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Cuidados paliativos Ă pessoa com demĂȘncia
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Abstract(s)
Segundo a Organização Mundial de SaĂșde, os Cuidados Paliativos tĂȘm como objetivo
central o bem-estar e qualidade de vida dos doentes com doença incuråvel e progressiva.
Medicina Geral e Familiar caracteriza-se pela prestação de cuidados centrados na pessoa,
inserida no seu contexto familiar, social e cultural, e também pela prestação de cuidados
longitudinais, ao longo de todo o ciclo vital. Prima pela prestação de cuidados abrangentes,
nos quais se inclui o acompanhamento de doenças crónicas, e também pela abordagem
holĂstica dos problemas do doente. Assim, a prestação de cuidados de cariz paliativo Ă©
inerente Ă s competĂȘncias nucleares de um MĂ©dico de FamĂlia e farĂĄ sentido que este esteja
incluĂdo na prestação de Cuidados Paliativos aos seus doentes.
à unùnime na literatura que a introdução precoce dos Cuidados Paliativos tem vantagens
para os doentes: melhoria da qualidade de vida, melhor controlo sintomĂĄtico, menor
necessidade de recorrer ao serviço de urgĂȘncia, maior probabilidade de morrer em casa e
de permanecer mais tempo no domicĂlio, mais satisfação com os cuidados.
Os doentes com demĂȘncia constituem um desafio particularmente difĂcil, nĂŁo sĂł no que
concerne às questÔes do estabelecimento de um prognóstico, mas também ao momento
ideal para introdução dos Cuidados Paliativos no seu plano de cuidados. A literatura mostra
que os doentes com demĂȘncia sĂŁo tendencialmente mais hospitalizados e submetidos a
intervençÔes mais invasivas, o que pode ser justificado pela inexistĂȘncia de identificação de
necessidades paliativas e escasso acesso a Cuidados Paliativos ou sua introdução tardia.
O presente relatĂłrio Ă© realizado no Ăąmbito do 9Âș Mestrado em Cuidados Paliativos da
Escola Superior de SaĂșde Dr. Lopes Dias, do Instituto PolitĂ©cnico de Castelo Branco. Ă parte
integrante dos requisitos necessårios para a obtenção do grau de Mestre em Cuidados
Paliativos. De forma complementar ao conhecimento teĂłrico jĂĄ adquirido, pretende-se
descrever de uma forma crĂtica e reflexiva todo o percurso desenvolvido no Ăąmbito do
EstĂĄgio de PrĂĄtica ClĂnica, realizado com uma equipa diferenciada, e que conduziu Ă
aquisição de competĂȘncias fundamentais para a prĂĄtica de Cuidados Paliativos.
Neste documento Ă© feita a reflexĂŁo sobre a âTipologiaâ, âNĂvel de diferenciação de
cuidadosâ e âModelo organizativoâ da Unidade de Cuidados Paliativos onde decorreu o
estågio. Pretende-se também descrever o processo de implementação e desenvolvimento
do Projeto de Intervenção e Formação. Este Projeto tem como objetivo contribuir para a
melhoria na identificação de necessidades paliativas nos doentes com demĂȘncia nos
Cuidados de SaĂșde PrimĂĄrios. Desse modo, mais doentes poderĂŁo ter acesso atempado a CP,
com melhoria da sua qualidade de vida. Ă um Projeto de melhoria contĂnua que inclui um
Plano de Formação dirigido aos profissionais do Centro de SaĂșde, sob a forma de um Curso
BĂĄsico, e que inclui um ciclo de Melhoria ContĂnua da Qualidade na aplicação de uma escala
de avaliação de necessidades paliativas, nos doentes com demĂȘncia seguidos numa Unidade
de SaĂșde Familiar, com a respetiva avaliação de indicador de desempenho.
Abstract: According to the World Health Organization, Palliative Care aims to the well-being and quality of life of patients with an incurable and progressive disease. Family Medicine is characterized by the provision of person-centered care, within their family, social and cultural context, and also by the provision of longitudinal care, throughout the life cycle. It strives for providing comprehensive care, which includes monitoring chronic illnesses, and also for a holistic approach to the patient's problems. Therefore, the provision of palliative care is inherent to the core competencies of a Family Doctor and it will make sense for this to be included in the provision of Palliative Care to their patients. It is unanimous in the literature that the early introduction of Palliative Care has advantages for patients: improved quality of life, better symptom control, less need to go to the emergency department, greater probability of dying at home and staying at home longer, more satisfaction with care. Patients with dementia present as a particularly difficult challenge, not only in terms of establishing a prognosis, but also regarding the ideal time to introduce Palliative Care into their care plan. The literature shows that patients with dementia tend to be hospitalized more often and undergo more invasive interventions, which can be justified by the lack of identification of palliative needs and limited access to Palliative Care or its late introduction. This report is carried out within the scope of the 9th Master's Degree in Palliative Care at the Escola Superior de SaĂșde Dr. Lopes Dias, at the Instituto PolitĂ©cnico de Castelo Branco. It is an integral part of the requirements needed to obtain the Master's degree in Palliative Care. In a complementary way to the theoretical knowledge already acquired, the aim is to describe in a critical and reflective way the entire path developed within the scope of the Clinical Practice Internship, carried out with a differentiated team, and which led to the acquisition of fundamental skills for the practice of Palliative Care. This document reflects on the âTypologyâ, âLevel of differentiation of careâ and âOrganizational modelâ of the Palliative Care Unit where the internship took place. It is also intended to describe the implementation and development process of the Intervention and Training Project. This Project aims to contribute to improving the identification of palliative needs in patients with dementia in Primary Health Care. In this way, more patients will have timely access to Palliative Care, improving their quality of life. It is a quality improvement Project that includes a Training Plan for de Primary Care professionals, as a Basic Training Plan, and that includes a cycle of Continuous Quality Improvement in the application of a palliative needs assessment scale, in patients with dementia followed in a Family Health Unit, with the evaluation of a performance indicator.
Abstract: According to the World Health Organization, Palliative Care aims to the well-being and quality of life of patients with an incurable and progressive disease. Family Medicine is characterized by the provision of person-centered care, within their family, social and cultural context, and also by the provision of longitudinal care, throughout the life cycle. It strives for providing comprehensive care, which includes monitoring chronic illnesses, and also for a holistic approach to the patient's problems. Therefore, the provision of palliative care is inherent to the core competencies of a Family Doctor and it will make sense for this to be included in the provision of Palliative Care to their patients. It is unanimous in the literature that the early introduction of Palliative Care has advantages for patients: improved quality of life, better symptom control, less need to go to the emergency department, greater probability of dying at home and staying at home longer, more satisfaction with care. Patients with dementia present as a particularly difficult challenge, not only in terms of establishing a prognosis, but also regarding the ideal time to introduce Palliative Care into their care plan. The literature shows that patients with dementia tend to be hospitalized more often and undergo more invasive interventions, which can be justified by the lack of identification of palliative needs and limited access to Palliative Care or its late introduction. This report is carried out within the scope of the 9th Master's Degree in Palliative Care at the Escola Superior de SaĂșde Dr. Lopes Dias, at the Instituto PolitĂ©cnico de Castelo Branco. It is an integral part of the requirements needed to obtain the Master's degree in Palliative Care. In a complementary way to the theoretical knowledge already acquired, the aim is to describe in a critical and reflective way the entire path developed within the scope of the Clinical Practice Internship, carried out with a differentiated team, and which led to the acquisition of fundamental skills for the practice of Palliative Care. This document reflects on the âTypologyâ, âLevel of differentiation of careâ and âOrganizational modelâ of the Palliative Care Unit where the internship took place. It is also intended to describe the implementation and development process of the Intervention and Training Project. This Project aims to contribute to improving the identification of palliative needs in patients with dementia in Primary Health Care. In this way, more patients will have timely access to Palliative Care, improving their quality of life. It is a quality improvement Project that includes a Training Plan for de Primary Care professionals, as a Basic Training Plan, and that includes a cycle of Continuous Quality Improvement in the application of a palliative needs assessment scale, in patients with dementia followed in a Family Health Unit, with the evaluation of a performance indicator.
Description
RelatĂłrio de estĂĄgio apresentado Ă Escola Superior de SaĂșde Dr. Lopes Dias, do Instituto PolitĂ©cnico de Castelo Branco, para cumprimento dos requisitos necessĂĄrios Ă obtenção do grau de Mestre em Cuidados Paliativos.
Keywords
Cuidados Paliativos Necessidades paliativas DemĂȘncia Palliative care Palliative needs Dementia