PALLIATIE BIJ HET LEVENSEINDE .


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PALLIATIE BIJ HET LEVENSEINDE. Dr. Jo Lisaerde. Postuniversitaire Farmacologische Dag zaterdag 16 april 2005. Historiek . 1899: aspirine 1950: heelkunde 1930: antibiotica 1980: technologie. Historiek .
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PALLIATIE BIJ HET LEVENSEINDE Dr. Jo Lisaerde Postuniversitaire Farmacologische Dag zaterdag 16 april 2005

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Historiek 1899: aspirine 1950: heelkunde 1930: antibiotica 1980: technologie

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Historiek 1899: aspirine 1950: heelkunde 1930: antibiotica 1980: technologie 1842: Dames de Calvaire 1967: St Christopher\'s Hospice 1974: "PALLIATIVE CARE" 1879: Sisters of Charity Ivan Illich: "medicalisation" 1977: eerste PC - team

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Definitie van palliatieve zorg (WHO) Palliatieve zorg is de actieve totaalzorg voor patiënten van wie de ziekte niet meer reageert operation genezende behandeling. Behandeling van pijn en andere symptomen, ondersteuning bij psychologische en sociale problemen en aandacht voor spirituele aspecten vanuit interdisciplinair samenwerkingsmodel. Het doel van palliatieve zorg is het bereiken van de best mogelijke kwaliteit van leven, zowel voor de patiënt als diens naasten.

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Begrip "TOTALE PIJN" (C. Saunders) FYSIEK EMOTIONEEL ziekte soort pijn angst woede kwaliteit hulpverlening depressie beschikbare technieken cultureel PATIENT persoonlijkheid pijndrempel opvoeding ervaringen SPIRITUEEL SOCIAAL schuld zin/onzin gezin - familie - werk visie operation pijn/lijden materi ële toestand wereld/godsbeeld plaats van sterven

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Definitie van palliatieve zorg (WHO) 2003 Palliative care is an approach that enhances the personal satisfaction of patients and their families confronting the issues connected with life-undermining sickness , trough the counteractive action and alleviation of affliction by method for early recognizable proof and immaculate evaluation and treatment of torment and different issues, physical, psychosocial and otherworldly

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Definitie van palliatieve zorg (WHO) 2003 gives help from agony and other upsetting side effects; attests life and views kicking the bucket as a typical procedure; plans neither to rush or put off death; coordinates the mental and profound parts of patient care; offers an emotionally supportive network to help patients live as effectively as would be prudent until death; offers an emotionally supportive network to help the family adapt amid the patients ailment and in their own particular loss;

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Definitie van palliatieve zorg (WHO) 2003 utilizations a group way to deal with address the necessities of patients and their families, including loss advising, if demonstrated; will upgrade personal satisfaction, and may likewise emphatically impact the course of disease; is pertinent right on time over the span of ailment , in conjunction with different treatments that are proposed to delay life, for example, chemotherapy or radiation treatment, and incorporates those examinations expected to better comprehend and oversee troubling clinical confusions.

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Wanneer begin palliatieve zorg? D O D curatief palliatief

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Wanneer begin palliatieve zorg? D O D curatief palliatief ROUW - - - comfort

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" The specialty of living admirably and biting the dust well are one " Epicurus " Death is one of the properties you were made with; death is a piece of you. Your life\'s constant errand is to manufacture your passing " Montaigne

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"A GOOD DEATH" To acknowledge that demise is coming, and to comprehend what can be normal; To have the capacity to hold control of what happens; To be managed pride and security; To have control over torment alleviation and other side effect control; To have decision and control over where passing happens (at home or somewhere else); To have entry to data and skill of whatever kind is fundamental; Richard Smith BMJ 2000;320;129-130

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"A GOOD DEATH" To have entry to any profound or enthusiastic bolster craved; To have admittance to hospice mind in any area, not just in healing center; To have control over who else is available and offers the end; To have the capacity to issue propel orders which guarantee wishes are regarded; To have sufficient energy to state farewell, and control over the parts of timing; To have the capacity to kick the bucket when the time has come to go, and not to have life drawn out pointlessly. Richard Smith BMJ 2000;320;129-130

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WILSONBEKWAME PATIENT Wilsverklaring: anticiperend verzoek (extreme lethargies) Andere wilsbeschikkingen: soms problematisch! Vertrouwenspersoon - vertegenwoordiger Naasten Team Arts

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HANDELINGEN ROND HET LEVENSEINDE Streven naar maximale overlevingsduur Vermijden therapeutische hardnekkigheid Staken levensverlengende behandeling Niet starten levensverlengende behandeling Maximale palliatie Terminale sedatie Levensbe ëindiging zonder verzoek Hulp bij zelfdoding euthanasie

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DE TOEKOMST: WAT KAN BETER? Nog veel pati ënten sterven met pijn Begrip totale pijn Aandacht voor andere comfortproblemen Autonomie van de patiënt Adequate waarheidsmededeling Advanced orders Eenheid patiënt-naasten Vocht en voeding Therapie-afbouw Daad met dubbel gevolg

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\'You don\'t fall flat in the event that you neglect to cure. You just come up short in the event that you neglect to mind\'

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