Guidelines for a Palliative Approach in Residential Aged Care

More documents

Recommendations

Info

INDEX Abbey Pain Scale 64, 71, 78 Aboriginal and Torres Strait Islanders 13, 73, 143–145 acupressure 11, 115, 86–87 acupuncture 11, 112, 115 acute care 40, 56 advance care planning 8, 56–60 advance directives 56, 247 advocacy 140 Aged Care Act 1997 15 aged care assessment teams 123–124 Alzheimer’s disease 3 analgesics 63, 73, 74, 79, 81 anorexia 69, 96 antibiotics 65 antidepressants 81, 121 antipyretics 65 anxiety 12, 38, 48, 117, 122–123, 127, 178 APRAC project see Australian Palliative Residential Aged Care project aromatherapy 112, 115 artificial nutrition see enteral nutrition Assessment of Discomfort in Dementia protocol 64 attitude to death 4, 51, 119 Australian Medical Sheepskins 104 Australian Medicines Handbook 80 Australian Medicines Handbook Drug Choice Companion: Aged Care 80 Australian Palliative Residential Aged Care project 1, 5 Australian Palliative Residential Aged Care project — Reference Group 32, 33, 34, 229 Australian Palliative Residential Aged Care project — Working Party 32, 34, 225–227 behavioural disturbances 112, 126 beliefs 143, 145 bereavement support 4, 173–181 bowel care 10, 106–108 bowel problems 69, 70 breakthrough pain see pain, breakthrough breathing difficulties see dyspnoea Brief Pain Inventory 77 cachexia 10, 96–97 CAM see complementary therapies Campbell Collaboration 6, 20, 22 cancer 4, 42, 86, 162, 163 care planning 43 care plans 39 carers 38 catheterization 167 cerebrovascular accident 3 Certification of Death 170 chaplains 154, 155 Cheyne-Stokes breathing 167 chronic obstructive lung disease 3 cleanliness 38 Cochrane Collaboration 6, 19, 20, 22 Code of Ethics 55 codes of professional conduct 52 Guidelines for a Palliative Approach in Residential Aged Care 255
cognitive ability 49 cognitive behaviour therapy 86 cognitive impairment 113 cognitive stimulation therapy 113–114 communication 7, 12, 37, 47, 55, 57, 65, 117, 130 communication difficulties 4 communication skills 70, 122, 149 communication, transcultural 148 Community Services and Health Industry Skills Council 34 co-morbidities 4, 38, 98 complementary therapies 11, 111–115 confidentiality 52, 140 conflict 41 confusion 4, 117, 123–124 constipation 69, 106, 107, 108 continence 47 continence see also incontinence coping mechanisms 151 Cornell Scale for Depression in Dementia 120 corticosteroids 97 counselling 121 CPOD see chronic obstructive lung disease CSDD see Cornell Scale for Depression in Dementia CSHIC see Community Services and Health Industry Skills Council cultural diversity 13 cultural issues 4, 13, 73, 144, 145, 147–150 death 169, 170, 177 decision making 40, 41, 55, 58 dehydration 9, 93–96 see also rehydration delirium 12, 123, 124–125, 127, 165 dementia 4, 8, 12, 57, 69, 91, 123, 124, 125, 126–127, 162, 163 assessment 62, 67 management 65–66 prevalence 61 pain 62–64, 73, 78 symptoms 126 dementia, advanced 61–67 D-E-N-T-A-L questionnaire 102 depression 11, 38, 51, 70, 88, 117, 118–123, 127 assessment 119–121 management 121–122 prevalence 118 symptoms 118, 119 desire to die 51, 119 diet 90 dignity 7, 49, 53, 169 see also dying with dignity Dignity-Conserving Care Model 47 disabilities 37 Discomfort Scale for Dementia of the Alzheimer’s Type 63, 64 distress 9, 12, 48, 71, 88, 117, 127 dying with dignity 42, 47 dysphagia 10, 66, 70, 99–101 dyspnoea 11, 38, 69, 70, 109–111, 167 eating difficulties 66 ecomap 131, 253 Edmonton Symptom Assessment Scale 71 end-of-life care 8, 14, 38, 56, 57, 65, 161–171 enduring health advocate 58 enduring power of attorney 52, 58 enduring power of guardianship 52 enteral feeding 9, 59, 60, 88, 90, 91–92, 93 ESAS see Edmonton Symptom Assessment Scale 256 Guidelines for a Palliative Approach in Residential Aged Care
Page 1 and 2:
Guidelines for a Palliative Approac
Page 3 and 4:
NHMRC APPROVAL These guidelines wer
Page 5 and 6:
4 ADVANCE CARE PLANNING 55 4.1 Impl
Page 7 and 8:
16 MANAGEMENT’S ROLE IN IMPLEMENT
Page 9 and 10:
17 Ann and Mr Wells’ family Helpi
Page 12:
IMPORTANT NOTICE On 8 December 2005
Page 15 and 16:
achieved for these guidelines from
Page 17 and 18:
facets of a palliative approach are
Page 19 and 20:
Additional levels of evidence The N
Page 21 and 22:
Guidelines Ref No. Evidence level A
Page 23 and 24:
Guidelines Ref No. Evidence Cachexi
Page 25 and 26:
Guidelines Ref No. Evidence Anxiety
Page 27 and 28:
Guidelines Ref No. Evidence 70. Und
Page 29 and 30:
1.1.1 Aims The aims of the systemat
Page 31 and 32:
Table 1: Search terms Terms Aborigi
Page 33 and 34:
1.1.5 Exclusion Criteria Although t
Page 35 and 36:
in the methodology that may invalid
Page 37 and 38:
To ensure the reliability of the re
Page 39 and 40:
1.2.2 Methodology When the first re
Page 41 and 42:
1.4.2 Method When feedback was requ
Page 43 and 44:
Several Working Party members conve
Page 45 and 46:
or disagreed with each stakeholder
Page 47 and 48:
All the feedback received was colla
Page 50 and 51:
CHAPTER 2 A PALLIATIVE APPROACH A s
Page 52 and 53:
• Profound weakness • Trouble s
Page 54 and 55:
• Has the resident had a recent d
Page 56 and 57:
in the RACF rather than transferrin
Page 58:
palliative care teams is more appro
Page 61 and 62:
or ageing progression (see Table 4)
Page 63 and 64:
Table 7: A practical model of socia
Page 65 and 66:
Vignette 2: Robert’s story Robert
Page 68 and 69:
CHAPTER 4 ADVANCE CARE PLANNING Car
Page 70 and 71:
efore discussing the advance care p
Page 72 and 73:
• A change in their health status
Page 74 and 75:
CHAPTER 5 ADVANCED DEMENTIA Advance
Page 76 and 77:
A study was conducted to investigat
Page 78 and 79:
5.3.2 Acute illness One study found
Page 80:
Vignette 5: Anna’s story Anna was
Page 83 and 84:
(see Fainsinger, Miller and Bruera
Page 85 and 86:
Dame Cicely Saunders first describe
Page 87 and 88:
Table 8: Common myths about pain ma
Page 89 and 90:
6.2.4 Breakthrough pain The term
Page 91 and 92:
Pain can lead to behavioural change
Page 93 and 94:
Vignette 7: Mrs Harris’ story Mrs
Page 95 and 96:
examined the addition of paracetamo
Page 97 and 98:
provision and storage of drugs, whe
Page 99 and 100:
successfully tested predominantly w
Page 101 and 102:
The reasons for malnutrition in old
Page 103 and 104:
The diets of residents should also
Page 105 and 106:
To assist in such a discussion, a d
Page 107 and 108:
appear until dehydration is far adv
Page 109 and 110:
Guideline: Hydration 24. Recommenda
Page 111 and 112:
6.7 NAUSEA AND VOMITING Nausea is t
Page 113 and 114:
• Do you have any problem control
Page 115 and 116:
6.9.1 Assessment A thorough oral as
Page 117 and 118:
6.10 SKIN INTEGRITY The major skin
Page 119 and 120:
Wounds can occur in residents for a
Page 121 and 122:
Brocklehurst and colleagues (1999)
Page 123 and 124:
medication treatment along with non
Page 125 and 126:
• CAM therapies may be culturally
Page 127 and 128:
word games, the present day, and fa
Page 130 and 131:
CHAPTER 7 PSYCHOLOGICAL SUPPORT A r
Page 132 and 133:
7.1.1 Death statements and depressi
Page 134 and 135:
the factor structure of the CSDD. I
Page 136 and 137:
7.2.2 Management Non-pharmacologica
Page 138 and 139:
Table 17: Distinguishing delirium f
Page 140:
is recognised that in many rural an
Page 143 and 144:
important [305] (Level QE). Familie
Page 145 and 146:
8.4 FAMILY INVOLVEMENT The role of
Page 148 and 149:
CHAPTER 9 SOCIAL SUPPORT, INTIMACY
Page 150 and 151:
Rather than denying the existence o
Page 152 and 153:
9.2.2 Management Imaginative progra
Page 154:
Guideline: Social Support Social Su
Page 157 and 158:
include lack of information about t
Page 160 and 161:
CHAPTER 11 CULTURAL ISSUES Australi
Page 162 and 163:
11.2 Assessment The best approach t
Page 164 and 165:
CHAPTER 12 SPIRITUAL SUPPORT Dein a
Page 166 and 167:
Vignette 13: Jack’s story Jack wa
Page 168:
Guideline: Spiritual Support 68. A
Page 171 and 172:
interpersonal and leadership skills
Page 174 and 175:
CHAPTER 14 END-OF-LIFE (TERMINAL) C
Page 176 and 177:
mood (61%), constipation (59%) and
Page 178 and 179:
e relevant, and may even worsen sym
Page 180 and 181:
Treatment involves changes in posit
Page 182 and 183:
14.5 PREPARING FOR IMMINENT DEATH
Page 184:
education of the aged care team and
Page 187 and 188:
Table 21: Grief, loss and bereaveme
Page 189 and 190:
• excessively avoiding tasks remi
Page 191 and 192:
Vignette 18: Reflections When provi
Page 193 and 194:
may have been able to contribute to
Page 196 and 197:
CHAPTER 16 Management’s role in i
Page 198 and 199:
REFERENCES 1. World Health Organiza
Page 200 and 201:
31. Hanson, L. C., Danis, M. & Garr
Page 202 and 203:
60. World Health Organization Quali
Page 204 and 205:
89. McCarthy, M., Addington-Hall, J
Page 206 and 207:
121. Saunders, C. M. (1998). Forewo
Page 208 and 209:
150. Sindrup, S. H. & Jensen, T. S.
Page 210 and 211:
177. Berry, E. M. & Marcus, E.-L. (
Page 212 and 213:
208. Robinson, S. B. & Rosher, R. B
Page 214 and 215:
237. Brocklehurst, J., Dickinson, E
Page 216 and 217: 265. Barraclough, J. (1997). ABC of
Page 218 and 219: 295. Brown, T. M. & Boyle, M. F. (2
Page 220 and 221: 328. Kristjanson, L. J., Leis, A.,
Page 222 and 223: 360. McGrath, P., Vun, M. & McLeod,
Page 224 and 225: 392. Saunders, C. M. & Baines, M. J
Page 226 and 227: 424. Rawlings, D. & Glynn, T. (2002
Page 228 and 229: Glossary acetaminophen Acetaminophe
Page 230 and 231: coordinator of volunteers coping A
Page 232 and 233: geropsychologist A geropsychologist
Page 234 and 235: opioids Opioid is a specific term u
Page 236: specialised palliative team A speci
Page 239 and 240: Ms Wendy Shiels Dr Jane Sims Dr Chr
Page 242: APPENDIX B The Australian Governmen
Page 245 and 246: APRAC GUIDELINES: EVIDENCE EVALUATI
Page 247 and 248: APRAC GUIDELINES: EVIDENCE EVALUATI
Page 250 and 251: APPENDIX F: Summary of the frequenc
Page 252: APPENDIX G: An example of how the g
Page 256 and 257: APPENDIX I: Resource list PALLIATIV
Page 258 and 259: Psychological Challenge Depression
Page 260 and 261: APPENDIX J: Examples of advance dir
Page 262 and 263: Schedule 1 MEDICAL POWER OF ATTORNE
Page 264: APPENDIX K An example of a Genogram
Page 270 and 271: evidence levels 5, 6, 20, 21, 22 ev
Page 272: andomized controlled trials 5, 21 R
Page 275 and 276: Palliative Care Australia PO Box 24
show all

Guidelines for a Palliative Approach in Residential Aged Care

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?