- Goals -
Prevent pain and other symptoms; Support patient emotional well-being; Support family and other caregivers; Continuity of care, advanced directives; Respect, well-being; Spiritual issues addressed respectfully; Psycho-social issues; Decide - Hospice or palliative care; Peace; Integrity; Dignity; Hope; Pain and symptom management; Knowledge;Empowerment (patient)

- Skills -
Listening; Communicating effectively; Culturally appropriate; Knowlegable about not just medical needs, but also available community resources, etc.; Emotional support; Anticipating needs; Just “being there”

- Patients Want -
Information; Hope; Social supports; Ability to make decisions; Dignity; Respect; Pain management; Family input (Input from significant others, friends, members of their religious community, etc.); Their own input; Ability to make final preparations

Pain is a huge issue for many chronically ill / terminally ill patients. In 88% of cases it is poorly managed – often other concerns such as secondary side-effects or concerns regarding drug abuse are factors. What is not considered is how the patient actually feels.

Non-pharmacological pain relief methods: heat/cold, relaxation, positioning/repositioning, music, distraction, imagery, massage, humor.

Medications: Non-steroidal; Opiates; Biphosphonates; Radiopharmaceuticals; Radiation Therapy

Fatigue – “tiredness” is not fatigue – tiredness is transitory and is relieved with rest. Fatigue is pervaisive and is unrelieved by even extensive rest. Often associated with stress – such as chronic illness/terminal illness. Validate patient’s feelings. Correct underlying physical causes, if possible. Balance meds that might be causing symptoms – such as meds causing side effects of drowsiness, breathing difficulties, etc. Reduce stressors. Consider anti-depressants (beware of side effects, consider time to take effect)

What is “spirituality” and how does spirituality play into chronic/terminal illness?

• No absolute definition – many cultural and religious definitions
• Brings meaning and a sense of “wholeness” to a person
• Deep, often religious feelings and beliefs – often quite strongly held
• Spiritual care providers can be family, friends, chaplain, clergy, social worker, case manager, outreach worker, even pets – can be any person involved in the person’s care
  

Studies consistently show, over and over, that patients state that faith is a significant factor in their care

• It is essential to treat the patient as a whole person
• It helps provide a framework to the patient to help the fine “meaning” for what they are going through
• Helps them find control over their feelings of anxiety, fear, and helplessness
• Gives them hope and comfort
• Is an effective coping mechanism

Why are faith issues often omitted from care and treatment planning?

• Lack of education on the part of care providers
• lack of expertise
• too challenging
• seen as too individual, too personal, “too intrusive”
• seen as too time consuming

Labels: catholic, Divine Mercy, eucharist, healing, reconcilation