Living with Life-Threatening Illness: The Patient Experience

 

<![if !supportLists]>1. <![endif]> Describe the 3 key tasks of the dying role: practical, relational, and personal

    Practical   Relational</o:p> <td width=174 valign=top style='width:174.0pt;border:solid windowtext 1.0pt; border-left:none;mso-border-left-alt:solid windowtext .5pt;mso-border-alt: solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal> Personal</o:p> <tr style='mso-yfti-irow:1;mso-yfti-lastrow:yes'> <td width=174 valign=top style='width:174.0pt;border:solid windowtext 1.0pt; border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal>Concrete tasks: <ul style='margin-top:0in' type=disc> <li class=MsoNormal style='mso-list:l1 level1 lfo3;tab-stops:list .5in'>financial legacy</li> <li class=MsoNormal style='mso-list:l1 level1 lfo3;tab-stops:list .5in'>end of life planning</li> <li class=MsoNormal style='mso-list:l1 level1 lfo3;tab-stops:list .5in'>caring for dependents</li> <li class=MsoNormal style='mso-list:l1 level1 lfo3;tab-stops:list .5in'>last good-byes</li> <li class=MsoNormal style='mso-list:l1 level1 lfo3;tab-stops:list .5in'>arrangements for dependents</li> <li class=MsoNormal style='mso-list:l1 level1 lfo3;tab-stops:list .5in'>estate &amp; will in order</li> </ul> <td width=174 valign=top style='width:174.0pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal>Engaging with others: <p class=MsoNormal style='margin-left:13.0pt;text-indent:-13.65pt;mso-list: l1 level1 lfo3'><![if !supportLists]><span style='font-family:Symbol; mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol'><span style='mso-list:Ignore'>· <![endif]>relating to other roles <p class=MsoNormal style='margin-left:41.05pt;text-indent:-.25in;mso-list: l1 level2 lfo3'><![if !supportLists]><span style='font-family:"Courier New"; mso-fareast-font-family:"Courier New";mso-bidi-font-family:"Courier New"'><span style='mso-list:Ignore'>o   <![endif]>the teaching role <p class=MsoNormal style='margin-left:13.0pt;text-indent:-13.65pt;mso-list: l1 level1 lfo3'><![if !supportLists]><span style='font-family:Symbol; mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol'><span style='mso-list:Ignore'>· <![endif]>passing the mantle &#8211; ie  handing down a recipe collection to children <p class=MsoNormal style='margin-left:13.0pt;text-indent:-13.65pt;mso-list: l1 level1 lfo3'><![if !supportLists]><span style='font-family:Symbol; mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol'><span style='mso-list:Ignore'>· <![endif]>giving permission &#8211; ie  assuring family it’s ok to move on; spouse that it’s ok to remarry <p class=MsoNormal style='margin-left:13.0pt;text-indent:-13.65pt;mso-list: l1 level1 lfo3'><![if !supportLists]><span style='font-family:Symbol; mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol'><span style='mso-list:Ignore'>· <![endif]>placing a legacy capstone &#8211; leave something behind <td width=174 valign=top style='width:174.0pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt; mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal>Finishing life’s story: <ul style='margin-top:0in' type=disc> <li class=MsoNormal style='mso-list:l1 level1 lfo3;tab-stops:list .5in'>adjustment to loss</li> <li class=MsoNormal style='mso-list:l1 level1 lfo3;tab-stops:list .5in'>reaching closure- reconnecting with family</li> <li class=MsoNormal style='mso-list:l1 level1 lfo3;tab-stops:list .5in'>existential tasks</li> <li class=MsoNormal style='mso-list:l1 level1 lfo3;tab-stops:list .5in'>final growth phase- apologies, repairing broken relationships </li> <li class=MsoNormal style='mso-list:l1 level1 lfo3;tab-stops:list .5in'>last rites of passage- last prayers, last acts </li> </ul>

<p class=MsoNormal style='margin-left:.7pt'> <span style='text-decoration: none'> </o:p>

<p class=MsoNormal style='margin-left:18.7pt;text-indent:-.25in;mso-list:l2 level1 lfo1'><![if !supportLists]><span style='mso-list:Ignore'>2. <![endif]> Describe your own attitudes and experiences toward death</o:p>

<p class=MsoNormal style='margin-left:.7pt'> <span style='text-decoration: none'> </o:p>

<p class=MsoNormal style='margin-left:18.7pt;text-indent:-.25in;mso-list:l2 level1 lfo1'><![if !supportLists]><span style='mso-list:Ignore'>3. <![endif]> Describe how a Palliative Care Team can address the needs of the dying patient</o:p>

<ul style='margin-top:0in' type=disc> <li class=MsoNormal style='mso-list:l1 level1 lfo3;tab-stops:list .5in'>Team includes physician, nurses, social workers, counselors, pastor, etc</li> <li class=MsoNormal style='mso-list:l1 level1 lfo3;tab-stops:list .5in'>Deliver appropriate symptom control</li> <li class=MsoNormal style='mso-list:l1 level1 lfo3;tab-stops:list .5in'>Address psychosocial needs: help patient emotional adapt to lost dreams, lost physical capacities and social roles</li> <li class=MsoNormal style='mso-list:l1 level1 lfo3;tab-stops:list .5in'>help patient reconnect with family, perform last acts</li> <li class=MsoNormal style='mso-list:l1 level1 lfo3;tab-stops:list .5in'>Provide informational materials: brochures, worksheets, websites</li> <li class=MsoNormal style='mso-list:l1 level1 lfo3;tab-stops:list .5in'>Make referrals to related services such as support groups </li> </ul>

<p class=MsoNormal style='margin-left:.7pt'> <span style='text-decoration: none'> </o:p>

<p class=MsoNormal style='margin-left:18.7pt;text-indent:-.25in;mso-list:l2 level1 lfo1'><![if !supportLists]><span style='mso-list:Ignore'>4. <![endif]> Describe the importance of effective communication skills for an experienced palliative care physician </o:p>

<ul style='margin-top:0in' type=disc> <li class=MsoNormal style='mso-list:l1 level1 lfo3;tab-stops:list .5in'>Necessary to negotiate with family and patient a realistic goal for care</li> <li class=MsoNormal style='mso-list:l1 level1 lfo3;tab-stops:list .5in'>Good communication skills needed to learn what cultural and spiritual support patients need </o:p> </li> <li class=MsoNormal style='mso-list:l1 level1 lfo3;tab-stops:list .5in'>Mediation between patient and family members during emotional reconnections, apologies, last-goodbyes </o:p> </li> <li class=MsoNormal style='mso-list:l1 level1 lfo3;tab-stops:list .5in'>Listening is a communication skill that is hugely important for a dying patient </o:p> </li> <li class=MsoNormal style='mso-list:l1 level1 lfo3;tab-stops:list .5in'>Essential for obtaining and delivering accurate information from patient &amp; family, and to keep everyone comfortable </o:p> </li> </ul>