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Abstract
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Abstract
BACKGROUND: When the general situation of
the patients becomes worse, the patient's
families and the patient can not cope with this
problem and apply to the hospital. Integrated
palliative care (IPC) has been introduced more
appropriate to patients and family carers needs.
It aims to achieve quality of life for the patient
and the family.
CASE REPORT: The patient was diagnosed
with gastric cancer which stage was T4N3M1.
Oral capecitabine treatment started. After
recurrence of gastroesophageal area, palliative
radiotherapy and concurrent oral capecitabine
treatment were used. After 2 months, tumor
implants were detected in the abdominal wall.
The patient's pain had palliatied after 40Gy RT.
After 6 months the tumor marker values began to
rise and the patient was treated with cisplatin for
2 cure but grade 3 neurotoxicity occured. The
patient was admitted to our palliative care
department with oral malnutrition and delirium
findings. The Patient nutrition screening tools
were shown to be malnutrition. In the
psychological evaluation, it was determined that
he was in the process of accepting the disease by
leaving the stages of shock, anger and denial
behind in the process between diagnosis and
palliative care unit.
Significant improvement was seen in delirium
findings after corticosteroids.
The patient was instructed to use his muscles
twice a day, exercised, and mobilized.High
calorie nutrition support was provided to the
patient as enteral nutrition product in
cooperation with the physician.
Cognitive Existentialist psychotherapy was
applied to the patient twice a week. Acceptance
of the socioeconomic and physical limitations brought about by the disease, future plan,
treatment compliance studies.
RESULTS: Patient was discharged by oral
feeding, VAS value 2, ECOG Performance score
3, improved delirium table after two months.
Palliative care units were also presented as a
case study showing how important the
multidisciplinary approach is for patients in this
situation.
DISCUSSIONS: It may be possible to deal with
some serious problems with a good evaluation
and team work in terminal period illnesses.T
here are many scales developed to evaluate the
situation of patients and their families. These
can be identified with the appropriate ones