palliative nursing care

1. Palliative Care
Dr. Arpi Manookian
Assistant Professor of Nursing and Midwifery School
Tehran university of Medical Sciences

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3. What is Palliative Care?
The World Health Organization describes palliative care as "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."
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4. Palliative care
The goal is not to cure.
Palliative care is also called
comfort care,supportive care,
and symptom management.
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5. Palliative care
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6. Palliative care
• Affirms life: Palliative care sustains the quality of life
throughout sickness, helping patients cope with the struggles
of disease.
• Promotes Quality of life: Palliative care helps patients manage
the symptoms of their disease and allows them to continue
with their daily lives.
• Treats the person: Palliative care offers a wide range of help
to patients, including assistance from pharmacists, nurses,
nutritionists, and social workers.
• Supports the family: Palliative care provides a network of
people who can help a patient and their family better
understand treatment options; thus alleviating much of the
stress surrounding illness.
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7. Dame Cecily Saunders, founder of St Christopher's Hospice.
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8. History of palliative care
The term “hospice” (from the same linguistic root as
“hospitality”) can be traced back to medieval times when it
referred to a place of shelter and rest for weary or ill travelers
on a long journey.
The name was first applied to specialized care for dying
patients by physician Dame Cicely Saunders, who began her
work with the terminally ill in 1948 and eventually went on to
create the first modern hospice—St. Christopher’s Hospice—in
London.
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9. History of palliative care
Saunders introduced the idea of specialized care for the dying to
the United States during a 1963 visit with Yale University. Her
lecture, given to medical students, nurses, social workers, and
chaplains about the concept of holistic hospice care, included
photos of terminally ill cancer patients and their families,
showing the dramatic differences before and after the symptom
control care.
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10. Palliative vs. Hospice Care
Palliative care can be provided from the time of diagnosis.
Palliative care can be given simultaneously with curative treatment.
Both services have foundations in the same philosophy of reducing
the severity of the symptoms of sickness. Hospice care could be
considered as a part of palliative care.
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14. Aspects of 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;
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15. Aspects of palliative care
Offers a support system to help the family cope during the
patients illness and in their own bereavement;
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 are intended to prolong life, such as
chemotherapy or radiation therapy.
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16. Who receives Palliative Care?
 Individuals struggling with various diseases
 Individuals with chronic diseases such as cancer, cardiac
disease, kidney failure, Alzheimer's, HIV/AIDS and Amyotrophic
Lateral Sclerosis (ALS)
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17. Who gives palliative care?
Palliative care specialists work as part of a multidisciplinary team
to coordinate care.
This palliative care team may consist of doctors, nurses,
registered dieticians, pharmacists, and social workers. Many
teams include psychologists or a hospital chaplain as well.
Palliative care specialists may also make recommendations to
primary care physicians about the management of pain and
other symptoms. People do not give up their primary care
physician to receive palliative care.
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18. Multidisciplinary team
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19. Palliative care and cancer
 It is generally estimated that roughly 7.2 to 7.5 million people
worldwide die from cancer each year.
 More than 70% of all cancer deaths occur in developing
countries, where resources available for prevention, diagnosis
and treatment of cancer are limited or nonexistent.
 More than 40% of all cancers can be prevented. Others can be
detected early, treated and cured. Even with late-stage cancer,
the suffering of patients can be relieved with good palliative
care.
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20. Family members and palliative care
Family members are an important part of cancer care, and,
like the patient, they have a number of changing needs.
It’s common for family members to become overwhelmed by
the extra responsibilities placed upon them.
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21. Many find it difficult to care for a relative who is ill while
trying to handle other obligations, such as work and caring for
other family members. Other issues can add to the stress,
including uncertainty about how to help their loved one with
medical situations, inadequate social support, and emotions
such as worry and fear.
These challenges can compromise their own health. Palliative
care can help families and friends cope with these issues and
give them the support they need.
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