This article discusses the challenges elderly patients face with dialysis as their kidney function declines. It notes that patients over age 85 who start dialysis only have a life expectancy of 2 years, while those between ages 75-79 have a life expectancy of 3 years. Dialysis can lead to physical decline, frailty, falls, and increased risk of illness and death for elderly patients. The article encourages patients to consider their current quality of life, health issues, and support system when deciding whether to start or continue dialysis. It emphasizes dialysis is a life-sustaining treatment that can be declined.
The document provides information about continuing education (CE) credit approval for various healthcare professionals through different VITAS Healthcare programs. It lists the states and professional groups that various VITAS programs are approved to provide CE credits for, including nurses, social workers, nursing home administrators, and respiratory therapists. It also provides the approval numbers and organizations. The document contains multiple sections that continue listing the state-by-state and professional group CE credit approval information for VITAS Healthcare programs.
This document provides information about dementia care at the end of life. It begins by defining common causes of dementia like Alzheimer's disease and vascular dementia. It then discusses the natural progression of dementia and common complications that contribute to death, such as pneumonia, falls, and malnutrition. The document emphasizes that hospice can improve outcomes for dementia patients by providing better care and support at the end of life compared to traditional medical care alone.
“Neurologic deficits
are frequently seen
in patients with
stroke. One of this is
a motor deficit
which is the
weakness of the
body. Another one is
an emotional deficit
which is
depression.”
Patient X has
decreased appetite
before
hospitalization
because of
depression due to
his condition. But
now he is willing to
eat during
hospitalization
because of proper
Page 7 of 38
pagkain...”
2. Hygiene
Daughter
verbalized:
“Hindi na siya
makapag-ayos
ng sarili...”
Needs minimal
assistance in
bathing and
g
Communication of prognosis has multiple barriers to achieve shared understanding between patient and clinician. In this slide deck designed for Hospice and Palliative Medicine fellows, I look at some key studies and applied techniques to best address talking about 'How long do I have, doc?'
This slide deck does not cover how to formulate a prognosis.
Deciding When Hospice Care is Needed | VITAS HealthcareVITAS Healthcare
The goal of this webinar is to help healthcare professionals address the specific challenges of end-of-life care when determining a terminal prognosis, so they can provide the optimum care for the patient and family during the final stages of life.
This article discusses the challenges elderly patients face with dialysis as their kidney function declines. It notes that patients over age 85 who start dialysis only have a life expectancy of 2 years, while those between ages 75-79 have a life expectancy of 3 years. Dialysis can lead to physical decline, frailty, falls, and increased risk of illness and death for elderly patients. The article encourages patients to consider their current quality of life, health issues, and support system when deciding whether to start or continue dialysis. It emphasizes dialysis is a life-sustaining treatment that can be declined.
The document provides information about continuing education (CE) credit approval for various healthcare professionals through different VITAS Healthcare programs. It lists the states and professional groups that various VITAS programs are approved to provide CE credits for, including nurses, social workers, nursing home administrators, and respiratory therapists. It also provides the approval numbers and organizations. The document contains multiple sections that continue listing the state-by-state and professional group CE credit approval information for VITAS Healthcare programs.
This document provides information about dementia care at the end of life. It begins by defining common causes of dementia like Alzheimer's disease and vascular dementia. It then discusses the natural progression of dementia and common complications that contribute to death, such as pneumonia, falls, and malnutrition. The document emphasizes that hospice can improve outcomes for dementia patients by providing better care and support at the end of life compared to traditional medical care alone.
“Neurologic deficits
are frequently seen
in patients with
stroke. One of this is
a motor deficit
which is the
weakness of the
body. Another one is
an emotional deficit
which is
depression.”
Patient X has
decreased appetite
before
hospitalization
because of
depression due to
his condition. But
now he is willing to
eat during
hospitalization
because of proper
Page 7 of 38
pagkain...”
2. Hygiene
Daughter
verbalized:
“Hindi na siya
makapag-ayos
ng sarili...”
Needs minimal
assistance in
bathing and
g
Communication of prognosis has multiple barriers to achieve shared understanding between patient and clinician. In this slide deck designed for Hospice and Palliative Medicine fellows, I look at some key studies and applied techniques to best address talking about 'How long do I have, doc?'
This slide deck does not cover how to formulate a prognosis.
Deciding When Hospice Care is Needed | VITAS HealthcareVITAS Healthcare
The goal of this webinar is to help healthcare professionals address the specific challenges of end-of-life care when determining a terminal prognosis, so they can provide the optimum care for the patient and family during the final stages of life.
Palliative care aims to provide relief from the symptoms and stress of serious illness through comprehensive treatment of pain and other physical, psychosocial, and spiritual problems. It can improve quality of life for both patients and families. Palliative care is provided along the illness continuum and can be beneficial at any stage of a serious illness, while hospice care focuses on comfort and support for those nearing the end of life. Both palliative care and hospice aim to improve quality of life, but palliative care is not limited to a prognosis of six months or less.
This document discusses end-of-life care considerations for patients with advanced dementia. It finds that feeding tubes do not prevent aspiration pneumonia or malnutrition in these patients and may in fact increase the risk of pressure ulcers and restraint use. Instead, oral assisted feeding is recommended to overcome eating difficulties. The benefits of discussing goals of care and treatment options are emphasized over defaulting to invasive interventions like feeding tubes that do not improve quality of life.
Respiratory Symptoms in the Terminally Ill PatientVITAS Healthcare
The goal of this webinar was to educate healthcare professionals on interventions for cough, dyspnea, hemoptysis, and the “death rattle” in patients with end-of-life respiratory symptoms.
The goal of this webinar was to help hospice and healthcare professionals understand the history, philosophy, and practice of hospice and palliative care.
A Change in Behavior: A Pragmatic Clinical Guide to Delirium, Terminal Restle...VITAS Healthcare
The goal of this webinar was to help physicians and healthcare professionals differentiate delirium, terminal restlessness, and dementia-related agitation and aggression in patients near the end of life.
The document discusses the development and applications of the Edinburgh Feeding Evaluation in Dementia (EdFED) scale. It describes how the EdFED scale was developed through factor analysis and Mokken scaling to measure 6 items related to feeding behavioral problems in people with dementia. Studies have found the EdFED scale is stable across cultures and a good measure of feeding difficulty. Research has also shown that interventions like music during meals and Montessori-based activities can help alleviate feeding problems for those with dementia.
Hospice Care - Is It Right for You or Your Loved One?Theresa Lynn
This presentation from Wings of Hope Hospice in Allegan, Michigan describes the benefits of hospice care, when hospice care might be appropriate and the geographic area Wings of Hope serves.
Hospice services can help alleviate distress for patients with advanced lung disease (ALD) through home nursing, symptom management, and caregiver support. However, physicians often fail to recognize eligibility and patients hesitate due to misconceptions. Presenting real patient cases helps illustrate how hospice can improve quality of life for those with burdensome ALD symptoms like Grace, who struggles with activities, and Mick, coping with recurrent hospitalizations.
The goal of this webinar was to help hospice and healthcare professionals understand the ethics and application of artificial nutrition and hydration (ANH) for patients near the end of life.
Success Principle 12: End of life care for COPDNHS Improvement
A series of mix and match cards providing practical examples of changes you can make and how to implement them to improve care and quality at every step of the pathway for patients with COPD and asthma.
The document discusses several key concepts around withholding and withdrawing life support:
1. It defines biological and biographical concepts of life and discusses standards for determining death, including cardiopulmonary and brain death standards.
2. It covers issues around patients in persistent vegetative states and cases like Karen Ann Quinlan where courts had to determine whether extraordinary measures could be withdrawn.
3. The document also discusses legal standards for proxy decision making and court rulings on informed nonconsent as well as debates around defining personhood and cases like Nancy Cruzan involving advanced directives.
Angela Trask is a registered nurse in South Dakota with over 15 years of experience in healthcare. She has a passion for helping people maintain their autonomy and quality of life. Her experience includes roles as a charge nurse, front-line caregiver, and rehabilitation coordinator. She is skilled in areas such as care planning, assessment, and quality improvement. Her licensure and education include a Bachelor of Science in Nursing degree.
This document outlines a presentation about optimizing stays at skilled nursing facilities (SNFs). It begins with introducing the speaker and their background in geriatrics. It then defines what a SNF is and who pays for SNF care. The presentation discusses factors to consider for SNF placement like a patient's functional status and goals of care. It also addresses challenges families and facilities face including lack of training, high patient loads, and navigating the healthcare system. The presentation aims to help attendees better understand SNFs and provide strategies to humanize care and plan for the well-being of patients and their loved ones.
This document discusses the spiritual side of patient care from the perspective of a hospital chaplain. It outlines what medical students and physicians are taught about addressing patients' spiritual needs. It also reviews medical literature showing that patients want their spiritual beliefs acknowledged and many find spiritual discussions with physicians strengthen their trust. The chaplain discusses their role in the medical community and offering suggestions for relating to hospital staff while meeting patients' spiritual needs. The document emphasizes the importance of addressing both the physical and spiritual aspects of healing.
This document contains information from Christian Sinclair, MD about resources for end-of-life planning and conversations. It lists websites, projects, books and articles about advance care planning, goals of care discussions, palliative care, healthcare directives, and preparing for death. Key resources mentioned include the Before I Die walls project, National Healthcare Decisions Day, the Center to Advance Palliative Care, and Ira Byock's book "The Four Things That Matter Most".
Withholding and withdrawal of medical therapies Jelisa1975
This document discusses the complex ethical and legal issues surrounding the withholding or withdrawal of life-sustaining medical treatments. It addresses key definitions, considerations regarding patient autonomy and provider responsibilities, relevant policies and acts, and two case studies that illustrate common dilemmas providers may face. Overall, the document stresses the importance of open communication, compassion, and ensuring the dignity and self-determination of the patient in all end-of-life medical decisions and care.
Hospice care and palliative care: Is there a difference between the two, and if so, what?
Many people still think that palliative care means hospice care. But today, hospice is only a small part of palliative care.
The goal of palliative care is to prevent or treat the symptoms and side effects of a disease; and it should be part of the picture from the first day a serious illness is diagnosed.
Dr. Jim Meadows, Director of Hospice and Palliative Care at Tennessee Oncology, will discuss this important topic. How does a family and a health care team best work together to guide a patient through a terminal illness? How does everyone continue to support quality, patient-centered, end-of-life care?
The document discusses palliative surgery for terminally ill patients. It defines terminally ill patients as those with an incurable diagnosis and less than a few months to live. Palliative surgery aims to improve quality of life and relieve symptoms of advanced disease, rather than cure the condition. Common symptoms in these patients like pain, weakness, vomiting, and bowel obstruction are discussed along with potential causes and treatments. Surgical procedures that may provide palliative benefit are also outlined. The document concludes by listing the American College of Surgeons' 10 principles of palliative care, which focus on respecting patient autonomy, communication, symptom relief, and discontinuing futile treatments.
This document summarizes the management of patients with kidney disease. It discusses:
1) There are two types of serious kidney disease - acute renal failure which is reversible damage, and chronic kidney disease which is generally caused by long-term diseases and results in reduced kidney function over time.
2) For patients with end-stage renal disease, kidney replacement options include hemodialysis, peritoneal dialysis, or kidney transplantation, each with their own risks and complications.
3) Oral manifestations of kidney disease can include high urea in saliva, xerostomia, periodontal disease, tooth sensitivity and mobility. Management of dental treatment depends on the patient's kidney function and treatment type.
Palliative care aims to provide relief from the symptoms and stress of serious illness through comprehensive treatment of pain and other physical, psychosocial, and spiritual problems. It can improve quality of life for both patients and families. Palliative care is provided along the illness continuum and can be beneficial at any stage of a serious illness, while hospice care focuses on comfort and support for those nearing the end of life. Both palliative care and hospice aim to improve quality of life, but palliative care is not limited to a prognosis of six months or less.
This document discusses end-of-life care considerations for patients with advanced dementia. It finds that feeding tubes do not prevent aspiration pneumonia or malnutrition in these patients and may in fact increase the risk of pressure ulcers and restraint use. Instead, oral assisted feeding is recommended to overcome eating difficulties. The benefits of discussing goals of care and treatment options are emphasized over defaulting to invasive interventions like feeding tubes that do not improve quality of life.
Respiratory Symptoms in the Terminally Ill PatientVITAS Healthcare
The goal of this webinar was to educate healthcare professionals on interventions for cough, dyspnea, hemoptysis, and the “death rattle” in patients with end-of-life respiratory symptoms.
The goal of this webinar was to help hospice and healthcare professionals understand the history, philosophy, and practice of hospice and palliative care.
A Change in Behavior: A Pragmatic Clinical Guide to Delirium, Terminal Restle...VITAS Healthcare
The goal of this webinar was to help physicians and healthcare professionals differentiate delirium, terminal restlessness, and dementia-related agitation and aggression in patients near the end of life.
The document discusses the development and applications of the Edinburgh Feeding Evaluation in Dementia (EdFED) scale. It describes how the EdFED scale was developed through factor analysis and Mokken scaling to measure 6 items related to feeding behavioral problems in people with dementia. Studies have found the EdFED scale is stable across cultures and a good measure of feeding difficulty. Research has also shown that interventions like music during meals and Montessori-based activities can help alleviate feeding problems for those with dementia.
Hospice Care - Is It Right for You or Your Loved One?Theresa Lynn
This presentation from Wings of Hope Hospice in Allegan, Michigan describes the benefits of hospice care, when hospice care might be appropriate and the geographic area Wings of Hope serves.
Hospice services can help alleviate distress for patients with advanced lung disease (ALD) through home nursing, symptom management, and caregiver support. However, physicians often fail to recognize eligibility and patients hesitate due to misconceptions. Presenting real patient cases helps illustrate how hospice can improve quality of life for those with burdensome ALD symptoms like Grace, who struggles with activities, and Mick, coping with recurrent hospitalizations.
The goal of this webinar was to help hospice and healthcare professionals understand the ethics and application of artificial nutrition and hydration (ANH) for patients near the end of life.
Success Principle 12: End of life care for COPDNHS Improvement
A series of mix and match cards providing practical examples of changes you can make and how to implement them to improve care and quality at every step of the pathway for patients with COPD and asthma.
The document discusses several key concepts around withholding and withdrawing life support:
1. It defines biological and biographical concepts of life and discusses standards for determining death, including cardiopulmonary and brain death standards.
2. It covers issues around patients in persistent vegetative states and cases like Karen Ann Quinlan where courts had to determine whether extraordinary measures could be withdrawn.
3. The document also discusses legal standards for proxy decision making and court rulings on informed nonconsent as well as debates around defining personhood and cases like Nancy Cruzan involving advanced directives.
Angela Trask is a registered nurse in South Dakota with over 15 years of experience in healthcare. She has a passion for helping people maintain their autonomy and quality of life. Her experience includes roles as a charge nurse, front-line caregiver, and rehabilitation coordinator. She is skilled in areas such as care planning, assessment, and quality improvement. Her licensure and education include a Bachelor of Science in Nursing degree.
This document outlines a presentation about optimizing stays at skilled nursing facilities (SNFs). It begins with introducing the speaker and their background in geriatrics. It then defines what a SNF is and who pays for SNF care. The presentation discusses factors to consider for SNF placement like a patient's functional status and goals of care. It also addresses challenges families and facilities face including lack of training, high patient loads, and navigating the healthcare system. The presentation aims to help attendees better understand SNFs and provide strategies to humanize care and plan for the well-being of patients and their loved ones.
This document discusses the spiritual side of patient care from the perspective of a hospital chaplain. It outlines what medical students and physicians are taught about addressing patients' spiritual needs. It also reviews medical literature showing that patients want their spiritual beliefs acknowledged and many find spiritual discussions with physicians strengthen their trust. The chaplain discusses their role in the medical community and offering suggestions for relating to hospital staff while meeting patients' spiritual needs. The document emphasizes the importance of addressing both the physical and spiritual aspects of healing.
This document contains information from Christian Sinclair, MD about resources for end-of-life planning and conversations. It lists websites, projects, books and articles about advance care planning, goals of care discussions, palliative care, healthcare directives, and preparing for death. Key resources mentioned include the Before I Die walls project, National Healthcare Decisions Day, the Center to Advance Palliative Care, and Ira Byock's book "The Four Things That Matter Most".
Withholding and withdrawal of medical therapies Jelisa1975
This document discusses the complex ethical and legal issues surrounding the withholding or withdrawal of life-sustaining medical treatments. It addresses key definitions, considerations regarding patient autonomy and provider responsibilities, relevant policies and acts, and two case studies that illustrate common dilemmas providers may face. Overall, the document stresses the importance of open communication, compassion, and ensuring the dignity and self-determination of the patient in all end-of-life medical decisions and care.
Hospice care and palliative care: Is there a difference between the two, and if so, what?
Many people still think that palliative care means hospice care. But today, hospice is only a small part of palliative care.
The goal of palliative care is to prevent or treat the symptoms and side effects of a disease; and it should be part of the picture from the first day a serious illness is diagnosed.
Dr. Jim Meadows, Director of Hospice and Palliative Care at Tennessee Oncology, will discuss this important topic. How does a family and a health care team best work together to guide a patient through a terminal illness? How does everyone continue to support quality, patient-centered, end-of-life care?
The document discusses palliative surgery for terminally ill patients. It defines terminally ill patients as those with an incurable diagnosis and less than a few months to live. Palliative surgery aims to improve quality of life and relieve symptoms of advanced disease, rather than cure the condition. Common symptoms in these patients like pain, weakness, vomiting, and bowel obstruction are discussed along with potential causes and treatments. Surgical procedures that may provide palliative benefit are also outlined. The document concludes by listing the American College of Surgeons' 10 principles of palliative care, which focus on respecting patient autonomy, communication, symptom relief, and discontinuing futile treatments.
This document summarizes the management of patients with kidney disease. It discusses:
1) There are two types of serious kidney disease - acute renal failure which is reversible damage, and chronic kidney disease which is generally caused by long-term diseases and results in reduced kidney function over time.
2) For patients with end-stage renal disease, kidney replacement options include hemodialysis, peritoneal dialysis, or kidney transplantation, each with their own risks and complications.
3) Oral manifestations of kidney disease can include high urea in saliva, xerostomia, periodontal disease, tooth sensitivity and mobility. Management of dental treatment depends on the patient's kidney function and treatment type.
Seminar presentation on AKI and CKD in pediatricsfasil wagnew
This document outlines a presentation on acute kidney injury (AKI) and chronic kidney disease (CKD). It begins with defining the objectives of the presentation, which are to define, identify causes, explain clinical features, identify diagnostics, describe treatments, and discuss nursing interventions for renal failure. It then covers definitions of AKI, epidemiology of AKI globally and in developing countries, etiologies of AKI including pre-renal, intrinsic renal and post-renal causes, pathogenesis, clinical presentation, diagnostic modalities, medical management including fluid maintenance, and complications of AKI.
The document presents the case of a 63-year-old male patient with end-stage renal disease secondary to diabetes who has been on dialysis for three years. He was recently hospitalized multiple times for various issues and experienced significant weight loss and decreased nutritional status. The case examines his medical history and diet during hospitalizations in order to assess his current protein-energy wasting status and recommend treatment.
This document provides information on medical nutrition therapy for a patient with end-stage renal disease undergoing hemodialysis. The patient has a GFR of 12 mL/min and receives hemodialysis twice a week. The goals of medical nutrition therapy are to prevent deficiencies, control fluid balance and electrolytes, and prevent complications related to calcium and phosphorus levels. The dietitian provides calculations to determine the patient's energy, protein, fluid and electrolyte needs and prescribes an appropriate diet.
This document discusses renal Doppler ultrasound techniques and findings. It describes three main approaches to imaging the renal arteries - anterior, oblique, and flank. Normal and abnormal Doppler waveforms are presented. Evaluation of renal artery stenosis can be done directly by imaging the renal arteries or indirectly by imaging intrarenal arteries. Findings suggestive of stenosis include increased velocities, renal/aortic ratios over 3.5, absence of the early systolic peak, and tardus parvus waveforms. Pathologies of renal transplants like rejection, infarction, and arterial or venous stenosis are also summarized.
Dialysis various modalities and indices usedAbhay Mange
Dialysis is a process used to remove waste and excess water from the blood of patients with kidney failure. There are various modalities of dialysis including intermittent hemodialysis, peritoneal dialysis, and continuous renal replacement therapy. Hemodialysis uses diffusion and ultrafiltration across a semi-permeable membrane in a dialyzer to clean the blood. Proper vascular access and anticoagulation are also important aspects of hemodialysis treatment.
Chronic renal failure results in the progressive loss of kidney function over time and can lead to end stage renal disease. The kidneys normally regulate fluid, electrolyte and acid-base balance, excrete waste, and produce hormones. Medical management focuses on slowing disease progression, controlling complications like hypertension, and dialysis to filter the blood when kidney function is severely impaired. Dental management for patients with chronic kidney disease or on dialysis requires precautions due to bleeding risks and considerations for medications that are cleared by the kidneys.
Dialysis is a method of removing waste and toxins from the blood when the kidneys fail. There are two main types: hemodialysis which uses a machine to filter blood outside the body through a semipermeable membrane, and peritoneal dialysis which uses the peritoneal membrane in the abdomen. Hemodialysis treatments typically last 4 hours and occur 3 times per week to cleanse the blood and maintain electrolyte and fluid balance for patients with kidney failure. Access points for hemodialysis include catheters, arteriovenous shunts, and arteriovenous fistulas or grafts.
This document provides an overview of palliative care, including its definition, goals, scope, principles, and models. Palliative care aims to relieve suffering and improve quality of life for patients facing serious illnesses. It focuses on addressing physical, psychological, social, and spiritual needs through a holistic, team-based approach. While still limited in availability worldwide, palliative care services are expanding, especially to address needs for chronic disease management in addition to cancer care.
Palliative care - Advance Nursing PracticeJaice Mary Joy
Palliative care aims to improve the quality of life of patients facing life-threatening illnesses by preventing and relieving suffering through comprehensive care that addresses physical, psychosocial, and spiritual needs. It focuses on symptom management, support for patients and families, and care that affirms life and dying as a normal process. Palliative care teams provide services like pain management, counseling, therapies, and equipment to help patients live as actively as possible.
The document outlines the table of contents for the IAHPC Manual of Palliative Care 3rd Edition. The table of contents covers 7 sections: I) Principles and Practice of Palliative Care, II) Ethical Issues in Palliative Care, III) Pain, IV) Symptom Control, V) Psychosocial, VI) Organizational Aspects of Palliative Care, and VII) Resources. Section I defines palliative care and discusses the need, goals, principles, teams, communication, and integration of palliative care.
The document summarizes key aspects of palliative care according to the IAHPC Manual of Palliative Care 3rd Edition. It defines palliative care as care for patients with active, progressive, far-advanced disease focused on relieving suffering and improving quality of life using a multidisciplinary approach. The World Health Organization definition emphasizes improving quality of life through pain and symptom management for patients with life-threatening illness and their families. Common misconceptions about palliative care are addressed such as it only applying to terminal care or being "old-fashioned" care provided when nothing more can be done.
This document discusses palliative and supportive care in oncology. It defines palliative care as preventing and relieving suffering through early management of pain and other physical, psychosocial, and spiritual problems across the cancer experience. The goals of palliative care are to anticipate, prevent, and reduce suffering and support the best possible quality of life regardless of disease stage. Early palliative care involvement has benefits like improved quality of life and mood over traditional late palliative care. An interdisciplinary team approach to palliative care is recommended.
Indiana University Health University Hospital Palliative Care ServicesMike Aref
Introduction
In the past three years, Indiana University Health (IUH) University Hospital Palliative Care Services has expanded its size and scope. Our mission remains to treat the suffering of patients with chronic, progressive illnesses, their families, and their providers through symptom optimization and the search for meaning. While continuing to work with patients near the end-of-life and transitioning to hospice we have increasingly been involved with complex patients whose deaths are not imminent or even expected.
Our Team
The team has transitioned from a part-time to a full-time physician, a new full-time nurse practitioner, a new position in a nurse clinical coordinator, increased time for out part-time social worker, and continued part-time chaplain.
New Opportunities for Palliative Care
IUH University Hospital sees some of the sickest of the sick including advanced liver failure, advanced pulmonary disease, and transplant patients. Our service has become involved in alleviating suffering in pancreatic, liver, renal, and multivisceral transplant patients. Our expertise in opiates has placed us in a unique position to assist with patients having pain due to opioid-hyperalgesia and narcotic bowel syndrome. In addition we have started seeing more hepatology, oncology, hematology, and pulmonary patients earlier in their disease.
Out-Patient Services
We have expanded our service to now include out-patient, currently by embedding within other clinics at University Hospital including seeing patient in the multidisciplinary oncology clinic, hematology, digestive and liver disease clinic, and surgical out-patient clinic. In the near future we hope to have dedicated clinic space within the geriatrics clinic.
45 minutes of suffering (or Anesthesia Grand Rounds on Palliative Care)Mike Aref
This document summarizes a presentation on palliative care. It discusses:
- The definition and goals of palliative care in alleviating suffering for patients with chronic illnesses
- How palliative care differs from hospice in focusing on symptom management rather than a prognosis of 6 months or less
- The concept of primary palliative care conducted by primary providers to assess physical, psychosocial and spiritual needs
- The importance of establishing goals of care through discussions of patient values, priorities and understanding of their illness
- Strategies for managing common symptoms like pain, depression and dyspnea
Palliative care aims to improve quality of life for patients facing life-threatening illness by preventing and relieving suffering through early identification and treatment of pain and other physical, psychosocial, and spiritual problems. It can be provided alongside curative treatment or on its own. The document discusses definitions of palliative care, differences between palliative care and hospice care, common diseases treated with palliative care, principles of palliative care, and benefits found in studies.
PALLIATIVE CARE BY NIRBHAYKUMAR TRADA 531A.pptxssusercbc9e61
Palliative care aims to improve quality of life for patients with serious illnesses through early identification and treatment of pain and other distressing symptoms. It takes a holistic approach addressing physical, psychosocial and spiritual suffering of patients and their families. Palliative care can be provided alongside curative treatment and continues during bereavement. It is delivered by an interdisciplinary team for patients of any age and illness type.
CareXperts Home Healthcare in Dubai is committed to offering premium in-home care in the UAE. We stand as a family to improve the quality of life and comfort of our patients. We strive to serve you better every day by offering best-in-class home nursing solutions in the UAE.
Palliative care aims to improve quality of life for patients with serious illnesses through pain and symptom management as well as addressing physical, psychological, social, and spiritual needs. It focuses on preventing and relieving suffering for the patient and their family from diagnosis through the end of life and into bereavement. Palliative care is provided through interdisciplinary teams in various settings including hospitals, outpatient clinics, nursing homes, and in the community.
Palliative Care Advance Care Planning A Collaborative ApproachSheldon Lewin
The document discusses the roles of various healthcare professionals in palliative care and advance care planning. It outlines 5 components of advance care planning including patient options, prognosis, pain management, patient/family treatment decisions, and spiritual needs assessment. It then describes the specific roles of social workers, nurses, chaplains, and case managers which include assessing psychosocial needs, providing education and support, facilitating advance care planning discussions, and coordinating referrals to home health or hospice.
The document provides an introduction to palliative care and a holistic approach. It defines palliative care according to the WHO as improving quality of life for patients facing life-threatening illness through preventing and relieving suffering. Key principles of palliative care discussed include taking a holistic, patient-centered approach and using a multidisciplinary team. Factors affecting provision of palliative care and strategies for improving services are also outlined.
18 feb 2021 sociology - physical therapist s view of disease and the hospitalsZaffarJunejo
This document discusses physical therapists, nurse-patient relationships, hospitals, and teaching hospitals. It describes how physical therapists help patients restore function, improve mobility, and prevent disabilities. It also explains that nurses build therapeutic relationships with patients through trust, respect, and addressing physical, emotional, and spiritual needs. Regarding hospitals, it notes they provide acute care services, concentrate resources through referral networks, and classify hospital types like acute care, psychiatric, and teaching hospitals which have medical residency programs.
This document discusses palliative care, including its definition, aims, models, barriers to development, and challenges in Indonesia. Some key points include:
- Palliative care aims to relieve suffering and improve quality of life for patients with life-limiting illnesses through pain and symptom management as well as psychological, social, and spiritual support.
- Barriers to palliative care development include lack of funding, opioid availability issues, public and government awareness, and education/training programs.
- Palliative care in Indonesia is developing but still faces challenges related to policy, education, attitudes, and social conditions. It is primarily available in major cities near cancer treatment centers.
- Effective palliative care requires an inter
The document summarizes the development and services of the Integrative Medicine and Palliative Care Team (IMPACT) at Children's Hospital at Montefiore. It describes how IMPACT began with a few clinicians in 2005 and has expanded to include various complementary and alternative medicine services. IMPACT assesses patients' physical, psychosocial and spiritual needs. It also provides education to medical staff and students on palliative care and integrative medicine. IMPACT is researching the effectiveness of interventions like aromatherapy, yoga and alternative diets.
The document summarizes the development and services of the Integrative Medicine and Palliative Care Team (IMPACT) at Children's Hospital at Montefiore. It describes how IMPACT evolved from initial assessments of patient needs to a multidisciplinary team providing services like herbal medicine, yoga, massage, and spiritual support. It also discusses IMPACT's education initiatives and current research studies exploring topics like the effectiveness of different diets for cancer patients and the impact of therapies like aromatherapy and yoga on symptoms.
The document summarizes the development and services of the Integrative Medicine and Palliative Care Team (IMPACT) at Children's Hospital at Montefiore. It discusses how IMPACT evolved from an initial focus on palliative care to offering additional complementary and alternative medicine services. IMPACT now includes practitioners of herbal medicine, yoga, massage, acupuncture, nutrition counseling, and other therapies. It also provides education to medical students and conducts research on topics like the effectiveness of different diets for pediatric oncology patients.
The document summarizes the development and services of the Integrative Medicine and Palliative Care Team (IMPACT) at Children's Hospital at Montefiore. It discusses how IMPACT evolved from an initial focus on palliative care to incorporate complementary and alternative medicine (CAM) approaches. IMPACT now provides a range of CAM services like yoga, massage, acupuncture, and herbal medicine to improve patients' quality of life. It also conducts education and research on palliative care and CAM for pediatric cancer patients.
Similar to Workshop Palliative Medicine - 13 Januari 2014 - ringkas (20)
The Children are very vulnerable to get affected with respiratory disease.
In our country, the respiratory Disease conditions are consider as major cause for mortality and Morbidity in Child.
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14...Donc Test
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
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- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
Dr. Tan's Balance Method.pdf (From Academy of Oriental Medicine at Austin)GeorgeKieling1
Home
Organization
Academy of Oriental Medicine at Austin
Academy of Oriental Medicine at Austin
Academy of Oriental Medicine at Austin
About AOMA: The Academy of Oriental Medicine at Austin offers a masters-level graduate program in acupuncture and Oriental medicine, preparing its students for careers as skilled, professional practitioners. AOMA is known for its internationally recognized faculty, award-winning student clinical internship program, and herbal medicine program. Since its founding in 1993, AOMA has grown rapidly in size and reputation, drawing students from around the nation and faculty from around the world. AOMA also conducts more than 20,000 patient visits annually in its student and professional clinics. AOMA collaborates with Western healthcare institutions including the Seton Family of Hospitals, and gives back to the community through partnerships with nonprofit organizations and by providing free and reduced price treatments to people who cannot afford them. The Academy of Oriental Medicine at Austin is located at 2700 West Anderson Lane. AOMA also serves patients and retail customers at its south Austin location, 4701 West Gate Blvd. For more information see www.aoma.edu or call 512-492-303434.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Nutritional deficiency Disorder are problems in india.
It is very important to learn about Indian child's nutritional parameters as well the Disease related to alteration in their Nutrition.
Giloy in Ayurveda - Classical Categorization and SynonymsPlanet Ayurveda
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
Giloy in Ayurveda - Classical Categorization and Synonyms
Workshop Palliative Medicine - 13 Januari 2014 - ringkas
1. PALLIATIVE CARE IN HOSPITAL
AN OVERVIEW
Ika Syamsul Huda MZ
Tim Perawatan Paliatif
RSUP Dr. Kariadi – Semarang
2014
Tim Perawatan Paliatif, 2014
2. KEPUTUSAN MENTERI KESEHATAN REPUBLIK INDONESIA
NOMOR : 812/Menkes/SK/VII/2007
TENTANG
KEBIJAKAN PERAWATAN PALIATIF
LATAR BELAKANG:
Meningkatnya jumlah pasien dengan penyakit yang belum dapat
disembuhkan baik pada dewasa dan anak seperti penyakit
kanker, penyakit degeneratif, penyakit paru obstruktif
kronis, cystic fibrosis, stroke, Parkinson, gagal jantung/heart
failure, penyakit genetika dan penyakit infeksi seperti HIV/AIDS
yang memerlukan perawatan paliatif, disamping kegiatan
promotif, preventif, kuratif, dan rehabilitatif.
Incurable
Promotive
Preventive
Rehabilitative
Tim Perawatan Paliatif, 2014
Curative
Palliative
3. Rumah sakit yang mampu
memberikan pelayanan
perawatan paliatif di Indonesia
masih terbatas di 5 (lima) ibu
kota propinsi yaitu
Jakarta, Yogyakarta, Surabaya, De
npasar dan Makassar.
KMK, No: 812/Menkes/SK/VII/2007
Tim Perawatan Paliatif, 2014
4. WHO Definition of Palliative Care
Palliative care is an approach that improves the
quality of life of patients and their families facing the
problem 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.
(WHO, 2010)
http://www.who.int/cancer/palliative/definition/en/
Tim Perawatan Paliatif, 2014
5. 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 in their own bereavement;
uses a team approach to address the needs of patients and
their families, including bereavement counseling, if indicated;
will enhance quality of life, and may also positively influence
the course of illness;
http://www.who.int/cancer/palliative/en/
Tim Perawatan Paliatif, 2014
6. Dimensi Kualitas Hidup
yang diinginkan pasien paliatif :
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Penanganan permasalahan fisik
(luka, nyeri, mual, muntah, sesak nafas, dan lain-lain)
Kemampuan fungsional dalam beraktifitas
Kesejahteraan keluarga
Kesejahteraan emosional
Kemampuan melakukan aktifitas spiritual
Kemampuan melakukan fungsi sosial
Kepuasan pada layanan terapi
Orientasi masa depan (rencana dan harapan)
Kehidupan seksual, termasuk gambaran terhadap diri
sendiri
Kemampuan / fungsi dalam bekerja
KMK, No: 812/Menkes/SK/VII/2007
Jennifer J. Clinch, Deborah Dudgeeon dan Harvey Schipper (2000)
Tim Perawatan Paliatif, 2014
7. Palliative care should be initiated
when the patient becomes
symptomatic of their
active, progressive, far-advanced
disease and should never be
withheld until such time as all
treatment alternatives for the
underlying disease have been
exhausted.
The IAHPC Manual of Palliative Care
3rd Edition
Tim Perawatan Paliatif, 2014
8. Death
Treatment
Old Concept
Curative care
Palliative
care
Time
Death
Treatment
Better Concept
Diseases modifying or
Potentially curative
Supportive and
Palliative care
Time
Bereavement care
Tim Perawatan Paliatif, 2014
Murray SA, Kendall M, Boyd K, Sheikh A.
Illness trajectories and palliative care.
BMJ. 2005; 330:1007-1011.
9. Many health care workers believe
that palliative care is the "soft
option“ adopted when "active"
therapy stops!
Palliative care, addressing all
the patient’s physical and
psychosocial problems, is
active therapy
The IAHPC Manual of Palliative Care
3rd Edition
Tim Perawatan Paliatif, 2014
11. Interdisciplinary Teamwork
Many different health care professionals are
involved in palliative care programs:
physicians, nurses, social
workers, chaplains, nurse aides, dieticians
and volunteers.
All members of the palliative care team work
together, along with the patient and family, to
create the best goals of care for the patient.
Karen Davis, RN, BSN, OCN
Tim Perawatan Paliatif, 2014
12. BARRIERS to PALLIATIVE CARE
Relatives
Physician
Society and Culture
Patient
Tim Perawatan Paliatif, 2014
13. Barriers related to the physician
• poor prognostication: does not recognise how advanced the patient’s
illness is
• may not recognise how much the patient is suffering
• lacks communication skills to address end-of-life issues
• believe they are already providing good palliative care and need no
assistance
• misunderstands what a palliative care service does or has to offer
• does not want to hand over the patient’s care: loss of control, loss of
income
• opiophobia: worries the patient may become addicted to opioids or
suffer severe side effects
• does not believe in palliative care
• does not know of the palliative care service
The IAHPC Manual of Palliative Care
3rd Edition
Tim Perawatan Paliatif, 2014
14. THE MYTHS ABOUT PALLIATIVE CARE
Myth: Palliative care = just end-of-life care
We often help patients whose life expectancy is good
Myth: Palliative care = just pain management
We could help manage challenging cases and symptoms
Myth: Palliative care = “no more treatment”
We assess the values & goals a patient, designing care around them
Suzana Makowski, MD MMM FACP
Tim Perawatan Paliatif, 2014
17. Dying is a 4D activity
Physical
Psychological
Social
Spiritual
Scott A Murray (2010)
Concept of trajectories at the end of life: physical and other dimensions.
Tim Perawatan Paliatif, 2014