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Palliative Care (宁养服务)

Palliative care is available to acutely ill patients, may be provided along with disease-specific, life-prolonging treatment. Meticulous attention to be prevention and relief of pain and other burdensome symptoms is a basic part of quality palliative care. Yet, comprehensive palliative care includes much more. Psychosocial and spiritual care, counseling, and guidance in choosing among treatment options, and assisting with practical support for patients and caregivers are all equally fundamental components of comprehensive palliative care. It is critical to stress that palliative care should be provided from the time of diagnosis of a serious, debilitating, or life-limiting illness. Palliative care should be an integral part of healthcare aimed to achieve best possible outcomes including optimal quality of life, function, and opportunities for personal growth across the life span. Palliative care can and should be provided along with any disease-modifying treatments. And, yes, for some people with advanced illness, palliative care may be the main focus of care.

寧養服務適用於任何人——無論什麼年齡, 種族, 文化, 背景或宗教, 而且大多數服務是免費的。您可以在病情的任何階段使用寧養服務,這並不僅僅是為生命即將到達終點的人而設。使用寧養服務並不意味著生命沒有希望,您已經“放棄”或您的家庭不在乎您。您可以在接受寧養服務的同時繼續治療。

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All About Nursing · Hospice & Palliative Care

Definitions Hospice

You matter because you are you. You matter to the last moment of life, and we will do all we can, not only to help you die peacefully, but also to live until you die. (Saunders in Stoddard, 1978)

  • Centers for Medicare & Medicaid Services (CMS) defines hospice as:

“A holistic approach to treatment that recognizes that the impending death of an individual warrants a change from curative to palliative care. Palliative care means ‘patient-and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. Palliative care throughout the continuum of illness involves addressing physical, intellectual, emotional, social, and spiritual needs and to facilitate patient autonomy, access to information, and choice.'”

  • The National Hospice and Palliative Care Organization (NHPCO) defines hospice as:
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All About Nursing · Hospice & Palliative Care

Origins and a Bit of History of Hospice- Notable Influences on Hospice Development and Acceptance

Concept antedates 475 AD (早于公元475年)

  • The term hospes, a Latin word, from which the term hospice is derived, means to be both host and guest and implies interaction and mutual caring between the patient, family, and hospice staff. (Hospes 一詞是一個拉丁詞,安寧療護一詞由此而來,意味著患者,家人和安寧療護員工之間的互動和相互關懷。)
  • Self-sustained communities evolved after 335 AD where ill, weary, homeless, and dying persons received care. 在公元335年后, 发展起来,病人,疲惫,无家可归和垂死的人得到照顾.
  • During the early middle ages, the words hospice, hospital, and hostel were used interchangeably. 在中世纪早期,临终关怀,医院和旅馆这些词可以互换使用。
  • Also during the middle ages, hospitia or travelers’ rest at monasteries and convents provided food, shelter, as well as care for those sick or dying. 同样在中世纪,修道院和修道院的收容所或旅行者休息提供食物,住所以及照顾生病或垂死的人。
  • The care and support of the whole person (the body, soul, mind, and spirit) evolved in these early hospices. 對整個人(身體、靈魂、思想和精神)的關懷和支持,在這些早期的安寧療護中演化而來。
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Hospice & Palliative Care

End Stage Disease Progression and Complications – Oncologic Disorders (Learning Hospice)

  • Breast cancer is the most frequently diagnosed and is the leading cause of death from cancer in women worldwide.
  • Lung cancer is the most frequently diagnosed and the leading cause of death from cancer in men worldwide.
  • Cancer is the second most common cause of death in the United States following heart disease.

Cancer refers to a group of diseases that are characterized by uncontrolled growth and spread of abnormal of mutated cells that can be caused by external and internal factors. Mutated cells have certain characteristics as follows:

  • can avoid apoptosis (cell death)
  • resist normal aging process
  • can replicate outside normal controlling mechanisms
  • produce chemicals that dissolve surrounding tissue
  • invade other parts of the body
  • overcome the immune system
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All About Nursing · Hospice & Palliative Care

Determining Prognosis: Patients with End-Stage Lung Disease (Reading & Sharing)

Disabling Dyspnea & Respiratory Distress

Defined by:

  • Dyspnea at rest or with minimal exertion
  • Dyspnea poorly responsive or unresponsive to bronchodilator therapy
  • Dyspnea results in other debilitating symptoms such as decreased functional activity, fatigue, and cough
  • FEV-1< 30% predicted post-bronchodilator, if available
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