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Advance Directives Advance action taken by a patient to document personal preferences for care and/or identify a surrogate in the event that the patient is unable to make health-care related decisions. Artificial Ventilation Process by which air is moved in and out of the lungs by mechanical means, either invasively, through an endotracheal tube, or noninvasively, through a face mask (CPAP, BIPAP). Caregiver Burden Emotional, physical, financial, social and/or psychological stresses (effects) potentially experienced by a caregiver that are associated with providing care to a chronically or terminally ill patient. Code Status A physician order that determines whether resuscitative measures should be taken in the event that a patient goes into cardiopulmonary failure; the order should reflect the patient’s preference and should use an international coding system. Comfort Care Treatment given in an attempt to protect and enhance the quality of life without artificially prolonging life (Arizona Revised Statute (ARS) § 36-3201). Culturally Competent Care Health care environment and health care providers which attempt to bridge the difference in attitudes, beliefs, and practices that may exist when health care providers and patients are not of the same race, ethnicity, culture, and/or religion. Decisional Capacity Ability of a patient to obtain information and express and make decisions about health care based on his/her own values and beliefs. Do not Resuscitate (DNR)/ Do not Intubate A statement, usually in writing, specifying a desire for no attempts to restore breathing and/or circulation in the event of cardiopulmonary arrest. Double Effect When an action intended to provide/relieve suffering has unintended consequences. Durable Health Care Power of Attorney A person who is an adult may designate another adult individual or other adult individuals to make health care decisions on that person’s behalf by executing a written [document] …. that is dated …. and notarized or witnessed by at least one adult who affirms that …. the person appeared to be of sound mind and free from duress at the time of execution of the health care power of attorney… (Arizona Durable Power of Attorney A written instrument by which a principal, the person who is the subject of power of attorney, designates another person to act as the principal’s surrogate to make financial decisions, in accordance with the individual’s previously expressed preferences, when the individual is no longer able to do so (Arizona Revised Statutes (ARS) §14-5501 et seq). End-of-life Care Care provided for a patient who has a limited life expectancy due to a terminal illness. Enteral Nutrition Feedings provided through tube(s) inserted into the stomach or small intestine, providing an alternative to oral food administration. Equianalgesic Dosing Adjustments in the dose of an analgesic medication according to the selected route of administration, based on consulting an evidence-based equianalgesic table for dosing guidelines. Euthanasia Situation in which a physician intentionally administers a lethal dose of medication resulting in a patient’s death. Fiduciary An individual entrusted with decisional capacity regarding financial and health decisions, usually a court-appointed relationship. It also refers to the professional physician-patient relationship in which is based on the physician’s specified knowledge; trusting dependence of the patient on the physician requires that the professional put his/her interests above those of the patient. Heroic Measures Interventions that require advanced technologies and/or intensive resources intended to prolong life as long as possible. Hospice Care Medical and support services (doctors’ services, social services, nursing care, counseling) provided to terminally ill patients and their families based on meeting the eligibility requirements to receive such benefits. Karnofsky Performance Index A health care provider’s assessment of a patient’s current health status, based on the impact that cancer has on his/her daily activities, using a 100- point scale. Living Will A statement written either by a person who has not written a health care power of attorney or by the principal as an attachment to a health care power of attorney and intended to guide or control the health care treatment decisions that can be made on that person’s behalf (Arizona Revised Statute (ARS) 36- 3201)). Medical Futility Situation in which the treatment recommended by the health care provider or requested by the patient is viewed by the patient’s family or his/her surrogate(s) as not achieving the patient’s intended goal, does not constitute good medical practice, is an ineffective treatment and/or falls outside the range of community-based standards of care. Medicare Hospice Benefit Eligibility is based on the patient (a) being qualified for Medicare Part A, (b) having a medical diagnosis of a terminal illness and six or fewer months to live as certified in writing by two physicians, (c) consenting to receive hospice care rather than Non-curative Treatment Treatment(s) administered primarily to reduce symptoms and/or ameliorate pain and not as a curative measure that is intended to restore health. Palliative Care Provision of competent and compassionate care, in the earlier stages of disease, for a terminally ill patient and his/her family with the goal to improve quality of life via symptom management and supportive care services that address physical, Physician-assisted Suicide Situation in which a physician provides a medical means for a patient’s death, usually in the form of a lethal dose of prescription medication that the patient self administers. Quality of Care Care that produces optimal health outcomes (i.e., physical, physiological, emotional, intellectual, and comfort) and is characterized by cost effectiveness Respite Care Hospice care that is provided temporarily by another caregiver to allow the regular caregiver (e.g., family member) a brief break from his/her duties. Spirituality Universal dimension of human life which is individually understood and defined through religious beliefs, universal purpose and/or personal meaning in the larger context of life itself. Surrogate A person authorized to make health care decisions for a patient by a power of attorney, a court order or the provision of section 36-3231 (Arizona Revised Symptom Management Involves thorough investigation of reported symptoms (e.g., nausea, vomiting, pain, depression, anxiety, delirium) including probable cause(s), pathophysiology, and subsequent administration of appropriate treatment (intervention) to relieve
symptoms and treat underlying disease. Terminal Restlessness Agitated state that may occur in close proximity to death which can be treated using pharmacologic or non-pharmacologic measures. Viatical Settlements / Reverse Mortgage Situation in which a person with terminal illness sells his/her life insurance policy or house for terminal income.
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