The Importance and Strategies of Comprehensive Assessment, Palliative Care, and Bereavement Support

Holistic assessment for comprehensive care

Overall assessment is fundamentally an important aspect of quality care focused on the patient’s health and individual needs. A comprehensive assessment also considers general health status (Hui, 2018). This also includes the patient’s psychological, social, physical and mental health. A holistic assessment is important because it helps address the root cause of the problem, not just the symptoms. Care is also taken to encourage individuals to take responsibility for their own well-being and health. It also helps prevent disease and find long-term solutions to it (Grant et al, 2021).

Your choices when enrolling in an Extended Care Plan are Willingness to Live, Power of Attorney, and Medical Surrogacy. Advanced care planning is also important, as it recognizes the patient’s palliative needs and takes into account the end of life. It also helps families prepare for the death of a loved one, resolve family conflicts, and manage bereavement (Dalberg, 2018).

Who makes the decision if there is no advance care plan?

Three major signs of the respiratory distress are –

• Breathing rate
• Nose flaring
• Wheezing

For palliative care patients, breathing exercises for long, slow breathing can be managed by proper upright posture, and relaxation exercises are also helpful for palliative care patients (Berntsen et al, 2019). Also helpful are opioids, which are effective in treating shortness of breath. Again, they may not affect respiratory rate, oxygenation and locomotion in the same way pCO2 does (Troost et al., 2019).

Signs and symptoms associated with dysphagia or difficulty swallowing include:

• Pain while swallowing
• Inability to swallow

These can be relieved and treated by chewing a little food or drinking a little liquid between the teeth. Sitting upright during meals and maintaining an upright posture for 30 minutes after meals may help. Otherwise, you should eat frequently (Bucsea, 2019).

Here are his two methods outside of the 1-10 scale that may be helpful in assessing Judy’s pain:

• Pain Quality Assessment Scale
• Brief Pain Inventory

For Judy, the doctor can use the Pain Quality Rating Scale. It is a valid tool for measuring the quality of pain perceived by patients and the depth of neuropathic pain. Similarly, to measure clinical pain, a simple pain inventory can be used to assess Judy’s pain, making him one of the most commonly used pain measurement tools. (Geziry, 2018). Patients can use a simple pain inventory to assess the severity of their pain.

Three examples of non-pharmacological pain management strategies that can be used in Judy’s case are:

• Patient psycho-education- as this can help them in verbally giving the therapy session which can be in the form of psychological tools handouts, chapter sessions, and Guides, this can be helpful in the case of Judy as these sessions can encourage her in discovering he information which is necessarily important for her (Kia, 2021).
• Supportive psychotherapy– It is in form of psychotherapy, this can be beneficial for bringing improvement in the case of Judy as this therapy mainly relies upon the therapeutic alliance which also can alleviate symptoms, and also which can improve their self-esteem, it also can restore the relationship which is to reality, it also can regulate the impulses and can stop the negative thinking (Harrington, 2021).
• Behavioral interventions– Adapting strategies of Behavioral interventions can help Judy with Anxiety, concerns about the image of the body, problems with the family, and also with the fear of the reoccurrence. It also can improve Judy’s mood and can also decrease the disturbance (Elli,et al, 2020).  

A syringe driver is plugged into a syringe that is inserted into a small plastic tube in the tip body. This tube is also inserted into the body with a thin needle and then removed. It is usually also inserted subcutaneously in the arms, abdomen and legs. The most important point to keep in mind is that syringe drivers are an alternative method of drug administration and not just a method of pain relief (Robinson, 2019).

Advanced care planning considering the end of life

Opposition to using a syringe driver is when patients are unable to take medication orally, primarily because of nausea and vomiting, or oral lesions. It is also used when oral medications are poorly absorbed (Cherny, 2018).

The main goal is to relieve the patient’s symptoms, followed by wound care and, if the doctor deems appropriate and possible, treatment of the underlying tumor. Two main areas of focus are the progress and quality of lodges designed to reduce physical symptoms. These include foul-smelling pain, bleeding risk, etc. (Van, 2019). The main goal is to reduce distress and help maintain a good quality of life for palliative care patients. This also allows us to focus more on the pain smell, exudate, and bleeding of Judy’s health.

• Central Nervous System: The part of the nervous system that rotates the brain and also includes the spinal cord where impulses are transmitted and transmitted. This helps coordinate activity throughout the nervous system (Boyle et al, 2020).
• Cardiovascular system: The system that supplies the body’s organs with oxygen and nutrients so that they can function properly. Again, blood vessels can transport carbon dioxide and also dispose of waste products.
• Breathing: A network of organs and tissues that help us breathe. This also includes airways, blood vessels, and lungs. Muscles can also power the lungs, which are part of the respiratory system (Ridley, 2020).
• Gastrointestinal tract: A series of organs hollow inside the human body, connected by long, tortuous tubes from the mouth to the anus (Geziry, 2018). These hollow organs also include the solid organs of the digestive system.
• Kidneys: A term used to describe how well the kidneys work in removing waste and additional waste products from the blood in the form of urine. It also helps the body retain the chemicals it needs. Integument (skin): Considered to be the body’s largest organ, it usually exists between the external and internal environments and forms a physical barrier that functions, maintains, and protects. This is a system that includes the epidermis, dermis, subcutaneous tissue, hair, nails, and other associated glands (Berntsen et al, 2019).
• Immune/Lymphatic System: The immune system is the system that protects the body from foreign invaders. The lymphatic system is also part of the immune system, it can make and break down white blood cells and other immune cells, it can monitor and destroy bacteria that arise in the body, and it can cause problems as well. There is a possibility. (Dalberg, 2018).

After the patient’s death and for the deceased family members, the caregiver’s responsibility is to encourage the client and educate them about effective strategies to help them cope with the loss of a family member.
In Chinese tradition, friends and relatives pour water on the hands of the deceased after death. This is part of the bathing ritual. The body is then placed in a coffin surrounded by candles, flowers and incense. Judy’s three main customs following his death are burial, water burial, and empty burial (Grant et al., 2021).

Grief is the grief that a family feels when a close or close relative dies. Bereavement assistance is provided by bereavement departments and counseling centers. Above all, they support and advise people and families on what steps to take to deal with post-mortem situations (Dalberg, 2018).

Some of the strategies that can help support colleagues after a patient’s death are asking staff and colleagues how they are feeling and communicating well with them. Creating an environment and physical care. It may be enough for everyone, and just yourself (Boyle et al, 2020).

References

Berntsen, G. K. R., Dalbakk, M., Hurley, J. S., Bergmo, T., Solbakken, B., Spansvoll, L., … & Rumpsfeld, M. (2019). Person-centred, integrated and pro-active care for multi-morbid elderly with advanced care needs: a propensity score-matched controlled trial. BMC health services research, 19(1), 1-17.

Boyle, F. M., Horey, D., Middleton, P. F., & Flenady, V. (2020). Clinical practice guidelines for perinatal bereavement care—an overview. Women and birth, 33(2), 107-110.

Bucsea, O., & Riddell, R. P. (2019, August). Non-pharmacological pain management in the neonatal intensive care unit: managing neonatal pain without drugs. In Seminars in Fetal and Neonatal Medicine (Vol. 24, No. 4, p. 101017). WB Saunders.

Cherny, N. I., Paluch-Shimon, S., & Berner-Wygoda, Y. (2018). Palliative care: needs of advanced breast cancer patients. Breast Cancer: Targets and Therapy, 10, 231.

Dalberg, T., McNinch, N. L., & Friebert, S. (2018). Perceptions of barriers and facilitators to early integration of pediatric palliative care: a national survey of pediatric oncology providers. Pediatric blood & cancer, 65(6), e26996.

El Geziry, A., Toble, Y., Al Kadhi, F., Pervaiz, M., & Al Nobani, M. (2018). Non-pharmacological pain management. Pain management in special circumstances, 1-14.

Elli, S., Mattiussi, E., Bambi, S., Tupputi, S., San Fratello, S., De Nunzio, A., … & Lucchini, A. (2020). Changing the syringe pump: a challenging procedure in critically ill patients. The Journal of Vascular Access, 21(6), 868-874.

Grant, M., de Graaf, E., & Teunissen, S. (2021). A systematic review of classifications systems to determine complexity of patient care needs in palliative care. Palliative Medicine, 35(4), 636-650. 

Harrington–Snr, A.(2021). GUIDELINE FOR SETTING UP AND CHANGING THE T34TM/BD BodyGuardTM T AMBULATORY SYRINGE PUMP FOR CHILDREN RECEIVING PALLIATIVE CARE.

Hui, D., Hannon, B. L., Zimmermann, C., & Bruera, E. (2018). Improving patient and caregiver outcomes in oncology: Team?based, timely, and targeted palliative care. CA: a cancer journal for clinicians, 68(5), 356-376.

Kia, Z., Allahbakhshian, M., Ilkhani, M., Nasiri, M., & Allahbakhshian, A. (2021). Nurses’ use of non-pharmacological pain management methods in intensive care units: A descriptive cross-sectional study. Complementary Therapies in Medicine, 58, 102705.

Ridley, A., & Frache, S. (2020). Bereavement care interventions for children under the age of 18 following the death of a sibling: a systematic review. Palliative Medicine, 34(10), 1340-1350.

Robinson, P. J., & Holloway, S. L. (2019). Psychological factors associated with malignant fungating breast wounds. EWMA Journal, 20(2).

Troost, E., Roggen, L., Goossens, E., Moons, P., De Meester, P., Van De Bruaene, A., & Budts, W. (2019). Advanced care planning in adult congenital heart disease: transitioning from repair to palliation and end-of-life care. International journal of cardiology, 279, 57-61.

Van Hilst, J., de Rooij, T., Bosscha, K., Brinkman, D. J., van Dieren, S., Dijkgraaf, M. G., … & Korrel, M. (2019). Laparoscopic versus open pancreatoduodenectomy for pancreatic or periampullary tumours (LEOPARD-2): a multicentre, patient-blinded, randomised controlled phase 2/3 trial. The lancet Gastroenterology & hepatology, 4(3), 199-207.