Understanding Palliative Care

Model of Care

The World Health Organization (WHO) defines palliative care as a team approach that improves the quality of life in those with life-threatening illnesses, through prevention and relief of suffering.  Their position is to assess and treat pain and other physical, psychosocial, and spiritual aspects of a patient's care; improving their quality of life. (http://www.who.int/cancer/palliative/definition. 

Differences Between Palliative  Care and Hospice

Both teams are made up of doctors, nurses, social workers, and chaplains.  Palliative care takes place at a facility where the patient is receiving treatment, like a nursing home or hospital.  Hospice care takes place primarily in a person's home or at a Hospice House if the community has one.  Hospice's goal is to provide comfort to the terminally ill and dying patient, so the emotional and practical issues of death can be dealt with.  With palliative care not only are comfort measures used but there is no expectation that life-prolonging therapies will be avoided, as is the case with Hospice.   Hospice care has time constraints; a person has to be considered terminal or within six months of dying, for insurance to pay for this service.  Palliative care has no time restrictions and can be received at anytime and at any stage of an illness whether terminal or not (www.caregivers library.org).

The Grieving Process and Being Culturally Sensitive

The patients and family culture should always be considered as this influences how they react to the illness, health rituals and remedies they might want to be included, food preferences, and how grief is expressed (www.dimensions of culture.com/2010/11.)

The Kubler-Ross Grief Model application for Palliative Care:

• Denial
• Anger
• Bargain
• Depression
• Acceptance

Please watch the video below on these stages of grief, and how good listening to what the patient is saying verbally and non-verbally will help design a palliative care plan that will be useful and collaborative.

Nursing Theory in Palliative Care:  The Humanistic nursing theory is one theory that fits well into palliative care, as it looks at the patient as a whole person rather than an illness (www.nursing-theory.org/theories-and-models/humanistic-model.php)

Online support groups and sites for those grieving any kind of a loss: health loss or loss of a loved one:

Fact Sheets form the National Institute of  Health on Palliative Care(2014): help for healthcare providers to communicate about this topic better with patients and families as well as frequently asked questions surrounding Palliative Care (http://www.nihr.nih.gov/news and information/conversations matter.

GriefShare: www.griefshare.org, HelpGuide.org, www.griefwatch.com/support-group, hospicefoundation.org/Grief-Support/Support-Groups, GriefNet.org  ( Pick some of the sites that you think are helpful and put them in your student tool box as a resource.

  Implementing What you Have Learned

After reviewing the above sites, video(below) and journal article: Advocates Call on Nurses to  Take Leading Role in Palliative Care, (2012) @http://www.onlinelibrary.wiley.com, doi: 10.1111/j.1365-2648.2011.05770.x, please see below how we are going to implement are new knowledge! 

You will be placed in a small group.  Within your small group this week, one of the palliative care topics will be assigned to each group; differences of palliative care and hospice, stages of grieving and loss, support for those that are grieving, and communicating the role of palliative care to patients and their families in a culturally sensitive way.  Each group will discuss their topic and  write down their thoughts and ideas that come out of their group.  The groups will then be changed some to include different members and again, the topic will be discussed and more ideas included in each group's list.  Staying with the last group you were in, a power-point using the Humanistic Theory of Nursing Theory, or another nursing theory that can fit with palliative care, along with graphics, will be done by each group, utilizing the ideas and concepts that came from your group discussion and material covered, depicting what you think would make for the perfect palliative team.  The power-point is to be no more than 10 slides and 3 references from each group.  Please put all the names of your team members on the title slide.  In one week, each group will be presenting their power points to be reviewed and discussed as a class.  Have fun with your slides and get as creative as you would like.