Tuesday, December 4, 2012

Palliative Care and Pain Assessment Tools

 They are numerous, and they are secret to we civilians. 
Yet, navigating the journey through disease trajectories is an important piece of helping a loved one die with dignity.

Geriatric Depression Scale (short form)

FAST Scale

 Sheikh and Yesavage, 1986
This fifteen-question mood scale screens for depression in older adults.

Pain Assessment

Functional Assessment Staging of Alzeimer’s Disease (FAST)
Reisberg, B. 1988 This tool assists the care provider in understanding
the stage of Alzheimer’s disease that the person is in and guides their approach to that individual’s unique deficits and needs.

Palliative Performance Scale

Developed by the Victoria Hospice Society

Edmonton Symptom Assessment System (ESAS)

A valid and reliable assessment tool to screen for the intensity of nine common symptoms experienced by cancer patients: pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, well-being and shortness of breath. 
Patients can report their ESAS scores electronically at many regional cancer centres using ISAAC. Find out more about ISAAC (Interactive Symptom Assessment and Collection) 

Nursing Guidelines: Assessment in LTC (PDF)

Assessment in LTC 

Fast p. 2

Effective communication with the physician is essential as it will affect the pain management regimen for the individual resident. How many times have family members understood the situation of their loved one? This document states:
The following measures should be considered before contacting the most responsible physician:

  • completing a comprehensive pain assessment 
  • knowing the goals of care for the person
  • knowing the person’s PPS
  • having the person complete the ESAS (if he/she is able)
  • knowing your agency/facility policies and standards
  • Mortality Risk
    'How long do I have?'
  • completing the Situation Background Assessment Recommendation (SBAR) Report to physician tool.  
Abbey Pain Scale

Symptom Management

Two things many at end-of-life face: dyspnea and dysphagia. Yet Primary Care staff communicate little of this information to family members, in order to make good treatment plans and information-based decisions. The inability to breathe (Dyspnea - from COPD or other breathing disorders) or swallow (Dysphagia) have a huge impact on quality of life and dying with dignity.

Management of Dyspnea in Cancer Patients


Deciding about tube feeding pamphlet

DecDeciding about Tube Feedin - St.

Anosognosia is a condition in which a person who suffers disability seems unaware of or denies the existence of his or her disability. This may include unawareness of quite dramatic impairments, such as blindness or paralysis. It was first named by neurologist Joseph Babinski in 1914,[1] although relatively little has been discovered about the cause of the condition since its initial identification.

amnesia, memory loss
aphasia, lack of language abilities
agnosia,  loss of recognition
apraxia, inability to perform complex movements
altered perception,
attentional deficits,

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