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care of patients at the end of life

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https://www.readbyqxmd.com/read/28106516/rural-end-of-life-care-from-the-experiences-and-perspectives-of-patients-and-family-caregivers-a-systematic-literature-review
#1
Suzanne Rainsford, Roderick D MacLeod, Nicholas J Glasgow, Christine B Phillips, Robert B Wiles, Donna M Wilson
BACKGROUND: End-of-life care must be relevant to the dying person and their family caregiver regardless of where they live. Rural areas are distinct and need special consideration. Gaining end-of-life care experiences and perspectives of rural patients and their family caregivers is needed to ensure optimal rural care. AIMS: To describe end-of-life care experiences and perspectives of rural patients and their family caregivers, to identify facilitators and barriers to receiving end-of-life care in rural/remote settings and to describe the influence of rural place and culture on end-of-life care experiences...
January 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28105900/feasibility-acceptability-and-tolerability-of-rgn107-in-the-palliative-wound-care-management-of-chronic-wound-symptoms
#2
M Madisetti, T J Kelechi, M Mueller, E J Amella, M A Prentice
OBJECTIVE: To assess the feasibility, acceptability and tolerability of RGN107 use, a natural powder blend of Arnica Montana, Calendula Officinalis, Mentha Arvensis and Santalum Album, among hospice patients and their wound caregivers in the palliative wound care management of chronic wound symptoms at end-of-life. METHOD: Data were collected between May 2013 and November 2015. A pilot trial conducted among 50 hospice patients with symptomatic (pain, odour, or exudate) chronic wounds...
January 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28104546/dying-in-intensive-care-units-of-india-commentaries-on-policies-and-position-papers-on-palliative-and-end-of-life-care
#3
REVIEW
Jaydeep Sengupta, Suhita Chopra Chatterjee
PURPOSE: This study critically examines the available policy guidelines on integration of palliative and end-of-life care in Indian intensive care units to appraise their congruence with Indian reality. MATERIALS AND METHODS: Six position statements and guidelines issued by the Indian Society for Critical Care Medicine and the Indian Association of Palliative Care from 2005 till 2015 were examined. The present study reflects upon the recommendations suggested by these texts...
December 24, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28100139/the-collision-of-inmate-and-patient
#4
Aline Chassagne, Aurélie Godard, Elodie Cretin, Lionel Pazart, Régis Aubry
Every year in France 100 inmates die in prison from illness, but their experiences with end of life (EOL) have not been investigated to date. The purpose of this article is to highlight the realities regarding inmates at the end of life, putting into perspective the viewpoints of the sick prisoners with those of the health and correctional professionals accompanying them. Based on qualitative research, the challenge is to identify potential barriers to palliative care for inmates in order to consider possible improvements...
January 2017: Journal of Correctional Health Care
https://www.readbyqxmd.com/read/28100061/outpatient-palliative-care-and-aggressiveness-of-end-of-life-care-in-patients-with-metastatic-colorectal-cancer
#5
Si Won Lee, Hyun Jung Jho, Ji Yeon Baek, Eun Kyung Shim, Hyun Mi Kim, Ji Yeon Ku, Eun Jung Nam, Yoon-Jung Chang, Hye Jin Choi, Sun Young Kim
BACKGROUND: Palliative care in outpatient setting has been shown to promote better symptom management and transition to hospice care among patients with advanced cancer. Nevertheless, specialized palliative care is rarely provided at cancer centers in Korea. Herein, we aimed to assess aggressiveness of end-of-life care for patients with metastatic colorectal cancer according to the use of outpatient palliative care (OPC) at a single cancer center in Korea. METHODS: We performed a retrospective medical record review for 132 patients with metastatic colorectal cancer who died between 2011 and 2014...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28099053/palliative-care-involvement-is-associated-with-less-intensive-end-of-life-care-in-adolescent-and-young-adult-oncology-patients
#6
Jennifer M Snaman, Erica C Kaye, Jessie J Lu, April Sykes, Justin N Baker
BACKGROUND: Adolescent and young adult oncology (AYAO) patients often receive intensive medical care and experience significant symptoms at the end of life (EOL). OBJECTIVE: This study aimed to describe the characteristics of AYAO patients aged 15-26 years who died as inpatients in a hospital and to compare the illness and EOL experiences of AYAO patients who did and did not receive palliative care (PC). DESIGN AND SETTING: A standardized data extraction tool was used to collect information about demographics, treatment, terminal characteristics, and symptoms during the last month of life (LMOL) for 69 AYAO patients who died while hospitalized between 2008 and 2014...
January 18, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28098622/physician-assisted-suicide-and-euthanasia-in-the-icu-a-dialogue-on-core-ethical-issues
#7
Ewan C Goligher, E Wesley Ely, Daniel P Sulmasy, Jan Bakker, John Raphael, Angelo E Volandes, Bhavesh M Patel, Kate Payne, Annmarie Hosie, Larry Churchill, Douglas B White, James Downar
OBJECTIVE: Many patients are admitted to the ICU at or near the end of their lives. Consequently, the increasingly common debate regarding physician-assisted suicide and euthanasia holds implications for the practice of critical care medicine. The objective of this article is to explore core ethical issues related to physician-assisted suicide and euthanasia from the perspective of healthcare professionals and ethicists on both sides of the debate. SYNTHESIS: We identified four issues highlighting the key areas of ethical tension central to evaluating physician-assisted suicide and euthanasia in medical practice: 1) the benefit or harm of death itself, 2) the relationship between physician-assisted suicide and euthanasia and withholding or withdrawing life support, 3) the morality of a physician deliberately causing death, and 4) the management of conscientious objection related to physician-assisted suicide and euthanasia in the critical care setting...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28095941/preparation-for-the-end-of-life-and-life-completion-during-late-stage-lung-cancer-an-exploratory-analysis
#8
Gail Adorno, Cara Wallace
OBJECTIVE: Our aim was to explore preparation for the end of life (EoL) and life closure among persons with advanced metastatic lung cancer. Understanding quality of life through the lens of preparation and completion is important since the trajectory of lung cancer can be relatively short, often leading to application of cancer-directed therapies near death without the opportunity for advance planning or palliative care. Clinical research is needed to understand the kinds of distress specific to older adults with advanced lung cancer that are amendable to palliative care interventions...
January 18, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28095906/cost-of-physician-led-home-visit-care-zaitaku-care-compared-with-hospital-care-at-the-end-of-life-in-japan
#9
Kentaro Kinjo, Tomoko Sairenji, Hidenobu Koga, Yasuhiro Osugi, Shin Yoshida, Hidefumi Ichinose, Yasunori Nagai, Hiroshi Imura, Jeannette E South-Paul, Mark Meyer, Yoshihisa Honda
BACKGROUND: Physician-led home visit care with medical teams (Zaitaku care) has been developed on a national scale to support those who wish to stay at home at the end of life, and promote a system of community-based integrated care in Japan. Medical care at the end of life can be expensive, and is an urgent socioeconomic issue for aging societies. However medical costs of physician-led home visits care have not been well studied. We compared the medical costs of Zaitaku care and hospital care at the end of life in a rapidly aging community in a rural area in Japan...
January 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28093387/dying-at-home-of-cancer-whose-needs-are-being-met-the-experience-of-family-carers-and-healthcare-professionals-a-multiperspective-qualitative-study
#10
Jackie Pottle, Julia Hiscock, Richard D Neal, Marlise Poolman
OBJECTIVES: Supporting patients to die in the place of their choosing is an important aspect of end of life care. Our study set out to answer the question: 'How does the home environment influence perceptions of quality of death, and the experience of caring for the dying at home, for family carers and healthcare professionals (HCPs)? METHODS: A qualitative approach, using multiperspective interviews with bereaved family carers (n=15) and a nominated HCP (n=13) ensured depth of insight gained into supporting a home death...
January 16, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28093312/palliative-medicine-and-preparedness-planning-for-patients-receiving-left-ventricular-assist-device-as-destination-therapy-challenges-to-measuring-impact-and-change-in-institutional-culture
#11
Brandon P Verdoorn, Angela J Luckhardt, Sara E Wordingham, Shannon M Dunlay, Keith M Swetz
CONTEXT: While left ventricular assist devices as destination therapy (DT-LVAD) can improve survival, quality of life, and functional capacity in well-selected patients with advanced heart failure, there remain unique challenges to providing quality end-of-life care in this population. Palliative care involvement is universally recommended, but how to best operationalize this care and measure success is unknown. OBJECTIVES: To characterize the process of preparedness planning (PP) for patients receiving DT-LVAD at our institution and better understand opportunities for quality improvement or procedural transferability...
January 13, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28092211/spanish-adaptation-of-the-frommelt-attitude-toward-care-of-the-dying-scale-fatcod-s-in-nursing-undergraduates
#12
Montserrat Edo-Gual, Joaquín Tomás-Sábado, Juana Gómez-Benito, Cristina Monforte-Royo, Amor Aradilla-Herrero
The Frommelt Attitude Toward Care of the Dying Scale (FATCOD) is designed to assess the attitudes of professionals and trainees toward caring for the dying patient and their family members. In this study the main aim is to adapt the FATCOD to a Spanish context (FATCOD-S). In addition, the relations between FATCOD-S, sociodemographic variables, emotional intelligence, and death attitudes have been analyzed. A sample of 669 Spanish nursing students from four Universities responded to a questionnaire. The exploratory factor analysis (EFA) concludes a structure composed of two significant factors...
January 1, 2017: Omega
https://www.readbyqxmd.com/read/28075655/experiences-and-preferences-for-end-of-life-care-for-young-adults-with-cancer-and-their-informal-carers-a-narrative-synthesis
#13
Nothando Ngwenya, Charlotte Kenten, Louise Jones, Faith Gibson, Susie Pearce, Mary Flatley, Rachael Hough, L Caroline Stirling, Rachel M Taylor, Geoff Wong, Jeremy Whelan
To review the qualitative literature on experiences of and preferences for end-of-life care of people with cancer aged 16-40 years (young adults) and their informal carers. A systematic review using narrative synthesis of qualitative studies using the 2006 UK Economic and Social Research Council research methods program guidance. Seven electronic bibliographic databases, two clinical trials databases, and three relevant theses databases were searched from January 2004 to October 2015. Eighteen articles were included from twelve countries...
January 11, 2017: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/28074585/a-good-death
#14
Tia Powell, Adira Hulkower
A good death is hard to find. Family members tell us that loved ones die in the wrong place-the hospital-and do not receive high-quality care at the end of life. This issue of the Hastings Center Report offers two articles from authors who strive to provide good end-of-life care and to prevent needless suffering. We agree with their goals, but we have substantial reservations about the approaches they recommend. Respect for the decisions of patients and their surrogates is a relatively new and still vulnerable aspect of medical care...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28073465/-depression-in-relatives-of-patients-with-schizophrenia-8-month-longitudinal-outcome-of-profamille-program
#15
E Valladier, D Willard, L Romo, Y Hodé, Y Morvan
INTRODUCTION: Mental illness such as schizophrenia is a major public health concern. In France, the economic cost of schizophrenia represents 2 % of total medical expenditures. Schizophrenia has an impact on health and quality of life not only for patients but also for relatives. Family psychoeducation is a complementary therapeutic intervention to ordinary clinical care deigned to alleviate the burden of care among relatives of patients with schizophrenia. Literature suggests such programs including the patients' family members reduce the risk of relapse...
January 7, 2017: L'Encéphale
https://www.readbyqxmd.com/read/28069009/multi-center-randomized-placebo-controlled-trial-of-nocturnal-oxygen-therapy-in-chronic-obstructive-pulmonary-disease-a-study-protocol-for-the-inox-trial
#16
Yves Lacasse, Sarah Bernard, Frédéric Sériès, Van Hung Nguyen, Jean Bourbeau, Shawn Aaron, François Maltais
BACKGROUND: Long-term oxygen therapy (LTOT) is the only component of the management of chronic obstructive pulmonary disease (COPD) that improves survival in patients with severe daytime hypoxemia. LTOT is usually provided by a stationary oxygen concentrator and is recommended to be used for at least 15-18 h a day. Several studies have demonstrated a deterioration in arterial blood gas pressures and oxygen saturation during sleep in patients with COPD, even in those not qualifying for LTOT...
January 9, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28068987/effects-of-acetyl-dl-leucine-on-cerebellar-ataxia-alcat-trial-study-protocol-for-a-multicenter-multinational-randomized-double-blind-placebo-controlled-crossover-phase-iii-trial
#17
Katharina Feil, Christine Adrion, Julian Teufel, Sylvia Bösch, Jens Claassen, Ilaria Giordano, Holger Hengel, Heike Jacobi, Thomas Klockgether, Thomas Klopstock, Wolfgang Nachbauer, Ludger Schöls, Claudia Stendel, Ellen Uslar, Bart van de Warrenburg, Ingrid Berger, Ivonne Naumann, Otmar Bayer, Hans-Helge Müller, Ulrich Mansmann, Michael Strupp
BACKGROUND: Cerebellar ataxia (CA) is a frequent and often disabling condition that impairs motor functioning and impacts on quality of life (QoL). No medication has yet been proven effective for the symptomatic or even causative treatment of hereditary or non-hereditary, non-acquired CA. So far, the only treatment recommendation is physiotherapy. Therefore, new therapeutic options are needed. Based on three observational studies, the primary objective of the acetyl-DL-leucine on ataxia (ALCAT) trial is to examine the efficacy and tolerability of a symptomatic therapy with acetyl-DL-leucine compared to placebo on motor function measured by the Scale for the Assessment and Rating of Ataxia (SARA) in patients with CA...
January 10, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28063864/the-end-of-life-experience-of-pediatric-heart-transplant-recipients
#18
Seth A Hollander, John Dykes, Sharon Chen, Lynsey Barkoff, Barbara Sourkes, Harvey Cohen, David N Rosenthal, Daniel Bernstein, Beth D Kaufman
CONTEXT: Despite advances in therapies, many pediatric heart transplant (Htx) recipients will die prematurely. We characterized the circumstances surrounding death in this cohort, including location of death and interventions performed in the final 24 hours. METHODS: We reviewed all patients who underwent Htx at Lucile Packard Children's Hospital, Stanford, survived hospital discharge, and subsequently died between 7/19/2007-9/13/2015. The primary outcome studied was location of death, characterized as inpatient, outpatient, or emergency department (ED)...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28062650/euthanasia-embedded-in-palliative-care-responses-to-essentialistic-criticisms-of-the-belgian-model-of-integral-end-of-life-care
#19
Jan L Bernheim, Kasper Raus
The Belgian model of 'integral' end-of-life care consists of universal access to palliative care (PC) and legally regulated euthanasia. As a first worldwide, the Flemish PC organisation has embedded euthanasia in its practice. However, some critics have declared the Belgian-model concepts of 'integral PC' and 'palliative futility' to fundamentally contradict the essence of PC. This article analyses the various essentialistic arguments for the incompatibility of euthanasia and PC. The empirical evidence from the euthanasia-permissive Benelux countries shows that since legalisation, carefulness (of decision making) at the end of life has improved and there have been no significant adverse 'slippery slope' effects...
January 6, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28062341/implementation-and-impact-of-patient-lay-navigator-led-advance-care-planning-conversations
#20
Gabrielle B Rocque, J Nicholas Dionne-Odom, Chao-Hui Sylvia Huang, Soumya J Niranjan, Courtney P Williams, Bradford E Jackson, Karina I Halilova, Kelly M Kenzik, Kerri S Bevis, Audrey S Wallace, Nedra Lisovicz, Richard A Taylor, Maria Pisu, Edward E Partridge, Linda A Briggs, Elizabeth A Kvale
CONTEXT: Advance care planning (ACP) improves alignment between patient preferences for life-sustaining treatment and care received at end of life (EOL). OBJECTIVES: To evaluate implementation of lay navigator-led ACP. METHODS: A convergent, parallel mixed-methods design was employed to evaluate implementation of navigator-led ACP across 12 cancer centers. Data collection included: (1) electronic navigation records, (2) navigator surveys (n=45), (3) claims-based patient outcomes (n=820), and (4) semi-structured navigator interviews (n=26)...
January 3, 2017: Journal of Pain and Symptom Management
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