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https://www.readbyqxmd.com/read/29776973/challenges-in-end-of-life-dementia-care
#1
REVIEW
Anne A Fetherston, Grace Rowley, Charlotte L Allan
Dementia is a chronic, progressive disease that is now much more widely recognised and treated. Patients with dementia may require palliative care when they reach the end stage of their illness, or they may have mild-moderate cognitive symptoms comorbid with a life-limiting illness. The variety of presentations necessitates a highly individual approach to care planning, and patients should be encouraged to set their own goals and contribute to advanced care planning where possible. Assessment and management of distressing symptoms at the end of life can be greatly helped by a detailed knowledge of the individuals' prior wishes, interdisciplinary communication and recognition of changes in presentation that may result from new symptoms, for example, onset of pain, nutritional deficits and infection...
May 18, 2018: Evidence-based Mental Health
https://www.readbyqxmd.com/read/29768072/an-integrated-developmental-four-year-medical-school-curriculum-in-palliative-care-a-longitudinal-content-evaluation-based-on-national-competency-standards
#2
Erin M Denney-Koelsch, Robert Horowitz, Timothy Quill, Constance D Baldwin
BACKGROUND: While palliative care (PC) competencies for medical school graduates have been defined, the lack of established curriculum models and assessment tools hampers curricular evaluation. OBJECTIVE: To describe the scope and content of the University of Rochester's longitudinal, integrated four-year PC curriculum after 17 years of implementation, review student evaluative responses, and compare the curriculum to national competency standards. DESIGN AND SETTING: Combining and reorganizing a published PC curriculum assessment tool and a list of medical school PC competencies, we created a novel nine-topic framework to assess the content coverage of our curriculum...
May 16, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29767825/-palliative-sedation-development-and-consensus-of-a-german-language-documentation-template
#3
C Klein, C Wittmann, K N Wendt, C Ostgathe, S Stiel
BACKGROUND: Palliative sedation (PS) serves as a therapeutic option in cases of otherwise intractable suffering. As the use of sedative and hypnotic medication in many diverse situations is a core competency of anesthesiology, anesthesiologists are confronted with questions of sedative therapy at the end of life in institutions for specialized palliative care, in intensive care units and intermediate care wards. In recent years a number of guidelines have been published internationally but so far no official guidelines exist in Germany...
May 16, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29764891/developing-a-complex-intervention-to-support-timely-engagement-with-palliative-care-for-patients-with-advanced-cancer-in-primary-and-secondary-care-in-the-uk-a-study-protocol
#4
Julia Hackett, Hilary Bekker, Michael I Bennett, Paul Carder, Jean Gallagher, Claire Henry, Suzanne Kite, Sally Taylor, Galina Velikova, Lucy Ziegler
INTRODUCTION: For patients with advanced cancer, timely access to palliative care can improve quality of life and enable patients to participate in decisions about their end-of-life care. However, in a UK population of 2500 patients who died from cancer, one-third did not receive specialist palliative care, and of those who did, the duration of involvement was too short to maximise the benefits. Initiating a conversation about palliative care is challenging for some health professionals and patients often have unmet information needs and misconceptions about palliative care...
May 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29751362/low-prevalence-of-palliative-care-and-ethics-consultations-for-children-with-chronic-critical-illness
#5
Renee D Boss, Alison Falck, Naomi Goloff, Nancy Hutton, Alison Miles, Miriam Shapiro, Elliott M Weiss, Pamela K Donohue
Medical advances over the past two decades have increased the numbers of children who survive serious conditions. Mortality from premature birth and genetic syndromes has improved such that more clinicians offer, and more families request, interventions to prolong their child's life. While some interventions promise cure, others result in chronic disease states that require ongoing medical care. This article is protected by copyright. All rights reserved.
May 11, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29742044/end-of-life-decision-making-in-palliative-care-and-recommendations-of-the-council-of-europe-qualitative-secondary-analysis-of-interviews-and-observation-field-notes
#6
Sandra Martins Pereira, Emília Fradique, Pablo Hernández-Marrero
BACKGROUND: End-of-life decisions (ELDs) are embedded in clinical, sociocultural, political, economic, and ethical concerns. In 2014, the Council of Europe (CoE) through its Committee on Bioethics launched the "Guide on the decision-making process regarding medical treatment in end-of-life situations," aiming at improving decision-making processes and empowering professionals in making ELDs. OBJECTIVE: To analyze if end-of-life decision making in palliative care (PC) is consistent with this Guide and to identify if disputed/controversial issues are part of current ELDs...
May 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29736869/muslim-physicians-and-palliative-care-attitudes-towards-the-use-of-palliative-sedation
#7
George Muishout, Hanneke W M van Laarhoven, Gerard Wiegers, Ulrike Popp-Baier
BACKGROUND: Muslim norms concerning palliative sedation can differ from secular and non-Muslim perceptions. Muslim physicians working in a Western environment are expected to administer palliative sedation when medically indicated. Therefore, they can experience tension between religious and medical norms. OBJECTIVE: To gain insight into the professional experiences of Muslim physicians with palliative sedation in terms of religious and professional norms. DESIGN: Interpretative phenomenological study using semi-structured interviews to take a closer look at the experiences of Muslim physicians with palliative sedation...
May 8, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29736119/professional-quality-of-life-among-professional-care-providers-at-cancer-palliative-care-centers-in-bengaluru-india
#8
Amanpreet Kaur, Mahendra P Sharma, Santosh K Chaturvedi
Context: Being a professional care provider at cancer palliative care settings is demanding and stressful. Literature has indicated the prevalence of high burnout (BO) and distress; however, there is a dearth of studies in India, with no study available on professional quality of life in the field of palliative care. Aims: The aim of the present study was to explore the professional quality of life, namely-compassion satisfaction [CS], burnout [BO], and secondary traumatic stress [STS] among professional care providers at cancer palliative care centers...
April 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29714995/issues-in-geriatric-care-medical-decision-making
#9
Jayesh Patel, Richard J Ackermann
Medical decision-making capacity (DMC), which is determined by clinicians, is the ability of patients to understand information about options for their care, express a choice among those options, appreciate the benefits and risks of those options, and explain the reasoning behind their particular choice. DMC differs from competence, which is a legal concept concerning the mental ability of individuals to be responsible for their decisions and actions. A variety of instruments can be used to assess DMC. If it is determined that a patient lacks DMC, clinicians have an ethical obligation to seek out a surrogate decision-maker...
May 2018: FP Essentials
https://www.readbyqxmd.com/read/29708014/the-difficulties-of-discharging-hospice-patients-to-care-homes-at-the-end-of-life-a-focus-group-study
#10
Tabitha Thomas, Gemma Clarke, Stephen Barclay
BACKGROUND: Discharge from inpatient palliative care units to long-term care can be challenging. In the United Kingdom, hospice inpatients move to a care home if they no longer require specialist palliative care and cannot be discharged home. There is evidence to suggest that patients and families find the prospect of such a move distressing. AIM: To investigate the issues that arise when patients are transferred from hospice to care home at the end of life, from the perspective of the hospice multidisciplinary team...
April 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29689298/-suffering-in-palliative-sedation-conceptual-analysis-and-implications-for-decision-making-in-clinical-practice
#11
Claudia Bozzaro, Jan Schildmann
Palliative sedation is an increasingly used and, simultaneously, challenging practice at the end of life. Many controversies associated with this therapy are rooted in implicit differences regarding the understanding of "suffering" as prerequisite for palliative sedation. The aim of this paper is to inform the current debates by a conceptual analysis of two different philosophical accounts of suffering, (1) the subjective and holistic concept and (2) the objective and gradual concept and by a clinical-ethical analysis of the implications of each account for decisions about palliative sedation...
April 21, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29666139/last-year-of-life-study-cologne-lyol-c-protocol-for-a-cross-sectional-mixed-methods-study-to-examine-care-trajectories-and-transitions-in-the-last-year-of-life-until-death
#12
Julia Strupp, Gloria Hanke, Nicolas Schippel, Holger Pfaff, Ute Karbach, Christian Rietz, Raymond Voltz
INTRODUCTION: The last year of life constitutes a particularly vulnerable phase for patients, involving nearly all health and social care structures. Yet, little scientific evidence is available that provides insight into the trajectories including the number and types of care setting transitions, transitions into palliative care and the dying phase. Only few studies have focused on difficulties associated with having to move between health and social care settings in the last year of life, although patients face a significant risk of adverse events...
April 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29656703/the-ethics-of-concurrent-care-for-children-a-social-justice-perspective
#13
Kim Mooney-Doyle, Jessica Keim-Malpass, Lisa C Lindley
Recent estimates indicate that over 40,000 children die annually in the United States and a majority have life-limiting conditions. Children at end of life require extensive healthcare resources, including multiple hospital readmissions and emergency room visits. Yet, many children still suffer from symptoms at end of life-including fatigue, pain, dyspnea, and anxiety-with less than 10% of these children utilizing hospice care services. A critical barrier to pediatric hospice use was the original federal regulations associated with the hospice care that required a diagnosis of 6 months to live and the discontinuation of all curative treatments...
January 1, 2018: Nursing Ethics
https://www.readbyqxmd.com/read/29656674/psycho-social-approach-of-perinatal-palliative-care
#14
Barthélémy Tosello, Lionel Dany
The diagnosis of some of these antenatal pathologies is difficult to reconcile with post-natal survival. Indeed, the diagnosis and management of pregnancies complicated by lethal fetal abnormalities (LFA) pose a challenge for both the parents and the clinicians. The practices discussed are characterized by the multiple challenges involved (on professional, informational, human, and ethical levels) and question the necessity and validity of a multidisciplinary approach. Revealing professional experiences and practices and the biopsychosocial processes behind them could prove useful in advancing attitudes toward LFA, how it is managed, and the care options available...
April 15, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29623160/geriatric-basics-for-the-neurohospitalist
#15
REVIEW
Josef G Heckmann, Jörg Kraus, Christoph J G Lang
Due to the increasing age of the population, neurohospitalists are more frequently caring for old and very old people. Fundamental definitions and topics related to geriatric medicine are therefore of particular importance. In this review, common issues encountered in geriatric patients hospitalized on the neurology service are discussed. Focus is put on the geriatric assessment, multiprofessional diagnostic and therapeutic procedures, geriatric syndromes, pharmacotherapy of the aged, delirium, pain, and palliative management as they are relevant for the neurohospitalist...
April 2018: Neurohospitalist
https://www.readbyqxmd.com/read/29618364/exploring-attitudes-toward-physician-assisted-death-in-patients-with-life-limiting-illnesses-with-varying-experiences-of-palliative-care-a-pilot-study
#16
Patricia Hizo-Abes, Lauren Siegel, Gil Schreier
BACKGROUND: On February 6th, 2015, the Supreme Court of Canada ruled that competent adults suffering intolerably from a grievous and irremediable medical condition have the right to the assistance of a physician in ending their own lives, an act known as physician-assisted death, and later defined as medical assistance in dying, allowing for provision by a physician or a nurse practitioner. As of June 6th, 2016, this is no longer illegal across Canada. There is strong support amongst the general population for physician-assisted death, however there is no recent data on the attitudes of terminally ill patients...
April 4, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29609787/-ethical-issues-and-limiting-of-cancer-treatments-in-the-advanced-stage
#17
Gisèle Chvetzoff, Géraldine Thevenet
Nurses play a strategic role alongside patients and their families in the process leading to the decision to limit cancer treatments in the advanced phase of the disease. This stage of the patient's care requires support and guidance as part of the palliative approach, which, in addition to the patient and the family, also concerns the oncologist.
April 2018: Revue de L'infirmière
https://www.readbyqxmd.com/read/29609785/-the-ethical-issues-of-inclusion-in-clinical-trials
#18
Julie Henry
Envisaging the wider ethical issues regarding the inclusion of patients in clinical trials means considering the wider context (regional coverage and patient pathway). It is also necessary to take into account the role of the lead caregivers in maintaining continuity of care for the patients, whether they are included in a clinical trial or given palliative care.
April 2018: Revue de L'infirmière
https://www.readbyqxmd.com/read/29591838/getting-comfortable-with-comfort-feeding-an-exploration-of-legal-and-ethical-aspects-of-the-australian-speech-language-pathologist-s-role-in-palliative-dysphagia-care
#19
Katherine Kelly, Steven Cumming, Belinda Kenny, Jennifer Smith-Merry, Hans Bogaardt
PURPOSE: With an ageing population, speech-language pathologists (SLPs) can expect to encounter legal and ethical challenges associated with palliative and end-of-life care more frequently. An awareness of the medico-legal and ethical framework for palliative dysphagia management will better equip SLPs to work effectively in this area. METHOD: This narrative review examines a range of legislation, legal, ethical and SLP literature that is currently available to orient SLPs to legal and ethical palliative dysphagia management in the Australian context...
March 28, 2018: International Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/29573444/assessment-of-palliative-care-needs-of-patients-families-living-with-cancer-in-a-developing-country
#20
Akon Ndiok, Busisiwe Ncama
PURPOSE: The study seeks to assess the care needs of oncology in-patients and clinic attendees or families in two tertiary health institutions. METHODS: This was a descriptive study which utilised a quantitative survey questionnaire of all cancer patients diagnosed between January 2014 and September 2016 (n = 547) with the return rate (n = 455) representing 82%. The questionnaire explored assessment of palliative care need. These instruments were used, because patients with cancer and their families are reluctant to talk about the disease...
March 24, 2018: Scandinavian Journal of Caring Sciences
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