Module 6B.txt

Holistic assessment of patient and family (physical, psychological, social, and spiritual); acknowledge diversity of patient�s beliefs and customs; use both traditional and complementary approaches; apply legal and ethical principles to end-of-life-care; demonstrate respect for patients� views and wishes during end-of-life-care; assess patient, family, colleagues, and one�s own success in coping with suffering, loss, grief, and bereavement at the end of life.

Provide education, support, and a listening ear; provide sensitive and compassionate care.

Advanced Directives �Durable Power of Attorney for Healthcare allows decisions by someone else; Living Will provides advanced instructions for care in the event you cannot make a decision; DNAR is a do not attempt resuscitation.

Client uses coping strategies for anxious situations and uses relaxation techniques as required.

• Exercise
• Talk with others
• Engage in pleasurable activities
• Deep breathing
• Relaxation programs

Anxiety ranges from normal to abnormal depending on its intensithy and duration. Normal is essential reaction to a realistic danger or threat to our physical or psychological integrity (mild or moderate), while abnormal is an out of proportion to the situation that lasts long after the threat is over (severe & panic).

Palliative care: supporting families and caregivers; ensure continuity of care; ensure respect for persons; ensure informed decision-making; attending to emotional and spiritual concerns; supporting function and survival duration; and managing symptoms. Hospice care: the quality of life is as important as the length of life; those who are terminally ill should be allowed to face death with dignity and surrounded by the comfort of their homes and families; treatment is holistic; and physical care is primarily palliative, involving symptom management.

The patient�s choice is highest priority when there is a conflict; when patient is not competent, highest priority is to advanced directives or surrogate decision makers; discuss DNAR orders with the patient and significant others; DNAR orders must be documented, reviewed, and updated; DNAR does not mean �discontinue care�!!!; educate patient and family; honor patient�s end-of-life preferences.