PALLIATIVE CARE FOR HEALTHCARE ASSISTANTS YOUR ROLE Version 1 What is Palliative Care Palliative care is an approach that improves the quality of life of people and their families facing the problems associated with lifelimiting illness through the ID: 775122
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Dr. Catherine Buckley PhD, MSc, BSc, RGN
PALLIATIVE CARE FOR HEALTHCARE ASSISTANTS YOUR ROLE
Slide2Version 1
What is Palliative Care?
“Palliative care is an approach that
improves the quality of life of people and their families facing the problems associated with life-limiting illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual”. (WHO, 2002)
Slide3Slide4Who Should Receive Palliative Care?
All persons with a life-limiting illness irrespective of age, diagnosis or setting
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Slide5Who Provides Palliative Care?
Everyone working in a service that provides health and social care is obliged to understand and provide a level of palliative care that uses palliative care principles and a palliative care approach
Slide6Slide7What is a Palliative Care Approach?
Recognises that death is inevitableProvides opportunities for the person to make plans and set goals about their careIncludes the family, should the person wish, to be involved in planning for their careMaximises the persons full potential and quality of life as defined by them
Slide8A core skill in health and social care and focuses on:
Promoting quality of lifeProviding effective symptom controlHolistic approach that includes the person’s life experience and current situationCare for the dying person and those who matter to the personOpen sensitive communication with the person, family/carers and colleagues
Slide9What are the Levels of Palliative Care Provision?
Level 1 – Palliative Care Approach: provided by all staff as part of their general roleLevel 2 – General Palliative Care:provided by some with extra knowledge/education/skill as part of their general roleLevel 3 – Specialist Palliative Care:provided by a few in a specialist palliativecare role with specialist knowledge and skills
Slide10What is the Role of the Specialist Palliative Care Team?
Clinical management and care coordination including:
triage, assessment and care planning for persons with complex care needs associated with life limiting illness and/or end of life
Act as a resource for other health and social care professionals in the area, by providing support and advice when needed.
Provide facilities for research and education in palliative care.
Provides support to families including bereavement support.
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What is a Palliative Care Needs Assessment?
A palliative care needs assessment is an individualised assessment of palliative care needs based on palliative care principles and the domains of palliative care
Slide13Domain 1: Physical Wellbeing
Unique to the person and may require prompting to share Pain Fatigue Respiratory Gastrointestinal Neurological Other
All forms of physical pain
Fatigue not relieved by rest and not appropriate to level of activity
Breathlessness, cough, secretions
Insomnia, confusion, delirium, anxiety,
depression
Anorexia, nausea, vomiting, constipation
Functional
status, balance problems, oedema, wound problems
Slide14Physical Wellbeing:
Health Care Assistant Role
Observe for signs of pain, discomfort, nausea, breathlessness or any evidence of distress and report to your teamReport promptly any complaints of pain, discomfort, nausea, breathlessness, constipation or any other distressFollowing intervention observe for signs of symptom relief and report if symptoms persist....and report back to the team
When interacting and providing care:
Slide15Assessing pain
P = pick up on mood changes A = Asses verbal ques I = Inspect facial expression's N= Notice body language
Slide16What can you do as a healthcare assistant to identify pain
Report any behaviours to nurse, family, and GP.Assessment begins by asking an individual about their pain because only the individual can determine how much pain they are experiencing, despite their cognitive impairment. Consider, interventions that can be done by you, at the time of pain, ie Pressure care, hunger, hydration, distraction, oral care and reassurance. Monitor for interventions that relieve or worsen pain.
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Domain 2: Social and Occupational Wellbeing
BackgroundFamily supportEmotional and social supportPractical concerns
Slide18Social and Occupational Wellbeing:
Health Care Assistant Role
Background Tell me about yourself: occupation, hobbies. Any concerns?Family Support Who lives with you: adults, children, dependants. Any worries, concerns?
Emotional and Social Support Other supports: friends, neighbours, community nurse, home help. How often do you see people? Mood Observe mood. Practical Concerns Practical issues, coping at home, stairs, cooking, money worries. Any worries or concerns ?
When interacting and providing care:
...and report back to the team
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Domain 3: Psychological Wellbeing
Persons mood and interestHow the person adjusts to their illnessWhat gives the person strengthTotal painPre-existing mental illness
Slide20Psychological Wellbeing:
Health Care Assistant Role
Mood and Interest Feeling down or bothered? Are you tense, frightened?Adjustment to Illness Do you understand your illness?
Resources What/who is your support? Total pain Pain that is more than physical e.g. emotional, spiritualCo-morbid diagnosis Current or past history of mental illness...and report back to team
When interacting and providing care observe, take note and consider gently exploring:
Slide21Domain 4:
Spiritual Wellbeing
People have many different understandings of the word spiritual and how it impacts on their lives.
When completing a spiritual assessment, assessors need to be aware of alternative terms i.e. faith, belief, philosophy, religion, inner strength.
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Slide22Spiritual Wellbeing:
Health Care Assistant Role
When interacting and providing care:Look around and see if the person has any pictures, ornaments, or religious symbols that you could use to open a conversationIf you see any religious symbols gently ask the person if their faith gives them strengthIf no religious symbols gently enquire about source of inner strengthDon’t probe too much if the person seems distressed and report back to the team ....and report back to team
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On completion of your assessment or observation report any issues you have identified back to the team.
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