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Iden%fica%on of the pallia%ve pa%ent
1. “Surprise ques-on” 2. Wish/ need of the pt 3. clinical indicators
Cancer
Organ failure
1. Heart failure
2. COPD
3. Renal failure 4. Motor neuron
disease
5. Z v Parkinson
6. Mul-ple
sclerosis
Communica%on about pal care in team, with pt /fam
Evalua%on needs and wishes pa%ent and fam.
.
1Fysical
2. Psychological
3. Social
4. Spiritual/existen-al
Communica%on & coordina%on in the team
Planning
(
medical management beleid:
1.Discuss with pt wishes : aim for
treatment (prolonging life , keep func-onal, just comfort)
2. Consensus in team about therapeu-c possibili-es/limita-ons
months - year
Palliative
therapy
weeks - months
Palliative care
Days – weeks
Terminal care
Hours-days
Last
24h
Elderly & demen%a
1. Frailty 2. Demen-a 3. CVA
Prognosis
=
1 Childhood
2 Psychiatr. pt.