CHCPAL001 Deliver Care Services Using A Palliative Approach

Part 1
Describe what a holistic approach to palliative care means

A holistic approach to palliative care is the care given to a dying person and their families, which is based on their psychological, religious, spiritual, and physical needs in order to improve the quality life.

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Discuss how you would respect and support the resident/client, and their family to express their changing needs and preferences and how would you report this to your supervisor?

It is an ethical requirement to support and respect the changes in needs and preferences of the client. In order to support their decisions, it is imperative as the caregiver to advice the client on the implications of the decisions they are making including the risks that might be involved in regards to the needs and preferences. In case the patient goes ahead and makes the changes, it is a requirement that I should report the same to the supervisor and the reasons behind the client’s decisions to make the changes.

Discuss how you can respond to a resident/clients signs of pain and other symptoms.

In cases where the client shows signs of pain and suffering, I will utilize the other members in the multidisciplinary team like the social workers to aid in the treatment of the suffering relating to pain.

Discuss two pain assessment tools

Verbal rating is an assessment tool with adjectives describing the levels of pain. The levels range from no pain to extreme pain, patients are required to read over the adjectives in order to describe their pain. In numerical rating, the patient is asked to rate the pain they are feeling in a scale of 0- 10 whereby zero represents no pain and ten representing extreme pain.

What are some of the ways that you can provide a supportive environment to ensure that all involved can share information about resident/clients changing needs and preferences?

The first way is by asking the client on how they think some situations should be handle rather than directing them on how to handle it. Second, it is imperative to assist them to think on the optional needs and preferences. Third, assisting them in the selection of an option rather than selecting one for them.

Choose a culture and discuss their Spiritual And Religious Preferences in relation to death and dying, and how would you encourage them to discuss their preferences

When interacting with a Muslim client, it is very important to respect their religious preferences as they do not consider illness and death to be God’s punishment. Muslims seek the help of God trough prayer and patience, therefore, one way to encourage their preferences is by respecting their privacy during this time.

How would you provide empathy and emotional support to residents/clients and families throughout the end of life and following death?

When handling the client, it is essential to use touch when communicating with the client in order to show concern and empathy. After death, communicating with the family is equally important to give emotional support and to help them move on.

What steps are involved in following end of life care strategies?

Step 1- discussion towards end of life approaches, Step 2- Assessment and review, Step 3- Coordination of care, step 4- delivering of quality services in different environment, step 5- Last days of life care, and step 6- after death care.

List three physical and three psychological symptoms that may indicate a carer is feeling stress
Physical Symptoms
Low energy
Easily irritated
Psychological Symptoms
Who would you discuss any misconceptions in regards to the use of pain relief?

Yes, so that the client can understand the side effects of pain relief drugs.

How can you maintain the dignity of your clients/residents immediately following their death?

One way to maintain the dignity of the client following death is to respect their privacy regardless of the absence and using respectful words when referring to them.

How can you manage your own emotional responses and ethical issues and who would you raise these issues with?

One way to manage ethical and emotional responses is through personal morality and ethics provided in the profession. As a caregiver, these issues should be raised with the supervisor for guidance.

What are some of the ways you can ensure you look after yourself emotionally when working with people with dementia and in a palliative environment?

One of the ideal way to take care emotionally is to talk to other people about the difficulties I am facing and to do activities I enjoy doing

What are some of the emotional effects for someone who has been diagnosed with a life threatening or life limiting illness?
Depression and
Describe what is pain relief and comfort promotion

Comfort promotion and pain relief is a pain management approach that aims at relieving the patient from extreme pain.

List three things that you need to consider in relation to hydration and nutrition when caring for someone palliative?
The nutritional needs of the patient
Therapy and Prognosis goals
Do you think any of the legal and ethical considerations change such as dignity of   risk, duty of care, human rights, privacy, confidentiality, disclosure and work role   boundaries when delivering palliative care?

No. because as a caregiver, I am supposed to maintain the above principles no matter the situation in orders to comply with the professional guidelines.

What symptoms and signs could be present immediately before death (within hours or days)?
Breathing disorder and
Peaceful and calm character in dementia cases
What are the five major needs for a person affected by dementia that relate to person centered practice?
Self- esteem
Relationships and social roles
Autonomy and independence
Inability to carry out duties
Part 2
What are some of the appropriate ways you can communicate with someone that is affected by dementia? 

Since Dementia is a mental disorder due to brain injury or disease, causing impaired judgment and memory loss, you can communicate with such people through body language and physical contact. Gestures can be used to transfer useful information as well as facial expression because of their condition.   One can also encourage them to speak slowly and maintain eye contact so that they can remember what they are talking about and also the person communicating with the patient should be a good listener.                                                                                                                                                             

Name two ways in which you can provide reassurance by using reality orientation?
Acknowledging one’s feelings is one way of providing reassurance to the victim and this is done by listening to them and making them understand that you know how they feel.
Redirecting their emotions into something more positive is another way of reassurance to the victim for example ensuring that you give them what they like most (Kalvemark, Hoglund , Hansson, Westerholm & Ametz, 2004).
List three strategies you would use to relieve distress and agitation with your resident/client whom is affected by dementia.

Involving the victim in recreational activities such as music or art and also encouraging them to engage in activities that they love doing.

Ensuring that the place where the patients stay is free from noise or loud music, which brings the agitation.

Listening to them complains and frustrations can help to prevent agitation

What activities can you provide that help maintain the dignity, skills and health of clients with dementia?

Making the patients with dementia to meet each other through forums where they are to share experiences about their conditions and encouraging each other to live with positivity and engaging activities such as aerobics to keep them physically fit.

What can you do to establish the right balance between a person’s safety and their autonomy?

This can be achieved by ensuring that the care specialists that take care of them and the medical facilitators that provide health care services are specialized and treat these people with respect (Macklin, 2013)

List three ways in which you can gather information about a resident/client’s routines and reminiscences

Observing the patients when they are on their homes or other environments

Interviewing the client

Giving the client questionnaires where they are to answer the questions on their routines.

What are the potential behaviors of concern and potential triggers for someone affected by dementia?

Since the patients cannot be able to carry out their duties properly, they may have violent outbursts due to frustrations.

List two ways you can contribute to the support, planning and review to minimize the impact of behaviors

Listening to their frustrations

Creating for them a safe environment

Discuss the documentation you use in your work with people with dementia, and the storage requirements for them

Video clips in CDs so that they can replay them when they experience memory loss.

What is advanced care directives?

It refers to a legal document that one writes to specify the course of action to be taken, when they no longer have the ability to make informed decisions due to health conditions.

What are some signs of imminent death or deterioration?

Some of the signs of imminent death are decreased blood circulation in the body, decreased cerebral function and also decreased cardiac output.

Define loss, grief and bereavement

Loss refers to the death of a loved one

 Grief refers to the deep sorrow that is brought about due to death of a person

Bereavement refers to the period of mourning when a person dies.

List the stages of grief

Denial and isolation





Define each of the following in a sentence in relation to residential and home and community care:

This refers to failure to care for someone.

Physical Abuse

This refers to the act of causing harm to an individual’s body by assaulting them.

Sexual Assault

This refers to the act of forcing someone to indulge in an intimate act without their consent.

Psychological Abuse

 This refers to the act of subjecting a person to conditions such as depression, trauma, stress and anxiety .Emotional abuse

This refers to the ill treatment of a person such as intimidation, threats, undermining them and criticizing them hence leading to stress and trauma.

Give a brief sentence of your understanding of the following:
Alzheimer’s Disease

This is a condition associated with memory loss, poor thinking and impaired judgments. It is a type of dementia that worsens over time hence interfering with one’s daily duties.

Vascular Dementia Or Multi-Infarct Dementia

 This is a type of dementia that occurs due to decreased or poor supply of blood in the brain and is normally associated with minor strokes which worsen over time.

Lewy Bodies

This refers to abnormal protein aggregates that normally appear or develop in the nerve cells usually in Parkinson’s disease, dementia and also other related disorders. Lewy bodies are usually found in brain stream (Woods & Pratt, 2005)  

Excessive Alcohol Intake Or Korsakov Syndrome

It is normally observed in long term users of alcohol and varies among patients

Fronto temporal lobar degeneration (FLTD) including Pick’s disease

This refers to a pathological process that takes in the human brain.

Huntington’s Disease

This refers to a generic disease that normally causes breakdown of the nerve cells in the brain.

Parkinson’s Disease

This is a disease that affects nerves in the brain which produce dopamine (Dro, 2006).

Younger Onset Dementia

This refers to the early stages of dementia diseases that are characterized by lack of co-coordination and balance

Dementia as a progressive neurological condition, including pathological features:

Amyloid Plaques

 This refers to accumulations that occur outside nerve cells.

Neurofibrillary Tangles

This refers to aggregates of a type of protein that is a major maker of Alzheimer disease.

Loss of connection between cells and cell death

This refers to the wasting away of cells.

Common Indicators And Symptoms Of Dementia

The common indicators of dementia are confusion at times, difficult in keeping track of things due to short-memory, sudden changes in mood and personality, difficulty in speaking and reading.

The common symptoms associated with dementia include: memory loss because the victims find it difficult to memorize stuff, difficult in communication, language, poor visual perception, also poor reasoning, and judgments (Hertogh, Me, Miesen & Eeffsting, 2004).  

Reference List

Dro¨ es RM., Boelens-Van Der Knoop E., Bos J., Meihuizen L., EttemaT., Gerritsen D., Hoogeveen F., De Lange J. & Scho¨ Lzel-Dorenbos C. (2006) Quality of life in dementia in perspective: an explorative study of variations in opinions among people with dementia and their professional caregivers, and in literature. Dementia 5, 533–558.

Degenholtz H.B., Rosen J., Castle N., Mittal V. & Liu D. (2008) The association between changes in health status and nursing home resident quality of life. The Gerontologist 48, 584–Hall  Hall S., Longhurst S. & Higginson I. (2009a) Living and dying with dignity: a qualitative study of the views of older people in nursinghomes. Age and Ageing, 38, 411–416.592

Hertogh C.M.P.M., Mei The B.A., Miesen B.M.L. & Eeffsting J.A. (2004) Truth telling and truthfulness in the care for patients withadvanced dementia: an ethnographic study in Dutch nursing homes. Social Science & Medicine 59, 1685–1693

Kalvemark S., Hoglund A., Hansson M., Westerholm P. & Ametz B. (2004) Living with conflict-ethical dilemmas and moral distress in the health care system. Social Science & Medicine 58, 1075–1084.

Macklin R. (2003) Dignity is a useless concept. British Medical Journal 327, 1419–1420

Woods R. & Pratt R. (2005) Awareness in dementia: Ethical and legal issues in relation to people with dementia. Aging and Mental Health 9, 423–429.