PALLIATIVE CARES

Nursing is an important part in palliative cares and in the death process because we stay much time with the patients and the family and we have to know how communicate with them, how answer their questions… So is important that we distinguish different methods to do this.

Basic principles

• Velocity of communication according to the assimilation of each person.
• The diagnostic, treatment and prognosis must be in different sessions, never in the same because the patient has to assimilate the information.
• If the patient won’t know the information we have to respect his posture and say her/his that if he/she change the opinion they can talk with us.
• Never take off the hope but neither generates it.

Bad notices

It’s an information that alters the vision of the patient about her/his future. Here are some directives to follow when you are going to say bad notices:

In this article The patient’s right to information: the art of communicating,there are 2 investigations about if the patients would know their diagnosis. Both studies mark that that if the patients know the diagnosis, the prognosis, the treatment… is better for their. I’m agree with this conclusion because if you know what happen with your body, what is wrong… you accept better the treatment and the cares.

Also, it’s described the silence pact. It’s an interesting point because in one study, 70% of the families occult the information to the sick. This situation is worse for the patient and in this article shows how we can confront this.
In this other guide there are 6 directives called Communication strategies of Buckman.

Loss

  - Death of a loved person.

  - Loss of an organ or corporal function.

  - Disaster.

  - Family separation.

  - Retirement.

  - Loss of employment.

Mourning

Emotional adaptation process that follows any loss and its associated physical and emotional symptoms.

Mourning stages

  1. Negation.

  2. Anger.

  3. Negotiation.

  4. Depression.

  5. Acceptance.

In this video are showing the stages.

Palliative cares

With this cares we pretend to get better the quality of life of the patient and their family by early diagnosis, adequate evaluation and a good treatment of the pain and other physical and spiritual problems.

Palliative medicine

 - That’s initiate when the patient doesn’t answer to the curative therapy.

 - Finish with the maximum comfort to the patient.

 - Duration: 60 – 65 days.

Diseases that need the palliative cares:

  • Cancer in terminal stage.

  • HIV and AIDS.

  • Organic insufficiency.

  • Neurodegenerative diseases.

Pain evaluation

With this scale we evaluate the pain.

Analgesia scale by WHO.

NURSING CARES

Anorexia

• Less food in big plates.
• Adequate preparation of the food.
• Delicious food for the patient.

Vomits and nauseas
  - Adequate diet and drugs.

Constipation
  - Increase the intake of liquids.
  - Restriction of diets rich in fiber.
  - Drugs.

Mouth
  - Clean lips and oral mucous.
  - Eliminate place and rests.
  - Prevent oral infection.
  - Eliminate pain in oral intake.

Finally, in this video, patients, family of patients and sanitary staff of an ospital have explained how they live the palliative cares, what can we do and how we can confront the death.