Palliative Care Overview and Key Concepts

Introduction to Palliative Care

  • Meeting context of the speaker and friends in nursing school.

Team Composition

  • Beth Scammell's role in the palliative care team for 9 years.
  • Team: 1 physician and 5 RNs covering Cumberland County.

Philosophy of Care

  • Importance of the patient: They choose team members and direction of care.
  • Quote by Dame Cicely Saunders emphasizing patient value until death.

Decision Makers

  • Patient as primary decision maker if capable.
  • Importance of recognizing legal decision makers (Power of Attorney).
  • Hierarchy of substitute decision makers in Nova Scotia: spouse, adult children, etc.

Family Dynamics

  • Challenges in decision-making among family members.
  • Need for formal documents to reduce conflict and clarify wishes.

Goals of Care

  • Overview of goals of care and DNR (Do Not Resuscitate) options.
  • Regular review of goals upon hospitalization and changes in health status.

Community Resources

  • Overview of services including VON, pharmacy, hospital foundation, hospice, etc.
  • Importance of community resources in supporting palliative care patients.

Symptom Management

  • Common symptoms and management strategies at end of life:
    • Increased sleeping, decreased food and drink intake
    • Confusion, restlessness, physiological changes (e.g., skin color, temperature fluctuations)

End of Life Conversations

  • Importance of education for families on what to expect during end of life.
  • Discussing comfort measures and medication management without prolonging suffering.

Emotional Challenges in Palliative Care

  • Emotional impact of frequent loss on caregivers and nurses.
  • Strategies for handling difficult family dynamics and ethical decisions.

Final Thoughts

  • Acknowledgment of palliative care misconceptions.
  • Encouragement to understand palliative care as supportive, not just a final stage.

Personal Reflections from Beth

  • Benefits of working in palliative care: making a difference, flexibility and independence.
  • Importance of connecting emotionally with the work while maintaining professionalism and boundaries.

Conclusion

  • Information about palliative care as a compassionate resource for patients and families.