Palliative Care at the Very End of Life - Dartmouth-Hitchcock

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Medications Limit essential medications Choose less invasive route of administration Buccal mucosal oral first, then consider rectal Subcutaneous, intravenous Intramuscular almost never
As Expected Death Approaches Discuss status of patient and realistic care goals Role of all team members What the patient experiences, what onlookers see
Page 1 and 2: Palliative Care at the Very End of
Page 3 and 4: Like every birth, every death is un
Page 5 and 6: ...Objectives ... Objectives Descr
Page 7 and 8: Where do people die Hospital-50% H
Page 9 and 10: Dementias Pneumonia Urosepsis En
Page 11 and 12: What Is “Good Good Death” Death
Page 13 and 14: Steinhauser et al. 2000 “…pain
Page 15 and 16: Symptom Frequency in Last 48 Hours
Page 17 and 18: Clinical Assessments and Interventi
Page 19 and 20: (Blues & Zerwekh, 1984) From Wilkie
Page 21 and 22: Overcoming Barriers Recognize key
Page 23 and 24: Weakness/Fatigue Decreased ability
Page 25 and 26: Benefits and Burdens of Artificial
Page 27 and 28: Unproven Benefits of Artificial Fee
Page 29 and 30: Benefits and Burdens Burdens of Ar
Page 31 and 32: Summary of Benefits/Burdens Few me
Page 33 and 34: …Decreasing Decreasing Fluid Inta
Page 35 and 36: Neurologic dysfunction Decreasing
Page 37 and 38: …Communication Communication with
Page 39 and 40: Palliative Care Interventions: Seda
Page 41 and 42: Fears …Changes Changes in Respira
Page 43: Pain Fear of increased pain Asses
Page 47 and 48: • Discontinue diagnostic tests
Page 49 and 50: Social Concerns Patient Preference
Page 51 and 52: Spiritual Care Unfinished business
Page 53 and 54: Signs of Death • Cessation of hea
Page 55 and 56: PRONOUNCEMENT OF DEATH When you are
Page 57 and 58: Pronouncing Death and Beyond Know

Palliative Care at the Very End of Life - Dartmouth-Hitchcock

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