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LEARNING OBJECTIVES

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LEARNING OBJECTIVES

Upon completion of the chapter, the reader will be able to:

  1. Describe the philosophy of palliative care including hospice care and its impact on medication therapy management.

  2. Discuss the therapeutic management of palliative care patients and how it differs from and is similar to traditional patient care at the end of life.

  3. List the most common symptoms experienced by the terminally ill patient.

  4. Explain the pathophysiology of the common symptoms experienced in the terminally ill patient.

  5. Assess the etiology of symptoms in the patient with a life-limiting illness.

  6. Describe the pharmacologic rationale of medication therapy used for symptom management in the terminally ill patient.

  7. Recommend nonpharmacologic and pharmacologic management of symptoms in a terminally ill patient.

  8. Develop a patient-specific palliative care management plan.

  9. Educate patients and caregivers regarding palliative care management plan, including rationale of treatment, importance of medication adherence, and assessment and monitoring of desired outcomes.

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KEY CONCEPTS

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  • Image not available. According to the World Health Organization (WHO), "Palliative care is defined as the active total care of patients whose disease is not responsive to curative treatment. The goal of palliative care is to achieve the best quality of life for patients and their families."

  • Image not available. The goals of palliative care include enhancing quality of life while maintaining or improving functionality.

  • Image not available. Palliative care is appropriate for all life-limiting diseases including cancer; chronic obstructive pulmonary disease; dementia, including Alzheimer's disease; Parkinson's disease; chronic cardiac disease; stroke, renal failure; hepatic failure; multiorgan failure; diabetes mellitus; etc.

  • Image not available. Following a complete assessment of the patient, developing a comprehensive therapeutic plan that uses the fewest number of medications to achieve the highest quality of life is essential.

  • Image not available. Palliative care is more than just pain management. It includes the treatment of symptoms resulting in the discomfort for the patient, which may include nausea and vomiting, agitation, anxiety, depression, delirium, dyspnea, anorexia and cachexia, constipation, diarrhea, pressure ulcers, and edema.

  • Image not available. Involving the patient, family, and caregivers in the development of the therapeutic plan demonstrates responsible palliative care.

  • Image not available. Positive therapeutic outcomes include resolution of symptoms while minimizing adverse drug events.

  • Image not available. Patient and caregiver education is vital to ensuring positive outcomes.

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INTRODUCTION

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Image not available. According to the WHO, "Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual." The goal of palliative care is to achieve the best quality of life for patients and their families.1 "Palliate" literally means "to cloak." The WHO goal of achieving high quality of life depends on management of disease-related symptoms while honoring the patient's goals for care.2 Palliative care is an approach to care focusing on patients and their families and the challenges they face associated with life-threatening illness.3 The goal ...

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