Tải bản đầy đủ

Administrative medical assisting 5th by lindh chapter06

Chapter 6

The Therapeutic Approach to the Patient
with a Life-threatening Illness

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Life-threatening Illness
• Cultural perspective on life-threatening
illness
– How you live, think, speak, and behave
– Viewed differently by different cultures
– Family strongest influence
• Work with family and belief system

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.



Choices in Life-threatening Illness
• Urgency of decisions depend on
possible life expectancy
• Patients have right to choose or refuse
treatment
• Palliative care focuses on quality of life,
relieving symptoms of pain and
suffering

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Choices in Life-threatening Illness
• VSED (voluntarily stop eating and
drinking)
• Total sedation; medication causes
unconsciousness and eventually death
• In a few states, option to seek aid in
dying

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Choices in Life-threatening Illness
• Issues appropriate to discuss with
patients facing life-threatening illnesses:





Alternative methods of treatment
Pain management and treatment
Loss of self image and independence
Legal protection
• Durable power of attorney for health care or health care
proxy
• Health care directives


• Patient Self-Determination Act

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Choices in Life-threatening Illness
• Issues appropriate to discuss with
patients facing life-threatening illnesses:
– Finances; insurance coverage
– Emotional needs of patient and family
– Life-threatening illnesses are family illnesses
• Primary patients (the one with the illness)
• Secondary patients (family and friends of patient)
• Helping patients live their last days is important

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


The Range of Psychological Suffering
• Often leads to physical symptoms
• Help patients understand that
relationships change
• Encourage patients to set goals for
themselves
• Listen carefully and seek clues to
nonverbal communication

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


The Patient with HIV/AIDS
• Patients will have great stress when
diagnosed with HIV or AIDS
– May have fairly good health for a period or very
serious near-death illness
– Recent developments in treatment of HIV infection
and AIDS help patients to live longer
– Lives greatly compromised because of
suppressed immune system

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


The Patient with HIV/AIDS
• HIV affects mostly individuals who are
relatively young
• Treating HIV expensive
• Many patients have little or no
insurance coverage

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


The Patient with HIV/AIDS
• May experience central nervous system
involvement
• AIDS when patients’ CD4 counts
decline to less than 200
• Particular type of opportunistic infection
or tumor, AIDS-related brain or lung
illness, severe body wasting

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


The Patient with Cancer
• Patients believe cancer and death
equated
• Choosing treatment complicated and
has many facets
• Treatments are surgery, radiation,
chemotherapy or combination

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


The Patient with Cancer
• Patients can experience serious side
effects from both radiation and
chemotherapy
• Even when there is “nothing more to do”
related to the cancer, there is still “much
to do” to maintain comfort

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


The Patient with ESRD
• Loss of kidney (renal) function leads to
end-stage renal disease (ESRD)
• Patients cannot live long unless they
receive dialysis or kidney transplant
• Dialysis is filtering blood to remove
wastes and can sustain life for years
• Some patients will opt not to have
dialysis and to let death come from
kidney failure
© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


The Stages of Grief
• Dr. Elisabeth Kübler-Ross determined
stages of grief






Denial
Anger
Bargaining
Depression
Acceptance

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


The Stages of Grief
• Not all patients go through all five
stages
• Some patients go through all five stages
over and over again, each time with a
little less stress; others get stuck in one
stage
• No two patients follow the same pattern
• Family members also suffer grief and
are often in different stages
© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


The Stages of Grief
• The acronym TEAR





To accept the reality of the loss
Experience the pain of the loss
Adjust to what was lost
Reinvest in a new reality

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


The Challenge for
the Medical Assistant
• Be sensitive and respectful
– Must be comfortable treating all patients

• Nonmedical forms of assistance
– Referrals to community-based organizations
– Recommend support systems
– Spiritual support

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.



Tài liệu bạn tìm kiếm đã sẵn sàng tải về

Tải bản đầy đủ ngay

×