Aged care and palliative care - LPNI
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Aged care and palliative care
LPNI Health Topic – May 2018
There is very little difference between aged care and palliative care, especially when considering dementia. Dementia is an incurable life-threatening illness. The symptoms are not very different from cancer. An older person is usually living with comorbidities such as osteoarthritis, diabetes, Parkinson’s disease and other musculoskeletal disorders. Sometimes when a person is starting to display accelerating behaviours this may be interpreted as worsening dementia rather than an increase in pain or other discomfort. People with dementia are not always able to articulate their pain on a visual or numerical analogue.
Pain is not the only area of discomfort to be considered in caring for an older person. There are also the areas of spiritual, social and psychological distress to think about. Especially if the person is no longer able to articulate this for themselves.
It is really important to refer back to their Advanced Care Plan or Spiritual Needs Assessment to find out what is important for them. Involve their family (if they are willing) in the assessments as a proxy. The aim is to make life as comfortable as possible and relieve all different aspect of distress. An early comprehensive assessment will enhance symptom management if it is referred to and consulted in care management. Assessments are not something to set and forget; they need to be referred to, reviewed and used in ongoing care management.
To palliate is to cover with a cloak of care. The assessments we do as nurses will hopefully merge aged care into palliative care. The goal of care is to cure sometimes, to relieve often and to comfort always. Aged care is more care not less. This is no different from palliative care.
For our own practice it is good to reflect on the assessments we do and the care that we give. As we rush in our task-oriented care – take a moment to be still and reflect!
Reference: (2017) Hudon, Rosalie: Hopeful care for people dying with dementia, in Journal of Gerontology and Geriatric Research (6:1)
Angela Uhrhane
Pastoral Care Nurse, Lutheran Aged Care Albury, Australia
+61 417 418 660 auhrhane@westnet.com.au