Clinical Practice Guidelines for Quality Palliative Care
Interdisciplinary team access and manage psychological status based on the available evidence, which is skillfully applied and where need be psychiatrist issues are addressed and treated. The purpose is to maximize patients and family coping and quality of life.
PedsCare, a Pediatric hospice and Palliative Care Program with a Focus on Patient and Family Psychological Needs, is a comprehensive in-home pediatric palliative and hospice program for children with life-limiting and life-threatening conditions. This program focuses on a wide category of patients and families, parental care of unborn child with fatal condition inclusive. Their services include hospital consultation and home care to allow children and their families the most respectful death within the setting where they are most comfortable. Great attention to psychological and psychiatric in this field of care is required in caring for a dying child. The program promotes a better grieving position like use of Bereavement Baskets when the death of a child draws near. This allows for catharsis and healthy grieving.
One’s family and friends may increase their misery due to major decisions that consider neither professional advice nor legal advice. Close family members are highly likely to be emotionally controlled in making their decisions. These decisions may lead to problems such as unnecessary costs in terms of medical bills or inappropriately expensive yet less helpful treatment.
The interdisciplinary team assesses and addresses the social aspect of the patients and their respective families to meet their needs promote patient’s-family’s goal and minimize patients-family strengths and well-being. This team’s assessment identifies the social strength, needs and goals of each patient and family. The care plan reflects the patient and family’s way of life that is culture, goal, values, strength and preference, and implement the intervention to maximize their social well-being and coping skills including education and family meeting.
St. Rose Dominican Hospital located in Henderson, develops an innovative social worker palliative pathway competency matrix to ensure the social workers are aware of the physical and psychological aspects of care while being able to communicate with and support patients and families.
Spirituality as assessed and addressed by the interdisciplinary team is recognized as a fundamental aspect of compassionate, patients and family centered care that honors the dignity of all persons. It is the responsibility of the team to recognize spiritual distress and attend to the patient and the families’ spiritual needs within their scope of practice. The palliative team should not impose their individual beliefs on the patient’s families or colleagues.
Standardized instruments should be used to assess and identify religious or spiritual backgrounds, preferences, and related belief, rituals and practices of the patient and family. This is to present equality of services offered by the team to its patients and families. Periodic reevaluation of impact of spiritual interventions should occur with regularity and be documented, and support is offered for issues of life closure, as well as other spiritual issues in a manner consistent with the patient and the family’s cultural, spiritual, and religious values.
Referral to an appropriate community-based professional with specialized knowledge or skill in spiritual and existential issues is made when desired by the patient and the family. The team ensures post death follow up after the patient’s death to offer support, identify any additional needs that require community referral and help the family during bereavement (Panke & Coyne, 2011).
Within the palliative program, spirituality is recognized as a significant factor that contributes to the patient’s health and well-being and that facilitates transcendent meaning, purpose and value. It is referred to as walking with the patient in Jewish model and in Christianity; it is referred as pastoring (Matzo & Sherman, 2009).
Patients, family, and community are served in a culturally and linguistically appropriate manner. During the assessment process, the team elicits and documents the cultural identifications, strength, concerns, and needs of the patients and family, with recognition that cultural identity and expression vary within families and communities. The plan addresses the cultural concern and needs, recognizing and maximizing their cultural strength. The staffs consistently convey respect for the patient’s family’s cultural perceptions, preferences, and practice regarding illness, disability, treatment, help seeking, disclosure, decision making, grief, death and family composition (Matzo & Sherman, 2009).
The program aims to respect and accommodate the range of language, dietary and ritual practices of patient and families. Communication should occur in language and manner the patient understands, otherwise the program make reasonable effort to use an appropriate interpreter service. If in case the interpreter is unavailable, other health care providers may be used to provide translation. In the absence of all alternative family members may be used in an emergency situation and only if, the patient is in agreement (Davis, 2009).
The University of Minnesota Medical Center (UMMC) offers services to these different populations. The surrogate’s goals and preference are adhered to according to the accepted standards of medical care and professional standard practice. To assist in understanding patient decision-making, the patient’s expressed values, care preferences; religious beliefs and cultural consideration are sensitive elicited in collaboration with the family.
The palliative care program identifies, acknowledges and addresses the complex ethical issues arising in the care with people with serious illness. The team aims at preventing, identifying, and resolving ethical dilemmas common to the provision of palliative care such as withholding or withdrawing treatments. This is to ensure safety of their lives and properties upon making the decision.
Matzo, M., & Sherman, D. (2009). Palliative Care Nursing: Quality Care to End of Life. 3rd ed. New York, NY: Springer Publishing Company.
Mizrahi, T., Davis, L.E. (2009). Social Work. 20th ed. Washington, DC and New York, NY: NASW Press/Oxford University Press; 2009
Panke, J., Coyne, P. (2011). Conversions in Palliative Care. 3rd ed. Pittsburgh, PA: Hospice and Palliative Nurses association.