1. Nursing Assistant Monthly Copyright © 2013 Cengage Learning. All rights reserved. A focus on palliative care February 2013

2. Copyright © 2013 Cengage Learning. All rights reserved. February 2013 A focus on palliative care What is palliative care?  Palliative care is: –a philosophy of care –aims to minimize the discomfort caused by serious illness –useful whether or not a cure is possible

3. Copyright © 2013 Cengage Learning. All rights reserved. February 2013 A focus on palliative care How is hospice care different?  Hospice care –Aims to reduce suffering at end of life –May be provided in a free-standing hospice center –May be provided in a health care facility or a patient’s home  All hospice care is palliative  Not all palliative care is hospice care  Palliative care can be given along with curative treatment

4. Copyright © 2013 Cengage Learning. All rights reserved. February 2013 A focus on palliative care Hospice benefits under Medicare  To qualify, a physician must certify that death is expected within six months –The benefit can be renewed at the end of six months if the person is still gravely ill –In general, no curative treatment will be covered –The person can return to regular Medicare if they decide to pursue a cure  The hospice benefit covers services not normally covered under Medicare, for example: –A hospice aide for personal care –A homemaker –Short-term respite care for the home caregiver

5. Copyright © 2013 Cengage Learning. All rights reserved. February 2013 A focus on palliative care Respect for individual choices We must honor the resident’s rights regarding:  Whether or not to pursue life saving treatment  Priorities for care, relief of symptoms –For example, a resident may prefer to experience some pain so he can be more awake for visitors –A resident may wish to skip a bath because she is too fatigued  His or her own beliefs of an afterlife or no afterlife –Never impose your own religious views on a resident

6. Copyright © 2013 Cengage Learning. All rights reserved. February 2013 A focus on palliative care Family involvement at end-of-life Every family is unique  Some family members may want to participate in care  Others may wish to visit without providing any hands-on care  Be sure the family knows that either is OK –(and they can change their level of involvement at any time)  Privacy –Ask if the family and resident would like some “alone time” –The resident and family may want you present when death is near

7. Copyright © 2013 Cengage Learning. All rights reserved. February 2013 A focus on palliative care Providing end-of-life care Some tips  Learn about the bodily changes that occur at this time –Knowing what to expect can lessen your anxiety  Offer to work alongside a more experienced CNA who is assigned to a dying resident  Ask for help and advice from other CNAs, licensed nurses, social worker  Remember: it takes a team to meet the dying person’s needs –Nurses, nursing assistants, hospice nurse, hospice aides, social worker, spiritual counselor/pastor/minister or priest, and more

8. Copyright © 2013 Cengage Learning. All rights reserved. February 2013 A focus on palliative care Some final thoughts “It is truly a privilege to be invited into such an intimate moment in the life of a family, and to ease that journey for all the people involved.” – Nina K. Miller