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Palliative Care 101 Gina M. Basello, D.O. Associate Program Director Jamaica Hospital Medical Center Family Medicine Residency Program
Overview ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Aging Population
The Aging Population ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
WHY? ,[object Object]
How do Patients View What is a “Good Death” ,[object Object],[object Object],[object Object],[object Object],[object Object]
Major Causes of Death in America ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Status of Palliative Care in the US: S UPPORT Study ,[object Object],[object Object]
SUPPORT: Phase I Findings ,[object Object],[object Object],[object Object],[object Object],[object Object]
Status of Palliative Care in the US: S UPPORT Study ,[object Object],[object Object]
Palliative Care: Definition ,[object Object],[object Object]
Medical Terms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Palliative Care Team PATIENT family Nurses Social Worker Chaplain Dietician Other health care professionals Administration Volunteers Occupational Therapist Other therapies Physiotherapist Pharmacist Physician Community resources Ajemian, Oxford Textbook of Palliative Medicine , 1993
Benefits of Palliative Care ,[object Object],[object Object],[object Object],[object Object],[object Object]
Improved Clinical Outcomes ,[object Object],[object Object],[object Object],[object Object]
Comparing Hospice vs. Palliative Care ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What is End of Life and Palliative Care? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Why Teach? Why Learn? Why Practice? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Family Medicine and Palliative Care ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
LCME Standards ,[object Object]
ACGME ,[object Object]
JCAHO ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Providers’ Need Assessment ,[object Object],[object Object],[object Object]
Essential Components of Palliative Care ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],From Institute of Medicine 2001
Domains of End-of-Life Care Disease Categories Special Interventions Terminal Care/Dying/ Patient- Family Experiences Communication/Ethics Non-Pain Symptoms/Syndromes Pain
PAIN ,[object Object],[object Object],[object Object],[object Object],[object Object]
Non-Pain Symptoms/Syndrome ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Communications/Ethics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Terminal Care/Dying ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Special Interventions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Disease Categories ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Living with Life-Limiting Disease Practical Issues Spiritual Issues Psychological Issues Physical Symptoms Emotional Issues Social Issues Medical Information
Curative vs. Palliative Model of Care
Restoring the Balance Life Prolonging Care Palliative Care
Continuum of Care Model Disease Progression D E A T H B E R E A V E M E N T Curative Intent Palliative Care Curative Care
Prognostication ,[object Object],[object Object],[object Object],[object Object]
Traditional Domains of Medicine ,[object Object],[object Object],[object Object]
Prognosis ,[object Object],[object Object],[object Object],[object Object],[object Object]
Prognostication ,[object Object],[object Object],[object Object],[object Object],[object Object]
The Dying Trajectory ,[object Object],[object Object],[object Object],[object Object]
Determining Prognosis ,[object Object],[object Object],[object Object],[object Object]
Prognostic Tools ,[object Object],[object Object]
Determining Prognosis ,[object Object],[object Object],[object Object]
Activities of Daily Living (ADL’s) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Nutritional Status ,[object Object],[object Object],[object Object],Three to Six Month Prognosis
Cancer ,[object Object],[object Object],[object Object],[object Object],[object Object]
CHF/COPD/CVA, etc ,[object Object],[object Object],[object Object],[object Object]
CHF/COPD/CVA, etc…. ,[object Object],[object Object],[object Object]
Palliative Care Patients ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Patterns of Death ,[object Object],[object Object],[object Object],[object Object]
 
Prognosis Perspectives ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
How Do You Know Someone is Dying? ,[object Object],[object Object],[object Object],[object Object]
Communicating prognosis… ,[object Object],[object Object],[object Object],[object Object],[object Object]
… Communicating prognosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
… Communicating prognosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Example ,[object Object],[object Object],[object Object]
Discussion ,[object Object],[object Object],[object Object]
Where Do We Go From Here? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Questions???

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Austin Pc Pre Conf

  • 1. Palliative Care 101 Gina M. Basello, D.O. Associate Program Director Jamaica Hospital Medical Center Family Medicine Residency Program
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  • 14. The Palliative Care Team PATIENT family Nurses Social Worker Chaplain Dietician Other health care professionals Administration Volunteers Occupational Therapist Other therapies Physiotherapist Pharmacist Physician Community resources Ajemian, Oxford Textbook of Palliative Medicine , 1993
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  • 27. Domains of End-of-Life Care Disease Categories Special Interventions Terminal Care/Dying/ Patient- Family Experiences Communication/Ethics Non-Pain Symptoms/Syndromes Pain
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  • 34. Living with Life-Limiting Disease Practical Issues Spiritual Issues Psychological Issues Physical Symptoms Emotional Issues Social Issues Medical Information
  • 35. Curative vs. Palliative Model of Care
  • 36. Restoring the Balance Life Prolonging Care Palliative Care
  • 37. Continuum of Care Model Disease Progression D E A T H B E R E A V E M E N T Curative Intent Palliative Care Curative Care
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