PALLIATIVE CARE

 

According to the World Health Organization, palliative care focuses on reducing the symptoms of a disease without attempting to provide a cure; it neither hastens nor postpones death. Palliative care affirms life while accepting death as its normal conclusion. interventions are designed to optimize the patient’s ability to live as active and complete a life as possible until death comes. Medical treatment and nursing care focus on actions that enable the dying person to have the highest quality of life for whatever time remains in his or her life.

Communication is an informative process that starts from a point of origin and arrives at a destination, irrespective of the channel or medium used.

Main fears:

• Death and a dying healthcare professionals and caregivers in psychological reactions that lead to the patient avoid communication terminal.
• Overcome à the anxiety generated disclose bad news, the fear of provoking and overreaction in sick, the fear of over identifying, fear of lack of response to questions from the patient.

Basic principles

• Velocity of communication according to the assimilation of each person.
• The diagnostic, treatment and prognosis must be in different sessions, never in the same because the patient has to assimilate the information.
• If the patient won’t know the information we have to respect his posture and say her/his that if he/she change the opinion they can talk with us.
• Never take off the hope but neither generates it.

Professional communication models:

• Technical: focus on à Health and disease  à Ignore the psychosocial area
• Paternalistic: Intermediate between health and illness and psychosocial area 
• Complacent: can not make therapeutic distance
• Deliberative: focus on à same level in health and disease in the psychosocial area.

Bad notices

It’s information that alters the vision of the patient about her/his future. Here are some directives to follow when you are going to say bad notices:

Analgesia scale by WHO

 

NURSING CARES

Anorexia

• Less food in big plates.
• Adequate preparation of the food.
• Delicious food for the patient.

Vomits and nauseas

• Adequate diet and drugs.

Constipation

• Increase the intake of liquids.
• Restriction of diets rich in fibber.
• Drugs.

Mouth

• Clean lips and oral mucous.
• Eliminate place and rests.
• Prevent oral infection.
• Eliminate pain in oral intake.

Nursing is very important in palliative cares. We must know how to communicate with the patient because is necessary to transmit to the patient our knowledge, explain carefully all they want to know... We must know how to ask their questions and help to them. We stay with the patient and with the family for along time and we must to be professionals but we must to have empathy with them too.

1.     Gloria Hoffmann Wold. Basic Geriatric Nursing. 5^th ed. Milwaukee, Wisconsin:Elsevier; 2012