Hospice, Palliative Care And End Of Life - Studentnurseresource
Hospice, Palliative careand End of LifeKechi Iheduru-Anderson DNP, RN.11/30/2016WIEN- EOL care, Palliative and Hospice Care1
Objectives11/30/2016 Develop the knowledge and skills needed toprovide quality care, across various healthcare settings, to people with life-limitingillnesses and their families. Describe the core values of palliative care andhospice care. Recognize how your own values and beliefsabout death and dying affect your responsesand interactions with people with life-limitingillnesses and their families. Distinguish between palliative care andhospice care.WIEN- EOL care, Palliative and Hospice Care2
The terms end of life care, hospice care, and palliative careare often used interchangeably, but there are significantdifferences between them. Hospice is a program that cares for patients with terminaldiagnoses, therefore patients only qualify for hospice carewhen it has been determined that they have less than sixmonths to live(Izumi et al 2012). The goal of palliative care is achievement of the best qualityof life for patients with life limiting illness. It can be providedto people of all ages regardless of prognosis. Effective communication is an essential component of endof life care, palliative care, and hospice care.11/30/2016WIEN- EOL care, Palliative and Hospice Care3
Hospice care provides pain reliefand comfort, incorporatingpsychosocial and emotional care inplace of curative medical care. Itcan also include spiritual care andsocial work consultation(Izumi et al 2012).'Hospice' has evolved as a programthat cares for patients withterminal diagnoses, thereforepatients only qualify for this carewhen it has been determined thatthey have less than six months tolive (Izumi et al 2012).11/30/2016Palliative care provides comfortalongside any desired curative carefor patients who are experiencingsuffering related to a lifethreatening illness (Izumi et al2012). Patients can receivepalliation at any time during thedisease process to allow pain reliefand comfort, and increased qualityof life (Izumi et al 2012).WIEN- EOL care, Palliative and Hospice Care4
Death andDying11/30/2016WIEN- EOL care, Palliative and Hospice Care5
The End of Life Care Strategy applicableto caring for an individual approachingthe end of life that contribute to a gooddeath:A GoodDeath Being treated as an individual, withdignity and respect. Being without pain and othersymptoms. Being in familiar surroundings. Being in the company of close familyand/or friends. Department of Health 2008a as cited in Sherwen, E. (2014).11/30/2016WIEN- EOL care, Palliative and Hospice Care6
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The role of the healthcare providersis crucial in determining what a gooddeath means to the individual andrequires regular assessment andreview.11/30/2016WIEN- EOL care, Palliative and Hospice Care8
Various social changes and medical advancesinfluence the way death and dying is experienced bypeople in different parts of the world.IndividualFactorsInfluencingDeath &Dying Age: we tend to see death as something thathappens in older age. This can make the death ofyounger people difficult to understand. It can alsomean older people who are dying might receive lesssupport because their death is 'expected'. Culture: the meaning given to illness, dying anddeath in different cultures can influence how anindividual deals with the experience. For example, culture may influence the family's role at thistime, communication patterns, or feelings of optimism orfatalism.11/30/2016WIEN- EOL care, Palliative and Hospice Care9
IndividualFactorsInfluencingDeath &Dying Cont.11/30/2016 Religion: religious beliefs can influence deathrituals and beliefs about the afterlife. For someit may provide a source of meaning, while forothers it may create a sense of conflict ordistress. Past experience with death and dying: somepeople may have no experience with dying, andmay be uncertain and fearful of what mayoccur. Others may be anxious about dyingbecause of the negative experiences ofsomeone they have known or heard about.WIEN- EOL care, Palliative and Hospice Care10
What IsEnd-ofLife?11/30/2016 There is no clear definition of end-of-lifecare. Izumi et al. (2012) described end-of-lifeas the period “usually evidenced by (a) the presence of a progressing chronicdisease with pronounced symptoms orfunctional impairments and (b) the presence of symptoms orimpairments resulting from theunderlying conditions leading to deaththat require care” (p. 613 – 614).WIEN- EOL care, Palliative and Hospice Care11
End-of-LifeCareDefined. Izumi et al. (2012) “proposed the definitionof end-of-life care as to assist persons whoare facing imminent or distant death tohave best quality of life possible till the endof their life regardless of their medicaldiagnosis, health conditions, or ages. (p.616). This definition looks at the end of life as adiscreet time period when a person isaware of the end of life, not a medicallydetermined period of time before death(Izumi et al., 2012) .11/30/2016WIEN- EOL care, Palliative and Hospice Care12
End-of-LifeCare?11/30/2016 End-of-life (EOL)care is thebroad term used to describethe special support andattention given during theperiod leading up to death,when the goals of care focuson comfort and quality of life.WIEN- EOL care, Palliative and Hospice Care13
End-of-LifeCare Cont.11/30/2016 End of life care can incorporate hospice andpalliative care services, and treatment variesfrom patient to patient. The goals of end of life care as being to mollifydistressing symptoms through the judicioususe of comfort measures to enhance quality oflife and achieve a peaceful death (Hodo & Buller, 2012). End of life care provides medical, spiritual,emotional and palliative care for anyone whois nearing death.WIEN- EOL care, Palliative and Hospice Care14
End-of-LifeCare Cont.11/30/2016 Good end of life care decreases thenumber of unnecessary interventionsand treatments. Healthcare teams that focus on curativecare and intensive treatment tend topostpone the use of palliative care,which can decrease patients' quality oflife.WIEN- EOL care, Palliative and Hospice Care15
End-of-LifeCare Cont.11/30/2016 End of life care can provide some of thepsychological and emotional support thatterminally ill patients often need. EOL care can address patients' limited controlover the process of dying and the possible lossof dignity that can accompany ageing andsymptoms of terminal illness. When Patients has been identified as nearingend of life, it is important that health careproviders must continue discussions withpatients and families about what patients‘ endof life care might entail.WIEN- EOL care, Palliative and Hospice Care16
End-of-LifeCare Cont.11/30/2016 Studies show that most older patients,whether in hospital, long-term care setting orliving independently, are never asked theirpreferences about end of life care. It is important to involve the patients inplanning EOL care. Nurses who provide EOL care must providecomfort, engage in open and frequentcommunication with patients and caregiversand garner support from co-workers andfriends, and reflect on the EOL process.WIEN- EOL care, Palliative and Hospice Care17
End-of-LifeCare Cont.11/30/2016 Nurses must recognize that individualshave the right to make informeddecision about EOL that reflects theindividuals personal, cultural andreligious values. It is also important to consider theindividual as a person in relationshipwith others, including the family andcaregivers.WIEN- EOL care, Palliative and Hospice Care18
Strategiesfor EnsuringQuality EOLCare11/30/2016 Communicating openly, honestly andin a timely fashion Maintaining comfort Ensuring social support and care forcaregivers Applying the principles of palliativecare Ensuring that care is ethically,spiritually and culturally appropriateWIEN- EOL care, Palliative and Hospice Care19
HospiceCare11/30/2016 Hospice care provides pain relief andcomfort, incorporating psychosocial andemotional care in place of curativemedical care. It can also include spiritualcare and social work consultation (Izumi etal.,2012). Hospice, as defined by the Center forMedicare and Medicaid Services, is aprogram of care and support for a dyingperson whose doctor and a hospicemedical director certify has less than sixmonths to live.WIEN- EOL care, Palliative and Hospice Care20
HospiceCare Cont.11/30/2016 One of the ways end-of-life care isprovided is through hospice. The focus of hospice is on comfort, notcure. Currently, patients must bewilling to give up curative treatmentsto receive Medicare coverage forhospice care. (Medicare continues topay for any covered health problemsthat are unrelated to the dyingperson’s terminal illness.)WIEN- EOL care, Palliative and Hospice Care21
TheInternational Council ofNurses(ICN) andPalliativeCare11/30/2016 “The International Council of Nurses (ICN)views the nurse’s role as fundamental to apalliative approach that aims to reducesuffering and improve the quality of life fordying patients and their families through earlyassessment, identification and managementof pain and physical, social, psychological,spiritual and cultural needs. ICN views accessto pain and other symptom relief medicationand interventions as a basic human right andas part of the right to die with dignity” (TheInternational Council of Nurses (ICN), 2012,p.1)WIEN- EOL care, Palliative and Hospice Care22
“The alleviation of pain and suffering is afundamental nursing responsibility andnurses are trained in pain management,palliative care and in helping people indealing with grief, death and dying. Thequality of care during the end stage of lifegreatly contributes to peaceful and dignifieddeath and provides support to familymembers in dealing with their loss andgrieving process” (ICN, 2012, p.2) .11/30/2016WIEN- EOL care, Palliative and Hospice Care23
PalliativeCare Palliative care is care provided forpeople of all ages who have a lifelimiting illness, with little or noprospect of cure, and for whom theprimary treatment goal is quality oflife.11/30/2016WIEN- EOL care, Palliative and Hospice Care24
The WorldHealthOrganizationDescribesPalliativeCare as:11/30/2016 “ an approach that improves quality oflife of patients and their families facingthe problem associated with lifethreatening illness, through theprevention of suffering by of earlyidentification and impeccableassessment and treatment of pain andother problems, physical, psychologicaland spiritual” (World HealthOrganization (WHO), 2014, p.1).WIEN- EOL care, Palliative and Hospice Care25
Provide emotional,physical, and spiritualsupportPromoteemotional,spiritual andphysicalwellbeingOverall Goal ofPalliative CareControl symptoms11/30/2016WIEN- EOL care, Palliative and Hospice CareIdentify patient andsignificant other needs.26
Palliative Care “provides relief from pain and other distressing symptoms; affirms life and regards dying as a normal process; intends neither to hasten or postpone death; integrates the psychological and spiritual aspects of patient care; offers a 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 intheir own bereavement; uses a team approach to address the needs of patients and their families, includingbereavement counselling, if indicated; will enhance quality of life, and may also positively influence the course of illness; is applicable early in the course of illness, in conjunction with other therapies that areintended to prolong life, such as chemotherapy or radiation therapy, and includesthose investigations needed to better understand and manage distressing clinicalcomplications” (WHO, 2014, p1)11/30/2016WIEN- EOL care, Palliative and Hospice Care27
What isPalliativeCare?11/30/2016 “Palliative care refers to interdisciplinary teambased care for persons and family membersexperiencing life-threatening illness or injury,that addresses their physical, emotional, socialand spiritual needs and seeks to improvequality of life across the illness/ dyingtrajectory” The goal of palliative care is to achieve the bestpossible quality of life through relief ofsuffering, control of symptoms and restorationof functional capacity while remainingsensitive to the personal, cultural and religiousvalues, beliefs and practices.”WIEN- EOL care, Palliative and Hospice Care28
PalliativeCare The term “palliative care” is sometimesmistakenly used to mean end-of-life care, butpalliative care is a treatment available toanyone of any age who is suffering from thediscomforts, symptoms, and stress of a seriousillness. Unlike hospice care, the individual do not haveto be dying or give up curative treatments toreceive palliative care.11/30/2016WIEN- EOL care, Palliative and Hospice Care29
PalliativeCare Cont.11/30/2016 Palliative care is used effectively toprovide relief from many chronicconditions and their treatments, too.Older persons who are living with oneor more chronic illnesses may benefitfrom palliative care long before theyneed end-of-life or hospice care. Unlikehospice care, palliative care may beused for as long as necessary.WIEN- EOL care, Palliative and Hospice Care30
Some of the services palliative care providesincludeServicesProvided byPalliativeCare11/30/2016 'assessment and management of pain; psychosocial and spiritual needs; discussion of prognosis and treatmentoptions; management of transition from primarilycurative to primarily palliative approach; decision making around resuscitation andother aggressive treatments; recognition of signs of the end of life; and support for the family before, during, andafter death' (Milhgan 2012).WIEN- EOL care, Palliative and Hospice Care31
LifeLimitingIllness The term life limiting illness is different from Chronicillness. where, even though there may be significantimpact on the patient’s abilities and quality of life,there is likely to be a less direct relationship betweenthe illness and the person’s death. Life limiting illness in the contest of Palliative care isused to describe illnesses where it is expected thatdeath will be a direct consequence of the specifiedillness. This definition is inclusive of illnesses of both amalignant and nonmalignant nature. A life limiting illness might be expected to shorten anindividual’s life” (Palliative Care Australia (PCA), 2005).11/30/2016WIEN- EOL care, Palliative and Hospice Care32
An interdisciplinary team is a team of health careproviders who work together to develop andimplement a plan of care.InterdisciplinaryTeam11/30/2016 Membership varies depending on the servicesrequired to address the identified expectations andneeds of the target population. An interdisciplinary team typically includes one ormore physicians, nurses, socialworkers/psychologists, spiritual advisors,pharmacists, personal support workers, andvolunteers. Other disciplines may also be part of theteam (PCA, 2005).WIEN- EOL care, Palliative and Hospice Care33
RespiteCare11/30/2016 Respite care temporarily relieves people of theresponsibility of caring for family memberswho cannot care for themselves. It is providedin a variety of settings, including homes, adultday centers, and nursing homes. Sources of respite care include formalproviders, such as home care agencies andvisiting nurse associations, and informalproviders, such as family, friends, andvolunteers from faith-based organizations.Make sure any formal provider you areconsidering is licensed by your state.WIEN- EOL care, Palliative and Hospice Care34
Respite care providers can ease the day-today demands of caregiving by assisting withRespiteCare Cont.11/30/2016 toileting, bathing, and dressing (often called“activities of daily living”) giving medicine housecleaning food shopping and cooking preparing and feeding meals (eating is another“activity of daily living”) providing company and emotional support. Respite care allows the caretaker to have a breakwhile knowing that the dying person is being wellcared for.WIEN- EOL care, Palliative and Hospice Care35
Failure to recognize that providing care for the dyingis one of the core roles of an acute hospital.Barriers ToProvidingGood EndOf Life Care Failure to recognize when continuation of treatmentis not in patients' best interests, resulting in a failureto address their holistic needs. Failure to take responsibility for enabling people toreturn home to die if that is their wish. Lack of leadership on end of life care from seniormanagers and clinicians. Staff at all levels not having the necessaryknowledge, skills and attitudes required to deliverhigh-quality, end of life care11/30/2016WIEN- EOL care, Palliative and Hospice Care36
A lack of linguistic skills and insufficient understandingof patients’ cultural backgrounds could influence thequality of palliative care they provided.BarriersCont.11/30/2016 Some of the barriers preventing nurses from providingculturally appropriate care to cancer patients andfamilies from different cultural backgrounds includelack of knowledge of cultural differences in values,behaviors and communication styles, distrust of someparticular cultures, stereotyping, ritualistic behaviors,language barriers and differences in perceptions andexpectations (Munoz & Luckmann 2005).WIEN- EOL care, Palliative and Hospice Care37
NursesRoles The care of patient at all times are basedon values and principles of dignity,empowerment, compassion, equity,respect, advocacy, excellence andaccountability.11/30/2016WIEN- EOL care, Palliative and Hospice Care38
Role of theNurse Cont.11/30/2016 Nurses are at the center ofend of life care because theyare in a unique position tointeract with the patient, thefamily and the physicians.WIEN- EOL care, Palliative and Hospice Care39
Role of theNurse Cont. “Support role in palliative carecomprises six interwovendimensions: valuing, connecting,doing for, empowering, findingmeaning and preserving ownintegrity” (Davies & Oberle, 1990).11/30/2016WIEN- EOL care, Palliative and Hospice Care40
Role of theNurse Cont.11/30/2016 Providing emotional support is asignificant part of he nurses role. Emotional support consists of comfortinggestures intended to alleviateuncertainty, anxiety, stress, hopelessnessand depression. Providing emotional support involves theexpression of feeling, development ofempathy, making the patient feelunderstood and encouraging self-beliefin coping skills.WIEN- EOL care, Palliative and Hospice Care41
Role of theNurse Cont.11/30/2016 Supporter: be present with families andlisten, build trust, acknowledge emotions,explore statements, pause, allow time, bepresent recognize cues of readiness totalk, support, sit close and make eyecontact, turn off phone and beeper, donot look at watch, rephrase, and exploreemotions.WIEN- EOL care, Palliative and Hospice Care42
Role of theNurse Cont.11/30/2016 Advocate: help family to understandthe implications of decisions, questionphysicians, speak up and give opinionsat family meetings, and help familythink about what patient would want.Initiate discussion with physicians,explain things to family in lay terms, andgive honest information without takingaway hope. Outcomes: “Enablingcoming to terms” and “helping to letgo.”WIEN- EOL care, Palliative and Hospice Care43
Role of theNurse Cont. Information broker: provide andclarify information. Nurses play animportant role in facilitatingcommunication between and amongfamily members and between familymembers and the health care team(team). Mediator: Facilitate communicationbetween family and medical team11/30/2016WIEN- EOL care, Palliative and Hospice Care44
CulturalInfluences11/30/2016 Culture is the 'lens' through whichwe view the world and interpret ormake sense of the experiences of lifeincluding illness, dying and death. Your personal attitudes and beliefscan block or distort how you areperceived by people from differentculturesWIEN- EOL care, Palliative and Hospice Care45
CulturalPerspective11/30/2016 “Dying persons and their familieshave cultural beliefs and values.Nurses must provide culturallysensitive and holistic care thatrespects spiritual and religious beliefs.A caring and supportive environmentthat acknowledges the inevitability ofdeath helps family members toaccept and deal with loss andgrieving. (ICN, 2012, p. 2)WIEN- EOL care, Palliative and Hospice Care46
CulturalPerspectiveCont.11/30/2016 The goal of palliative care is theachievement of the best quality of lifefor patients and their families,consistent with their values, regardlessof the location of the patient” (Stayer 2012, p.351). Care, decision-making and careplanning should always be based on arespect for the uniqueness of thepatient, their caregiver/s and family.WIEN- EOL care, Palliative and Hospice Care47
CulturalPerspectiveCont.11/30/2016 The contributory factors to theprovision of nursing care in amulticultural context included nurses’ views and understandings of cultureand cultural mores, nurses’ philosophy of cultural care, previous experiences with people fromcultures different to their own and organizational approaches to culture andcultural care.WIEN- EOL care, Palliative and Hospice Care48
CulturalPerspectiveCont.11/30/2016 Be respectful. Respect is recognized as animportant attribute in providing cultural care.Cultural care requires that nurses respect thepatient as a unique individual with needs thatare influenced by cultural beliefs and values. Apositive nurse–patient relationship is mostlikely to be established in an atmosphere oftrust.WIEN- EOL care, Palliative and Hospice Care49
CulturalPerspectiveCont.11/30/2016 Be proactive. To accommodate patients’cultural needs, nurses should activelycommunicate with patients and understandtheir needs. A comprehensive assessment ofthe cultural aspects of a patient’s lifestyle,health beliefs and health practices will go along way in enabling nurses to make decisionsand judgments related to care interventions.Providing cultural care is an active process,requiring deliberate assessment andintervention strategies to be effective.WIEN- EOL care, Palliative and Hospice Care50
CulturalPerspectiveCont.11/30/2016 Be competent with communication skills.Communication was an important element ofproviding quality cultural care. Open and ongoing communication with patients and theirfamilies improve nurses understanding of thecultural needs of patients and helped nurses toprovide appropriate nursing care throughoutthe continuum of patient care. Active listening,providing time and appropriate questioningand a range of creative communicationstrategies are essential components of qualitycultural care.WIEN- EOL care, Palliative and Hospice Care51
CulturalPerspectiveCont.11/30/2016 Previous experiences with people fromother cultures. Nurses’ previousexperiences with people from othercultures, including caring for cancerpatients and families from diversecultural backgrounds and their personallife experiences can influence the nurses’approach to care. Previous experiences with people fromother cultures can possibly lead tonurses’ unintentionally stereotypingcultures.WIEN- EOL care, Palliative and Hospice Care52
CulturalPerspectiveCont.11/30/2016 Personal life experiences. Personallife experiences influenced nurses’views and perceptions of culturesand their attitudes and responses topatients from other cultures. Experiences with people from othercultures can influences nursespositively and negatively.WIEN- EOL care, Palliative and Hospice Care53
Organizational approaches to culture andcultural care. Barriers to provision ofculturally specific care include;CulturalPerspectiveCont.11/30/2016 Lack of support from the organization inpromoting cultural based care, lack of clear guidelines and policies on howto accommodate cultural practices in thehospital, lack of human resources and educationalmaterials to promote culture focused careand poor allocation of resources and servicesWIEN- EOL care, Palliative and Hospice Care54
CulturalPerspectiveCont.11/30/2016 Organizational culture. Organizationalphilosophy and workplace culture influenceshow patients’ cultural needs are addressed.Supportive organizational approach tocultural competent care is very important. Nursing education and continuing educationwithin work settings are key factors inimproving cultural competence in providingcultural care. nurses who receive training incare of the dying from other cultures are morelikely to be sensitive to the need for educationto develop expertise in this area.WIEN- EOL care, Palliative and Hospice Care55
CulturalPerspectiveCont.11/30/2016 Caring environment. cultural safety, which is animportant part of cultural care, can be achievedby creating a caring environment where culturaladaptation takes place between nurses andpatients. Patients who experience a sense of culturalsafety are more likely to have trust in nurses andderive further benefits from the therapeuticrelationship which is vital for interventionsdesigned to meet cultural needs. An environment that meets the cultural needs ofpatients is a key factor that influences nursingcare.WIEN- EOL care, Palliative and Hospice Care56
CulturalPerspectiveCont.11/30/2016 Availability and accessibility ofsupport services and resources. Availability of services and resourcessuch as social workers, culturalsupport services, interpretingservices and information andmaterials about cultural needs canhelp nurses in the provision ofcultural care.WIEN- EOL care, Palliative and Hospice Care57
Providing support for people with life-limitingillnesses requires you to understand the meaning ofthe illness and its effects on individuals.Communicating withPeople withLife-limitingIllnesses11/30/2016 It's vital to identify and acknowledge an individual'sconcerns and sources of distress, and respond tothese effectively. Some people may not be used to discussing personalpsychological issues and may find theseconversations difficult. There are some general communication strategiesthat may help facilitate discussion about existentialand psychological concerns, and demonstrate respectfor the person's individuality.WIEN- EOL care, Palliative and Hospice Care58
Communication11/30/2016 Poor communication as a source ofdistress. Unaddressed concerns lead toanxiety/depression. Good communication improvespatient coping. Promoting self-determination.WIEN- EOL care, Palliative and Hospice Care59
The acronym PREPARED is used to conveythese strategies.KeyCommunicationStrategies PPrepare for the discussion, where possible RRelate to the person E Elicit patient and caregiver preferences PProvide information tailored to the individual needsof both patients and their families AAcknowledge emotions and concerns R(foster) Realistic hope (e.g. peaceful death, support) E Encourage questions and further discussions DDocument Adopted from Palliative Care Australia (2005). principles/11/30/2016WIEN- EOL care, Palliative and Hospice Care60
EffectiveCommunication “Communicating effectively involves providingpatients and their families with information sothat they are able to make decisions aboutcare, initiating discussions about end-of-lifecare when the patient can actively participate,and facilitating discussions with patients andtheir families in a supportive andcompassionate manner. Discussions with patients failing to improve inan intensive care setting need to take place atthe earliest possible opportunity. (Peden, Grantham&Paquin, nd, p.6).11/30/2016WIEN- EOL care, Palliative and Hospice Care61
How does thenurse talkabout deathand dying? Discussions with patients and theirfamilies about end-of-life care arechallenging and difficult to initiate. Nurses need to explore their ownattitudes, values and beliefs aboutissues surrounding death to improvecommunication and maximize endof life care.11/30/2016WIEN- EOL care, Palliative and Hospice Care62
When assisting patients and families to makedecisions about end-of-life care the nurseshould:How does thenurse talkabout deathand dyingCont.? be clear and avoid euphemisms be specific about goals and expectations oftreatment be willing to initiate and engage in discussion use the words the “death” and “dying” talk about hope, clarify goals and burdens oftreatment and prognosis collaborate with other providers to giveconsistent information Effective communication is every nurse’sbusiness when providing end-of-life care.11/30/2016WIEN- EOL care, Palliative and Hospice Care63
How does thenurse talkabout deathand dyingCont.? During a therapeutic encounter thenurse assesses whether the patientand family have an understandingand sense of complexity of thepatient’s illness, explores concerns,and answers questions.11/30/2016WIEN- EOL care, Palliative and Hospice Care64
Outcome ofEffectiveCommunication. “Effective communication, when combinedwith informed and skilled decision making,leads to better care delivery decisions, lessconflict, a more effective plan of care, greaterpatient, family and caregiver satisfactionwith therapeutic relationships, fewercaregiver errors, less stress and fewerburnout and retention problems” (Peden, Grantham &Paquin, nd, p. 8).11/30/2016WIEN- EOL care, Palliative and Hospice Care65
“Quality end of life care is provided by health careworkers who:Core Valuesof End-ofLife Care11/30/2016 endeavor to maintain the dignity of the patient, theircaregiver/s and family; work with the
End-of-Life Care Cont. End of life care can incorporate hospice and palliative care services, and treatment varies from patient to patient. The goals of end of life care as being to mollify distressing symptoms through the judicious use of comfort measures to enhance quality of life and achieve a peaceful death (Hodo & Buller, 2012).
Palliative vs Hospice 1 SM Hospice Care vs Palliative Care Easing the burden of illness, Improving quality of life Seasons Hospice and Palliative Care Cheryl Ledesma, FNP-BC Jacklyn Griffin, ACNP-BC Michelle Briggs, FNP-BC SM Objectives
Palliative Care is a specialized medical care for people living with advanced illnesses. It focuses on symptom management. While hospice and palliative care both focus on relief of symptoms, palliative care goes beyond end-of-life care. It is different from hospice, where a patient has to have a 6 month or less prognosis, in that it can
2014 Inducted as a Fellow in Palliative Care Nursing awarded by the Hospice and Palliative Nurses Association at the Annual Assembly of the American Academy of Hospice and Palliative Medicine and Hospice and Palliative Nurses Association, March 12 -15. San Diego, CA. 2012-2014 Awarded National Palliative Care Research Center . Junior Faculty
DEPARTMENT DIVISION NAME Family Medicine Palliative Medicine Algu,Kavita Palliative Medicine Arvanitis,Jennifer Palliative Medicine Berman,Hershl (Hal) Palliative Medicine Buchman,Stephen (Sandy) Palliative Medicine Cellarius,Victor Palliative Medicine Goldman,Russell Palliative Medicine Hashemi,Narges Palliative Medicine Howe,Marnie
Implementation of Palliative and Hospice Care for Patients with Neurological Diseases Although the examples cited do illustrate that many neurological patients need palliative and hospice care, the terms palliative and hospice are currently
Palliative Care: Goals of Care, Advanced Care Planning & Symptom Management Dr. Toni Cutson MD Director of Hospice & Palliative Medicine DVAHCS Michaelene Moore, MSN, ANP-C, CNS-BC, ACHPN. Jamie Grant, MSW, LCSW (Palliative Care/Hospice Coordinator) Laura
palliative care plan 2012-2016 Inpatient palliative care There are 300 specialist palliative care beds located in NSW public hospitals, affiliated hospitals and other facilities in the NSW health system. Care is also routinely provided in non-designated palliative care beds. In 2008-09, there were 19,800 palliative care
54 good shepherd hospice (fl) 0.22% 55 covenant care 0.21% 56 hospice of michigan 0.21% 57 hospice & palliative care charlotte region 0.21% 58 alacare home health & hospice 0.21% 59 arkansas hospice 0.21% 60 catholic healthcare west 0.21% 61 agrace hospicecare 0.21% 62 msa 0.21% 63 the c
