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"Advance Directive"

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https://www.readbyqxmd.com/read/28096041/advance-care-planning-in-adults-with-congenital-heart-disease-a-patient-priority
#1
Lisa X Deng, Lacey P Gleason, Abigail M Khan, David Drajpuch, Stephanie Fuller, Leah A Goldberg, Christopher E Mascio, Sara L Partington, Lynda Tobin, Yuli Y Kim, Adrienne H Kovacs
BACKGROUND: Adult congenital heart disease (ACHD) patients with moderate or great defect complexity are at risk for premature death. Although early engagement in advance care planning (ACP) is recommended, previous research suggests that it seldom occurs. METHODS: This study investigated ACHD patient preferences for ACP and factors that impact preferences. ACHD patients completed an ACP preferences questionnaire, the Hospital Anxiety and Depression Scale and a measure of attachment styles...
January 4, 2017: International Journal of Cardiology
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
#2
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/28074586/the-theory-and-practice-of-surrogate-decision-making
#3
David Wendler
When a patient lacks decision-making capacity and has not left a clear advance directive, there is now widespread agreement that patient-designated and next-of-kin surrogates should implement substituted judgment within a process of shared decision-making. Specifically, after discussing the "best scientific evidence available, as well as the patient's values, goals, and preferences" with the patient's clinicians, the patient-designated or next-of-kin surrogate should attempt to determine what decision the patient would have made in the circumstances...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28073292/health-care-utilization-after-hospice-enrollment-in-patients-with-heart-failure-and-cancer
#4
Meredith A MacKenzie, Alexandra Hanlon
This study aimed to examine the role of diagnosis in health-care utilization patterns after hospice enrollment. Using 2007 National Home and Hospice Care Survey data from hospice patients with heart failure (n = 311) and cancer (n = 946), we analyzed emergency service use and discharge to hospital via logistic regression pre- and postpropensity score matching. Prematching, patients with heart failure had twice the odds of emergency services use than patients with cancer ( P < .001) and twice the odds of discharge to hospital ( P = ...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28062350/discordance-of-patient-reported-and-clinician-ordered-resuscitation-status-in-patients-hospitalized-with-acute-decompensated-heart-failure
#5
Kathleen A Young, Sara E Wordingham, Jacob J Strand, Vėronique L Roger, Shannon M Dunlay
CONTEXT: Accurate documentation of preferences for cardiopulmonary resuscitation at hospital admission is critical to ensure that patients receive resuscitation or not in accordance with their wishes. OBJECTIVES: We sought to identify and characterize inconsistencies in patient-reported and clinician-ordered resuscitation status in patients hospitalized with acute decompensated heart failure (ADHF). METHODS: Southeastern Minnesota residents hospitalized with ADHF were prospectively enrolled into a study that included the administration of face-to-face questionnaires from January 2014 through February 2016...
January 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28062339/defining-advance-care-planning-for-adults-a-consensus-definition-from-a-multidisciplinary-delphi-panel
#6
Rebecca L Sudore, Hillary D Lum, John J You, Laura C Hanson, Diane E Meier, Steven Z Pantilat, Daniel D Matlock, Judith A C Rietjens, Ida J Korfage, Christine S Ritchie, Jean S Kutner, Joan M Teno, Judy Thomas, Ryan D McMahan, Daren K Heyland
BACKGROUND: Despite increasing interest in advance care planning (ACP) and prior ACP descriptions, a consensus definition does not yet exist to guide clinical, research, and policy initiatives. OBJECTIVE: To develop a consensus definition of ACP for adults. DESIGN: Delphi Panel SETTING/PARTICIPANTS: Participants included a multidisciplinary panel of international ACP experts consisting of 52 clinicians, researchers, and policy leaders from 4 countries, and a patient/surrogate advisory committee...
January 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28057703/advance-directives-and-end-of-life-care-among-nursing-home-residents-receiving-maintenance-dialysis
#7
Manjula Kurella Tamura, Maria E Montez-Rath, Yoshio N Hall, Ronit Katz, Ann M O'Hare
BACKGROUND AND OBJECTIVES: Little is known about the relation between the content of advance directives and downstream treatment decisions among patients receiving maintenance dialysis. In this study, we determined the prevalence of advance directives specifying treatment limitations and/or surrogate decision-makers in the last year of life and their association with end-of-life care among nursing home residents. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using national data from 2006 to 2007, we compared the content of advance directives among 30,716 nursing home residents receiving dialysis to 30,825 nursing home residents with other serious illnesses during the year before death...
January 5, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28040231/differences-between-pediatricians-and-internists-in-advance-care-planning-for-adolescents-with-cancer
#8
Nobuyuki Yotani, Yoshiyuki Kizawa, Haruo Shintaku
OBJECTIVE: To evaluate differences between pediatricians and internists in the practice of and barriers to advance care planning (ACP) for adolescent patients with cancer. STUDY DESIGN: A self-reported questionnaire was administered to assess the practice of ACP, advance directives, and barriers to ACP for adolescent patients with cancer. All 3392 Japanese board-certified hematologists were surveyed, and 600 hematologists (227 pediatricians, 373 internists) who take care of adolescent patients with cancer with decision-making capacity were analyzed...
December 28, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/28033524/advance-directives-and-mortality-rates-among-nursing-home-residents-in-taiwan-a-retrospective-longitudinal-study
#9
Hsiu-Hsin Tsai, Yun-Fang Tsai, Chia-Yih Liu
BACKGROUND: No data-based evidence is available regarding the best time for nursing home nurses to obtain residents' signatures on advance directives, especially for do-not-resuscitate directives, the most common type of advance directive. This information is needed to enhance the low prevalence of advance directives in Asian countries. OBJECTIVES: The purposes of this study were to understand (1) the timing between nursing home admission and signing a do-not-resuscitate directive, (2) the factors related to having a do-not-resuscitate directive, and (3) the association between having a do-not-resuscitate directive and nursing home residents' mortality in Taiwan...
December 15, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28032821/doctors-lawyers-and-advance-care-planning-time-for-innovation-to-work-together-to-meet-client-needs
#10
Nola M Ries, Maureen Douglas, Jessica Simon, Konrad Fassbender
Health organizations in canada have invested considerable resources in strategies to improve knowledge and uptake of advance care planning (acp). Yet barriers persist and many canadians do not engage in the full range of acp behaviours, including writing an advance directive and appointing a legally authorized decision-maker. not engaging effectively in acp disadvantages patients, their loved ones and their healthcare providers. This article advocates for greater collaboration between health and legal professionals to better support clients in acp and presents a framework for action to build connections between these typically siloed professions...
November 2016: Healthcare Policy, Politiques de Santé
https://www.readbyqxmd.com/read/28032354/end-of-life-treatment-decisions-in-nursing-home-residents-dying-with-dementia-in-the-netherlands
#11
Simone A Hendriks, Martin Smalbrugge, Luc Deliens, Raymond T C M Koopmans, Bregje D Onwuteaka-Philipsen, Cees M P M Hertogh, Jenny T van der Steen
OBJECTIVE: The objective was to describe end-of-life treatment decisions for patients dying with dementia in various stages of dementia in long-term care facilities in the Netherlands with elderly care physicians responsible for treatment and care. METHODS: We present data collected in the nationally representative Dutch End of Life in Dementia study (2007-2011). Within 2 weeks after death, 103 physicians completed questionnaires about the last phase of life in 330 residents with dementia who resided in 1 of 34 participating long-term care facilities...
December 29, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28028678/the-effect-of-advance-directive-completion-on-hospital-care-among-chronically-homeless-persons-a-prospective-cohort-study
#12
Alexander K Leung, Matthew J To, Linh Luong, Zahra Syavash Vahabi, Victor L Gonçalves, John Song, Stephen W Hwang
Advance care planning is relevant for homeless individuals because they experience high rates of morbidity and mortality. The impact of advance directive interventions on hospital care of homeless individuals has not been studied. The objective of this study was to determine if homeless individuals who complete an advance directive through a shelter-based intervention are more likely to have information from their advance directive documented and used during subsequent hospitalizations. The advance directive included preferences for life-sustaining treatments, resuscitation, and substitute decision maker(s)...
December 27, 2016: Journal of Urban Health: Bulletin of the New York Academy of Medicine
https://www.readbyqxmd.com/read/28009732/patient-reported-limitations-to-surgical-buy-in-a-qualitative-study-of-patients-facing-high-risk-surgery
#13
Michael J Nabozny, Jacqueline M Kruser, Nicole M Steffens, Kristen E Pecanac, Karen J Brasel, Eva H Chittenden, Zara Cooper, Martin F McKneally, Margaret L Schwarze
OBJECTIVE: To characterize how patients buy-in to treatments beyond the operating room and what limits they would place on additional life-supporting treatments. BACKGROUND: During a high-risk operation, surgeons generally assume that patients buy-in to life-supporting interventions that might be necessary postoperatively. How patients understand this agreement and their willingness to participate in additional treatment is unknown. METHODS: We purposively sampled surgeons in Toronto, Ontario, Boston, Massachusetts, and Madison, Wisconsin, who are good communicators and routinely perform high-risk operations...
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/27989399/the-long-term-impact-of-an-end-of-life-communication-intervention-among-veterans-with-copd
#14
Lynn F Reinke, Laura C Feemster, Jennifer McDowell, Eric Gunnink, Erica V Tartaglione, Edmunds Udris, J Randall Curtis, David H Au
OBJECTIVE: To assess if an end-of-life communication intervention with patients with COPD led to higher long-term documentation of advance care planning discussions at the end-of-life. BACKGROUND: We previously demonstrated that providing clinicians a patient-specific feedback form about patients' communication preferences improved the occurrence and quality of clinician communication about end-of-life care. METHODS: Among those individuals enrolled in the intervention study (2004-2007) who had died during the follow-up period (up to 2013), we assessed if patients in the intervention arm had more goals of care discussions and formal advance directives completed as compared to controls...
January 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/27983894/health-system-advance-care-planning-culture-change-for-high-risk-patients-the-promise-and-challenges-of-engaging-providers-patients-and-families-in-systematic-advance-care-planning
#15
Jennifer Reidy, Jennifer Halvorson, Suzana Makowski, Delila Katz, Barbara Weinstein, Christine McCluskey, Alex Doering, Kathryn DeCarli, Jennifer Tjia
BACKGROUND: The success of a facilitator-based model for advance care planning (ACP) in LaCrosse, Wisconsin, has inspired health systems to aim for widespread documentation of advance directives, but limited resources impair efforts to replicate this model. One promising strategy is the development of interactive, Internet-based tools that might increase access to individualized ACP at minimal cost. However, widespread adoption and implementation of Internet-based ACP efforts has yet to be described...
December 16, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27976624/palliative-care-for-dementia-patients
#16
France Hirot
Dementia is a life-limiting disease without curative treatments but the data suggest that advanced dementia is not viewed as a terminal diagnosis by physicians. Although symptoms of dementia and cancer patients are similar, palliative care is less frequently proposed for dementia patients. However, professionals and family members of demented patients strongly favor comfort care for end-stage dementia. To improve the patients' relief near the end of life, advance care planning with patients and their proxies should be encouraged...
December 1, 2016: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/27955853/-palliativer-medicine-in-surgery
#17
César Gutiérrez Samperio, Raúl Ruiz Canizales, Salvador Arellano Rodríguez, Hilda Romero Zepeda, Robert T Hall, Bernardo García Camino
The concepts and background of palliative medicine, the patient-health team relationship and the right of the patients to receive palliative care, its application in surgery, the criterion defining the terminally ill, proportionate and disproportionate measures, where it is applied and what this consists of, drugs and procedures used, who should administrate them and for how long, the requirements for advanc directives and avoidance of therapeutic obstinacy, were reviewed. It describes and reflects their ethical and legal bases...
December 9, 2016: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/27955707/desire-for-predictive-testing-for-alzheimer-s-disease-and-impact-on-advance-care-planning-a-cross-sectional-study
#18
Meera Sheffrin, Irena Stijacic Cenzer, Michael A Steinman
BACKGROUND: It is unknown whether older adults in the United States would be willing to take a test predictive of future Alzheimer's disease, or whether testing would change behavior. Using a nationally representative sample, we explored who would take a free and definitive test predictive of Alzheimer's disease, and examined how using such a test may impact advance care planning. METHODS: A cross-sectional study within the 2012 Health and Retirement Study of adults aged 65 years or older asked questions about a test predictive of Alzheimer's disease (N = 874)...
December 13, 2016: Alzheimer's Research & Therapy
https://www.readbyqxmd.com/read/27943487/a-comparison-of-attitudes-toward-length-and-quality-of-life-between-community-dwelling-older-adults-and-patients-with-advanced-cancer
#19
Chetna Malhotra, Ling Xiang, Semra Ozdemir, Ravindran Kanesvaran, Noreen Chan, Eric Andrew Finkelstein
OBJECTIVE: Applying prospect theory to end-of-life (EOL) decision-making, we hypothesize that community dwelling older adults (CDOAs) will be relatively less inclined towards extending length over improving quality of life compared to patients. We also hypothesize that differences in relative inclination for length over quality of life between the two groups will decrease with advancing age. METHODS: We tested these hypotheses by administering the Quality-Quantity questionnaire to 1067 CDOAs and 320 stage IV cancer patients and applying a linear regression model to assess whether relative inclination for length over quality of life, as estimated by the questionnaire, differed between CDOAs and patients after controlling for differences in socio-demographic characteristics...
December 10, 2016: Psycho-oncology
https://www.readbyqxmd.com/read/27940700/acceptability-of-family-centered-advanced-care-planning-for-adolescents-with-hiv
#20
Ronald H Dallas, Allison Kimmel, Megan L Wilkins, Sohail Rana, Ana Garcia, Yao I Cheng, Jichuan Wang, Maureen E Lyon
BACKGROUND AND OBJECTIVE: Small pilot studies support the appropriateness of engaging adolescents with chronic or life-limiting illnesses in pediatric advance care planning (pACP). We do not yet know if pACP is acceptable, feasible, and worthwhile, even if emotionally intense, in a fully powered randomized controlled trial. METHODS: We conducted a prospective 2-arm randomized controlled trial at 6 US urban hospitals. Adolescent/family member dyads were randomized to receive the 1-session-a-week 3-session FAmily-CEntered Advance Care Planning (FACE) pACP intervention (1, ACP Survey; 2, Goals of Care Conversation/Treatment Preferences; 3, Completion of Advance Directive) or active comparator (1, Developmental History; 2, Safety Tips; 3, Nutrition/Exercise)...
December 2016: Pediatrics
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