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https://www.readbyqxmd.com/read/29676777/do-not-resuscitate-orders-in-older-adults-during-hospitalization-a-propensity-score-matched-analysis
#1
Karishma Patel, Liron Sinvani, Vidhi Patel, Andrzej Kozikowski, Christopher Smilios, Meredith Akerman, Kinga Kiszko, Sutapa Maiti, Negin Hajizadeh, Gisele Wolf-Klein, Renee Pekmezaris
OBJECTIVES: To explore the effect of the presence and timing of a do-not-resuscitate (DNR) order on short-term clinical outcomes, including mortality. DESIGN: Retrospective cohort study with propensity score matching to enable direct comparison of DNR and no-DNR groups. SETTING: Large, academic tertiary-care center. PARTICIPANTS: Hospitalized medical patients aged 65 and older. MEASUREMENTS: Primary outcome was in-hospital mortality...
April 20, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29671084/-advance-care-planning-a-qualitative-investigation-on-patients-perspectives-with-advanced-heart-failure
#2
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/29656565/rural-urban-differences-in-costs-of-end-of-life-care-for-the-last-6-months-of-life-among-patients-with-breast-lung-or-colorectal-cancer
#3
Elizabeth Crouch, Jan M Eberth, Janice C Probst, Kevin Bennett, Swann A Adams
PURPOSE: The purpose of this study was to examine rural-urban differences in utilization and expenditures in the last 6 months of life for patients with breast, lung, or colorectal cancer. METHODS: The study used a 5% sample of the 2013 Medicare Research Identifiable Files to study utilization and expenditures for beneficiaries with breast, lung, or colorectal cancer during the last 6 months before death (n = 6,214). End of life expenditures were calculated as the sum of total Medicare expenditures for inpatient, outpatient, physician, home health, hospice, and skilled nursing facility costs during the last 6 months of life...
April 15, 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/29651900/encounters-with-health-care-providers-and-advance-directive-completion-by-older-adults
#4
Catheryn Koss
BACKGROUND: The Patient Self-Determination Act (PSDA) requires hospitals, home health agencies, nursing homes, and hospice providers to offer new patients information about advance directives. There is little evidence regarding whether encounters with these health-care providers prompt advance directive completion by patients. OBJECTIVE: To examine whether encounters with various types of health-care providers were associated with higher odds of completing advance directives by older patients...
January 1, 2018: Journal of Palliative Care
https://www.readbyqxmd.com/read/29650892/-continuous-subcutaneous-injection-therapy-in-end-of-life-symptoms-of-cancer-and-non-cancer-patients
#5
Tatsuo Oshiro, Hisako Oshiro, Masahito Tanimizu
The significance of continuous subcutaneous injection(CSI)therapy was assessed in end-of-life symptoms of cancer and non-cancer home hospice patients. In a retrospective analysis of 106 advanced cancer patients who underwent opioid CSI therapy, the most frequent symptom was pain(65%), followed by dyspnea(46%), seizure(8%), ileus(8%), and other uncontrolled end-of-life symptoms(23%). The median oral morphine equivalent daily opioid dose was 90 mg(2.5-1,920 mg)and the median duration of CSI administration was 3 days(1-350 days)...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29650883/-cancer-disease-trajectory-and-the-contribution-of-artistic-outreach-activity-to-palliative-care
#6
Hisako Oshiro, Tatsuo Oshiro, Masahito Tanimizu
The purpose of this article is to show some unintentional aspects of palliative supports offered by the community. The activities of the Opera Ehime, an amateur opera group, play an important role in palliative and grief care. This community is also committed to providing supportive care for home hospice cancer patients through an outreach music program that offers patients connection with others and reduces isolation. Assessment by the coordinator includes determiningthe patients' preferences and the relevance of music throughout their lives...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29649400/impact-of-inpatient-palliative-care-on-quality-of-end-of-life-care-and-downstream-acute-and-postacute-care-utilization
#7
Peter S Khang, Susan E Wang, In-Lu Amy Liu, Heather L Watson, Sandra Y Koyama, Dan N Huynh, Janet S Lee, Huong Q Nguyen
BACKGROUND: Additional evidence is needed regarding the impact of inpatient palliative care (IPC) on the quality of end-of-life care and downstream utilization. AIM: Examine the effects of IPC on quality of end-of-life care and acute and postacute care use in a large integrated system. DESIGN: Retrospective cohort design. SETTING/PARTICIPANTS: Adult decedents from January 1, 2012, to December 31, 2014, who had at least one hospitalization at 11 Kaiser Permanente Southern California medical centers in the 12 months before death and not hospitalized for a trauma-related condition or receiving home-based PC or hospice were included in the cohort...
March 13, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29649394/perspective-on-care-at-the-end-of-life-at-hospice-africa-uganda
#8
Joshua Campbell, Nasur Buyinza, Joshua Hauser
BACKGROUND: Since its beginning in 1993, Hospice Africa Uganda (HAU) has become a leader in palliative care in Africa. Despite this, there remains a sparsity of research elucidating the priorities of patients in their care at the end of life. This study aimed to identify those priorities in three groups: patients with life-limiting illness, their caregivers, and their healthcare providers at HAU, and thus to identify differences in what these groups find important in the last month of life...
March 13, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29621893/facilitating-home-hospice-transitions-of-care-in-oncology-evaluation-of-clinical-pharmacists-interventions-hospice-program-satisfaction-and-patient-representation-rates
#9
Alison P Duffy, Nina M Bemben, Jueli Li, James Trovato
BACKGROUND: The importance of medication reconciliation and the pharmacist's role within the interdisciplinary team at the point of transition to home hospice is understudied. A transitions of care pilot initiative was developed to streamline the transition for patients at end of life from inpatient cancer center care to home hospice. The initiative consisted of using a hospice discharge checklist, pharmacist-led discharge medication reconciliation in consultation with the primary team responsible for inpatient care, review of discharge prescriptions, and facilitation of bedside delivery of discharge medications...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29610828/interactions-between-physicians-and-skilled-home-health-care-agencies-in-the-certification-of-medicare-beneficiaries-plans-of-care-results-of-a-nationally-representative-survey
#10
Cynthia M Boyd, Bruce Leff, Julia Bellantoni, Navpreet Rana, Jennifer L Wolff, David L Roth, Kim Carl, Orla C Sheehan
Background: Physicians are required to certify a plan of care for patients who receive Medicare skilled home health care (SHHC) services. The Centers for Medicare & Medicaid Services form 485 (CMS-485) is typically used for certification of SHHC plans of care and for interactions between SHHC agencies and physicians. Little is known about how physicians use the CMS-485 or their perceptions of its usefulness with respect to coordinating care with SHHC agencies. Objective: To determine how physicians interact with SHHC agencies and use the CMS-485 in care coordination for patients receiving SHHC services...
April 3, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29608394/surrogate-decision-makers-perspectives-on-family-members-prognosis-after-intracerebral-hemorrhage
#11
Darin B Zahuranec, Renee R Anspach, Meghan E Roney, Andrea Fuhrel-Forbis, Daniel M Connochie, Emily P Chen, Bradford B Thompson, Panayiotis N Varelas, Lewis B Morgenstern, Angela Fagerlin
BACKGROUND: Surrogate communication with providers about prognosis in the setting of acute critical illness can impact both patient treatment decisions and surrogate outcomes. OBJECTIVES: To examine surrogate decision maker perspectives on provider prognostic communication after intracerebral hemorrhage (ICH). DESIGN: Semistructured interviews were conducted and analyzed qualitatively for key themes. SETTING/SUBJECTS: Surrogate decision makers for individuals admitted with ICH were enrolled from five acute care hospitals...
April 2, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29608380/the-alzheimer-s-disease-home-hospice-knowledge-scale-development-validity-and-reliability
#12
Pnina Sela-Katz, Perla Werner
BACKGROUND: Several instruments are available to assess knowledge about hospice care, but none specifically address knowledge about home hospice for persons with Alzheimer's disease (AD). AIM: To develop and validate the Alzheimer's Disease Home Hospice Knowledge Scale (AD-HHK-S). METHODS: A total of 107 Israeli family caregivers of persons with dementia (mean age=71.2; 73% female) participated in the study. RESULTS: The AD-HHK-S included 28 true/false items assessing 3 areas of knowledge: knowledge about hospice, knowledge about home hospice, and knowledge about home hospice for AD...
March 2, 2018: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/29601083/analysis-of-episodes-of-care-in-medicare-beneficiaries-newly-diagnosed-with-alzheimer-s-disease
#13
Rezaul K Khandker, Christopher M Black, Lin Xie, M Furaha Kariburyo, Baishali M Ambegaonkar, Onur Baser, Huseyin Yuce, Howard Fillit
OBJECTIVES: To study transitions between healthcare settings and quantify the cost burdens associated with different combinations of transitions during a 6-month period before initial Alzheimer's disease (AD) diagnosis so as to investigate how using an episode-of-care approach to payment for specific disease states might apply in AD. DESIGN: A retrospective observational cohort study. SETTING: United States. PARTICIPANTS: A random sample of 8,995 individuals aged 65 to 100 with a diagnosis of AD (International Classification of Diseases, Ninth Revision, Clinical Modification code 331...
March 30, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29594487/-being-with-or-doing-for-how-the-role-of-an-end-of-life-volunteer-befriender-can-impact-patient-wellbeing-interviews-from-a-multiple-qualitative-case-study-elsa
#14
Steven Dodd, Matt Hill, Nick Ockenden, Guillermo Perez Algorta, Sheila Payne, Nancy Preston, Catherine Walshe
PURPOSE: To explore the perspectives of people anticipated to be in their last year of life, family carers, volunteers and staff on the impacts of receiving a volunteer-provided befriending service. Patient participants received up to 12 weeks of a volunteer-provided befriending intervention. Typically, this involved one visit per week from a trained volunteer. Such services complement usual care and are hoped to enhance quality of life. METHODS: Multiple case study design (n = 8)...
March 29, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29565052/-accessibility-of-home-palliative-care-and-place-of-death-of-cancer-patients-data-analysis-of-the-emilia-romagna-region
#15
Andrea A Martoni, Elena Strocchi
INTRODUCTION: The ANT Foundation is one of the main non-profit organizations providing palliative care in Italy. For more than 30 years, it has developed a comprehensive home palliative care program for cancer patients predominately active in the Bologna province. One of its main achievements has allowed for the majority of patients to be assisted at home during the last weeks of their lives until time of death. The purpose of the present study is to evaluate the possible impact of the ANT program on health data relating to the location of where cancer patients die within the Local Health Care system area (AUSL) of Bologna, compared to what happens in the other AUSLs of the Emilia-Romagna Region (ERR) where it is not present...
March 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29564901/-palliative-care-for-patients-at-home
#16
Irena Závadová
In the Czech Republic, around 70 % of deceased people die in hospital settings every year. On the other hand, surveys showed that almost 78% Czech wish to die at home. General practitioners take care of most of dying at their homes. Unfortunately, hours of attendance and visiting hours are not always sufficient when complications develop and health status rapidly deteriorates and the goal is to die at home. Significant proportion of patients is then transferred to acute hospital settings and lots of them dies there during so called terminal hospitalization...
2018: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/29548893/palliative-sedation-in-terminal-cancer-patients-admitted-to-hospice-or-home-care-programs-does-the-setting-matter-results-from-a-national-multicenter-observational-study
#17
Augusto Caraceni, Raffaella Speranza, Elio Spoldi, Cristina Sonia Ambroset, Stefano Canestrari, Mauro Marinari, Anna Maria Marzi, Luciano Orsi, Laura Piva, Mirta Rocchi, Danila Valenti, Gianluigi Zeppetella, Furio Zucco, Alessandra Raimondi, Leonor Vasconcelos Matos, Cinzia Brunelli
CONTEXT: Few studies regarding palliative sedation (PS) have been carried out in home care (HC) setting. A comparison of PS rate and practices between hospice (HS) and HC is also lacking. OBJECTIVES: Comparing HC and HS settings for PS rate, patient clinical characteristics before and during PS, decision-making process and clinical aspects of PS. METHODS: 38 HC/HS services in Italy participated in a multicenter observational longitudinal study...
March 13, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29540416/what-are-healthcare-providers-understandings-and-experiences-of-compassion-the-healthcare-compassion-model-a-grounded-theory-study-of-healthcare-providers-in-canada
#18
Shane Sinclair, Thomas F Hack, Shelley Raffin-Bouchal, Susan McClement, Kelli Stajduhar, Pavneet Singh, Neil A Hagen, Aynharan Sinnarajah, Harvey Max Chochinov
BACKGROUND: Healthcare providers are considered the primary conduit of compassion in healthcare. Although most healthcare providers desire to provide compassion, and patients and families expect to receive it, an evidence-based understanding of the construct and its associated dimensions from the perspective of healthcare providers is needed. OBJECTIVES: The aim of this study was to investigate healthcare providers' perspectives and experiences of compassion in order to generate an empirically derived, clinically informed model...
March 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29523364/implementing-the-molst-medical-order-for-life-sustaining-treatments-challenges-faced-by-nursing-home-staff
#19
Kathrin Boerner, Jason Rodriquez, Emma Quach, Meghan Hendricksen
This study examined how the Medical Order for Life-sustaining Treatment (MOLST) is implemented in two nursing homes in Massachusetts; one had primarily long-term care residents and high hospice utilization, the other had low hospice utilization and a high proportion of post-acute care residents. Qualitative in-person interviews with 21 staff members who had a role implementing the MOLST explored their experiences using the form in their daily work routines. Staff at both nursing homes described benefits of the MOLST such as providing guidance for staff and family...
March 6, 2018: Geriatric Nursing
https://www.readbyqxmd.com/read/29512426/end-of-life-care-for-an-undocumented-mexican-immigrant-resident-perspective
#20
Lilit Karapetyan, Om Dawani, Heather S Laird-Fick
The immigrant population in the United States has grown over the past years. Undocumented immigrants account for 14.6% of the uninsured population in the United States. Decisions about end-of-life treatment are often difficult to reach in the best of situations. We present a 43-year-old undocumented Mexican female immigrant with metastatic sarcomatoid squamous cell cervical cancer and discuss the barriers that she faced during her treatment. Limited English proficiency, living below the poverty line, low level of education, and lack access to Medicare, Medicaid, or other insurance coverage under the Affordable Care Act are major causes of decreased health-care access and service utilization by the immigrant population...
January 1, 2018: Journal of Palliative Care
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