PALLIATIVE CARE

 Communication is an informative process that starts from a point of origin and arrives at a destination, irrespective of the channel or medium used.

Main fears:

▪ Death and  à dying healthcare professionals and caregivers in psychological reactions that lead to the patient avoid communication terminal.

▪ Overcome à the anxiety generated disclose bad news, the fear of provoking and overreaction in sick, the fear of over identifying, fear of lack of response to questions from the patient.

Basic principles:

-        speed adapted to the rate of uptake of each patient

-        never tell the same session of the diagnosis, treatment and prognosis

-        informing the client when the desired

-        never remove the hope but also generate

Professional communication models:

-        Technical: focus on à Health and disease  à Ignore the psychosocial area

-        Paternalistic: Intermediate between health and illness and psychosocial area

-        Complacent: can not make therapeutic distance

-        Deliberative: focus on à same level in health and disease in the psychosocial area.

Bad news:

Any information can drastically alter a patient's vision for the future, both in communicating the diagnosis of a disease considered deadly, as to report the failure of curative therapy.

-        Chronic disease

-        Neurodegenerative disease

-        HIV

-        Cancer

Terminal illness:

Present progressive, incurable advanced disease.

Objectives:

-        attention sick integral

-        symptom control

-        emotional support for the family

Agony:

State that precedes death in situations that life gradually dies.

-        Palliative sedation

-        Sedation in agony

Stages of grief:

-        negation

-        ire/rage

-        negotiation/pact

-        depression

-        acceptance

Personal reflection:

For the process of end of life, communication is very important with the patient.

Patient care in fundamental communicate bad news the best way possible and to do this in stages.

Always show our readiness for anything.

Take into account the patient's family.

BIBLIOGRAPHY:

Sociedad Española de Cuidados Paliativos. Guía de cuidados paliativos. SEPCAL

SciELO. "NEW PERSPECTIVES IN PALLIATIVE CARE." Leo Pessini * and Luciana. BERTACHINI. Acta Bioethica Interfaces 2006, 12 (2) Revised May 2012.