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"Advance directives"

Peter G Lawlor, Nicole A Rutkowski, Alistair R MacDonald, Mohammed T Ansari, Lindsey Sikora, Franco Momoli, Salmaan Kanji, David K Wright, Erin Rosenberg, Annmarie Hosie, Jose L Pereira, David Meagher, Jill Rice, John Scott, Shirley H Bush
CONTEXT: Based on the clinical care pathway of delirium in palliative care (PC), a published analytic framework (AF) formulated research questions in key domains and recommended a scoping review to identify evidence gaps. OBJECTIVES: To produce a literature map for key domains of the published AF: screening; prognosis and diagnosis; management and the health-related outcomes. METHODS: A standard scoping review framework was used by an interdisciplinary study team of nurse and physician delirium researchers, an information specialist and review methodologists to conduct the review...
December 11, 2018: Journal of Pain and Symptom Management
Jane R Schubart, Benjamin H Levi, Megan M Bain, Elana Farace, Michael J Green
PURPOSE: Advance directives (AD) have been heralded as vehicles to promote patient autonomy and have been decried as ineffective. Efforts to improve advance care planning (ACP) and AD documents are wide ranging but have not been prospectively studied. MATERIALS AND METHODS: In an institutional review board-approved, single-blind, randomized, controlled trial, we compared an interactive, educational ACP decision aid to standard ACP among patients with advanced cancer...
December 13, 2018: Journal of Oncology Practice
C Justinger, T Lang, T Serrano Contreras, M Schreiner, F Kehl, M R Schön
BACKGROUND: Patient advance directives and other forms of precautionary medical provisions have arisen from patients' determination to influence and decide about medical treatment even in extreme situations. Although this topic is very present in the media, clinical experience indicates that the majority of patients are not yet aware of this subject. This current investigation aimed to collect data about the familiarity and degree of distribution of patient medical advance directives...
December 12, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Heather R Britt, Meghan M JaKa, Karl M Fernstrom, Paige E Bingham, Anne E Betzner, Jessica R Taghon, Nathan D Shippee, Tetyana P Shippee, Sandra E Schellinger, Eric W Anderson
Whole-person care is a new paradigm for serious illness, but few programs have been robustly studied. We sought to test the effect of LifeCourse (LC), a person-centered program for patients living with serious illness, on health-care utilization, care experience, and quality of life, employing a quasi-experimental design with a Usual Care (UC) comparison group. The study was conducted 2012 to 2017 at an upper-Midwest not-for-profit health-care system with outcomes measured every 3 months until the end of life...
December 13, 2018: American Journal of Hospice & Palliative Care
Wayne Shelton, Evelyn Tenenbaum, Kevin Costello, David Hoffman
Patients with Alzheimer's disease and other types of dementia with acute medical problems, who have lost capacity and are without advance directives, are at risk of being over treated inhospitals. To deal with this growing demographic and ethical crisis, patients with dementia need to plan for their future medical care while they have capacity to do so. This article will examine the role of each member of the dementia care triad and how to empower the patient to participate in planning future medical care. A case will be made that physicians have the same professional disclosure obligations to dementia patients as they do to all other capable patients with terminal illnesses...
December 13, 2018: American Journal of Alzheimer's Disease and Other Dementias
Anjali V Desai, Virginia M Klimek, Kimberly Chow, Andrew S Epstein, Camila Bernal, Kelly Anderson, Molly Okpako, Robin Rawlins-Duell, Dana Kramer, Danielle Romano, Jessica I Goldberg, Judith E Nelson
BACKGROUND: Prior work to integrate early palliative care in oncology has focused on patients with advanced cancer and primarily on palliative care consultation. We developed this outpatient clinic initiative for newly diagnosed patients at any stage, emphasizing primary (nonspecialist) palliative care by oncology teams, with enhanced access to palliative care specialists. METHODS: We piloted the project in two medical oncology specialty clinics (for patients with myelodysplastic syndrome and GI cancer, respectively) to establish feasibility...
December 2018: Journal of Oncology Practice
Venkata L Narasimha, Sagar Karia, Chittaranjan Andrade
No abstract text is available yet for this article.
November 2018: Indian Journal of Psychological Medicine
Bheemsain Tekkalaki, Veerappa Y Patil, Sandeep Patil, Sameeran S Chate, Ramling Dhabale, Nanasaheb M Patil
No abstract text is available yet for this article.
November 2018: Indian Journal of Psychological Medicine
Vinutha Ramesh, Aditya Somani
No abstract text is available yet for this article.
November 2018: Indian Journal of Psychological Medicine
Armando Mansilla-Olivares, Joaquín López-Bárcena, Ricardo Plancarte-Sánchez, Fermín Valenzuela-Gómez-Gallardo, Julieta Rojo, Fernando Meneses-González, Gilberto Felipe Vázquez-De Anda, Patricio Santillán-Doherty, José Ignacio Santos-Preciado, María de Jesús Medina, Asunción Álvarez, Beatriz Vanda
There are decisions at the end of life that currently are relevant as humanistic values. Respect for human life and dignity are part of human rights. The National Academy of Medicine of Mexico declares its posture about end-of-life decisions that include treatment refusal, limitation of the therapeutic effort, advance directives and palliative sedation, among others, with the purpose to favor a peaceful death.
2018: Gaceta Médica de México
Bo Xie, Jane Dimmitt Champion, Jung Kwak, Kenneth R Fleischmann
BACKGROUND: Mobile health (mHealth) technology holds promise for promoting health education and reducing health disparities and inequalities in underserved populations. However, little research has been done to develop mHealth interventions for family caregivers of people with dementia, particularly those in rural Hispanic communities, who often serve as surrogate decision makers for their relatives with dementia. OBJECTIVE: As part of a larger project to develop and test a novel, affordable, and easy-to-use mHealth intervention to deliver individually tailored materials in rural Hispanic communities, in this pilot study, we aimed to examine (1) characteristics of people with dementia and their family caregivers in rural Hispanic communities, (2) caregivers' preferences for types and amounts of health information and participation in surrogate decision making, and (3) caregivers' mobile device usage and their desire for receiving information via mobile devices...
December 10, 2018: Journal of Medical Internet Research
Ashley S Mogul, David M Cline, Jennifer Gabbard, Casey Bryant
BACKGROUND: Early integration of palliative care from the emergency department (ED) is an underutilized care modality with potential benefits, but few studies have identified who is appropriate for such care. OBJECTIVE: Our hypothesis is that patients aged 65 years or older who present to the ED as level I Emergency Severity Index from a long-term care (LTC) facility have high resource utilization and mortality and may benefit from early palliative care involvement...
December 6, 2018: Journal of Emergency Medicine
Anastasia Vishnevetsky, Carla Zapata Del Mar, Juan Luis Cam, Mario Cornejo-Olivas, Claire J Creutzfeldt
BACKGROUND: The development of palliative care in Peru remains limited, particularly for nononcological services, such as neurology. The goal of this study was to explore attitudes toward and knowledge about palliative and end-of-life care among patients, families, nurses, and doctors in a specialized neurological institute in Lima, Peru. MATERIALS AND METHODS: We used a mixed methods approach consisting of 78 surveys and 21 qualitative, semistructured interviews that were recorded, transcribed, and analyzed using thematic analysis...
December 8, 2018: Journal of Palliative Medicine
Hoby Razafimbelo, Kenza Laloui, Sadia Lassouane, Annie-Claude Ribemont, Marie-Thérèse Rabus, Jean-Paul Rwabihama
Advance directives (AD) are not sufficiently applied in geriatric setting despite their widespread dissemination since the publication of Claeys-Leonetti law. The aim of this study was to analyze geriatricians' knowledge of the concept of AD and to evaluate their practices in the process of patient information and AD collection.
July 2018: Soins. Gérontologie
Daniel K Partain, Justin J Sanders, Richard E Leiter, Elise C Carey, Jacob J Strand
OBJECTIVE: To characterize the end-of-life care of all international patients who died at a global destination medical center from January 1, 2005, through December 31, 2015. PATIENTS AND METHODS: We performed a retrospective review of all adult international patients who died at a global destination medical center from January 1, 2005, through December 31, 2015. RESULTS: Eighty-two international patients from 25 countries and 5 continents died during the study period (median age, 59...
December 2018: Mayo Clinic Proceedings
Stephen H Linder, Kimberly Aguillard, Kelsey French, Arthur Garson
According to some estimates, the United States wastes as much as 30% of health care dollars. Some of that waste can be mitigated by reducing certain costs associated with Medicaid. We chose 5 areas of savings applicable to Medicaid: (1) modification of physician payment models to reduce unnecessary care, (2) development of a medication adherence program for patients dually eligible for Medicaid and Medicare support ("dual eligibles"), (3) improvement in unnecessary admissions and readmissions for dual eligibles, (4) reduction in emergency department visits among children in Medicaid and dual-eligible beneficiaries, and (5) improvement in adoption of end-of-life advance directives...
2018: Health Services Insights
Jessie Lenagh-Glue, Anthony O'Brien, John Dawson, Katey Thom, Johnnie Potiki, Heather Casey, Paul Glue
AIMS: To document the process of developing a local advance directive for mental health care, which we are calling a MAP (Mental-health Advance Preferences statement). METHODS: Data on advance directive preferences were collected from consumers and service providers using online surveys and analysed using quantitative methods. RESULTS: Both groups reported strong overall support for advance directives. They particularly favoured inclusion of items concerning personal support at difficult times...
November 30, 2018: New Zealand Medical Journal
Sara Garcia-Ptacek, Beth Dahlrup, Ann-Katrin Edlund, Helle Wijk, Maria Eriksdotter
BACKGROUND: Dementia presents barriers to the collaboration between individuals and the healthcare system. Caregivers perform multiple functions helping patients with basic and instrumental activities but also communicating and mediating the dyads' needs within the broader social group. Interventions focusing on caregivers show that caregiver burden can be reduced, improving patient outcomes in a cost-effective way, but the generalisation of these findings is limited by several factors such as low participation rates of caregivers in studies...
November 29, 2018: Scandinavian Journal of Caring Sciences
Frances R Nedjat-Haiem, Tamara J Cadet, Anup Amatya, Shiraz I Mishra
BACKGROUND: Advance care planning for end-of-life care emerged in the mid-1970's to address the need for tools, such as the advance directive (AD) legal document, to guide medical decision-making among seriously ill patients, their families, and healthcare providers. OBJECTIVE: Study aims examine providers' perspectives on AD education that involve examining (1) a range of attitudes about educating patients, (2) whether prior knowledge was associated with practice behaviors in educating patients, and (3) specific factors among healthcare providers such as characteristics of work setting, knowledge, attitudes, and behaviors that may influence AD education and documentation...
November 28, 2018: American Journal of Hospice & Palliative Care
Henry C Barry
No abstract text is available yet for this article.
December 1, 2018: American Family Physician
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