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Palliative AND (Nursing Home OR Community)

Karina Deckert, Julia Walter, Larissa Schwarzkopf
BACKGROUND: When patients die in a hospital their quality of life is lower than when they die at home or in a hospice. Despite efforts to improve palliative care supply structures, still about 60% of lung cancer patients die in a hospital. Studies have examined factors related to inhospital death in lung cancer patients, yet none used data of a representative German population, additionally including economic aspects. This study aimed to identify factors related to inhospital death in German lung cancer patients and analysed resulting costs...
October 19, 2018: BMC Health Services Research
Annelieke Damen, Dirk Labuschagne, Laura Fosler, Sean O'Mahony, Stacie Levine, George Fitchett
It is well accepted that attention to spiritual concerns is a core dimension of palliative care. It is similarly well accepted that chaplains are the spiritual care specialists who should address such concerns. However, what chaplains do when they provide care for patients and families is often poorly understood by their palliative care colleagues. Having a clear understanding of what chaplains do is important because it contributes to improved utilization of the spiritual care and other resources of the palliative care team and thereby to better care for patients and families...
October 18, 2018: American Journal of Hospice & Palliative Care
Joshua D Niznik, Song Zhang, Maria K Mor, Xinhua Zhao, Mary Ersek, Sherrie L Aspinall, Walid F Gellad, Joshua M Thorpe, Joseph T Hanlon, Loren J Schleiden, Sydney Springer, Carolyn T Thorpe
OBJECTIVES: To evaluate the predictive validity of an adapted version of the Minimum Data Set (MDS) Mortality Risk Index-Revised (MMRI-R) based on MDS version 3.0 assessment items (MMRI-v3) and to compare the predictive validity of the MMRI-v3 with that of a single MDS item indicating limited life expectancy (LLE). DESIGN: Retrospective, cross-sectional study of MDS assessments. Other data sources included the Veterans Affairs (VA) Residential History File and Vital Status File...
October 18, 2018: Journal of the American Geriatrics Society
Steven Vanderstichelen, Joachim Cohen, Yanna Van Wesemael, Luc Deliens, Kenneth Chambaere
Ageing populations increasingly face chronic and terminal illnesses, emphasising the importance of palliative care and quality of life for terminally ill people. Facing resource constraints in professional healthcare, some governments expect informal caregivers like volunteers to assume a greater share of care provision. We know volunteers are present in palliative care and perform many roles, ranging from administration to providing companionship. However, we do not know how involved they are in the organisation of care and how healthcare organisations appraise their involvement...
October 16, 2018: Health & Social Care in the Community
Paola Di Giulio, Silvia Finetti, Fabrizio Giunco, Ines Basso, Debora Rosa, Francesca Pettenati, Alessandro Bussotti, Daniele Villani, Simona Gentile, Lorenzo Boncinelli, Massimo Monti, Sandro Spinsanti, Massimo Piazza, Lorena Charrier, Franco Toscani
CONTEXT: End-of-life care in nursing homes (NH) needs improvement. We carried out a study in 29 NHs in the Lombardy Region (Italy). OBJECTIVES: To compare End-of-Life care in NH residents with advanced dementia before and after an educational intervention aimed to improving palliative care. METHODS: The intervention consisted of a 7-hour lecture, followed by two 3-hour meetings consisting of case discussions. The intervention was held in each NH and well attended by NH staff...
October 10, 2018: Journal of Pain and Symptom Management
Thomas R Freeman, Leslie Boisvert, Eric Wong, Stephen Wetmore, Heather Maddocks
OBJECTIVE: To determine the range of services and procedures offered by family physicians who define themselves as comprehensive practitioners and compare responses across 3 generations of alumni of a single family practice program. DESIGN: Cross-sectional survey. SETTING: Western University in London, Ont. PARTICIPANTS: All graduates of the family medicine program between 1985 and 2012. MAIN OUTCOME MEASURES: Self-reported provision of the following types of care: in-office care, in-hospital care, intrapartum obstetrics, housecalls, palliative care, after-hours care, nursing home care, minor surgery, emergency department care, sport medicine, and walk-in care...
October 2018: Canadian Family Physician Médecin de Famille Canadien
Stacy M Fischer, Sung-Joon Min, Adam Atherly, Danielle M Kline, Wendolyn S Gozansky, John Himberger, Joseph Lopez, Kathleen Lester, Regina M Fink
Latinos are more likely to experience uncontrolled pain, and institutional death, and are less likely to engage in advance care planning. Efforts to increase access to palliative care must maximize primary palliative care and community based models to meet the ever-growing need in a culturally sensitive and congruent manner. Patient navigator interventions are community-based, culturally tailored models of care that have been successfully implemented to improve disease prevention, early diagnosis, and treatment...
October 10, 2018: Research in Nursing & Health
Gabriela Píriz Alvarez
PURPOSE OF REVIEW: To describe how Project ECHO works and to analyze what has been published on Project ECHO Palliative Care (Project ECHO PC) over the last 18 months. RECENT FINDINGS: Only two articles on Project ECHO PC have been published over the last 18 months: a descriptive study of experiences in seven health centers of the United States, the United Kingdom, Uruguay and India; and a quantitative and qualitative study of the impact of the teleECHO clinic on physicians and nurses in Northern Ireland, which reports a significant boost in knowledge acquisition and self-efficacy...
October 8, 2018: Current Opinion in Supportive and Palliative Care
Akon Ndiok, Busisiwe Ncama
AIMS: The aims are to examine the effect of home visiting and resources for instituting the programme as a follow-up strategy in integration of palliative care in daily clinical practice by nurses caring for cancer patients in Nigeria, and on how it can be used to improve care for cancer patients. BACKGROUND: Home visiting by nurses has been used as a follow-up option in maternal and child health care globally. Most cancer patients default after diagnosis, home visiting offers potential as a strategy for follow-up of these patients too...
October 8, 2018: Scandinavian Journal of Caring Sciences
Alexandra Gray-Renfrew, Barbara Kimbell, Anne Finucane
Introduction Patients with advanced liver disease live mainly in the community with treatment of complications provided for in-hospital. The illness trajectory of advanced liver disease is uncertain and most do not have access to end of life care. Gaps in knowledge and understanding of the patient experience of this condition have been identified. Methods Secondary analysis of 15 transcripts from in-depth interviews with people with advanced liver disease collected as part of a previous longitudinal study on the experience of liver disease...
October 4, 2018: Chronic Illness
Lara Pivodic, Tinne Smets, Nele Van den Noortgate, Bregje D Onwuteaka-Philipsen, Yvonne Engels, Katarzyna Szczerbińska, Harriet Finne-Soveri, Katherine Froggatt, Giovanni Gambassi, Luc Deliens, Lieve Van den Block
BACKGROUND: Nursing homes are among the most common places of death in many countries. AIM: To determine the quality of dying and end-of-life care of nursing home residents in six European countries. DESIGN: Epidemiological survey in a proportionally stratified random sample of nursing homes. We identified all deaths of residents of the preceding 3-month period. MAIN OUTCOMES: quality of dying in the last week of life (measured using End-of-Life in Dementia Scales - Comfort Assessment while Dying (EOLD-CAD)); quality of end-of-life care in the last month of life (measured using Quality of Dying in Long-Term Care (QoD-LTC) scale)...
October 1, 2018: Palliative Medicine
Carles Blay, Joan Carles Martori, Esther Limon, Cristina Lasmarías, Ramon Oller, Xavier Gómez-Batiste
OBJECTIVE: To describe the use of health resources of people with advanced chronicity, quantifying and characterizing its cost to suggest improvements in health care models. DESIGN: Observational, analytical and prospective study during 3 years of a cohort of people with advanced chronicity. LOCATION: Three primary care teams (EAP) of Osona, Cataluña. PARTICIPANTS: 224 people identified as advanced patients through a systematic population strategy...
September 24, 2018: Atencion Primaria
Marta Kramer Mikkelsen, Cecilia Margareta Lund, Anders Vinther, Anders Tolver, Anne-Mette Ragle, Julia Sidenius Johansen, Inna Chen, Lotte Engell-Noerregaard, Finn Ole Larsen, Bo Zerahn, Dorte Lisbet Nielsen, Mary Jarden
BACKGROUND: Several intervention studies have demonstrated that exercise training has beneficial effects among cancer patients. However, older cancer patients are underrepresented in clinical trials, and only few exercise-based studies have focused specifically on older patients with cancer. In particular, research investigating the effects of exercise training among older patients with advanced cancer is lacking. The purpose of the current study is to investigate the effect of a 12-week multimodal and exercise-based intervention among older patients (≥65 years) with advanced pancreatic, biliary tract or lung cancer, who are treated with first-line palliative chemotherapy, immunotherapy or targeted therapy...
September 27, 2018: BMC Cancer
Margaret O'Connor, Stacey Palfreyman, Felice Borghmans
BACKGROUND: Nurse practitioners have been well-established in many parts of the world and valued as a senior role in healthcare systems. This paper offers an appraisal of a palliative care nurse practitioner model of care project and augments an understanding of being a nurse practitioner (NP) in the Australian context. AIMS: To enhance outcomes for people regardless of care setting; and to enhance professional relationships between hospital and community services...
September 2, 2018: International Journal of Palliative Nursing
Michele Vitacca, Laura Comini, Erminio Tabaglio, Bruno Platto, Lidia Gazzi
BACKGROUND: Despite real needs, very few chronic obstructive pulmonary disease (COPD) patients with life-limiting disease receive a well-organized support for palliative care (PC). OBJECTIVE: To test the feasibility of, and patient satisfaction with, an advanced care plan for severe COPD patients followed by tele-assistance at home for six months that focused on monitoring patient's palliative topics through a dedicated checklist. METHODS: Ten hospitalized patients with severe COPD (<1-year life expectancy) received a 60 minutes PC talk by a specialist to define an advanced care plan in the case of very severe respiratory insufficiency, based on three options: (1) endotracheal intubation (EI); (2) noninvasive ventilation; or (3) no mechanical aid; O2 and drugs, for example, opiates...
September 26, 2018: Journal of Palliative Medicine
Deb Rawlings, Jennifer Tieman, Lauren Miller-Lewis, Kate Swetenham
Current health and social care systems do not always meet the needs of the dying in our communities. As a result, patients and families are choosing to place their trust in those who can advocate for them or fill the gaps in care. Birth Doulas have been working with women during pregnancy and after birth for many years, and we are now seeing a new role, that of a Death Doula emerging in the end-of-life care space. How Death Doulas work within health and social care systems is not understood and we conducted a systematic review to explore the published literature to explore the role and potential implications for models of care delivery...
September 26, 2018: Health & Social Care in the Community
Amandine Bertrand, Anna Marcault-Derouard, Yves Devaux, Yves Bertrand, Christophe Bergeron, Véronique Veyet, Marie Cervos, Shirley Filion, Florence Goy, Matthias Schell
BACKGROUND/OBJECTIVE: Our home-care unit (HCU) is specialized for pediatric cancer patients and has a strong palliative care activity. We believe that the introduction of home-care services can influence the place of palliative care and of death as well as the length of hospitalization. We aimed at describing characteristics and care course of patients treated in our HCU, and tried to identify some factors contributing to home care at the end of life. DESIGN/METHODS: We conducted a retrospective, observational, monocentric study about patients in pediatric onco-hematology, treated at least one day in our home-care unit, who died between July 1st 2013 and December 31st 2015...
September 2018: Bulletin du Cancer
Joseph T S Low, Gudrun Rohde, Katherine Pittordou, Bridget Candy, Sarah Davis, Aileen Marshall, Paddy Stone
BACKGROUND: People with cirrhosis have unmet needs, which could benefit from a palliative care approach. Developing effective services needs to be evidence based from those with personal experience. This review aims to explore; patient and family perspectives of perceived needs including communication; health professionals' perspectives on delivery of care and improving palliative care between specialities. METHODS: A literature search conducted in Medline, Embase and CINAHL using key words reporting on the perspectives of patients with liver cirrhosis (18 years and over), family members or health professionals on the provision of care in liver cirrhosis...
September 19, 2018: Journal of Hepatology
Charlotte Scheerens, Kenneth Chambaere, Koen Pardon, Eric Derom, Simon Van Belle, Guy Joos, Peter Pype, Luc Deliens
BACKGROUND: Research suggests that palliative home care should be integrated early into standard care for end-stage COPD patients. Patients also express the wish to be cared for and to die at home. However, a practice model for early integration of palliative home care (PHC) into standard care for end-stage COPD has not been fully developed. AIM: To develop an intervention for early integration of PHC into standard care for end-stage COPD patients. METHODS: We conducted a Phase 0-I study according to the Medical Research Council Framework for the development of complex interventions...
2018: PloS One
Kristel Paque, Robert Vander Stichele, Monique Elseviers, Koen Pardon, Tinne Dilles, Luc Deliens, Thierry Christiaens
BACKGROUND: Knowing the barriers/enablers to deprescribing in people with a life-limiting disease is crucial for the development of successful deprescribing interventions. These barriers/enablers have been studied, but the available evidence has not been summarized in a systematic review. AIM: To identify the barriers/enablers to deprescribing of medications in people with a life-limiting disease. DESIGN: Systematic review, registered in PROSPERO (CRD42017073693)...
September 19, 2018: Palliative Medicine
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