June 17, 2023

1400H - 1500H
Via Zoom

Empowerment
objective - for
Hospice Care laypeople to have an
in Cancer essential
Patients understanding of
HOSPICE CARE in
Cancer Patients.
 June 17, 2023
1400H - 1500H
Via Zoom
Welcome all!

MUTE yourself but always

show your video picture.
Empowerment
Sign in your name, FB
objective - for account, or email address in
Hospice Care laypeople to have an the Chat Box! Include names
of companions attending.
in Cancer essential
Patients understanding of Use the Chat Box to ask
questions and make
HOSPICE CARE in comments while the PEP TALK
is on.
Cancer Patients.
Group pictures at start and
end of PEP TALK – show your
face in video.
Reminder after the PEP
Talk:

Take the Online Learning

cum Evaluation Test
Exercise (OLETE) for
mastery of learning and
have a perfect score to get
a Certificate.

Link is in Chat Box.

Reminder:
50 OLETE Certificates = 1
Voucher for ROJoson
Telemedical Consultation
 ROJOSON’S REQUEST:

Empowerment FEEDBACK TO THIS

objective - for PEP TALK!
Hospice Care laypeople to have an
Pls. type in your
in Cancer essential feedback in the chat
Patients understanding of box during the open
HOSPICE CARE in forum and before we
Cancer Patients. adjourn!

Thank you!
 LET’S NOW HAVE A
GROUP PICTURE
TAKING BEFORE WE
Empowerment START PEP TALK
objective - for PROPER IN 2
Hospice Care laypeople to have an MINUTES!
in Cancer essential
Patients Pls. turn on your
understanding of
video!
HOSPICE CARE in Show your face!
Cancer Patients.
 ROJoson PEP Talk
Empowerment
objective - for I have a Patient
Hospice Care laypeople to have an Empowerment
in Cancer Program in which I
essential like to empower the
Patients understanding of lay people or
HOSPICE CARE in patients to take
Cancer Patients. control in the
management of
their health.
I started the PEP Talk
on May 15, 2021.
There are 3 courses
in the PEP Talk.
I completed the Core
Course on October 9,
2021.
 From October 23,
2021 onwards, I have
been tackling Health
Disorder and Health
Issue Courses. This
may take 3 years or
longer depending on
our enthusiasm,
discipline and
perseverance.
 My PEP TALK today is
entitled:
Empowerment HOSPICE CARE IN
objective - for CANCER PATIENTS
Hospice Care laypeople to have an
in Cancer essential In consonance with
Patients understanding of DOH Health
Awareness Calendar
HOSPICE CARE in
Cancer Patients. National Cancer
Survivors Day
(June)
 Contents
• What is a HOSPICE CARE in general? In cancer patients?
Hospice Care • What is the difference between HOSPICE CARE and
in Cancer PALLIATIVE CARE?
Patients • What are the indications for HOSPICE CARE in cancer
patients?
• Can HOSPICE CARE be done at home?
• What are basically done in HOSPICE CARE for cancer
patient?
• What is a typical HOSPICE CARE for cancer patients at
home?
• What are ROJoson advocating statements and advice
on HOSPICE CARE?
 What is a HOSPICE CARE?

Hospice Care
in Cancer
Patients
 What is a HOSPICE CARE? “NO more heroic
measures” is
Hospice Care HOSPICE CARE is a special type of medical and embodied in these
in Cancer health care that focuses on the quality of life for statements -
Patients the people / patients who are experiencing an "Let me die naturally,
advanced, life-limiting illness in which a decision according to the
has been made on NO MORE HEROIC MEASURES function of my body.
in curing the illness.
No more anti-disease
In the process of providing quality of life to the treatment with
patients, HOSPICE CARE also provides quality of attempts for cure,
life to the loved ones of the patients. just supportive
treatment.”
 What is the difference between HOSPICE CARE A patient is declared
and PALLIATIVE CARE? to have a terminally
Hospice Care incurable disease.
in Cancer Hospice is comfort care without curative intent;
the patient no longer has curative options or has
Patients He can choose
chosen not to pursue treatment because the side PALLIATIVE CARE or
effects outweigh the benefits. HOSPICE CARE.
He can choose
Palliative care is comfort care without curative initially PALLIATIVE
intent; the patient may still try curative options CARE then HOSPICE
with the hope they may be beneficial. CARE (if he decides
on NO anti-disease
HOSPICE CARE = PALLIATIVE CARE WITH NO treatment anymore.
MORE HEROIC MEASURES.
 What is a HOSPICE CARE in cancer patients? “NO more heroic
measures” is
Hospice Care HOSPICE CARE in cancer patients is a special type embodied in these
in Cancer of medical and health care that focuses on the statements -
Patients quality of life for the people / patients who are "Let me die naturally,
experiencing an advanced, life-limiting CANCER according to the
in which a decision has been made on NO MORE function of my body.
HEROIC MEASURES in curing the CANCER.
No more anti-
In the process of providing quality of life to the CANCER treatment
patients, HOSPICE CARE also provides quality of with attempts for
life to the loved ones of the patients. cure, just supportive
treatment.”
 What is the difference between HOSPICE CARE A patient is declared
and PALLIATIVE CARE in CANCER PATIENTS? to have a terminally
Hospice Care incurable CANCER.
in Cancer Hospice is comfort care without curative intent;
the patient no longer has curative options or has
Patients He can choose
chosen not to pursue treatment because the side PALLIATIVE CARE or
effects outweigh the benefits. HOSPICE CARE.
He can choose
Palliative care is comfort care without curative initially PALLIATIVE
intent; the patient may still try curative options CARE then HOSPICE
with the hope they may be beneficial. CARE (if he decides
on NO anti-CANCER
HOSPICE CARE = PALLIATIVE CARE WITH NO treatment anymore.
MORE HEROIC MEASURES.
 What are the indications for HOSPICE CARE in
cancer patients?
Hospice Care
in Cancer
Patients
 What are the indications for HOSPICE CARE in cancer patients?

Hospice Care The patient no longer has curative options (either from the very
in Cancer start or after other curative options have failed).
Patients
The patient has chosen not to pursue curative treatment because
of:
• low chance for cure;
• side effects outweigh the benefits;
• financial constraints;
• unavailability of effective treatment in the community;
• Other personal reasons.
 What are the indications for HOSPICE CARE in
cancer patients?
Hospice Care
in Cancer HOSPICE CARE is usually decided on cancer
Patients patients in the advance stage (stage 4 – with
distant metastasis) in which chances for cure and
prolongation of life are extremely low.

HOSPICE CARE is usually decided on when a

cancer patient is expected to live about 6 to 12
months or less if the cancer runs its usual course.
 What are the indications for HOSPICE CARE in
cancer patients?
Hospice Care
in Cancer When does one declare a cancer to be
Patients INCURABLE:
• Track record that it is incurable
• Advanced stage cancer
• Fast growth and recurring and progressive
• Absence of effective curative treatment
 What are the indications for HOSPICE CARE in
cancer patients?
Hospice Care
in Cancer Who decides on HOSPICE CARE?
Patients
An empowered patient who knows about
HOSPICE CARE; futility of cancer treatment
already; and high probability of dying soon.

An advance directive made by an empowered

patient on HOSPICE CARE.

Physicians and relatives may advise only.

 Can HOSPICE CARE be done at home?

Hospice Care YES, it can be done anywhere, at home, in

in Cancer hospitals, hospice centers and in nursing homes.
Patients
With the popularity of TELEMEDICINE, it will be
more cost-beneficial to have HOSPICE CARE
outside the hospitals (at homes if not in hospice
centers or nursing homes, if there are).
 What are basically done in HOSPICE CARE for
cancer patient?
Hospice Care
in Cancer Pain management
Patients • Physical
• Mental
• Spiritual

Quality of life promotion

Until the end-of-life moment!

With no anti-cancer treatment anymore!

 What is a typical HOSPICE CARE for cancer
patients at home?
Hospice Care
in Cancer
Patients
 What is a typical HOSPICE CARE for cancer
patients at home?
Hospice Care
in Cancer Pain management
Patients • Physical
• Mental
• Spiritual

Quality of life promotion

Until the end-of-life moment!

With no anti-cancer treatment anymore!

 What is a typical HOSPICE CARE for cancer patients at home?

Hospice Care PAIN MANAGEMENT

in Cancer DISCOMFORT MANAGEMENT
Patients TARGET: ZERO OR NEAR –ZERO PAIN AND DISCOMFORT

MEDICATIONS – oral, patches, parenteral (if needed)

OXYGEN ADMINISTRATION
CATHETERIZATION
TUBE FEEDINGS
OTHER NURSING CARE

*ROOM AMBIANCE FOR GOOD REST

 What is a typical HOSPICE CARE for cancer
patients at home?
Hospice Care
in Cancer DIET and FLUIDS in Hospice Care
Patients Helpful Things to Consider:
• Decreasing food and fluid intake is a common,
natural part of the dying process.
• Most dying people do not experience thirst or
hunger as death approaches.
• Giving food and fluids by artificial means (e.g.,
intravenously) does not usually prolong life or
improve its quality.
 What is a typical HOSPICE CARE for cancer patients
at home?
Hospice Care
in Cancer DIET and FLUIDS in Hospice Care
Patients Helpful Things to Consider:
• Providing food and fluids by artificial means may,
in fact, increase distressing symptoms such as
shortness of breath, respiratory congestion,
restlessness, nausea and vomiting.
• When people have difficulty swallowing, eating
and drinking may put them at risk for choking.
• Artificial hydration does not provide nutrition.
 What is a typical HOSPICE CARE for cancer
patients at home?
Hospice Care
in Cancer DIET and FLUIDS in Hospice Care
Patients Helpful Things to Consider:
• Artificial hydration does not usually prevent
or improve thirst or relieve a dry mouth.
• Frequent mouth care can help relieve a dry
mouth.
 What is a typical HOSPICE CARE for cancer
patients at home?
Hospice Care
in Cancer MENTAL MANAGEMENT
Patients
ACCEPTANCE OF FUTILITY OF CANCER
CURABILITY
ACCEPTANCE OF EVENTUALITY
LAST WILL
ADVANCE HEALTHCARE DIRECTIVE
PEACE OF MIND

*DEATH CERTIFICATE
 What is a typical HOSPICE CARE for cancer
patients at home?
Hospice Care
in Cancer SPIRITUAL MANAGEMENT
Patients
BELIEF IN A CREATOR
BELIEF IN AN AFTERLIFE
PRAYERS
OTHER RELIGIOUS RITES
 What are ROJoson advocating statements and
advice on HOSPICE CARE?
Hospice Care
in Cancer
Patients
 What are ROJoson advocating statements and
advice on HOSPICE CARE?
Hospice Care
in Cancer All laypeople must know the basic concepts,
Patients principles and processes of HOSPICE CARE.
Part of PATIENT EMPOWERMENT.
Use the 4Ks of Patient Empowerment:
Kaalaman, Kakayanan, Karapatan and
Kapangyarihan
to gain greater control over decisions in medical
management of oneself and relatives by knowing
the basic concepts and principles and processes
in HOSPICE CARE.
 What are ROJoson advocating statements and
advice on HOSPICE CARE?
Hospice Care
in Cancer The 4Ks promote sound decision-making by both
Patients patient-relatives and physicians in the realms of:
• Formulating realistic goal of management
(HOSPICE-palliative vs curative)
• Promoting quality of life to both patients and
relatives
• Controlling unnecessary expenses
 What are ROJoson advocating statements and
advice on HOSPICE CARE?
Hospice Care
in Cancer One has to accept that some cancers are really
Patients incurable or already incurable!

In some cancers, one may just have to let nature

take its course.
 What are ROJoson advocating statements and
advice on HOSPICE CARE?
Hospice Care
in Cancer If the cancer is deemed incurable already – Rather than:
Patients choose the most practical and the most cost-
effective treatment to promote palliation. TRY. TRY, TRY
GO ALL OUT
If the cancer is deemed terminally incurable
already – choose the most practical and most In cancer treatment
cost-effective treatment to promote a peaceful
death. Even if it is
realistically futile!
 What are ROJoson advocating statements and Parameters to use:
• Track record of the
advice on HOSPICE CARE?
Hospice Care specific cancer
in Cancer Know the bases of declaring a cancer to be:
• curable? • Stage of the cancer
Patients
• not curable?
• terminally incurable already? • Behavior of the
• not yet terminally incurable? cancer – growth
rate / recurring

• Presence or
absence of effective
curative treatment
 What are ROJoson advocating statements and
advice on HOSPICE CARE?
Hospice Care
in Cancer For terminally incurable cancer:
Let nature take its
Patients Have an advance health care directive.
course!
Give details on how the terminally-ill patient will
Palliate to promote a
be managed up to his last breath.
• Place of care – home / hospital / hospice peaceful death!
center – nursing home
• Diet and nutrition Palliate to promote a
• Procedures (diagnostic tests / treatment) quality of life for
• Etc. patients and
relatives!
 What are ROJoson advocating statements and
advice on HOSPICE CARE?
Hospice Care
in Cancer Hattie Bryant’s four steps to a peaceful death are
Let nature take its
Patients as follows:
course!
• Acknowledge the inevitability of death
• Understand the limits of medicine
• Educate yourself about your health care Palliate to promote a
peaceful death!
choices
• Communicate your wishes and choose a
Palliate to promote a
proxy (advance directive)
quality of life for
patients and
relatives!
 Contents
• What is a HOSPICE CARE in general? In cancer patients?
Hospice Care • What is the difference between HOSPICE CARE and PALLIATIVE
in Cancer CARE?
Patients • What are the indications for HOSPICE CARE in cancer patients?
• Can HOSPICE CARE be done at home?
• What are basically done in HOSPICE CARE for cancer patient?
• What is a typical HOSPICE CARE for cancer patients at home?
• What are ROJoson advocating statements and advice on
HOSPICE CARE?

Summary
Take Away
 Be always in touch with reliable medical Take Away in
information on HOSPICE CARE IN CANCER relation to
Hospice Care
PATIENTS! Patient
in Cancer
Patients Empowerment
Knowledge is power; it gives power.
Use the 4Ks of Patient Empowerment:
Kaalaman, Kakayanan, Karapatan and
Kapangyarihan
to gain greater control over decisions /
make better decisions on HOSPICE CARE IN
MANAGEMENT OF CANCER PATIENTS.
 Empowerment
objective - for
Hospice Care laypeople to have an
in Cancer essential
Patients understanding of
HOSPICE CARE in
Cancer Patients.
Reminder after the PEP
Talk:

Take the Online Learning

cum Evaluation Test
Exercise (OLETE) for
mastery of learning and
have a perfect score to get
a Certificate.

Link is in Chat Box.

Reminder:
50 OLETE Certificates = 1
Voucher for ROJoson
Telemedical Consultation
 ROJOSON’S REQUEST:

Empowerment FEEDBACK TO THIS

objective - for PEP TALK!
Hospice Care laypeople to have an
Pls. type in your
in Cancer essential feedback in the chat
Patients understanding of box during the open
HOSPICE CARE in forum and before we
Cancer Patients. adjourn!

Thank you!
 LET’S NOW HAVE A
GROUP PICTURE
TAKING BEFORE WE
Empowerment START Q&A AND
objective - for INTERACTIONS!
Hospice Care laypeople to have an
in Cancer essential Pls. turn on your
Patients video!
understanding of
Show your face!
HOSPICE CARE in
Cancer Patients.