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2007)
& economic function either through restoration of previously held abilities AND/OR helping patients acquire new skills and behaviours appropriate to a changing health status
Promoting self-management and resilience
(Rankin J 2008)
Function?
function?
concerns on function?
NICE GUIDANCE
Improving Supportive and Palliative Care for Adults with Cancer. The Manual
impact on patients ability to carry on with their usual daily routines Ch 10.1
Cancer rehabilitation attempts to maximise
patients ability to function, to promote their independence and to help them to adapt to their condition Ch 10.2
Occupational Therapist
Physiotherapist Speech & Language Therapists Lymphoedema Specialists
NICE GUIDANCE: Improving Supportive and Palliative Care for Adults with Cancer. The Manual (2004)
access them when and where they need them, and services are provided without delay Ch 10.12
NICE GUIDANCE: Improving Supportive and Palliative Care for Adults with Cancer. The Manual (2004)
identify functional rehabilitation needs resulting from disease or treatment related symptoms?
Evidence suggests rehabilitation needs are not
Fear Shame
Uncertainty Fatigue
Anxiety Communication
Loss of function
Depression Pain
Stigma
Breathlessness Guilt
Impaired mobility
Thoughts of death
early intervention
Examples-
expected
Examples-
Examples-
progressive disease but maximum quality of life in terms of comfort & function is the aim
Liminality
Temporality
independence, resilience and dignity. (NCAT 2011) Responds quickly to help people to adapt to their illness. Takes a realistic approach to defined goals. Is continually evolving, taking its pace from the individual (National Council for Hospice & Specialist Palliative Care
Services, 2000. Fulfilling Lives. London: NCHPSPC)
Can help people prepare for death? (Charon 2009) Rehabilitation in a deteriorating body?
(Rasmussen 2010)
Any symptom or concern impacting on physical, emotional or social functioning? Any risk of future problems or deconditioning? Consider referral to rehabilitation team, OT, physio, dietitian, SALT.
family caregivers
and lifeways of a designated or particular group that are generally transmitted intergenerationally and influence ones thinking and action modes. Cultural competence the ability to perform and obtain positive clinical outcomes in cross-cultural encounters. Spiritual care competence the ability to perform and obtain positive clinical outcomes in spiritual care encounters.
A Sense of meaning
Relationship
Hope
Our way of coping with lifes variety of experiences,
especially the difficult and uncertain times. Influenced by current and past life experiences. In times of illness hope is focused on an available treatment and that it will be ssuccessful. I hope my family will be OK.
Being There
Can counter feelings of abandonment but it can also
be challenging. To be there without doing is not easy and demands time and experience.
Peace
Pain and symptom control are crucial in achieving
a sense of peace; but this is broader than just physical needs. Key elements in achieving peace are information, honesty and a recognition that sometimes the answer has to be I dont know Honest recognition that sometimes we cant resolve all a patients needs but it may be that we can help them cope with their needs and find peace.
Do not rush with an answer. Listen actively. Explore what has prompted this question. Respond to the patients feelings. Be aware of your own feelings. Refer to other professionals when appropriate.
Hopelessness
Characterized by a lack of interest and involvement
in everyday life and a withdrawal from the company of others. This is a part of clinical depression
Spiritual distress
A person experiences feelings of despair in relation
to their intrinsic personal beliefs and values. Linked to the concept of total pain, which recognizes that pain can have not only a physical component but also an emotional, a social and a spiritual component. Linked to suffering.
events which threaten the intactness of a person. Linked to feelings of lack of control and an overwhelming sense of fear of what the future holds.
See Box 6.2 for indicators of spiritual distress (p.
179-180)
the family can also be a source of stress and distress to the patient. Spiritual self-awareness One needs to appreciate our own essence of self. Be aware of our own feelings and spirituality, aware of the personal and professional limitations.
choose to whome they will talk and when and where. Privacy is often preferred and this explains why so many deep and spiritual conversations take place with nursing staff in intimate setting. Chaplaincy responds to the needs of the other person regardless of their faith, background or life stance.
Expected competencies
Appropriate understanding of the concept of
spirituality at that level. Awareness of their own personal spirituality Recognition of personal limitations Recognition when to refer on Documentation of perceived need and referral options.
patient and family, with care being provided by the multiprofessional team.
Thank you!