week 4: community health concerns & care of special populations

Term
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what is end-of-life care?
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Terms in this set (34)
what is end-of-life care?
a broad term used to describe formal or informal care for a person who is dying; hospice and palliative care are two types of formal
specialized medical care for people with serious illnesses, focused on providing patients with relief from the symptoms, pain, and stress of a serious illness - whatever the diagnosis
palliative care
the goal is to improve quality of life for both the patient and the family
palliative care
it is appropriate at any stage in a serious illness and an be provided along with curative treatment
palliative care
to palliate is to?
reduce the violence of disease by reducing symptoms without curing the underlying cause
the focus relies on the belief that each of us has the right to die pain-free and with dignity, and that our loved ones will receive the necessary support to allow us to do so
hospice care
focuses more on caring, not curing and, in most cases; care is provided in the patient's home
hospice care
what is a benefit of using morphine during hospice care?
due to its effects to decrease pain and ease breathing, it often enables patients to catch up on sleep that has been lost due to pain and/or shortness of breath
medicare hospice benefit
a Medicare entitlement that provides for comprehensive, interdisciplinary palliative care and services for eligible beneficiaries who have a terminal illness and a life expectancy of less than 6 months
you are eligible for Medicare Part A (hospital insurance)
eligibility for medicare hospice benefits
your doctor and the hospice medical director certify that you have a life limiting illness and if the disease runs its normal course, death may be expected in 6 months or less to liveeligibility for medicare hospice benefitsyou sign a statement choosing hospice care instead of routine medicare covered benefits for your illnesseligibility for medicare hospice benefitsyou receive care from a medicare-approved hospice programeligibility for medicare hospice benefitsmany patients do not get referred to hospice or do so very late in their illness although most persons prefer to die at home, only 25% do so previous research suggests a variety of reasons patients do not get referred to hospice by providersthe problems relating to hospicereasons for lack of referral to hospice?do not want to give up on the patient, desire to maintain hope. difficulty with illness prognosticationmove past the "horse on the dining room table", elicit open communication, provide support to patient and family by listeninghow to help patients with life-long illnessescase-findinga set of activities used by the nurse to identify clients who are not currently receiving healthcare but could benefit from such carecould be another way nurses help patients who might be appropriate candidates for palliative care or hospicecase-findingscreening is a strategy that is used to detect illness or disease and can be a formcase-findingvulnerable populationsgroups of people who have an increased risk for developing adverse health outcomeslimited resources, limited social support/social isolation, limited education; all of these things contribute to making these groups disenfranchised from societyfactors contributing to vulnerabilitypovertyinsufficient resources to meet basic living expenses; causes are complex; related to poor health outcomes. can lead to homelessnessmany contributing factors: poverty, unemployment, divorce, domestic violence, shortage of affordable housing, divorce, natural disasters. average life expectancy of 44 yrshomelessnesschildren: poor nutrition, inconsistent healthcare, behavioral issues, problems in school, witness more violence, risks of abuseeffects of homelessnessadolescents: hight risk for contracting serious illnesses such as STD's, HIV, HepB, unwanted pregnancy, more likely to use substances, risk for various abuseseffects of homelessnesspregnant women: high risk for health problems themselves and their babieseffects of homelessnessour veterans: twice as likely, 53% have disabilitieseffects of homelessnessolder adults: often lived in long-standing poverty, reduced lifespan, multiple chronic conditions and permanent disabilitieseffects of homelessness across lifespanrural healthoften poorer health status due to lack of access and other disparities; often calculated based on population density; generally higher proportion of caucasians in these areasforestry, fishing, mining and agriculture are the top high risk occupational industrieshealth problems in rural areasno OSHA guidelines for farming (if small enterprise); tractor accidents are the most common unintentional injury in farming; physical demands take their tool; exposure to pesticides have long term damage to CNShealth problems in rural areasmigrant healththe state of physical health of migrant workers and the healthcare system in place to supposedly help themoften called "rural homeless"; majority are foreign-born and predominately mexican (75%) although specific ethnicities can very by region; not all are documented US citizens; 75% earn less than 10k annuallymigrant workersdental diseases, TB, HIV/AIDS, depression/mental health issues, lack of prenatal care, health of their children is a problemcommon health problems in migrant workers