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https://www.readbyqxmd.com/read/29444775/persistent-inequalities-in-hospice-at-home-provision
#1
Jackie Buck, Liz Webb, Lorraine Moth, Lynn Morgan, Stephen Barclay
OBJECTIVE: To describe the nature and scope of a new Hospice at Home (H@H) service and to identify its equality of provision. METHODS: Case note review of patients supported by a H@H service for 1 year from September 2012 to August 2013 (n=321). Descriptive analysis to report frequencies and proportions of quantitative data extracted from service logs, referral forms and care records; thematic analysis of qualitative data from care record free text. RESULTS: Demand outstripped supply...
February 14, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29443395/subcutaneous-infusion-of-fluids-for-hydration-or-nutrition-a-review
#2
REVIEW
Riccardo Caccialanza, Thierry Constans, Paolo Cotogni, Gary P Zaloga, Alessandro Pontes-Arruda
Subcutaneous infusion, or hypodermoclysis, is a technique whereby fluids are infused into the subcutaneous space via small-gauge needles that are typically inserted into the thighs, abdomen, back, or arms. In this review, we provide an overview of the technique, summarize findings from studies that have examined the use of subcutaneous infusion of fluids for hydration or nutrition, and describe the indications, advantages, and disadvantages of subcutaneous infusion. Taken together, the available evidence suggests that, when indicated, subcutaneous infusion can be effective for administering fluids for hydration or nutrition, with minimal complications, and has similar effectiveness and safety to the intravenous route...
February 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29427519/quality-of-hospice-care-at-home-versus-in-an-assisted-living-facility-or-nursing-home
#3
Kathleen T Unroe, Timothy E Stump, Shannon Effler, Wanzhu Tu, Christopher M Callahan
OBJECTIVES: To describe differences in perceived quality of hospice care for individuals living at home or in a nursing home (NH) or assisted living facility (ALF) through analysis of after-death surveys of family members. DESIGN: Retrospective cohort study using hospice medical record data and Family Evaluation of Hospice Care (FEHC) survey data. SETTING: Large, national hospice provider. PARTICIPANTS: Individuals who died while receiving routine hospice care and family caregivers who completed after-death quality-of-care surveys...
February 10, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29425055/caring-for-life-limiting-illness-in-ethiopia-a-mixed-methods-assessment-of-outpatient-palliative-care-needs
#4
Eleanor Anderson Reid, Esayas Kebede Gudina, Nicola Ayers, Wondimagegnu Tigineh, Yoseph Mamo Azmera
BACKGROUND: Palliative care aims to reduce physical suffering and the emotional, spiritual, and psychosocial distress of life-limiting illness. Palliative care is a human right, yet there are vast disparities in its provision: of the 40 million people globally in need of palliative care, less than 10% receive it, largely in high-income countries. There is a particular paucity of data on palliative care needs across the spectrum of incurable disease in Ethiopia. OBJECTIVES: The aims of this research were to assess the overall burden of life-limiting illness, the costs associated with life-limiting illness, and barriers to accessing palliative care in Ethiopia...
February 9, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29421848/characterization-conservation-and-loss-of-dignity-at-the-end-of-life-in-the-emergency-department-a-qualitative-protocol
#5
Cayetano Fernández-Sola, José Granero-Molina, María Del Mar Díaz-Cortés, Francisca Rosa Jiménez-López, Pablo Roman-López, Encarnación Saez-Molina, Cayetano José Aranda-Torres, José María Muñoz-Terrón, María Paz García-Caro, José Manuel Hernández-Padilla
AIMS: to explore and understand the experiences of terminally-ill patients and their relatives regarding dignity during end-of-life care in the emergency department. BACKGROUND: the respect given to the concept of dignity is significantly modifying the clinical relationship and the care framework involving the end-of-life patient in palliative care units, critical care units, hospices and their own homes. This situation is applicable to in-hospital emergency departments, where there is a lack of research which takes the experiences of end-of-life patients and their relatives into account...
February 8, 2018: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/29405014/-sharing-perspectives-on-home-healthcare
#6
Pi-Shan Hsu, Jui-An Chen, Yu-Tso Chen, Han-Ming Wu, Szu-Ying Lee, Chung-Liang Lai
The baby boom after World War II, coupled with the rapid advances in medical technology and public health, has led to the current rapid aging in the world's population. Countries in Asia are experiencing a faster rate of aging than most other countries around the world. Taiwan is expected to advance from an aged society to a super-aged society in the next 7~10 years. Consequently, the demand for long-term care is increasing. The focus of healthcare has changed from acute to chronic, from disease-oriented to function-oriented and from cure to care...
February 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29403331/we-re-the-eyes-and-the-ears-but-we-don-t-have-a-voice-perspectives-of-hospice-aides
#7
Djin Lai, Kristin G Cloyes, Margaret F Clayton, Katherine Doyon, Maija Reblin, Anna C Beck, Lee Ellington
Hospice aides are integral to the delivery of home hospice care and play an essential role in the effective communication and collaboration of the hospice interdisciplinary team. Despite their critical role, little is known about hospice aides' perceptions of their role in providing hospice services. This qualitative study explores hospice aides' perspectives of their work, their relationships with patients, families and interdisciplinary team members, and their contributions to end-of-life care. Two focus groups of hospice aides (N = 13), and 16 hours of observation of in-home caregiving were conducted...
February 2018: Journal of Hospice and Palliative Nursing: JHPN
https://www.readbyqxmd.com/read/29400598/circumstances-of-hospital-admissions-in-palliative-care-a-cross-sectional-survey-of-patients-admitted-to-hospital-with-palliative-care-needs
#8
Jackie Robinson, Merryn Gott, Rosemary Frey, Christine Ingleton
BACKGROUND: On average, people will experience 2.28 hospital admissions in the last year of life with the likelihood of a hospital admission increasing in the last 2 weeks of life. Reducing hospital admissions has become a focus for high-income countries as they work to manage the financial implications of an ageing population. However, the circumstances by which patients with palliative care needs are admitted to hospital remain poorly understood. AIM: To explore the circumstances of hospital admissions for patients with palliative care needs...
February 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29385757/in-hospital-palliative-care-should-we-need-to-reconsider-what-role-hospitals-should-have-in-patients-with-end-stage-disease-or-advanced-cancer
#9
REVIEW
Paolo Cotogni, Andrea Saini, Anna De Luca
Traditionally, palliative care (PC) systems focused on the needs of advanced cancer patients, but most patients needing PC have end-stage organ diseases. Similarly, PC models focus on the needs of patients in hospices or at home; however, in most cases PC is provided in acute hospitals. Indeed, the symptom burden that these patients experience in the last year of life frequently forces them to seek care in emergency departments. The majority of them are admitted to the hospital and many die. This issue poses important concerns...
January 30, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29370765/place-of-death-for-people-with-hiv-a-population-level-comparison-of-eleven-countries-across-three-continents-using-death-certificate-data
#10
Richard Harding, Stefano Marchetti, Bregje D Onwuteaka-Philipsen, Donna M Wilson, Miguel Ruiz-Ramos, Maria Cardenas-Turanzas, YongJoo Rhee, Lucas Morin, Katherine Hunt, Joan Teno, Cecilia Hakanson, Dirk Houttekier, Luc Deliens, Joachim Cohen
BACKGROUND: With over 1 million HIV-related deaths annually, quality end-of-life care remains a priority. Given strong public preference for home death, place of death is an important consideration for quality care. This 11 country study aimed to i) describe the number, proportion of all deaths, and demographics of HIV-related deaths; ii) identify place of death; iii) compare place of death to cancer patients iv), determine patient/health system factors associated with place of HIV-related death...
January 25, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29361072/long-term-care-workforce-issues-practice-principles-for-quality-dementia-care
#11
Susan D Gilster, Marie Boltz, Jennifer L Dalessandro
Purpose: This article is one in a series of articles in this supplement addressing best practice for quality dementia care. The Alzheimer's Association, in revising their Dementia Care Practice Recommendations for 2017 has identified staff across the long-term care spectrum as a distinct and important determinant of quality dementia care. The purpose of this article is to highlight areas for developing and supporting a dementia-capable workforce. Methods: The Alzheimer's Association Principles For Advocacy To Assure Quality Dementia Care Across Settings provide a framework to examine interventions to support the dementia care workforce in long-term care settings...
January 18, 2018: Gerontologist
https://www.readbyqxmd.com/read/29361065/from-research-to-application-supportive-and-therapeutic-environments-for-people-living-with-dementia
#12
Margaret P Calkins
The evidence about the role the designed and built environment plays in supporting individuals living with dementia has been steadily mounting for almost 40 years. Beginning with the work of M. Powell Lawton at the Weiss Pavilion at the Philadelphia Geriatric Center, there are now dozens of researchers who are exploring how the environment can be either supportive and therapeutic, indeed even serving as a prosthetic for various changes in cognition, or be a barrier to independent functioning and high quality of life...
January 18, 2018: Gerontologist
https://www.readbyqxmd.com/read/29360571/communicating-caregivers-challenges-with-cancer-pain-management-an-analysis-of-home-hospice-visits
#13
Claire J Han, Nai-Ching Chi, Soojeong Han, George Demiris, Debra Parker Oliver, Karla Washington, Margaret F Clayton, Maija Reblin, Lee Ellington
CONTEXT: Family caregivers of hospice cancer patients face significant challenges related to pain management. Addressing many of these challenges requires effective communication between family caregivers and hospice nurses, yet little empirical evidence exists on the nature of communication about pain management between hospice nurses and family caregivers. OBJECTIVES: We identified ways in which family caregivers of hospice cancer patients communicated their pain management challenges to nurses during home visits and explored nurses' responses when pain management concerns were raised...
January 19, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29360140/effects-of-survey-mode-on-consumer-assessment-of-healthcare-providers-and-systems-cahps-hospice-survey-scores
#14
Layla Parast, Marc N Elliott, Katrin Hambarsoomian, Joan Teno, Rebecca Anhang Price
OBJECTIVES: To examine the effect of mode of survey administration on response rates and response tendencies for the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey and develop appropriate adjustments. DESIGN: Survey response data were obtained after sampling and fielding of the CAHPS Hospice Survey in 2015. Sampled caregivers and decedents were randomized to one of three modes: mail only, telephone only, and mixed mode (mail with telephone follow-up)...
January 23, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29359631/-we-take-care-of-people-what-happens-to-us-afterwards-home-health-aides-and-bereavement-care-in-hospice
#15
Angela Ghesquiere, Ariunsanaa Bagaajav
After a hospice patient dies, hospice providers can experience a variety of emotional responses. While work has been done on social workers' and nurses' reactions to patient death, home health aides (HHAs) have been overlooked. To address this gap, we conducted focus groups and individual qualitative interviews with 14 hospice HHAs. Questions covered HHAs' grief responses and how they coped with grief. We found a high burden of grief reactions; many HHAs often developed very close patient relationships. HHAs also noted that they often started working with new patients almost immediately after a death, leaving little time to process the loss...
January 1, 2018: Omega
https://www.readbyqxmd.com/read/29325534/increasing-trend-in-hospital-deaths-consistent-among-older-decedents-in-korea-a-population-based-study-using-death-registration-database-2001-2014
#16
Tran Thi Xuan Mai, Eunsook Lee, Hyunsoon Cho, Yoon Jung Chang
BACKGROUND: With improvement in hospice palliative care services and long-term care, Republic of Korea (hereafter South Korea) has recorded significant changes in places of death (e.g., hospital, home), especially among older adults. Over the last few decades, the most common places of death in South Korea were hospitals. However, Koreans, especially older adults, reportedly prefer to receive terminal care and eventually die at home. This study was conducted to investigate trends in places of death among older Korean adults and factors associated therewith...
January 11, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29308990/change-in-va-community-living-centers-2004-2011-shifting-long-term-care-to-the-community
#17
Kali S Thomas, Danielle Cote, Rajesh Makineni, Orna Intrator, Bruce Kinosian, Ciaran S Phibbs, Susan M Allen
The United States Department of Veterans Affairs (VA) is facing pressures to rebalance its long-term care system. Using VA administrative data from 2004-2011, we describe changes in the VA's nursing homes (called Community Living Centers [CLCs]) following enactment of directives intended to shift CLCs' focus from providing long-term custodial care to short-term rehabilitative and post-acute care, with safe and timely discharge to the community. However, a concurrent VA hospice and palliative care expansion resulted in an increase in hospice stays, the most notable change in type of stay during this time period...
January 8, 2018: Journal of Aging & Social Policy
https://www.readbyqxmd.com/read/29307208/implementation-issues-relevant-to-outpatient-neurology-palliative-care
#18
Benzi M Kluger, Michael J Persenaire, Samantha K Holden, Laura T Palmer, Hannah Redwine, Julie Berk, C Alan Anderson, Christopher M Filley, Jean Kutner, Janis Miyasaki, Julie Carter
BACKGROUND: There is growing interest in the application of palliative care principles to improve care for patients and families affected by neurologic diseases. We developed an interdisciplinary outpatient clinic for patients and families affected by neurologic disorders to better address the problems faced by our highest need patients. We have developed and improved this program over the past three years and share several of our most important lessons as well as ongoing challenges and areas where we see our clinic evolving in the future...
November 29, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29305322/a-systematic-review-of-palliative-care-intervention-outcomes-and-outcome-measures-in-low-resource-countries
#19
REVIEW
Maryellen Potts, Kathleen B Cartmell, Lynne Nemeth, Gautam Bhattacharjee, Suparna Qanungo
CONTEXT: To meet the growing need for palliative care in low-resource countries, palliative care programs should be evidence-based and contextually appropriate. This study was conducted to synthesize the current evidence to guide future programmatic and research efforts. OBJECTIVES: This systematic review evaluated palliative care outcome measures, outcomes, and interventions in low resource countries. METHODS: Following title searches, abstracts and full text articles were screened for inclusion...
January 2, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29301804/recurrent-hospitalisations-in-a-rare-case-of-hemicorporectomy-a-challenging-case-for-medical-management
#20
Ajit Thakur, Brittney Elliott, Rohan Naik, Nabeel Khan, Shayna McQuaid, Camelia Arsene
Hemicorporectomy, or translumbar amputation, is a radical surgery involving the dissection of the body at the waist and is usually reserved for complex medical conditions including locally invasive malignancy and terminal pelvic osteomyelitis. Only 71 cases have previously been reported. We present a rare case of hemicorporectomy in a 53-year-old patient with terminal pelvic osteomyelitis which occurred after he suffered a gunshot wound at T6 causing paraplegia at the age of 31. Unfortunately, this patient continued to suffer recurrent hospitalisations and sepsis events secondary to chronic, non-healing advanced pressure ulcers and complicated urinary tract infections despite repeated courses of broad-spectrum intravenous antibiotics and surgical debridements...
January 4, 2018: BMJ Case Reports
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