PALLIATIVE

CARE
PREPARED BY
DIPTI PUNJAL
• “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.”
• Palliative care aims to relieve symptoms
and improve the quality of living and
dying for a person and/or family living
with a life threatening illness.
PALLIATIVE CARE STRIVES TO HELP
INDIVIDUALS AND THEIR FAMILIES

• Address physical, psychological, social,

spiritual and practical issues and
associated expectations, needs, hopes and
fears
• Prepare for and manage life closure and
the dying process and
• Cope with loss and grief during the illness
and bereavement.
 PHILOSOPHY
• Palliative or comfort care recognizes that
death is a normal part of life and strives
to prepare patients and their families – so
we can all die on our own terms.
• From the start of a serious or terminal illness,
practitioners reduce the burden on family
caregivers by identifying and providing for the
needs of patient and patient family.
• These needs may be
- physical
- emotional
- social or spiritual
 SCOPE
• Provides relief from pain, shortness of breath,
nausea 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.
• Offers a support system to help patients live as
actively as possible.
• Offers a support system to help the family
cope
• Uses a team approach to address the needs of
patients and their families.
• Will enhance quality of life.
• Is applicable early in the course of illness
- in conjunction with other therapies that are
intended to prolong life, such as chemotherapy
or radiation therapy.
 MAIN AIMS
• Improve the quality of life
• Promote comfort (by reducing symptoms)
• Wellbeing
• Comprehensive care
• Avoid the avoidable suffering
• Building capacity: empowerment to adjust, relief and
support the unavoidable suffering
 PRINCIPLES OF PALLIATIVE
CARE
• Respect the likes and dislikes, goals choices of the
dying person.
• Integrate the psychological and spiritual aspects of
patient care.
• Offer a support system to help patients live as
actively as possible until death through education of
care providers, appropriate health policies and
adequate funding from insurers and the government.
• Provides relief from pain and other distressing
symptoms.
• Death accepting but also life enhancing.
• Intends neither to hasten nor post pone death.
• Patient centered rather than disease focused.
• Concerned with healing rather than curing.
• Affirms life & regards dying as normal process i.e. as
a part of the life cycle.
• Builds ways to provide excellent care at the end of
the life.
• Adds life to days and not days to life.
• Partnership between the patient and the care
providers.
• Supports the need of the family members.
• Helps them in gaining access to needed health care
providers & appropriate care settings.
• Involving various kinds of trained providers in
different setting tailored to the needs of the patient an
his or her family.
 WHAT IS THE GOAL OF PALLIATIVE
CARE?

• The goal is to improve the quality of life for

individuals who are suffering from severe diseases.
• Offering a diverse array of assistance and care to the
patient.
• Achievement of the best possible quality of life for
patients and their families regardless of the stage of
the disease or the need for other therapies.
• 3 essential component of palliative care

PARTNERSHIP
 SERVICES PROVIDED BY PALLIATIVE
CARE
• Interdisciplinary team care – nursing services,
medical, social, counselling, home health aide
• Bereavement counselling
• Dietary counseling
• Physical therapy
• Occupational therapy
• Speech therapy
• Investigations and drugs
• Durable medical equipment and supplies
 PALLIATIVE CARE PATIENT
SUPPORT SERVICES
3 categories of support
1. PAIN MANAGEMENT- vital for comfort
and to reduce patients distress.
Health care professionals and families can
collaborate to identify the sources of pain and
relieve them with drugs and other forms of
therapy.
2. SYMPTOM MANAGEMENT
• Treating symptoms other than pain such as
nausea, weakness, bowel & bladder problems,
mental confusion, fatigue and difficulty
breathing.
3. EMOTIONAL & SPIRITUAL
• Support – important for both the patient and
family in dealing with the emotional demands of
critical illness.
 FEW INTERVENTIONS
Pain-
• Limit unnecessary painful procedures
• Sedation and giving pre-emptive analgesia
prior to a procedure
• Consider guided imagery, relaxation,
hypnosis, play therapy, acupuncture, massage,
heat/cold, yoga, distraction.
Dyspnea or air hunger-
• Suction secretions if present
• Positioning, comfortable loose clothing, fan to
provide cool, blowing air
• Limit volume of IV fluids, consider diuretics if
fluid overload/pulmonary edema present.
• Behavioral strategies including breathing
exercises, relaxation & MUSIC.
Fatigue-
• Sleep hygiene
• Gentle exercise
• Address potentially contributing factors (e.g.,
anemia, depression, side effects of
medications)
Nausea/vomiting-
• Consider dietary modifications (bland,
soft, adjust timing/volume of foods or
feeds).
• Aromatherapy : peppermint, lavender
• Constipation - increase fibers in diet,
encourage fluids.
Oral lesions/dysphagia-
• Oral hygiene
• Appropriate liquid, solid and oral medication
formulation
• Treat infections, complications (mucositis,
pharyngitis, dental abscess, esophagitis)
• Oropharyngeal motility study and speech
(feeding team) consultation