Chapter 4 Palliative Care

Chapter 4
Palliative Care (2)

Weiwei Liu (Vivian)
Public Health and Management
Department
Objectives
What is palliative care?

Challenges
How can palliative care help?
Hospice Care
five stages of psychological changes of
the dying patients
1. What is Palliative Care?

Palliative care seeks:
to prevent or relieve physical, social,
emotional and spiritual suffering produced by a
life threatening medical condition or its treatment
to help patients with such conditions and their
families live as normally as possible
to provide them with timely and accurate
information and support in decision making
Palliative Care
Identification,
impeccable
assessment &
treatment of
symptoms
Goals of Palliative Care

1. to provide relief from pain and other physical
symptoms
2. to maximize the quality of life
3. to provide psychosocial and spiritual care
4. to provide support to help the family during the
patients illness and bereavement
Palliative Care
IS
Evidence based medical
treatment
Vigorous care of pain
and symptoms through
illness
Care that patients may
want at the same time as
treatment to cure or
prolong life
NOT
giving up
accelerating death
the same as hospice
care
Ethics of Euthanasia & Natural

Death Difference of Euthanasia and Natural Death
Euthanasia
Natural Death
Motivation
Relief patients pain
Relief patients pain
Method
killing
Palliative care could

improve the quality of
life
Patients
state
Despair, destroy
themselves
Cherish the end of

life period
Religion
Be against
Naturally, all in
favor
Medical
Ethics
Against to no harm"
principle
In accordance with the

do no harm
principle
Relatives
feeling
Regret due to kill

the patient
The patient received

good care, relative
without regret when
the patient die
Palliative Care
Palliative
Medicine
Hospice
Palliative Care Model

Old- Abrupt transition to hospice
D
I
A
G
N
O
S
I
S
Disease
Modifying
Therapy
Prolongation of life
Palliative
Therapy
Relief of
Suffering
D
E
A
T
H
Palliative Care Model

Optimal- Continuum of care
Disease
Modifying
Therapy
Palliative Therapy
Presentation
Acute
Illness
Chronic
End of
Life Care Death Bereavement
Who Needs Palliative

Care?
People of all ages with lifethreatening or debilitating illness
Children with congenital injuries or
conditions
Persons with severe trauma
People living with progressive chronic
illness
2. Challenges
Patient
Not legally competent

Lacks verbal skills to describe
needs, feelings, etc.
Not achieved a "full and complete
life
Family
Difficulty understanding treatment

plans, prognosis, etc.
Needs relief from burden of care
Stress on finances
Challenges
Caregivers
sense of failure
lack familiarity with
dosages and
medications for
symptom management
lack experience in
caring for dying patients
3. How Can Palliative Care Help
Symptom Management
Hospital Care
Home Care
Psychosocial Support
Bereavement
How is Palliative Care Different from

Curative Care? (
)
Curative Care
(=disease-oriented, restorative)
Palliative Care
(=supportive, person-oriented)
Diagnosis
Dying
Person with Illness
Family
Caregivers
DISEASE PROGRESSION
Be
re
av
em
en
Death
Support services for
families and caregivers
4.
Palliative Care
VS. Hospice
Care
Should start at the time of diagnosis
Provided in the last six months of life
Occurs simultaneously with aggressive

or curative treatments, often managing
symptoms that these therapies cause
Usually cannot be given at the same as

curative or aggressive treatments such as
chemotherapy, radiation therapy
Often underfunded and difficult to

access in many areas
Paid for in full by the Medicare benefit

and by Medicaid (in most states)
Most often done in the hospital

setting; More community-based
outpatient palliative care services are
beginning to pop up in larger
metropolitan areas but access is still
limited; Nowadays moving into homecare
Most often provides care in a patients

home setting, could be at their own
home or that of a relative, a nursing home
or assisted living facility, or retirement
community; Some hospices offer
inpatient services in dedicated hospice
facilities
5. five stages of psychological

changes of the dying patients
1 shock and denial
2 anger
3 bargaining
4 depression
5 acceptance
Anger
Why
me
Bargaining
acceptance
Im ready
for death.
yeap, its
me,
but
Gradually understand the
Health
true consequences
Stable diease
The loneliness,
inner guilt
Diagnosis
with a
terminal
illness
Denial
Its
impossible
You make a
mistake
More self-sustaining
growth
depression
Yes, its me.
The psychological
process of dying
patients.
Summary
The focus of palliative care is the
comfort and well being of the
patient and family.
Thank you!

Chapter 4 Palliative Care

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Chapter 4 Palliative Care

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What is palliative care?

What is palliative care?

What are some challenges of palliative care?

What are some challenges of palliative care?

Chapter 4

Palliative Care (2)

What is palliative care?

1. What is Palliative Care?

Goals of Palliative Care

Ethics of Euthanasia & Natural

Relief patients pain

Relief patients pain

Palliative care could

Cherish the end of

In accordance with the

Regret due to kill

The patient received

Palliative Care Model

Palliative Care Model

Who Needs Palliative

Not legally competent

Difficulty understanding treatment

3. How Can Palliative Care Help

How is Palliative Care Different from

Provided in the last six months of life

Occurs simultaneously with aggressive

Usually cannot be given at the same as

Often underfunded and difficult to

Paid for in full by the Medicare benefit

Most often done in the hospital

Most often provides care in a patients

5. five stages of psychological

Gradually understand the

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