If you have a serious illness, should you get palliative care?

caregivers

Yes. Palliative care provides an additional level of support while still providing curative treatment. Hospice care, on the other hand, also provides support but focuses on pain management and a good quality end-of-life care. Coming from NYU, I’m aware of the NICHE program (Nurses Improving Care for Healthsystem Elders). One thing it does is provide caregiver resources especially useful while you or your loved one is at the hospital. Here is their guide for helping you determine if you need palliative care.

1. Do you have one or more serious illnesses?

Such as: • Cancer • Congestive heart failure (CHF) • Kidney failure • Liver failure • Neurological diseases (e.g., ALS, Parkinson’s) • Dementia • Chronic obstructive pulmonary disease (COPD), emphysema, lung disease

Yes___ No___

2. Do you have symptoms that make it difficult to be as active as you would like to be, or impact your quality of life?

These symptoms might include: • Pain or discomfort • Shortness of breath • Fatigue • Anxiety • Depression • Lack of appetite • Nausea • Constipation

Yes___ No___

3. Have you, or someone close to you, experienced the following:

• Difficult side effects from treatment • Eating problems due to a serious illness • Frequent emergency room visits • Three or more admissions to the hospital within 12 months, and with the same symptoms

Yes___ No___

4. Do you, or someone close to you, need help with:

• Knowing what to expect • Knowing what programs and resources are available • Making medical decisions about treatment choices/options • Matching your goals and values to your medical care • Understanding the pros and cons (benefits/burdens) of treatments (e.g., dialysis, additional cancer treatments, surgery, etc.)

Yes___ No___

5. Do you, or someone close to you, need help with:

• Coping with the stress of a serious illness • Emotional support • Spiritual or religious support • Talking with your family about your illness and what is important to you

Yes___ No___

If you answered yes to more than one of the questions, palliative care is something you or your loved one may need. If you feel you may benefit from palliative care, please talk to your healthcare provider today.


Update from April 24, 2014
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How to care for the dying

CARES: How to Care for the Dying

Within the first four months of working as a new bedside nurse, I’ve encountered two patients who were actively dying. I wasn’t sure what to do. After coming across this article from Medscape though (btw you need a free login to read this article), I finally understand what the palliative care nurse practitioners were doing.

The City of Hope came up with a tool called CARES to help the nurse take care of those who are dying.

C stands for comfort. You aim to alleviate pain and suffering for the patient. Additional testing and blood draws should be questioned, as the aim is to comfort, not treat.

C: Comfort

A stands for airway. We used a scopolamine patch placed behind the ear. It’s used to help stop secretions from building up. While oxygen and oral secretion will not necessarily help, it may be comforting for the patient to have those things.

How to care for the dying

A: Airway

R stands for restlessness or delirium. It occurs in 25-85% of actively dying patients. It could be due to uncontrolled pain, a distended bladder, or it could be that the patient feels that there are unresolved issues with the family. Playing familiar music and providing a non-stimulating environment will help.

How to care for the dying

R: Restlessness or Delirium

E stands of emotional and spiritual support. Don’t underestimate a listening ear and providing clear and open communication. Whatever can be done to promote a comfortable and peaceful death should be considered.

How to Care for the Dying

E: Emotional and Spiritual Support

S stands for self-care. The nurse is often stressed and may need to debrief too.

CARES: How to Care for the Dying

S: Self Care