Module 1 E: Palliative and End-of-Life care

Palliative care

is an approach that improves the quality of life of patients (adults and children) and their families who are facing problems associated with life-threatening illness.

End-of-life care

is increasingly important in critical care settings, where the focus is often on life-saving measures. However, as the recognition of death becomes more integrated into patient care, there is a shift towards more compassionate language, moving away from terms like "withdrawal of care" or "do not resuscitate" to "allow natural death" and "withholding non-beneficial treatment." 

POLST Forms (Physician Orders for Life-Sustaining Treatment) 

Are created to ensure that patient wishes regarding life-sustaining treatment are honored, especially in emergencies. Unlike advance directives, ________ are medical orders and are easier for emergency responders to interpret and act upon. Nurses must be familiar with state laws regarding compliance. 

Comfort Care Principles 

begins after life-sustaining treatments are decided. The focus is on pain management and ensuring the family understands the plan to manage symptoms without prolonging suffering. Withdrawing and withholding treatments are ethically the same, emphasizing that no interventions are made that are unlikely to benefit the patient. 

Do Not Resuscitate (DNR) Orders 

prevent CPR and intubation, ensuring that while comfort care continues, no aggressive life-prolonging measures are taken

Symptom management

in end-of-life care focuses on comfort and avoiding unnecessary procedures. Team coordination is essential, and specialist consultation may be required if symptoms persist.