Barriers to palliative care in a prehospital case study

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Ouellette, Xana; Cook, Stephen
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Palliative Care and End of Life Care (EoLC) requires a new focus for a multidisciplinary team to provide excellent care. Unlike most healthcare, which focuses on prolonging life, palliative care instead focuses on providing comfort prior to death, with no regards to life expectancy. Paramedicine has focused on the legal aspects of Do Not Resuscitate orders and has shown a dictomoy of care provided or not provided, which does not work with patient wishes for EoLC. The flexibility of Nursing to identify care priorities still struggles with a model that does not prioritize life prolonging care. As a developing field Kinesiology is underrepresented in the field of EoLC, and most Kinesiology care is focused on rehabilitation and recovery. In this case study, Kinesiology approaches to fall prevention and fall risk assessment would have prevented this adverse outcome. A case study of a palliative patient who had adverse care outcomes after a fall included treatment not in accordance with the family’s wishes or the patient’s existing care plan. This case study has identified three ways to address barriers to pre-hospital and emergency department EoLC. These suggestions to improve care are understanding care priorities, patient advocacy, and multidisciplinary team involvement. This case study identifies how the existing system failed the patient, the consequences of this failure, and how the failure can be prevented in care of future clients.