ROJoson PEP Talk: HOSPICE CARE IN CANCER PATIENTS

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

2. Hospice Care
in Cancer
Patients
June 17, 2023
1400H - 1500H
Via Zoom
Empowerment
objective - for
laypeople to have an
essential
understanding of
HOSPICE CARE in
Cancer Patients.
Welcome all!
MUTE yourself but always
show your video picture.
Sign in your name, FB
account, or email address in
the Chat Box! Include names
of companions attending.
Use the Chat Box to ask
questions and make
comments while the PEP TALK
is on.
Group pictures at start and
end of PEP TALK – show your
face in video.

3. 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.

4. Reminder:
50 OLETE Certificates = 1
Voucher for ROJoson
Telemedical Consultation

5. Hospice Care
in Cancer
Patients
Empowerment
objective - for
laypeople to have an
essential
understanding of
HOSPICE CARE in
Cancer Patients.
ROJOSON’S REQUEST:
FEEDBACK TO THIS
PEP TALK!
Pls. type in your
feedback in the chat
box during the open
forum and before we
adjourn!
Thank you!

6. Hospice Care
in Cancer
Patients
Empowerment
objective - for
laypeople to have an
essential
understanding of
HOSPICE CARE in
Cancer Patients.
LET’S NOW HAVE A
GROUP PICTURE
TAKING BEFORE WE
START PEP TALK
PROPER IN 2
MINUTES!
Pls. turn on your
video!
Show your face!

7. Hospice Care
in Cancer
Patients
Empowerment
objective - for
laypeople to have an
essential
understanding of
HOSPICE CARE in
Cancer Patients.
ROJoson PEP Talk
I have a Patient
Empowerment
Program in which I
like to empower the
lay people or
patients to take
control in the
management of
their health.

8. 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.

9. 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.

10. Hospice Care
in Cancer
Patients
Empowerment
objective - for
laypeople to have an
essential
understanding of
HOSPICE CARE in
Cancer Patients.
My PEP TALK today is
entitled:
HOSPICE CARE IN
CANCER PATIENTS
In consonance with
DOH Health
Awareness Calendar
National Cancer
Survivors Day
(June)

11. Contents
• What is a HOSPICE CARE in general? In cancer patients?
• What is the difference between HOSPICE CARE and
PALLIATIVE CARE?
• 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?
Hospice Care
in Cancer
Patients

12. What is a HOSPICE CARE?
Hospice Care
in Cancer
Patients

13. What is a HOSPICE CARE?
HOSPICE CARE is a special type of medical and
health care that focuses on the quality of life for
the people / patients who are experiencing an
advanced, life-limiting illness in which a decision
has been made on NO MORE HEROIC MEASURES
in curing the illness.
In the process of providing quality of life to the
patients, HOSPICE CARE also provides quality of
life to the loved ones of the patients.
Hospice Care
in Cancer
Patients
“NO more heroic
measures” is
embodied in these
statements -
"Let me die naturally,
according to the
function of my body.
No more anti-disease
treatment with
attempts for cure,
just supportive
treatment.”

14. What is the difference between HOSPICE CARE
and PALLIATIVE CARE?
Hospice is comfort care without curative intent;
the patient no longer has curative options or has
chosen not to pursue treatment because the side
effects outweigh the benefits.
Palliative care is comfort care without curative
intent; the patient may still try curative options
with the hope they may be beneficial.
HOSPICE CARE = PALLIATIVE CARE WITH NO
MORE HEROIC MEASURES.
Hospice Care
in Cancer
Patients
A patient is declared
to have a terminally
incurable disease.
He can choose
PALLIATIVE CARE or
HOSPICE CARE.
He can choose
initially PALLIATIVE
CARE then HOSPICE
CARE (if he decides
on NO anti-disease
treatment anymore.

15. What is a HOSPICE CARE in cancer patients?
HOSPICE CARE in cancer patients is a special type
of medical and health care that focuses on the
quality of life for the people / patients who are
experiencing an advanced, life-limiting CANCER
in which a decision has been made on NO MORE
HEROIC MEASURES in curing the CANCER.
In the process of providing quality of life to the
patients, HOSPICE CARE also provides quality of
life to the loved ones of the patients.
Hospice Care
in Cancer
Patients
“NO more heroic
measures” is
embodied in these
statements -
"Let me die naturally,
according to the
function of my body.
No more anti-
CANCER treatment
with attempts for
cure, just supportive
treatment.”

16. What is the difference between HOSPICE CARE
and PALLIATIVE CARE in CANCER PATIENTS?
Hospice is comfort care without curative intent;
the patient no longer has curative options or has
chosen not to pursue treatment because the side
effects outweigh the benefits.
Palliative care is comfort care without curative
intent; the patient may still try curative options
with the hope they may be beneficial.
HOSPICE CARE = PALLIATIVE CARE WITH NO
MORE HEROIC MEASURES.
Hospice Care
in Cancer
Patients
A patient is declared
to have a terminally
incurable CANCER.
He can choose
PALLIATIVE CARE or
HOSPICE CARE.
He can choose
initially PALLIATIVE
CARE then HOSPICE
CARE (if he decides
on NO anti-CANCER
treatment anymore.

17. What are the indications for HOSPICE CARE in
cancer patients?
Hospice Care
in Cancer
Patients

18. What are the indications for HOSPICE CARE in cancer patients?
The patient no longer has curative options (either from the very
start or after other curative options have failed).
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.
Hospice Care
in Cancer
Patients

19. What are the indications for HOSPICE CARE in
cancer patients?
HOSPICE CARE is usually decided on cancer
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.
Hospice Care
in Cancer
Patients

20. What are the indications for HOSPICE CARE in
cancer patients?
When does one declare a cancer to be
INCURABLE:
• Track record that it is incurable
• Advanced stage cancer
• Fast growth and recurring and progressive
• Absence of effective curative treatment
Hospice Care
in Cancer
Patients

21. What are the indications for HOSPICE CARE in
cancer patients?
Who decides on HOSPICE CARE?
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.
Hospice Care
in Cancer
Patients

22. Can HOSPICE CARE be done at home?
YES, it can be done anywhere, at home, in
hospitals, hospice centers and in nursing homes.
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).
Hospice Care
in Cancer
Patients

23. What are basically done in HOSPICE CARE for
cancer patient?
Pain management
• Physical
• Mental
• Spiritual
Quality of life promotion
Until the end-of-life moment!
With no anti-cancer treatment anymore!
Hospice Care
in Cancer
Patients

24. What is a typical HOSPICE CARE for cancer
patients at home?
Hospice Care
in Cancer
Patients

25. What is a typical HOSPICE CARE for cancer
patients at home?
Pain management
• Physical
• Mental
• Spiritual
Quality of life promotion
Until the end-of-life moment!
With no anti-cancer treatment anymore!
Hospice Care
in Cancer
Patients

26. What is a typical HOSPICE CARE for cancer patients at home?
PAIN MANAGEMENT
DISCOMFORT MANAGEMENT
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
Hospice Care
in Cancer
Patients

27. What is a typical HOSPICE CARE for cancer
patients at home?
DIET and FLUIDS in Hospice Care
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.
Hospice Care
in Cancer
Patients

28. What is a typical HOSPICE CARE for cancer patients
at home?
DIET and FLUIDS in Hospice Care
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.
Hospice Care
in Cancer
Patients

29. What is a typical HOSPICE CARE for cancer
patients at home?
DIET and FLUIDS in Hospice Care
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.
Hospice Care
in Cancer
Patients

30. What is a typical HOSPICE CARE for cancer
patients at home?
MENTAL MANAGEMENT
ACCEPTANCE OF FUTILITY OF CANCER
CURABILITY
ACCEPTANCE OF EVENTUALITY
LAST WILL
ADVANCE HEALTHCARE DIRECTIVE
PEACE OF MIND
*DEATH CERTIFICATE
Hospice Care
in Cancer
Patients

31. What is a typical HOSPICE CARE for cancer
patients at home?
SPIRITUAL MANAGEMENT
BELIEF IN A CREATOR
BELIEF IN AN AFTERLIFE
PRAYERS
OTHER RELIGIOUS RITES
Hospice Care
in Cancer
Patients

32. What are ROJoson advocating statements and
advice on HOSPICE CARE?
Hospice Care
in Cancer
Patients

33. What are ROJoson advocating statements and
advice on HOSPICE CARE?
All laypeople must know the basic concepts,
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.
Hospice Care
in Cancer
Patients

34. What are ROJoson advocating statements and
advice on HOSPICE CARE?
The 4Ks promote sound decision-making by both
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
Hospice Care
in Cancer
Patients

35. What are ROJoson advocating statements and
advice on HOSPICE CARE?
One has to accept that some cancers are really
incurable or already incurable!
In some cancers, one may just have to let nature
take its course.
Hospice Care
in Cancer
Patients

36. What are ROJoson advocating statements and
advice on HOSPICE CARE?
If the cancer is deemed incurable already –
choose the most practical and the most cost-
effective treatment to promote palliation.
If the cancer is deemed terminally incurable
already – choose the most practical and most
cost-effective treatment to promote a peaceful
death.
Hospice Care
in Cancer
Patients
Rather than:
TRY. TRY, TRY
GO ALL OUT
In cancer treatment
Even if it is
realistically futile!

37. What are ROJoson advocating statements and
advice on HOSPICE CARE?
Know the bases of declaring a cancer to be:
• curable?
• not curable?
• terminally incurable already?
• not yet terminally incurable?
Hospice Care
in Cancer
Patients
Parameters to use:
• Track record of the
specific cancer
• Stage of the cancer
• Behavior of the
cancer – growth
rate / recurring
• Presence or
absence of
effective curative
treatment

38. What are ROJoson advocating statements and
advice on HOSPICE CARE?
For terminally incurable cancer:
Have an advance health care directive.
Give details on how the terminally-ill patient will
be managed up to his last breath.
• Place of care – home / hospital / hospice
center – nursing home
• Diet and nutrition
• Procedures (diagnostic tests / treatment)
• Etc.
Hospice Care
in Cancer
Patients
Let nature take its
course!
Palliate to promote a
peaceful death!
Palliate to promote a
quality of life for
patients and
relatives!

39. What are ROJoson advocating statements and
advice on HOSPICE CARE?
Hattie Bryant’s four steps to a peaceful death are
as follows:
• Acknowledge the inevitability of death
• Understand the limits of medicine
• Educate yourself about your health care
choices
• Communicate your wishes and choose a
proxy (advance directive)
Hospice Care
in Cancer
Patients
Let nature take its
course!
Palliate to promote a
peaceful death!
Palliate to promote a
quality of life for
patients and
relatives!

40. Contents
• What is a HOSPICE CARE in general? In cancer patients?
• What is the difference between HOSPICE CARE and
PALLIATIVE CARE?
• 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?
Hospice Care
in Cancer
Patients
Summary
Take Away

41. Be always in touch with reliable medical
information on HOSPICE CARE IN CANCER
PATIENTS!
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.
Take Away in
relation to
Patient
Empowerment
Hospice Care
in Cancer
Patients

42. Hospice Care
in Cancer
Patients
Empowerment
objective - for
laypeople to have an
essential
understanding of
HOSPICE CARE in
Cancer Patients.

43. 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.

44. Reminder:
50 OLETE Certificates = 1
Voucher for ROJoson
Telemedical Consultation

45. Hospice Care
in Cancer
Patients
Empowerment
objective - for
laypeople to have an
essential
understanding of
HOSPICE CARE in
Cancer Patients.
ROJOSON’S REQUEST:
FEEDBACK TO THIS
PEP TALK!
Pls. type in your
feedback in the chat
box during the open
forum and before we
adjourn!
Thank you!

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