative care
Integrates the psychological and spiritual aspects of
care
Offers a support system to help patients live as
actively as possible until death

Offers a support system to help patients' families cope during the
patient's illness and in their own bereavement
Care does not end with the death of the patient

but continues through death
pronouncement, family notification

of the death, discussion of autopsy, and
immediate bereavement

support.


Palliative Care in the Final Days of Life "They Were Expecting It at Any Time" James
Hallenbeck, MD


Focus of Care
The focus of hospice is not on treatment, but on
pain and symptom management,
comfort measures,
acknowledging that the individual will die,
supporting the family, and
trying to provide the best quality of life for the time
remaining.

Hospice functions under the philosophy that although
some terminally ill patients may no longer receive
treatment, they still require and deserve care.

Palliative Care Questions and Answers

Question Palliative Care Hospice Care
Who can receive
this care?
Anyone with a serious
illness, regardless of life
expectancy, can receive
palliative care
Someone with an illness
with a life expectancy
measured in months not
years
Can I continue to
receive treatments
to cure my illness?
You may receive palliative
care and curative care at the
same time
Treatments and medicines
aimed at relieving symptoms
are provided by hospice
Palliative Care Questions and Answers
Question Palliative Care Hospice Care
Where are
services
provided?
Home
Assisted living facility
Nursing facility
Hospital
Usually, wherever the
patient resides, in their
home, assisted living
facility, nursing facility, or
hospital.
Some hospices have
facilities where people
can live, like a hospice
residence, or receive
care for short-term
reasons, such as acute
pain or symptom
management.
Palliative Care Questions and Answers
Question Palliative Care Hospice Care
Who provides
these services?
It varies. However
usually there is a team
including doctors,
nurses, social workers
and chaplains, similar to
the hospice team.
A team doctor, nurse,
social worker, chaplain,
volunteer, home health
aide and others.
Some people mistakenly think hospice care is just about
dyingthat hospice is the place you call when theres nothing
more that can be done.

Hospice helps patients and families focus on living.

Hospice care brings comfort, dignity, and peace to help people
with a life-limiting illness live every moment of life to the fullest.
It also reaches out to provide support for the family and friends
who love and care for them.



Ten Facts about Hospice Care You may not Know

1. Hospice is not a place; its high-quality medical care that helps the
patient and family caregivers focus on comfort and quality of life.

2. Hospice is paid for by Medicare, Medicaid, most insurance plans,
HMOs, and managed care plans. Fear of costs should never
prevent a person from accessing hospice care.

3. Hospice serves anyone with a life-limiting illness, regardless of age
or type of illness.

4. Hospice serves people of all backgrounds and traditions; the core
values of hospiceallowing the patient to be with family,
including spiritual and emotional support, treating paincut
across all cultures.

5.Research has shown that the majority of Americans would prefer to
be at home at the end of lifes journeyhospice makes this possible
for most people.

6. Hospice serves people living in nursing homes and assisted living
facilities.

7. Hospice patients and families can receive care for six months or
longer.
8. A person may keep his or her referring physician involved while
receiving hospice care.
9. Hospice offers grief and bereavement services to family members
and the community.
10. To get the most out of what hospice offers, its better to have care
for more than just a few days.

November is National Hospice/Palliative Care Month.

A time for raising awareness about the compassionate care that
hospice and palliative care provide to patients and families coping
with serious and life-limiting illness. One of the most important
things that people need to learn is that hospice [and palliative care
depending on focus you want to give the piece] helps patients and families
focus on living.