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Palliative care

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palliative care and hospice

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Palliative care

  1. 1. Palliative Care
  2. 2.  Medical care that focuses on alleviating the intensity of symptoms of disease.  Palliative care focuses on reducing the prominence and severity of symptoms. APEX HOSPITAL’S INITIATIVE PAIN CLINIC
  3. 3. WHAT IS PALLIATIVE CARE?  Medical care that focuses on alleviating the intensity of symptoms of disease.  Palliative care focuses on reducing the prominence and severity of symptoms.
  4. 4. WHO DEFINITION OF PALLIATIVE CARE Palliative care:  provides relief from pain and other distressing symptoms;  affirms life and regards dying as a normal process;  intends neither to hasten or postpone death;  integrates the psychological and spiritual aspects of patient care;
  5. 5.  offers a support system to help patients live as actively as possible until death;  offers a support system to help the family cope during the patients illness and in their own bereavement;  uses a team approach to address the needs of patients and their families.
  6. 6. Why needed?
  7. 7. Why needed?
  8. 8. What is the goal of Palliative Care?  The goal is to improve the quality of life for individuals who are suffering from severe diseases.  Palliative care offers a diverse array of assistance and care to the patient.
  9. 9. Palliative vs. Hospice Care • Division made between these two terms in the United States • Hospice is a “type” of palliative care for those who are at the end of their lives. Image courtesy of http://www.ersj.org.uk/content/32/3/796.f ull
  10. 10. Palliative vs. Hospice Care • Palliative care can be provided from the time of diagnosis. • Palliative care can be given simultaneously with curative treatment. • Both services have foundations in the same philosophy of reducing the severity of the symptoms of a sickness or old age.
  11. 11. Who receives Palliative Care? Individuals with chronic diseases such as  Cancer  cardiac disease  kidney failure  Alzheimer's  HIV/AIDS  Amyotrophic Lateral Sclerosis (ALS)
  12. 12. Who Provides Palliative Care?  Usually provided by a team of individuals , Interdisciplinary group of professionals
  13. 13. Patient and Family Volunteers Physicians Spiritual Counselors Social Workers Pharmacists Home Health Aides Therapi sts Nurses
  14. 14. Approaches to Palliative Care • Not a “one size fits all approach” • Care is tailored to help the specific needs of the patient • Since palliative care is utilized to help with various diseases, the care provided must fit the symptoms. Image courtesy of uwhealth.org
  15. 15. Palliative Care Patient Support Services  Three categories of support: 1. Pain management is vital for comfort and to reduce patients’ distress. Health care professionals and families can collaborate to identify the sources of pain and relieve them with drugs and other forms of therapy.
  16. 16. 2. Symptom management involves treating symptoms other than pain such as nausea, weakness, bowel and bladder problems, mental confusion, fatigue, and difficulty breathing
  17. 17. 3. Emotional and spiritual support is important for both the patient and family in dealing with the emotional demands of critical illness.
  18. 18. What does Palliative Care Provide to the Patient? • Helps patients gain the strength and peace of mind to carry on with daily life • Aid the ability to tolerate medical treatments • Helps patients to better understand their choices for care
  19. 19. What does Palliative Care Provide to the Patient? • Helps patients gain the strength and peace of mind to carry on with daily life • Aid the ability to tolerate medical treatments • Helps patients to better understand their choices for care
  20. 20. What Does Palliative Care Provide for the Patient’s Family?  Helps families understand the choices available for care  Improves everyday life of patient; reducing the concern of loved ones  Allows for valuable support system
  21. 21. Where to find Palliative Care? • In most cases, palliative care is provided in the hospital. • The process begins when doctors refer individuals to the palliative care team. • In the hospital, palliative care is provided by a team of experts.
  22. 22. Settings for Palliative Care  Outpatient practice  Hospital Inpatient  Unit based  Consultation Team  Home care  Nursing Home  Hospice
  23. 23. Uses of Radiotherapy in palliative care
  24. 24. BONE METS • Frequently arise from • breast, prostate (combined = 80% of incidence) • lung, kidney, thyroid, multiple myeloma, gastrointestinal • Pain may be due to • Bone changes • Pathological fracture • Neuropathic pain if presses on adjacent nerve • Spinal cord compression
  25. 25. SPINAL CORD COMPRESSION
  26. 26. SPINAL CORD COMPRESSION
  27. 27. HOW DOES IT WORKS?? • Cytotoxic effect on normal bone cells inhibits the release of chemical mediators of pain such as prostaglandins • Some patients get relief in 24 hours • Effect on cancer cells prevents further bone destruction, reduces tumour size and enables bone resorption • The pain relief effect achieved between 2 and 8 weeks of treatment
  28. 28. BRAIN METS
  29. 29. SUPERIOR VENA CAVA SYNDROME • A: Plethora of face and neck. • B: Distended jugular veins. • C: Cyanosis of the lips. • D: Right arm and hand massively swollen. • E: Substantial collateral circulation (arrow). • F: Computed tomogram shows compression of the superior vena cava (arrow) due to a large mediastinal mass, causing (F Ј ) tracheal compression and deviation, and stridor.
  30. 30. FULL FLEDGED PALLIATIVE SET-UP WITH HOSPICE
  31. 31. • DEPARTMENT OF RADIATION ONCOLOGY • Dr Ankita Patel(DIRECTOR)(MD Radiation Oncology) • Dr Neha Gupta(MD Radiation Oncology) • Dr CP Verma(MD Radiation Oncology)
  32. 32. • DEPARTMENT OF MEDICAL ONCOLOGY: • Dr Abishek Kumar Singh(DNB Medical Oncology)
  33. 33. • DEPARTMENT OF SURGICAL ONCOLOGY • Dr Anurag Dixit(MS,Fellowship in oncology) • Dr Sandeep Kumar(MS,Mch Surgical Oncology) • Dr Swaroop Patel(DIRECTOR)(Bone and Soft tissue Oncology)(MS ORTHO) • Dr Akhil Sareen(MS,ENT,HNNOnco fellowship) • Dr PK Keshari(Mch, Uro-Surgeon) • Dr L K Pandey (MS,Gynae ans Obs)
  34. 34. • ANAESTHETIST TEAM • Dr Rakesh(MD ,Anaesthesia) • Dr Umesh (MD ,Anaesthesia) • Dr Arvind(MD ,Anaesthesia) • Dr Abhishek Singh(Diploma, Anaesthesia) • Nerve blocks and patient controlled analgesia
  35. 35. • DEPARTMENT OF NUCLEAR MEDICINE • Dr R S Meena (MD, Nuclear Medicine) • Dr Saumya Agarwal Balja(DNB, Nuclear Medicine) • Our NUCLEAR MEDICINE services include PET-CT Scanner(GE) GAMMA SCAN Bone scan Renal scan Stress myocardial perfusion scan Parathyroid scans Brain SPECTS Ventilation perfusion scans Radioiodine Probe
  36. 36. • CATHETER CARE • CHEMOPORT INSERTION • Dr Amit Srivastava (Mch CTVS) • PICC PLACEMENT • Dr Rakesh (MD,ANAESTHESIA) • DEPARTMENT OF DIETETICS • Ms Neha Dubey • Ms Neha Chaubey
  37. 37. • OCCUPATIONAL THERAPY DEPARTMENT • Dr U K Singh • Dr Manoj Pandey • Dr Ruchi Singh • Dr Akshay Dixit • Dr Arpita • PATIENT AND FAMILY COUNCELOR • Ms Sarita Singh
  38. 38. • OCCUPATIONAL THERAPY DEPARTMENT • Dr U K Singh • Dr Manoj Pandey • Dr Ruchi Singh • Dr Akshay Dixit • Dr Arpita • PATIENT AND FAMILY COUNCELOR • Ms Sarita Singh
  39. 39. THANK-YOU
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