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"Advance Directive"

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https://www.readbyqxmd.com/read/29776701/nonstandard-advance-directives-in-emergency-medicine-what-should-we-do
#1
Kenneth V Iserson
BACKGROUND: Critically ill or injured emergency department or prehospital patients who lack decision-making capacity sometimes present with a non-standard advance directive, such as a "Do Not Resuscitate" tattoo or medallion. Emergency clinicians must immediately address the question of whether to withhold treatment based on what may or may not be a valid patient directive. DISCUSSION: Advance directives have been standardized for a good reason. Emergency department or prehospital healthcare providers must be able to immediately interpret and act on them without needing a legal interpretation...
May 16, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29771249/-new-italian-law-about-end-of-life-self-determination-and-shared-care-pathway
#2
Rosagemma Ciliberti, Matteo Gulino, Ilaria Gorini
The Italian Parliament has recently approved the Law n. 219/2017 concerning "Rules on informed consent and advance directives". The manuscript points out the main key points of the new law, in order to clarify the role of the advance directives and to provide clear operational guidelines for healthcare personnel. Taking into consideration the Italian deontological and juridical context, along with the main jurisprudential judgements, the law has been analysed. The Authors discussed the new rules and the bioethical issues also in relation to the provisions stated by the Convention on Human Rights and Biomedicine (Convention of Oviedo)...
May 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29767827/directing-citizens-to-create-advance-directives
#3
Sophie Haesen, David Shaw
This article describes the Swiss law on advance directives that was passed at the beginning of 2013 and led to more certainty about the legally binding character of such directives. However, for various reasons the drafting of advance directives is not yet widespread in Switzerland, and many resources might be put to better use if this became a common practice. A recent proposal by members of a political party to make the discussion, although not the actual drafting, of advance directives mandatory was rejected by the Swiss Federal Parliament, and the proposal was written off after having been pending for 2 years...
May 16, 2018: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29757843/strategies-used-to-facilitate-the-discussion-of-advance-care-planning-with-older-adults-in-primary-care-settings-a-literature-review
#4
Guillermina R Solis, Bibiana M Mancera, Megan Johnson Shen
BACKGROUND AND PURPOSE: The purpose of this literature review was to evaluate strategies used in primary care settings to initiate advance care planning (ACP) conversations leading to the completion of an advance directive (AD). Approximately 50% of older adults have an AD; few talk to their primary care provider (PCP) about end-of-life wishes. The Institute of Medicine report and recent changes in Medicare reimbursement policies create opportunities for PCPs to address ACP in primary care settings...
May 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29748717/ethical-challenges-in-resuscitation
#5
REVIEW
Spyros D Mentzelopoulos, Anne-Marie Slowther, Zoe Fritz, Claudio Sandroni, Theodoros Xanthos, Clifton Callaway, Gavin D Perkins, Craig Newgard, Eleni Ischaki, Robert Greif, Erwin Kompanje, Leo Bossaert
PURPOSE: A rapidly evolving resuscitation science provides more effective treatments to an aging population with multiple comorbidites. Concurrently, emergency care has become patient-centered. This review aims to describe challenges associated with the application of key principles of bioethics in resuscitation and post-resuscitation care; propose actions to address these challenges; and highlight the need for evidence-based ethics and consensus on ethical principles interpretation. METHODS: Following agreement on the article's outline, subgroups of 2-3 authors provided narrative reviews of ethical issues concerning autonomy and honesty, beneficence/nonmaleficence and dignity, justice, specific practices/circumstances such as family presence during resuscitation, and emergency research...
May 10, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29747762/-why-a-very-little-use-for-advance-directives-regarding-end-of-life
#6
EDITORIAL
Sidonie Hubert, François Philippart
No abstract text is available yet for this article.
April 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29743764/definition-of-terms-used-in-limitation-of-treatment-and-providing-palliative-care-at-the-end-of-life-the-indian-council-of-medical-research-commission-report
#7
Naveen Salins, Roop Gursahani, Roli Mathur, Shivakumar Iyer, Stanley Macaden, Nagesh Simha, Raj Kumar Mani, M R Rajagopal
Background: Indian hospitals, in general, lack policies on the limitation of inappropriate life-sustaining interventions at the end of life. To facilitate discussion, preparation of guidelines and framing of laws, terminologies relating to the treatment limitation, and providing palliative care at the end-of-life care (EOLC) need to be defined and brought up to date. Methodology: This consensus document on terminologies and definitions of terminologies was prepared under the aegis of the Indian Council of Medical Research...
April 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29743759/knowledge-and-attitude-of-er-and-intensive-care-unit-physicians-toward-do-not-resuscitate-in-a-tertiary-care-center-in-saudi-arabia-a-survey-study
#8
Alaa Gouda, Norah Alrasheed, Alaa Ali, Ahmad Allaf, Najd Almudaiheem, Youssuf Ali, Ahmad Alghabban, Sami Alsalolami
Introduction: Only a few studies from Arab Muslim countries address do-not-resuscitate (DNR) practice. The knowledge of physicians about the existing policy and the attitude towards DNR were surveyed. Objective: The objective of this study is to identify the knowledge of the participants of the local DNR policy and barriers of addressing DNR including religious background. Methods: A questionnaire has been distributed to Emergency Room (ER) and Intensive Care Unit (ICU) physicians...
April 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29741765/advance-care-planning-for-older-homeless-experienced-adults-results-from-the-health-outcomes-of-people-experiencing-homelessness-in-older-middle-age-study
#9
Rebecca L Sudore, Isabel Arellano Cuervo, Lina Tieu, David Guzman, Lauren M Kaplan, Margot Kushel
Older homeless-experienced adults have low engagement in advance care planning (ACP) despite high morbidity and mortality. We conducted a cross-sectional analysis of a cohort of 350 homeless-experienced adults aged 50 and older in Oakland, California. We assessed the prevalence of potential surrogate decision-makers, ACP contemplation, discussions, and ACP documentation (surrogate designation, advance directives). We used multivariable logistic regression to examine factors associated with ACP discussions and documentation...
May 9, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29728768/therapeutic-decisions-in-als-patients-cross-cultural-differences-and-clinical-implications
#10
Peter M Andersen, Magdalena Kuzma-Kozakiewicz, Jürgen Keller, Helena E A Aho-Oezhan, Katarzyna Ciecwierska, Natalia Szejko, Cynthia Vázquez, Sarah Böhm, Gisela Badura-Lotter, Thomas Meyer, Susanne Petri, Katharina Linse, Andreas Hermann, Olof Semb, Erica Stenberg, Simona Nackberg, Johannes Dorst, Ingo Uttner, Ann-Cristin Häggström, Albert C Ludolph, Dorothée Lulé
OBJECTIVE: Quantitative analysis of decision-making on therapeutic options in different sociocultural context in amyotrophic lateral sclerosis (ALS). METHODS: ALS patients (n = 244) were consecutively recruited in Germany (n = 83), Poland (n = 83), and Sweden (n = 78) in a prospective cross-cultural study ( www.NEEDSinALS.com ). They were interviewed on preferences for therapeutic techniques including invasive (IV) and non-invasive ventilation (NIV), as well as percutaneous endoscopic gastrostomy (PEG) and on hypothetical termination of these using quantitative questions...
May 4, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29728467/predictors-of-location-of-death-for-children-with-cancer-enrolled-on-a-palliative-care-service
#11
Erica C Kaye, Samantha DeMarsh, Courtney A Gushue, Jonathan Jerkins, April Sykes, Zhaohua Lu, Jennifer M Snaman, Lindsay J Blazin, Liza-Marie Johnson, Deena R Levine, R Ray Morrison, Justin N Baker
BACKGROUND: In the U.S., more children die from cancer than from any other disease, and more than one third die in the hospital setting. These data have been replicated even in subpopulations of children with cancer enrolled on a palliative care service. Children with cancer who die in high-acuity inpatient settings often experience suffering at the end of life, with increased psychosocial morbidities seen in their bereaved parents. Strategies to preemptively identify children with cancer who are more likely to die in high-acuity inpatient settings have not been explored...
May 4, 2018: Oncologist
https://www.readbyqxmd.com/read/29720286/impact-of-brief-education-on-healthy-seniors-attitudes-and-healthcare-choices-about-alzheimer-s-disease-and-associated-symptoms
#12
Robyn E Waxman, Barbara J Russell, Oscar C T Iu, Benoit H Mulsant
ABSTRACTObjective:The primary objective of this study was to determine whether a brief education session about Alzheimer's disease (AD) stages and associated behavioral and psychological symptoms of dementia (BPSD) changes healthy seniors' treatment choices. A secondary objective was to determine whether pharmacotherapy to reduce BPSD would be preferred over other potentially more restrictive interventions. METHODS: Participants (n = 32; 8 men; aged > 64years; no self-reported dementia diagnosis) were assigned to one of ten group sessions during which they received information about AD and BPSD...
May 3, 2018: International Psychogeriatrics
https://www.readbyqxmd.com/read/29714994/issues-in-geriatric-care-alzheimer-disease
#13
Kathy Kemle, Richard J Ackermann
Alzheimer disease (AD) occurs in 8.8% of older US adults and is the sixth leading cause of death among older adults. Medicare annual wellness visits require screening for cognitive impairment but do not specify screening methods. Numerous screening instruments are available. If results are positive, evaluation with well-validated assessment tools is needed. If cognitive impairment is confirmed, laboratory tests and imaging studies should be obtained to rule out reversible etiologies. If patients meet diagnostic criteria for AD, clinicians should educate patients and families on the expected course and help them complete advance directives...
May 2018: FP Essentials
https://www.readbyqxmd.com/read/29703114/addressing-palliative-and-end-of-life-care-needs-with-native-american-elders
#14
Mary J Isaacson
BACKGROUND: Life-limiting illness plagues Native Americans, yet access to palliative and end-of-life care, including hospice care, is severely limited. AIM: This study aimed to explore palliative and hospice care with Native American elders and tribal health educators on a Northern Plains reservation in the US. METHODS: Using a community-based participatory approach, participants discussed the cultural acceptability of palliative and hospice care in their tribal community...
April 2, 2018: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/29701595/factors-influencing-advance-directives-among-psychiatric-inpatients-in-india
#15
Guru S Gowda, Eric O Noorthoorn, Peter Lepping, Channaveerachari Naveen Kumar, Raveesh Bevinahalli Nanjegowda, Suresh Bada Math
OBJECTIVES: Advance directives are documents stating treatment preferences in case of future lack of decision making capacity. In India, as in many other countries, legislators advocate Psychiatric Advance Directives (PADs), while evidence on its use is limited. This study examined factors influencing PADs by gathering inpatients perspectives on PADs at discharge and investigating patient characteristics associated with the expression of treatment wishes in PADs. METHODS: We conducted a hospital based descriptive study in Bangalore...
January 2018: International Journal of Law and Psychiatry
https://www.readbyqxmd.com/read/29671084/-advance-care-planning-a-qualitative-investigation-on-patients-perspectives-with-advanced-heart-failure
#16
Lena Werdecker, Matthias Kujawa, Nils Schneider, Gerald Neitzke
BACKGROUND: The Hospice and Palliative Care Act (2015) promotes advance care planning (ACP) for patients in nursing homes, but chronically ill patients living at home can also benefit from ACP. OBJECTIVE: The aim of the study was to analyze the perception of ACP consultations by patients with advanced heart failure. MATERIAL AND METHODS: Patients (70 years and older) with advanced heart failure participated in two physician-led ACP consultations...
April 18, 2018: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/29661479/the-minimally-conscious-state-the-disability-bias-and-the-moral-authority-of-advance-directives
#17
Stephen Napier
No abstract text is available yet for this article.
April 13, 2018: International Journal of Law and Psychiatry
https://www.readbyqxmd.com/read/29658817/racial-and-ethnic-differences-in-advance-care-planning-results-of-a-statewide-population-based-survey
#18
Melissa A Clark, Sharina D Person, Anna Gosline, Atul A Gawande, Susan D Block
BACKGROUND: Few studies have focused on racial and ethnic differences in advance care planning other than advance directives among population-based samples of adults across the lifespan. METHODS: Using data from a statewide random-digit dial telephone survey of adults 18 years or older (n = 1851), we investigated racial and ethnic differences in (1) designation of a healthcare agent (HCA); and (2) communication of goals, values, and preferences for end-of-life care with healthcare providers, a HCA, or other family members and friends...
April 16, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29657368/the-advance-directives-and-foregoing-of-life-support-where-do-we-stand-now
#19
EDITORIAL
Raj Kumar Mani, Sri Nagesh Simha, Roop Gursahani
No abstract text is available yet for this article.
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29656801/-the-law-of-march-5-2007-and-the-care-of-persons-placed-under-guardianship
#20
Matthieu Modot, Clotilde Rougé-Maillart
The care of persons placed under guardianship has changed considerably since the law of March 5, 2007, as greater autonomy is granted to them. By advocating greater autonomy of protected adults, the French Civil Code is in opposition with the French Public Health Code since the latter states that the systematic consent of the guardian is required in addition to that of the protected adult for so-called general care. In cases of serious injury to bodily integrity, the guardianship judge's opinion must be sought by the guardian...
April 12, 2018: La Presse Médicale
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