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Introduction : Multidisciplinary Team's Approach To Palliative Care
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- Palliative care is defined as a delicate medical care approach toward patients who are fighting their life-threatening diseases and illnesses.
- The care may last depending upon the final stage of the disease, which can be a matter of hours, days, weeks or even months to several years also.
- Palliative care relieves the patient from the symptoms of the diseases they are enduring to ease their pain (gov, 2022).
The primary aspect of this entire presentation is to understand the palliative care team's approach toward end-of-life care for people at hydration and nutrition. This specialized medical care addresses concerns like spiritual, emotional, mental, and psychosocial to the patients. The special medical care-like palliative approach helps the patients to live comfortably and fully even when they are on the verge of death. Palliative care supports the patient’s family also in reducing their unnecessary visits to the hospital. This care is for all age groups who are suffering from the life-limiting disease.
“National Palliative Standard Care” in Australia in Palliative Care
- Specialized medical care like the palliative approach is centered on the patient, that is principle is followed based on Standard 4 of NPCs of Australia.
- Medical care in the form of palliative and special care is provided based on the assessment that is done.
- Another principle determines to meet the needs of the patients, their families and carers to provide them with service networks and other access, following standard 6 of the NPCS (org, 2022).
SN: Standards of Palliative care are simply regarded as a "good clinical practice". This holistic approach incorporates a whole spectrum of medical, nursing, psychological, social, cultural and spiritual care. The different levels of complexity a person is going through are assessed. Further, the assessment determines the appropriate response the patient needs for their care from the "National Palliative Standard Care Terms". The palliative approach is coordinated and integrated care which is followed based on Standard 5 of NPCs of Australia. Their families and the career are needed to take care of the patient. This is followed by Standard 2 and Standard 3 of NPCs of Australia. It is essential to inform and provide guidance and provisional support to the patient’s family and the carer who is collaboratively treating the patient.
Applications of NPCs and providing care to end of life
- The palliative care given to the patients is culturally and clinically safe and effective, as it is evidence-based care.
- This specialized medical care approach is equitable. Standard 7 determines this practice to focus on applying this on a day-to-day level ( int, 2020).
- Understanding and assisting with the living of the patients is another application that is being followed by the carer as well as the family of the patient as per Standard 2,3 and 4.
The multidisciplinary team of the palliative care department needs to treat patients irrespective of their social status, culture, education or creed. Palliative care is a quality-based provision that is followed by Australian as a commitment to them. The applications of NPCs that were followed are briefly discussed here. Counselling the patients and therapy providence to them for their mobility is applied as per following the standard 5 of NPCs in Australia.
Importance of diet and hydration in palliative care
- The very first importance is that it provides a comfortable quality fi life by providing the patient with a resident enjoyment of their diet.
- Proper nutrition and hydration are very critical for maintaining healthy body functions.
- Avoiding the risk factor of a contracting urinary tract infection, which can be very common for elderly people, is maintained by having healthy fluids and proper dietary foods (Wilson et al. 2019).
SN: Proper food intake and fluid consumption can help in faster recovery and a lower risk of complications for end-of-life patients during their palliative care.
- Hydration and nutrition prevent the pressure of ulcers and other diseases like heart disease, lung or kidney disease, or even urinary tract or diabetes.
- Nutrition and hydration boost immunity in the patients causing them to fight illness for a little longer period.
- Proper intake of food and hydration increases the power of wound healing and repair of tissue of the patients.
Nutrition in specialized medical care like that in palliative care is an important goal in improving the health and quality of the patient's life. It's not only nutrition that is important but the hydration of the patient is equally essential, from a psychological, mental and physical perspective.
Goals regarding Hydration and Nutrition in palliative care
- Healthy diet food and proper hydration drink benefits in boosting immunity the patients suffering life limiting illnesses and diseases.
- The goal of nutrition and hydration is to provide the patients with adequate health and wellbeing life.
- The key aspect of nutrition and hydration is to reduce tension or anxiety and improve the quality of the patient's life (Philip et al. 2021).
- Proper nutrition and hydration enhance the remaining life of the patient by managing the troublesome symptoms they are enduring.
Having a proper hydration and nutrition intake for the end-of-life patient is one of the fundamental aspects to them of having healthy well-being. Also, at times artificial nutrition and hydration are provided to the patient to support them
Evaluating research regarding hydration and nutrition for end-of-life care
- The immunity of the patients was boosted
- High blood pressure and high glucose level are controlled.
- Difficulty in swallowing is improved by providing them with nutritive fluid foods and fluid drinks (org, 2022).
Various factors cause the patient to have a lower and decreased appetite and this tends to make the patient's intake less fluid. Changes in the taste of fluid and food with increased weakness and fatigue in patients are evaluated after providing them required nutrition and hydration. Offering the patients mindfully good nutritive foods and fluids helped in improving their quality of life. Bleeding gums or any type of dental issues were also resolved by providing them with beneficial foods that they require. Liver or abdominal or pancreatic or any other cancer at a terminal stage received quality of life at their end-of-life care. Nausea, constipation, and vomiting tendencies are curbed
Breathing issues like having asthma or any general breathing problems are reduced.
Quality improvement in hydration and nutrition guidelines
- Offering a frequent yet small amount of nutritive foods and fluids might improve the patient well being
- Maintaining the hydration of the patient through small sips of fluid but keeping it frequently throughout the day, might improve the health status of the patient fighting a life-threatening illness (Wilson et al. 2019).
- Altering the meal timings according to the symptoms the patients are having, might improve the quality of life of the patient.
The quality of hydration and nutrition guidelines for treating patients with a life-limiting illness needs to be improved for a better palliative care approach. Family food may be accepted by a few patients who show a "hard time" swallowing other food prepared at the hospital. Liquid food should be offered to a patient who is feeling nauseous or in pain. Not forcing a patient to engulf food or fluid might improve their emotional and physical discomfort. Experimenting with little flavours might give taste to the patient eating that nutritious food.
Development of care pathways addressing hydration and nutrition in end-of-life care
- Dysphagia, which is difficulty in swallowing, can be improved in the care pathway by addressing hydration and nutrition in end-of-life care for the patients.
- Paying attention closely to the patient's oral hygiene is also required which might develop in their care pathways.
- “Artificial Nutrition And Hydration” (ANH) is another care pathway to provide nutrition and hydration (gov, 2022).
The different pathways for specialized medical care approaches for patients enduring life-limiting diseases are discussed in this slide. It can be managed by providing them with soft and paste food, or fluids. These types of nutritional pathways include "inserting tubes into the gut" to provide nutrition to the person who is unable to even sip the fluid. The liquid is given intravenously and monitors the response of the patient. Also, changing medication might improve health. Parenteral nutrition and enteral nutrition are often termed under ANH. These nutritional care pathways are often termed "CANH ( Clinically Assisted Nutrition and Hydration.)”
- Palliative care and its importance are discussed.
- The application of standards of palliative care approach following NPCs is interpreted.
- The objective of "National Palliative Standard Care '' and its significance is discussed.
- The importance of Nutrition and Hydration was discussed.
The pathways that address nutrition and hydration may effectively improve the health of the patient who is suffering from a life-threatening disease. Following the NPCs of Australia might enhance palliative care in nursing homes.
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