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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

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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All About Nursing · CNE self study · Hospice & Palliative Care · Nursing Continue Education

Chronic Obstructive Pulmonary Disease (COPD) – Reading & Sharing

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States. It is highly prevalent, and as it progresses, causes patients to become too disabled to work, thus creating substantial economic and social burdens. In 2010, U.S. healthcare data estimated the total economic burden from COPD at $50 billion, of which $30 billion was related to direct medical expenditures and the remaining $20 billion related to morbidity, loss of work, and premature death. There are also unacknowledged and unquantified costs including the economic value of care provided by family members and their potential lost wages as they stay home to care for the patient.

As the disease progresses, some patients will choose mechanical ventilation as a palliative treatment option. although the patient with advanced disease is eligible for hospice care, many hospices cannot afford to accept the patient with mechanical ventilation into their programs because this high-tech intervention drives the cost of care beyond the standard insurance reimbursement. Thus, patients and families may be deprived of the benefits of hospice care.

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