Konsep dan Model Perawatan Palliative

KONSEP DASAR & MODEL
PERAWATAN PALIATIF
Maria A. Witjaksono
Lampung, 1 Mei 2016
KASUS
 Wanita 42 th,
 Tidak menikah, hidup dengan 16 orang
di rumah sederhana
 Terbaring sejak beberapa bulan
 Ibu, 72 th seorang janda, hidup dengan
berjualan di rumah tidak laku karena
tetangga takut tertular
 Ibu tidak sanggup merawat
Latar Belakang
 Pasien dengan penyakit yang dapat mengancam jiwa mengalami
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penderitaan yang muncul akibat masalah fisik, gangguan
psikologis, kesulitan sosial dan problem spiritual
Penderitaan pasien menjadi beban keluarga
Diperlukan pendekatan komprehensif dan berkelanjutan untuk
mencegah dan mengatasi penderitaan pasien sehingga tercapai
kualitas hidup yang lebih baik dan untuk mengurangi beban
keluarga PALLIATIVE CARE
Rumah menjadi tempat yang paling banyak dipilih untuk
perawatan pasien terminal
Perawat memiliki peranan besar dalam Perawatan Paliatif
PENDERITAAN: FISIK, PSIKOLOGIS, SOSIAL,
SPIRITUAL
MEMAHAMI PENDERITAAN PASIEN
PETUGAS KESEHATAN
PASIEN
 Nyeri
 Menjadi beban
 Tidak bisa makan
 Tergantung keluarga
 Hipersekresi
 Tidak bisa
 Bau
menyampaikan
kebutuhan dan
perasaannya: malu,
kasihan mama
 Imobilitas
 Disfigurement
“The relief of suffering when cure is impossible should become the
heart of all medical services. It is what every patient and family
hopes for and has a right to expect. Therefore, each health care
professional has responsibility to provide it when it is indicated”.
Derek Doyle, 1999
 To have information presented that is easy to
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understand
To have input into the type of their medical care
To make medical decision with their family if they
choose to
To use health information to make longer term
decisions about end of life care
For pain relief and relief of suffering
To access palliative care
To know they are in terminal illness
To have a dignified death
Something to Ponder about:
 The Dying Patient is a Living Person -
Saunders had a revelation:
 “I realized that we needed not only
better pain control but better overall
care. People needed the space to be
themselves. I coined the term ‘total
pain,’ from my understanding that dying
people have physical, spiritual,
psychological, and social pain that must
be treated. I have been working on that
ever since.”
Definition
 Palliative care is an approach that improves the quality of life
of patients and their families facing the problems associated
with life-threatening illness through the prevention and relief
of suffering by means of early identification and impeccable
assessment and treatment of pain and other problems --physical, psychosocial and spiritual (WHO 2002)
 PC is an integrated system of care that improves QoL by
providing pain & symptoms relief, spiritual and psychosocial
support from diagnosis to the end of life and bereavement
(WHO 2005)