Question

CHCPAL001-Deliver care services using a palliative approach

1. Give one example of support that the family and/or carer may require from a palliative care worker.
2. Communication strategies can empower the person, family, carers and/or significant others. Explain how you can empower these people.
3. Describe the legal and ethical considerations for duty of care when caring for a person at end-of-life.
4. Identify three members of the palliative care team and briefly outline their role.
5. Following the death of a person a support worker has cared for, give two examples of behaviour that may demonstrate a need for further support.

Answer 1

Palliative Care

Active total Cary of patients whose disease is not responsive to curative treatment.

Care giver should Focus on

Controlling pain & other symptoms of the patient

Reducing psychological, social & spiritual distress to the family & to the patient

Role of a care giver in palliative settings

1) Communication

2) Decision Making

3) Management of complications

4) Symptoms control

5) Psychological care of patient & family

6) Care of dying

Methods of Communication

Communication play as a key ingredient between patient, family & the care giver.

Therapeutic Communication is used here to asdass the patient & family.

Empathy & Active listening are other essential communication compounds.

Always remember to give time to the patient & family to express their feelings & thoughts.

Consider ethnic, cultural & religious background.

The patient should be free to express feelings of anger, fear or guilt without judgement on the part of the nurse. Nurse should understand that in communication anger is a normal response to grief.

Nurse should respect the patient privacy & the need or desire to talk or not talk.

Legal & Ethical issues

Legal issues

1. Negligence
2. Malpractice
3. Omissions
4. Torts
5. Invasion of privacy
6. Neglect
7. Abuse
8. Abandonments

Ethical issues

1. Do not resuscitate order ( not following )
2. Restraints ( for personal benefits )
3. Withholdings & withdrawing treatment ( if there is chances of survival )

Palliative care team

A medically supervised interdisciplinary team of professionals & volunteers provide palliative care to the patient.

a) Nurse : Plays a pivotal role in coordinating the team. She works in collaboration with the other team members. Educated in pain control & symptom Management. She also requires excellent teaching skill, compassion, flexibility & adaptability to patient need. Daily assessment of the terminally ill. Documentation of allergies & medication profile

b) Physician

Palliative care is mainly given to the patients who is certified by a phytsician that he is 6 months or less to live or has a terminal illness.

c) Pharmacist

d) Dietitian

Plan for a menu based on the disease condition & dietary needs of the patient

e) Physical therapist

Educate & heph for the Possible exercises patterns to the patient & check for the outcome.

f) Social worker

Bereavement counseling

Grief support

g) Certified Nursing assistant

Provide assistance to the nursing tasks for making the care more efficient.

g) Volunteers

Patient in hospice settings receives help from the volunteer members for providing community counseling & local support.

After the death

As the death approaches, the nurse should encourage the family to respond appropriately to the patients psychological manifestations at the end of life.

Situation in which further support needed are;

Recognise signs & behaviours among family members who may be at risk for abnormal grief reactions is an important nursing intervention. It shows the need gfo further support

It includes ;

• Dependency & negative feelings about dying person
• Inability to express feelings
• Concurrent life crisis
• Difficult reaction to previous loss
• Low self esteem
• Multiple previous bereavement
• Alcoholism
• Substance abuse

Can be Managed by;

• Community counseling & local support
• Exercises to reduce stress
• Emotional support