1. Palliative Care Of the Dying Woman

3. 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

4. Women's Funeral of 1901

5. What is palliative Care? CHPCA Model CHPCA Model

8. 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

9. …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

10. 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

11. Shock: Denial vs. PanicDenial vs. Panic

12. Emotion: Catharsis vs. DepressionCatharsis vs. Depression

13. Negotiation: bargaining vs. selling outbargaining vs. selling out

14. Cognition: Realistic Hope vs. DespairRealistic Hope vs. Despair

15. Commitment: Acceptance vs. ResignationAcceptance vs. Resignation

16. Completion: Fulfillment vs. ForlornnessFulfillment vs. Forlornness

17. Fear : The fear of my own undoingFear : The fear of my own undoing Intimacy Intimacy

18. 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

19. Anxiety: Tolstoy- The Death of Ivan IlychAnxiety: Tolstoy- The Death of Ivan Ilych Death anxiety

20. Good Death: Bad Death Is there such a thing?Is there such a thing?

21. Open, ongoing communication Open, ongoing communication

22. Preservation of the patient’s decision- making power Preservation of the patient’s decision- making power

23. Sophisticated Sophisticated Symptom control

24. Limits are set on excessive treatment Limits are set on excessive treatment

25. A focus on preserving patient quality of life A focus on preserving patient quality of life

26. Emotional support Emotional support

27. Spiritual support Spiritual support

28. 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.

29. 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

30. Thank you for your kind attention. Questions?