Sedação paliativa do paciente terminal

Abstract

Although in recent years palliative sedation is being considered a normal medical practice, there are still many gaps in our current understanding. There is no consensus about which are the standard drugs, maintenance or not of food, fluid intake, and hydration. Moreover, there is no ethical clarification on possible life-shortening effects and decision-making process.

Integrative Literature Review Nursing Interventions Aimed at the Family of the Person in End of Life Under Palliative Sedation.

“…The last author also alerts to the need for the nurse to intervene at the level of listening the family, allowing moments of clarification. As for family involvement in decision making of palliative sedation, there are several authors and studies who support that, namely Cherny & Radbruch (2009);Nogueira et al, (2012) and Swart et al, (2014). Pereira (2010) advocates the inclusion of family members in the taking care of terminal patients, and that this inclusion should embrace clarifying any questions the family may have, providing them with information that seems to be the most important, and supporting them with what they consider having more difficulty.…”

“…As for the latter intervention, the one that warns the family for signs, also Venke Gran& Miller (2008); Anquinet (2013b) highlight them. Regarding these interventions, Cherny & Radbruch (2009) and Nogueira et al, (2012) are excellent in ensuring that nurses should provide regular and updated information, dealing with all the clinical situation of the person, as well as the changes that may arise from the therapeutic plan. In turn, Bruinsma et al, (2013) refer the need of the family to have access to information, regarding the aspects of the welfare of the sick person, and the need of sharing information in a more objective way, also Bruce & Boston (2011) and Brinkkemper et al, (2011) support this intervention.…”

“…In turn, the "palliative action," according to Direção-Geral daSaúde (2005, p. 6), means "any therapeutical measure without curative intent, is an integral part of professional practice, whatever the disease or stage." Palliative sedation is used for symptomatic control and is not related to the decreasing survival rate of patients (Lacerda et al, 2014;Nogueira et al, 2012.). According Twycross (2001), the clinical experience indicates that those to which the pain is relieved tend to live longer when compared with those who continuously live with severe non-remitting pain.…”

“…Families need tranquility, emotional support that should be a constant throughout the internment. The moments before death arrives, it should be given to the family the opportunity to express all their sadness, discuss any unanswered questions, and validate all their contributions during hospitalization (Cherny & Radbruch, 2009;Nogueira et al, 2012.). The contribution and importance of the health team must be pointed out, especially the nursing team, in the inclusion of the family when taking palliative sedation decision, there is, however, still a long way to wander by the team, since family involvement It is not as active as intended.…”

Palliative Care in the Process of Human Terminality: Integrative review

“…However, for a dignified intervention, that decision must be shared, there must be consensus among patients, staff and family, as well as psychological and spiritual support should be directed to all those involved in the finitude life process [24].…”