A glossary of keywords you should know around Advance Care and end of life planning

 

Acute pain

Pain that results from something recent eg new injury or surgery

 

Adjuvant medications

Medications that are given for reasons other than solely pain relief.

 

Advance care directive

Advance care directives tell other people what the writer’s wishes are for medical care, and are only used when that person cannot speak for themselves.

 

Anorexia

Anorexia is a lack of appetite. It can result from pain,

infection, constipation, depression, medical treatment

treatment.

 

Atrial Fibrillation

Atrial Fibrillation is an irregular heart beat and can mean the heart does not pump effectively because the four heart chambers are not in sequence.

 

 

B

Best interest decisions

In making decisions about end of life care, courts have expressed the need to make decisions in accordance with a person’s best interests. This means a person’s views and recorded or expressed wishes need to be recognised when deciding what is in their best interest.

 

Breakthrough pain

When someone has a stable amount of pain, but their pain intensity suddenly increases, or breaks through their normal baseline level of pain.

 

C

Cachexia

Cachexia is a complex syndrome including loss of appetite ( anorexia), weight loss, loss of fat (lipolysis) loss of muscle. It can include nausea

 

Chaplain

A chaplain can be a person from any religion or belief system- for example a minister, priest, pastor, rabbi, imam, lay preacher or other representative

 

Chronic heart failure

Chronic heart failure results from structural or functional changes in a heart. Structural changes include problems with valves, or the heart muscle itself such as can happen after a heart attack.

Functional changes can include disorders of the electrical signalling and rhythm changes.

For whatever structural or functional reason, heart failure means the heart cannot pump enough blood to the body’s organs and other tissues, which therefore do not receive enough oxygen and nutrients to function at their best.

 

 

Chronic pain

Pain that remains after an injury has healed, or after than the original painful stimulus. It can be longstanding and may not have an identifiable

cause.

 

 

Co-morbidity

Co-morbidity is the presence of more than one disorders or disease. The co-existing disorder may be an issue of mental or physical health.

 

COPD – Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD), is a progressive lung disease that makes it difficult to breathe. It can be related to longstanding lung infections, smoking, or inhaling lung irritants.

 

 

Cultural safety

Ensuring that those individuals and systems delivering health care are aware of the impact of their own cultural values on the delivery of services and that they have some knowledge of, respect for and  sensitivity about the cultural needs of others. (Committee of Deans of Australian Medical Schools 2004)

 

Curative care

Curative care is care that aims to heal or overcome disease or illness and to

promote recovery.

 

D

Delirium

Delirium is an acute or recent onset of confusion and alteration in concentration and focus. It can be fluctuating- that is, come and go. It can occur in someone who has an infection or pain or a change in their environment, who is mentally stable and healthy. A person who already has some dementia may be at increased risk of developing delirium if they get an infection, pain or a change in their environment.

 

 

Dementia

Dementia may result from many different causes, at many different ages. There is progressive cognitive decline over time.

 

Dermatome

A localised area of skin that is has its sensation via a single nerve from a single nerve root of the spinal canal

 

Dysarthria

Difficulty in forming and speaking words. This can occur because of brain injury, emotional stress, paralysis, or spasticity

 

Dyskinesia

Inability to control movements. There may be repetitive, spasmodic, or uncontrolled movements of limbs, body or head, or face.

 

Dysphagia

Difficulty in swallowing.

 

Dyspnoea

Dyspnoea is breathlessness, or a feeling of uncomfortable beathing.

 

F

Fatigue

Fatigue is a persistent, subjective sense of tiredness.

 

Forced Vital Capacity (FVC)

Forced Vital Capacity (FVC) – The amount of air which can be forcibly exhaled from the lungs after taking the largest breath possible.

Fraility

A physiologic syndrome characterized by decreased reserve and resistance to stressors, resulting from decline across multiple physiologic systems, and causing vulnerability to adverse outcomes.

 

Functional status

Functional status is an individual’s ability to perform normal daily activities required to meet basic needs, roles, and maintain health and well-being. Functional status can be influenced by biological or physiological states,

symptoms, mood, and other factors. It is also likely to be influenced by health  perceptions. For example someone who most would judge to be well but who views himself as ill may have a low level of functional performance and capacity.

 

H

Holistic care

The term holistic refers to a whole made up of interdependent parts. You are most likely to hear this term when speaking about the mind-body connection, mind-body-spirit or physical-mental-emotional-spiritual-sexuality aspects.

When applied to the treatment of illness it is called holistic medicine and includes a number of factors dealing with the root cause of an illness,increasing patient involvement and considering both conventional and complementary therapies. The principles of palliative care are framed around holistic care and the inter physical, social, emotional, psychological, cultural and spiritual aspects. (Palliative Care Australia 2008)

 

Hypertension

Abnormally high blood pressure.

 

I

Incident pain

Usually pain occurring as a direct and immediate consequence of a movement or activity.

 

Interdisciplinary team

A group of health care professionals from diverse fields who work in a coordinated fashion toward a common desire top help the patient.

 

M

Multidisciplinary team

A multidisciplinary team consists of a mix of health care disciplines. Team members share common goals and work together in the planning and delivery of care. Members of a multidisciplinary team might include surgeons, medical or radiation oncologists, palliative care specialists, pastoral care workers, nurses, social workers , occupational therapists, physiotherapists, dieticians, volunteers, pharmacists or care assistants.

 

N

Nausea

Unpleasant feeling of the need to vomit.

 

Nerve block

A procedure in which an anesthetic agent is injected directly near a nerve to block pain  from of region

 

Neuralgia

Pain along a nerve pathway following injury.

 

Neuropathic pain

Pain coming from damage to the central or peripheral nerves, rather than the areas that they innervate,

 

Nociceptive pain

Nociceptive pain occurs as a result of the stimulation of nerve endings (called nociceptors)

 

O

Osteoarthritis

Osteoarthritis – degeneration of joint cartilage and the underlying bone, most common from middle age. Causes pain and stiffness, especially in the hip, knee, and thumb joints.

 

P

Palliative approach

An approach to care that does not attempt to lengthen or shorten the client’s life. It acknowledges death although this may be many months or even years away. The approach also recognises that a range of symptoms need to be addressed to improve overall comfort during life and around the time of death.

Palliative rehabilitation

Palliative rehabilitation aims to minimise some of the effects of the disease or its treatment. It is often aimed to improve quality of life regardless of the prognosis by helping the client to achieve their maximum potential ability and independence or to gain relief from distressing symptoms.

 

Prognosis

A prediction of the probable course and outcome of a disease. The likelihood of recovery from a disease

 

Q

Quality of life

Quality of life is defined as an individual’s perception of their position in life in the context of the culture ,systems in which they live and in relation to their goals, expectations, standards and concerns. It is affected in a complex way by the person’s physical health, psychological state, level of independence relationships, and their relationships to salient features of their environment. (World Health Organisation Group 1993b)

 

R

Referred pain

Pain felt at a site other than where the cause is situated.

 

Rigor

A subjective sensation of feeling cold, accompanied by muscle tremor and shakes. Usually accompanies a high fever

 

Somatic pain

Pain associated with body surface and linings, that is, pain from skin muscles, tendons and bones.

Spirituality

Spirituality is defined as that which lies at the core of each person’s being, and may be affected by one’s religion and culture.

 

Syringe driver

Delivery of continuous pain relief via a range of different routes, usually continuously and subcutaneously