Terminal Illness and Palliative Care Overview
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Questions and Answers

What characterizes terminal illness?

  • Active and progressive disease (correct)
  • Death occurring within 5 years
  • The possibility of curative treatment
  • Short-term illness episodically
  • Which of the following conditions is NOT classified as a terminal illness in adults?

  • Respiratory system disease
  • Leukemia
  • Cystic Fibrosis (correct)
  • Lung cancer
  • What is a primary focus of palliative care effectiveness?

  • Extending the lifespan of patients
  • Improving quality of life before and at the time of dying (correct)
  • Curing the underlying disease
  • Reducing hospital admissions
  • Which factor is crucial for providing quality care at home for terminally ill patients?

    <p>A supportive social network</p> Signup and view all the answers

    What is one benefit of hospice day care?

    <p>It offers weekly therapy and relaxation visits</p> Signup and view all the answers

    Which of these is NOT a consideration for hospice/palliative care units?

    <p>They can guarantee a cure for terminal illnesses</p> Signup and view all the answers

    What emotional elements does palliative care aim to address?

    <p>The patient's family's emotional distress</p> Signup and view all the answers

    Terminal illnesses can lead to the need for which type of care?

    <p>Palliative care</p> Signup and view all the answers

    What is the purpose of hospice care?

    <p>To provide comfort and support at the end of life</p> Signup and view all the answers

    Which phase of death describes the irreversible cessation of all vital functions?

    <p>Mortality phase</p> Signup and view all the answers

    What is a common belief about death in American and European culture?

    <p>To avoid and deny the occurrence of death</p> Signup and view all the answers

    Which of the following describes passive euthanasia?

    <p>Withholding life-sustaining treatments</p> Signup and view all the answers

    What is NOT a characteristic of a 'good death'?

    <p>Emotional burden on family</p> Signup and view all the answers

    Which phase of death typically allows for a brief possibility of resuscitation?

    <p>Clinical death</p> Signup and view all the answers

    What does prolonged grief refer to?

    <p>An unresolved and extended emotional suffering after losing a loved one</p> Signup and view all the answers

    What is a common result of patients being admitted to a busy hospital?

    <p>May hinder the achievement of a 'good death'</p> Signup and view all the answers

    What is disenfranchised grief?

    <p>Grief related to the death of a loved one that cannot be openly expressed socially.</p> Signup and view all the answers

    Which factor influences the experience of grief?

    <p>Cultural background and belief systems.</p> Signup and view all the answers

    What characterizes dysfunctional grief?

    <p>An exaggerated response to actual or potential loss.</p> Signup and view all the answers

    Which of the following is a phase of grieving according to Engel's theory?

    <p>Shock and disbelief.</p> Signup and view all the answers

    How does sudden loss impact the grieving process?

    <p>It may lead to prolonged recovery due to unexpected nature.</p> Signup and view all the answers

    What is meant by anticipatory grief?

    <p>Grief experienced before the actual loss is confirmed.</p> Signup and view all the answers

    What can be a consequence of prolonged grief after a terminal illness?

    <p>Increased need for dependence on others.</p> Signup and view all the answers

    During which phase of Engel's grieving process might a person experience physical symptoms such as fainting or rapid heartbeat?

    <p>The shock and disbelief phase.</p> Signup and view all the answers

    What is the main focus of Phase IV in the grieving process?

    <p>Suppressing all negative feelings towards those who have left</p> Signup and view all the answers

    In Rando's grieving theory, which of the following is the correct sequence of responses?

    <p>Avoidance, Confrontation, Accommodation</p> Signup and view all the answers

    Which of the following best describes the 'Anger' stage in Kubler-Ross's grieving process?

    <p>Increased sensitivity and easily triggered emotions</p> Signup and view all the answers

    What characterizes the 'Bargaining' phase in grieving according to Kubler-Ross?

    <p>Seeking support and sharing feelings with others</p> Signup and view all the answers

    What does the 'Depression' phase indicate in Kubler-Ross's model?

    <p>Realizing the impact of loss and beginning to process it</p> Signup and view all the answers

    What development occurs during Phase V of grief?

    <p>An awareness and acceptance of one's condition</p> Signup and view all the answers

    In the context of grieving, which stage involves shock and denial?

    <p>Avoidance</p> Signup and view all the answers

    Which of the following descriptions matches the 'Acceptance' phase of Kubler-Ross's model?

    <p>Allowing oneself to face the reality of the loss</p> Signup and view all the answers

    Study Notes

    Terminal Illness

    • Terminal illness refers to a progressive disease where curative treatment is impossible or inappropriate, resulting in certain death.
    • The duration of a terminal illness varies from a few days to many months.
    • Types of Terminal Illness:
      • Cancer: Lung, trachea, bronchus, ear, nose, throat, female breast, lymphatic, digestive tract, genitourinary, leukemia, and haemopoetic.
      • Progressive Non-Malignant Diseases: Cardio/cerebrovascular diseases, respiratory system diseases, HIV/AIDS.
      • Children's Terminal Illnesses: Cystic fibrosis, muscular dystrophy.

    Palliative Care

    • Palliative Care Effectiveness:
      • Quality of life before and at the time of death.
      • "Good death" for the patient.
      • Impact on family or carers.
    • Elements of Palliative Care:
      • Pain and symptom control.
      • Relief of emotional problems.
      • Grief resolution.
      • Achievement of specific wishes.

    Place of Care for Terminal Illness

    • Home:
      • Provides quality care if the patient has a good social network and involved family members.
      • Requires careful consideration for emergencies.
      • Family members may experience burnout and fatigue.
    • Hospice Day Care:
      • Offers palliative care for patients in the community 1-2 days a week.
      • Provides complementary therapies and relaxation along with necessary nursing care.
      • Allows patients to stay at home longer.
    • Hospice/Palliative Care Unit:
      • Offers the highest level of palliative care.
      • Patients stay for 10-14 days after symptom management.
      • Approximately 50% of patients die while receiving care, while others return home for Hospice Day Care.
    • Hospital:
      • Patients are often brought to the hospital in critical condition.
      • Hospital care is needed primarily when curative therapies are still being employed.
      • The busy hospital environment may not be conducive to achieving a "good death."

    Death

    • Some cultures hold specific philosophical/religious beliefs surrounding death and have rituals for dealing with it.
    • American and European cultures typically avoid and deny death.

    Phases of Death

    • Agonal Phase: Characterized by changes in heart rhythm.
    • Clinical Death: A brief interval during which life-saving measures are still possible.
    • Mortality: Permanent death.

    Issues in Terminal Illness/Terminal Care

    • Advance Directives: Procedures for withdrawing life support when a patient is dying.
    • Euthanasia:
      • Passive Euthanasia: Withholding treatment previously provided.
      • Active Euthanasia: Intentionally inducing death.
    • Good Death: Physical comfort, support from loved ones, adequate healthcare, acceptance of impending death, and not being a burden on others.
    • Hospice: A program committed to achieving a painless, anxiety-free, and depression-free end of life. Hospice prioritizes symptom management rather than life extension.

    Grief

    • Grief: Emotional numbness, disbelief, anxiety due to separation, despair, sadness, and loneliness accompanying the loss of a loved one.
    • Prolonged Grief: Persistent and unresolved despair for an extended period.
    • Disenfranchised Grief: Grief over the loss of someone that is socially unacceptable to openly express.
    • Grief is Multidimensional: Grief can last for years.

    Types of Grief

    • Anticipatory Grief: A state in which an individual experiences the emotional responses to an actual or perceived loss of a relationship, object, or functional ability before the actual loss occurs.
    • Dysfunctional Grief: A state in which an individual's response is exaggerated, particularly when experiencing an actual or potential loss of a relationship, object, or functional ability. This type of grief may approach abnormal grieving patterns.

    Factors Affecting Grief

    • Personal characteristics.
    • Social, cultural, and spiritual beliefs.
    • Nature of the relationship.
    • Socioeconomic status.
    • Individual's physical and psychological condition.
    • Support system.

    Nature of Loss

    • Sudden (Unpredictable) Loss:
      • Sudden and unexpected losses may lead to a slower recovery.
      • Death due to violence, suicide, or murder can be particularly difficult to accept.
    • Gradual (Predictable) Loss:
      • Prolonged and debilitating illnesses can cause emotional exhaustion for survivors.
      • Research suggests that those who lose a loved one after a long illness of at least 6 months have greater needs for dependency, are more prone to isolation, and experience heightened feelings of anger and hostility..

    Theories of Grief

    • Engel's Theory (1964):
      • Stage I (Shock and Disbelief): Denial of the loss, withdrawal, and physical reactions such as fainting, sweating, nausea, diarrhea, rapid heart rate, sleeplessness, and fatigue.
      • Stage II (Developing Awareness): Experiencing the loss in a real and acute manner, which may lead to desperation. Anger, guilt, frustration, depression, and emptiness may arise.
      • Stage III (Restitution): Trying to accept the feeling of emptiness and seeking ways to cope.
      • Stage IV: Suppression of negative feelings, like hostility and guilt, towards the deceased.
      • Stage V: Acceptance of the loss, developing a new way of life while acknowledging the loss.
    • Rando's Theory (1993):
      • Avoidance: Characterized by shock, denial, and disbelief.
      • Confrontation: Involves intense emotional outbursts as the individual repeatedly confronts their loss and deepest grief.
      • Accommodation: Gradual reduction in acute grief and a return to emotional and social involvement in daily life. The individual learns to live with their loss.
    • Kübler-Ross' Theory (1969):
      • Denial: The individual acts as if nothing has happened, often refusing to believe the loss has occurred. Common expressions include "No, it can't be true," or "It won't happen to me!"
      • Anger: The individual is more sensitive and easily irritated, manifesting a coping mechanism to cover up disappointment and anxieties about facing the loss.
      • Bargaining: The individual seeks support to alleviate feelings of loss. They may turn to others for reassurance and vent their frustrations.
      • Depression: Occurs when the individual acknowledges the loss and its impact. This stage allows the opportunity to process the loss and start to solve problems associated with it.
      • Acceptance: Physiological reactions decrease, and social interactions resume. Kübler-Ross defines acceptance as the ability to face reality rather than surrendering or despairing.

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    Description

    This quiz explores the concepts of terminal illness and palliative care. It covers types of terminal illnesses, the effectiveness of palliative care, and the elements crucial for providing quality end-of-life care. Test your knowledge about this important aspect of healthcare that emphasizes comfort and support for patients and their families.

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