Palliative Care Of the Dying Woman
Objectives Describe the Philosophy of Palliative CareDescribe the Philosophy of Palliative Care Discuss the emotionsDiscuss the emotions Discuss how a women's terminal diagnosis may affect her familyDiscuss how a women's terminal diagnosis may affect her family Examples that contribute or detract from a good deathExamples that contribute or detract from a good death
Women's Funeral of 1901
What is palliative Care? CHPCA Model CHPCA Model
Palliative Care… Focuses on relieving suffering, improving quality of lifeFocuses on relieving suffering, improving quality of life –Affirms life, sees death as a personal and natural process –Many diagnoses –Appropriate early in course of illness –Patient and family preferences respected –May be combined with curative therapies or may be the focus of care
…Palliative Care Interdisciplinary care of the patient and familyInterdisciplinary care of the patient and family Pain and symptom managementPain and symptom management May include disease-modifying treatmentsMay include disease-modifying treatments Psychological, social, spiritual supportPsychological, social, spiritual support Bereavement supportBereavement support
Essence of palliative care – A personal reflection Improving the Quality of life is the total approachImproving the Quality of life is the total approach Relieving total sufferingRelieving total suffering The intersection of biology and biographyThe intersection of biology and biography Making people matterMaking people matter Having the courage to be inspired and then to actHaving the courage to be inspired and then to act Meeting the needs of the patient and their caregiversMeeting the needs of the patient and their caregivers Care and compassionCare and compassion Goals of careGoals of care
Shock: Denial vs. PanicDenial vs. Panic
Emotion: Catharsis vs. DepressionCatharsis vs. Depression
Negotiation: bargaining vs. selling outbargaining vs. selling out
Cognition: Realistic Hope vs. DespairRealistic Hope vs. Despair
Commitment: Acceptance vs. ResignationAcceptance vs. Resignation
Completion: Fulfillment vs. ForlornnessFulfillment vs. Forlornness
Fear : The fear of my own undoingFear : The fear of my own undoing Intimacy Intimacy
Guilt : families anger toward the dying personGuilt : families anger toward the dying person : need to review what has happened or what was neglected : need to review what has happened or what was neglected
Anxiety: Tolstoy- The Death of Ivan IlychAnxiety: Tolstoy- The Death of Ivan Ilych Death anxiety
Good Death: Bad Death Is there such a thing?Is there such a thing?
Open, ongoing communication Open, ongoing communication
Preservation of the patient’s decision- making power Preservation of the patient’s decision- making power
Sophisticated Sophisticated Symptom control
Limits are set on excessive treatment Limits are set on excessive treatment
A focus on preserving patient quality of life A focus on preserving patient quality of life
Emotional support Emotional support
Spiritual support Spiritual support
The patient is not abandoned by medical staff even when curative treatment is no longer required. The patient is not abandoned by medical staff even when curative treatment is no longer required.
The dying need the friendship of the heart – its qualities of care, acceptance, vulnerability; but they also need the skills of the mind- the most sophisticated treatment that medicine can offer. On its own, neither is enough Dame Cicely Saunders
Thank you for your kind attention. Questions?