PALLIATIVE CARE OF HEART FAILUE, COPD AND IN THE ACUTE TRUST (in 5 minutes!!)

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PALLIATIVE CARE OF HEART FAILUE, COPD AND IN THE
ACUTE TRUST (in 5 minutes!!)

• Dr Sharon Chadwick
• Macmillan Consultant in Palliative Medicine
• Hospice of St Francis

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Heart Failure and COPD

• Main problems
• There is nothing else we can do
• Lack of recognition of what palliative care can
  achieve.
• Fear of the Hospice in patients
• Helplessness/hopelessness in healthcare
  professionals
• Prognostic paralysis

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Prognostic paralysis

• Fears of HCPs around introducing advanced care
  planning too early mean
• People dying unprepared
• Indadequate symptom control
• No choice in where they die

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Key points in Heart Failure

• Symptom control of breathlessness
• Seek out other symptoms
• Rationalisation of medication
• Advanced care planning

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Key points in COPD

• Management of breathlessness and anxiety
• Seek out other symptoms
• Carer support
• Advanced care planning

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What are we doing?

• Education sessions
• Monthly meeting with specialist respiratory
  nurses/ specialist heart failure nurses and
  community matrons
• Reaching out to patients
• Breathe Easy Groups
• Patient Information leaflets

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In Hospital

• Often too little too late
• Only for patients on the LCP
• No recognition of possibility of palliative care
  working alongside active management in patients
  likely to die
• No recognition that patients might die!

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Plan of Action in the Hospital

• Education, education, education!
• Helping with difficult ethical dilemmas
• Feeding issues
• Hydration issues
• In through the back door
• Ward nurses
• Ear to the ground
• Showing what can be achieved