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Asb 353 Review Chapters 5, 6, 7

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ASB 353
Chapter 5
1/5 of Americans are home when they die, over 30% die in nursing homes, and 50% die in hospitals.
Three major categories of institutional medical care * Hospital are devoted mainly to acute intensive care of a limited duration. * Nursing homes provide long-term residential care for people who are chronically ill and those whose illness does not require acute, intensive care. * Hospice care is distinguished by its orientation toward the needs of dying patients and their families
Rationing-refers to the allocation of scarce resources among competing individuals. In health care it is defined as any system that limits the amount of health care a person can receive.
Paternalism- the assumption of parent like authority by medical practitioners, is seen as infringing on a patient’s autonomy or freedom to make medical decisions.
Covenantal relationship- which implies a mutuality of interest between provider and patients.
Eight principles that are important when delivering bad news 1. Keep it simple 2. Ask yourself, “What does this diagnosis mean to the patient?” 3. Meet on “cool ground” first. Get to know a patient prior to presenting the news. 4. Wait for questions. 5. Do not argue with denial. 6. Ask questions yourself. 7. Do not destroy all hope. 8. Do not say anything that is untrue.
Strategies that either curtail or encourage conversation when speaking of death by a caregiver * Reassurance * Denial * Changing the subject * Fatalism * Discussion
“Whole person care”- caring for seriously ill and dying patients involves attending not just to a patients physical needs but also to his or her mental, emotional, and spiritual needs.
Care can be both personal and comprehensive when the guidelines are in place. Total care also means attending to the needs of the patient’s family.…...

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