Hospice and Pallative Care

1. Hospice and
Palliative Care

2. Palliative Care
Palliative care is specialized medical care focused on identifying and
relieving pain and other symptoms of serious illnesses.
It is focused on quality of life rather than curing the disease but can
also be provided along with curative treatment
Palliative care can happen at any point during a patient's illness.
Often accompanies other kinds of treatment.

3. Who would benefit from Palliative Care
·High-risk patients
·Socially vulnerable
·Exhausted family caregivers
·Patients with:
·Cognitive impairment
·Multiple comorbidities
·Frailty
Who would benefit
from Palliative Care

4. During her breast cancer treatment, Adriana experienced anemia. She was advised
to receive a blood transfusion by a palliative care specialist to treat her anemia and
lessen some of the exhaustion she was feeling. Adriana was able to continue receiving
curative chemotherapy by managing her discomfort. As part of palliative care, her
anemia will be treated.
Adriana's case

5. Hospice Care
Hospice is a care program that provides assistance to those individuals
who have an incurable disease and have chosen not to pursue any
further aggressive treatment.
It is designed to provide comfort and support to patients and families
when a life-timing illness no longer responds to cure-oriented
treatments.
Hospice care is provided wherever a patient calls "home."
.

6. Provides physical, emotional and spiritual support
Helps patients remain in their home or in the facility
Offers pain and symptom management
Helps individuals live the best that they can with what they have been
given
Focuses on quality of life more than quantity
Its purpose is to allow patients to die with dignity with minimal suffering
while maintaining control and support for families
to individuals at end of life
Hospice Care

7. Dolores Case
The decision to use hospice does not need to be made permanently. For
instance, Dolores discovered that her kidneys were failing at the age of 82. Dolores
started receiving hospice care because she didn't want to undergo dialysis and
believed that she had lived a long and fulfilling life. She found out that her
granddaughter was expecting a baby a week later.
Dolores changed her mind about using hospice care after speaking with her
husband, and she departed to start dialysis in the hopes of one day holding her
first great-grandchild. The medical professionals noted that Dolores' blood
pressure was too low shortly after the baby was born. She then made the decision
to rejoin hospice.

8. Approaches of Palliative and
Hospice Care
•Focus on Quality of Life
•Multidisciplinary team approach
•Decisions are driven by the patient's goals of care and wishes
•Provide support to the patient to express wishes
•Provide support to family and caregivers so that patients may
realize goals of care
•Navigate, and coordinate a complex/confusing healthcare system,
understand the plan of care
•Physical and psychosocial relief

9. Domains of Palliative and Hospice Care
The assessment focused on relieving symptoms such as pain, SOB, fatigue, nausea,
constipation
Care delivered is based on the patient’s wishes
Assess the psychological status of the patient: identify anxiety, fears
WOF signs of family members struggling
Provide resources for family and make appropriate referrals for consultations
Know patient and SO’s social support network
Identify financial barriers
Access to healthcare such as transportation, medications
Resolve problems through regular family meetings
Physical Aspect
Psychological Aspect of Care
Social Aspect

10. Offer support of a spiritual counselor, priest, pastor
Determine the patient and SO’s beliefs and faith
Quality of an individual's inner resources which consists of hope, love,
connection, inner peace, comfort, support, the ability to give and receive
spiritual love, and the types of relationships.
Assist in remembering and commemorating memorable past life experiences
Know cultural origins that may influence perspective on palliative and hospice
care
Respect values, beliefs, and traditions related to health and illness
Honor patient preferences especially those made by legal proxies
Maintain professional boundaries
Spiritual and Existential Aspects
Cultural Aspect
Ethical and Legal Aspects

11. Nurses spend more time with patients and their families than any other
healthcare provider which allows for the building of trust
Trust in nurses allows nurses to have a unique ability to educate patients and SO
in a way other HC members do
Nurses are advocates for such patients and families
Nurses empower them to make informed and autonomous decisions
Timely referral and education are important roles of nurses in such types of care
Importance of Nurses

12. THANK YOU!
Stream Moonlight Sunrise by TWICE

13. References
Hospice Foundation of America, (2014). What is hospice?.
http://www.hospicefoundation.org/whatishospice.
Pullis, B. (2015). Integration of End-of-life-education into community health
nursing course. Public Health Nursing, 30(5), 463-467.
Sutton, S., & Grant, M. (2015). Effective public engagement to improve palliative
care for Serious Illness. Health Affairs Retrieved from
https://www.healthaffairs.org/do/10.1377/hblog20150310.044884/full/
The National Consensus Project. (2018). Clinical Practice Guidelines for Quality
Palliative Care. 4th edition