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https://www.readbyqxmd.com/read/28542833/why-are-patients-with-blood-cancers-more-likely-to-die-without-hospice
#1
Oreofe O Odejide, Angel M Cronin, Craig C Earle, James A Tulsky, Gregory A Abel
BACKGROUND: Although patients with blood cancers have significantly lower rates of hospice use than those with solid malignancies, data explaining this gap in end-of-life care are sparse. METHODS: In 2015, we conducted a mailed survey of a randomly selected sample of hematologic oncologists in the United States to characterize their perspectives regarding the utility and adequacy of hospice for blood cancer patients, as well as factors that might impact referral patterns...
May 22, 2017: Cancer
https://www.readbyqxmd.com/read/28542732/impact-of-subsequent-metastases-on-costs-and-medical-resource-use-for-prostate-cancer-patients-initially-diagnosed-with-localized-disease
#2
Tracy T Li, Neal D Shore, Maneesha Mehra, Mary B Todd, Ryan Saadi, Gaetan Leblay, Jyoti Aggarwal, Robert I Griffiths
BACKGROUND: The impact of subsequent metastases on costs and medical resource use (MRU) for prostate cancer (PC) patients initially diagnosed with localized disease was estimated. METHODS: Surveillance, Epidemiology, and End Results data, linked to Medicare (1999-2012), were used to identify 7482 patients diagnosed with subsequent metastases 12 months or more after the initial diagnosis of localized PC (cases), and they were matched to 25,709 localized PC patients without subsequent metastases (controls)...
May 23, 2017: Cancer
https://www.readbyqxmd.com/read/28537965/the-affordable-care-act-and-end-of-life-care-for-patients-with-cancer
#3
Ravi B Parikh, Alexi A Wright
The Affordable Care Act (ACA) expanded access to high-quality end-of-life care for Americans with serious illness, including cancer. Before the ACA was enacted in 2010, nearly 715,000 patients died in hospitals annually, despite evidence that most Americans prefer to die at home. Moreover, fewer than half of Medicare beneficiaries used hospice before death, despite evidence that hospice services improve cancer patients' quality of life near death and caregivers' bereavement outcomes. The ACA-stipulated programs and subsequent efforts were designed to address these deficiencies in access to high-quality end-of-life care...
May 2017: Cancer Journal
https://www.readbyqxmd.com/read/28530501/palliative-care-for-advanced-heart-failure-in-a-department-of-veterans-affairs-regional-hospice-program-patient-selection-a-treatment-protocol-and-clinical-course
#4
George J Taylor, Dorothy M Lee, Catalin F Baicu, Michael R Zile
BACKGROUND: Palliative care for advanced heart failure (HF) is generally recommended. However, few reports have focused on the particulars of treatment, or the clinical course of HF on a specific treatment regimen. OBJECTIVE: Palliation adequate to allow patients to avoid HF admission and die at home. METHODS: Patients from a veterans administration regional practice with multiple, recent hospital admissions were enrolled in community hospice programs...
May 22, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28494634/changing-place-of-death-in-children-who-died-after-discharge-from-paediatric-intensive-care-units-a-national-data-linkage-study
#5
Lorna K Fraser, Sarah Fleming, Roger Parslow
BACKGROUND: Although child mortality is decreasing, more than half of all deaths in childhood occur in children with a life-limiting condition whose death may be expected. AIM: To assess trends in place of death and identify characteristics of children who died in the community after discharge from paediatric intensive care unit. DESIGN: National data linkage study. SETTING/PARTICIPANTS: All children resident in England and Wales when admitted to a paediatric intensive care unit in the United Kingdom (1 January 2004 and 31 December 2014) were identified in the Paediatric Intensive Care Audit Network dataset...
May 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28491911/navigating-long-term-care
#6
James D Holt
Americans over age 65 constitute a larger percentage of the population each year: from 14% in 2010 (40 million elderly) to possibly 20% in 2030 (70 million elderly). In 2015, an estimated 66 million people provided care to the ill, disabled, and elderly in the United States. In 2000, according to the Centers for Disease Control and Prevention (CDC), 15 million Americans used some form of long-term care: adult day care, home health, nursing home, or hospice. In all, 13% of people over 85 years old, compared with 1% of those ages 65 to 74, live in nursing homes in the United States...
January 2017: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/28479411/end-of-life-place-of-care-health-care-settings-and-health-care-transitions-among-cancer-patients-impact-of-an-integrated-cancer-palliative-care-plan
#7
V Casotto, M Rolfini, E Ferroni, V Savioli, N Gennaro, F Avossa, M Cancian, F Figoli, D Mantoan, A Brambilla, M C Ghiotto, U Fedeli, M Saugo
CONTEXT: Frequent end-of-life health care setting transitions can lead to an increased risk of fragmented care and exposure to unnecessary treatments. OBJECTIVES: We assessed the relationship between the presence and the intensity of an Integrated Cancer Palliative Care plan and the occurrence of multiple transitions during the last month of life. METHODS: Decedents of cancer aged 18-85 years residents in two Regions of Italy where investigated accessing their integrated administrative data (Death Certificates, Hospital Discharges, Hospice and Home care records)...
May 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28467121/companion-animal-caregiver-knowledge-attitudes-and-beliefs-regarding-end-of-life-care
#8
Roschelle A Heuberger, Jessica Pierce
Although awareness of end-of-life care is growing within the veterinary field and there appears to be consumer demand for these services, it is unclear exactly what caregivers know about end-of-life options for their companion animals. Are companion-animal caregivers aware of the range of options for their nonhuman animals? What do they value most highly for their nonhuman animals at the end of life? Answers to these and other related questions about caregiver perceptions are important because what they know about end-of-life care and how they approach decision-making for their companion animals will shape the kind of care an animal receives...
May 3, 2017: Journal of Applied Animal Welfare Science: JAAWS
https://www.readbyqxmd.com/read/28464961/supporting-home-hospice-family-caregivers-insights-from-different-perspectives
#9
Lee Ellington, Kristin G Cloyes, Jiayun Xu, Lanell Bellury, Patricia H Berry, Maija Reblin, Margaret F Clayton
OBJECTIVE: Our intention was to describe and compare the perspectives of national hospice thought leaders, hospice nurses, and former family caregivers on factors that promote or threaten family caregiver perceptions of support. METHOD: Nationally recognized hospice thought leaders (n = 11), hospice nurses (n = 13), and former family caregivers (n = 14) participated. Interviews and focus groups were audiotaped and transcribed. Data were coded inductively, and codes were hierarchically grouped by topic...
May 3, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28457493/nursing-home-care-trajectories-for-older-adults-following-in-hospital-palliative-care-consultation
#10
Joan G Carpenter, Patricia H Berry, Mary Ersek
Palliative care consultation (PCC) during hospitalization is increasingly common for older adults with life-limiting illness discharged to nursing homes. The objective of this qualitative descriptive study was to describe the care trajectories and experiences of older adults admitted to a nursing home following a PCC during hospitalization. Twelve English-speaking adults, mean age 80 years, who received a hospital PCC and discharge to a nursing home without hospice. Data were collected from medical records at five time points from hospital discharge to 100 days after nursing home admission and care trajectories were mapped...
April 27, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/28452909/exploring-the-predictive-ability-of-dysfunctional-high-density-lipoprotein-for-adverse-outcomes-in-emergency-department-patients-with-sepsis-a-preliminary-investigation
#11
Faheem W Guirgis, Sunita Dodani, Lyle Moldawer, Christiaan Leeuwenburgh, Jennifer Bowman, Colleen Kalynych, Alan E Jones, Srinivasa T Reddy, Frederick A Moore
BACKGROUND: High Density Lipoprotein (HDL) can be readily oxidized in inflammatory conditions and exhibit pro-inflammatory and dysfunctional (Dys-HDL) characteristics. We hypothesize that Dys-HDL may predict adverse outcomes and correlate with inflammatory cytokines in sepsis. METHODS: Emergency department (ED) patients with sepsis were enrolled. Blood was drawn at enrollment and after 48 hours. Dys-HDL, expressed as HDL inflammatory index (HII), and cytokines were measured...
April 27, 2017: Shock
https://www.readbyqxmd.com/read/28450217/hospice-enrollment-after-referral-to-community-based-specialist-palliative-care-impact-of-telephonic-outreach
#12
Alexa Riggs, Brenda Breuer, Lara Dhingra, Jack Chen, Russell K Portenoy, Helena Knotkova
CONTEXT: In the United States, palliative care programs improve access to hospice through enhanced communication and efficiencies in hospice eligibility review and enrollment. For community-based programs, this task may begin with telephone contact. OBJECTIVES: To evaluate the incidence and predictors of hospice enrollment following telephonic outreach by a nurse after referral to a community-based, specialist palliative care program. METHODS: During 2012-2014, 299 consecutive patients who were referred to a palliative care program and subsequently enrolled in hospice provided electronic health record data for a retrospective cohort study...
April 24, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28438589/specialty-palliative-care-consultations-for-nursing-home-residents-with-dementia
#13
Susan C Miller, Julie C Lima, Orna Intrator, Edward Martin, Janet Bull, Laura C Hanson
CONTEXT: U.S. nursing home (NH) residents with dementia have limited access to specialty palliative care beyond Medicare hospice. OBJECTIVES: To examine the value of expanded palliative care access for NH residents with moderate to very severe dementia. METHODS: We merged palliative care consultation data in 31 NHs in two states to Medicare data to identify residents with consultations, moderate to very severe dementia, and deaths in 2006-2010...
April 21, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28437205/-she-would-be-flailing-around-distressed-the-critical-role-of-home-based-palliative-care-for-patients-with-advanced-cancer
#14
Brook A Calton, Nicole Thompson, Nancy Shepard, Redwing Keyssar, Kanan Patel, Virginia Dzul-Church, Helen Kao, Christine Ritchie, Michael W Rabow
BACKGROUND: Patients with advanced cancer experience significant symptoms, ineffective treatments, and hospice underutilization. Home-based palliative care (HBPC) may fill a service gap for patients who require intensive home management, but are not enrolled in hospice. Even as data emerge on the utilization impacts of HBPC, other impacts are not as well known. METHODS: We describe findings of a pilot project in HBPC, Community Bridges (CB), for patients with advanced cancer...
February 16, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28419414/association-between-aggressive-care-and-bereaved-families-evaluation-of-end-of-life-care-for-veterans-with-non-small-cell-lung-cancer-who-died-in-veterans-affairs-facilities
#15
Mary Ersek, Susan C Miller, Todd H Wagner, Joshua M Thorpe, Dawn Smith, Cari R Levy, Risha Gidwani, Katherine Faricy-Anderson, Karl A Lorenz, Bruce Kinosian, Vincent Mor
BACKGROUND: To the authors' knowledge, little is known regarding the relationship between patients' and families' satisfaction with aggressive end-of-life care. Herein, the authors examined the associations between episodes of aggressive care (ie, chemotherapy, mechanical ventilation, acute hospitalizations, and intensive care unit admissions) within the last 30 days of life and families' evaluations of end-of-life care among patients with non-small cell lung cancer (NSCLC). METHODS: A total of 847 patients with NSCLC (34% of whom were aged <65 years) who died in a nursing home or intensive care, acute care, or hospice/palliative care (HPC) unit at 1 of 128 Veterans Affairs Medical Centers between 2010 and 2012 were examined...
April 17, 2017: Cancer
https://www.readbyqxmd.com/read/28404600/qualitative-interviews-exploring-palliative-care-perspectives-of-latinos-on-dialysis
#16
Lilia Cervantes, Jacqueline Jones, Stuart Linas, Stacy Fischer
BACKGROUND AND OBJECTIVES: Compared with non-Latino whites with advanced illness, Latinos are less likely to have an advance directive or to die with hospice services. To improve palliative care disparities, international ESRD guidelines call for increased research on culturally responsive communication of advance care planning (ACP). The objective of our study was to explore the preferences of Latino patients receiving dialysis regarding symptom management and ACP. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Qualitative study design using semistructured face-to-face interviews of 20 Latinos on hemodialysis between February and July of 2015...
May 8, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28401622/predicting-mortality-in-the-emergency-department-external-validation-and-derivation-of-a-clinical-prediction-tool
#17
Rajat N Moman, Caitlin Loprinzi Brauer, Katherine M Kelsey, Rachel D Havyer, Christine M Lohse, M Fernanda Bellolio
BACKGROUND: he Choosing Wisely campaign has called for better engagement of palliative and hospice care services for patients in the emergency department (ED). PREDICT is a clinical prediction tool that was derived in an Australian ED cohort. It assesses a patient's risk of mortality at one year to select those who would benefit from advanced care planning. Such goals of care discussion can improve patients' ability to communicate what they want out of their healthcare and, in cases of end-of-life, potentially reduce the number of futile interventions...
April 12, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28393347/-an-experience-of-providing-palliative-care-in-a-long-term-care-facility-let-good-death-in-place-become-a-feasible-reality
#18
Ming-Mei Chen, Chun-Chen Chou, Kuei-Ying Hsu, Yung-Feng Yen, Ya-Ting Yang, Hsiu-Li Huang
As the number of elderly in long-term care facilities (LTCFs) continues to increase, the number of resident deaths in these facilities is expected to increase. Thus, LTCFs may become a main focus for end-of-life (EoL) care in the future. Therefore, promoting quality EoL care in LTCFs should be a priority issue. Currently, the four types of hospice services include hospice wards and hospice-share-services in hospitals and home hospice care and community hospice care in patient homes. However, to date, there has been limited discussion regarding promoting palliative care in LTCFs...
April 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28384683/characterizing-18-years-of-the-death-with-dignity-act-in-oregon
#19
Charles Blanke, Michael LeBlanc, Dawn Hershman, Lee Ellis, Frank Meyskens
Importance: Numerous states have pending physician-aided dying (PAD) legislation. Little research has been done regarding use of PAD, or ways to improve the process and/or results. Objectives: To evaluate results of Oregon PAD, the longest running US program; to disseminate results; and to determine promising PAD research areas. Design, Setting, and Participants: A retrospective observational cohort study of 991 Oregon residents who had prescriptions written as part of the state's Death with Dignity Act...
April 6, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28384309/-if-i-had-stayed-back-home-i-would-not-be-alive-any-more%C3%A2-exploring-end-of-life-preferences-in-patients-with-migration-background
#20
Piret Paal, Johannes Bükki
BACKGROUND: In patients with life-limiting conditions and a history of migration, a higher risk of not dying at home and limited access to palliative care services has been reported. AIM: To explore the views and end-of-life preferences of patients with a migration history in Germany and to identify migration specific themes. DESIGN: Two-armed study using Kaufmann's 'understanding interview' ('focused interview') method and grounded theory approach...
2017: PloS One
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