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Palliative AND (Nursing Home OR Community)

Sarah Ziegler, Margareta Schmid, Matthias Bopp, Georg Bosshard, Milo Alan Puhan
BACKGROUND: In the last decade, the use of sedative substances to keep a patient in deep sedation until death increased fourfold in German-speaking Switzerland, where every third patient admitted to hospital, palliative care unit or hospice died continuously deeply sedated. AIM: To investigate sedation practices across healthcare settings and to identify their associations with conventional symptom control. DESIGN: National mortality follow-back study in Switzerland between 2013 and 2014...
December 5, 2018: Palliative Medicine
Asta B Petursdottir, Erna Haraldsdottir, Erla Kolbrun Svavarsdottir
RATIONALE: Healthcare providers' beliefs, attitudes, experiences and knowledge, which guide the care they deliver, are the key factors influencing the quality of palliative care. Education and coaching innovation are needed to translate research outcomes and adopt evidence-based nursing care into practice. OBJECTIVES: To evaluate the impact of an advanced educational and coaching programme in a family systems' nursing approach for palliative care nurses in a home-care setting...
November 29, 2018: Scandinavian Journal of Caring Sciences
Anna Klarare, Johan Hansson, Bjöörn Fossum, Carl Johan Fürst, Carina Lundh Hagelin
To meet complex needs in persons and families within specialist palliative care, care team members are expected to work together in performing a comprehensive assessment of patient needs. Team type (how integrated team members work) and team maturity (group development) have been identified as components in team effectiveness and productivity. The aim of the study reported in this paper was to identify team types in specialist palliative care in Sweden, and to explore associations between team type, team maturity and team effectiveness in home care teams...
November 28, 2018: Journal of Interprofessional Care
Roger W Hunt, Katina D'Onise, Anh-Minh Thi Nguyen, Kamalesh Venugopal
AIMS: To describe changes in the place of death of patients with cancer from 1990 to 2012, and to identify issues for their end-of-life care. MATERIALS AND METHODS: Population-based descriptive study, with analyses of place of death patterns, using the South Australian Cancer Registry records of 86 257 patients with cancer who died from 1990 to 2012. RESULTS: From 1990 to 2012, the proportion of cancer deaths in hospital decreased from 63...
November 28, 2018: Journal of Palliative Care
Kathleen T Unroe, Susan E Hickman, Jennifer L Carnahan, Zach Hass, Greg Sachs, Greg Arling
Background and Objectives: To examine the relationship between hospital diagnoses associated with hospital transfers of long stay nursing home residents, ratings of avoidability of transfer, and RN-identified quality improvement opportunities. Research Design and Methods: Prospective clinical demonstration project, named OPTIMISTIC, with trained RNs embedded in nursing homes that performed root cause analyses for 1,931 transfers to the hospital between November 2014 and July 2016...
June 2018: Innovation in Aging
Silvia Gonella, Ines Basso, Valerio Dimonte, Barbara Martin, Paola Berchialla, Sara Campagna, Paola Di Giulio
OBJECTIVE: Less aggressive end-of-life (EOL) care has been observed when health care professionals discuss approaching EOL and preferences about life-sustaining treatments with nursing home (NH) residents or their families. We performed a comprehensive systematic review to evaluate the association between health care professionals-residents and health care professionals-family EOL conversations and EOL care outcomes. DESIGN: Systematic review with meta-analysis...
November 20, 2018: Journal of the American Medical Directors Association
Bianca F Nieves-Pérez, Sullynette Guerrero-De Hostos, Mariela I Frontera-Hernández, Iadelisse Cruz González, José Josué Hernández Muñoz
OBJECTIVES: Prevalence of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs). DESIGN: Cross-sectional study through review of residents' records. SETTING: Three nursing homes of Puerto Rico's metropolitan area. PARTICIPANTS: Nursing home residents. INTERVENTION: Records of residents 65 years of age and older with documented medications and chronic diseases were reviewed. Hospitalized and hospice/palliative care residents were excluded. Beers criteria-2015 and START-STOPP criteria-2014 were applied to identify PIMs and PPOs...
November 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Hanan Khalil, Peter Poon, Anny Byrne, Eli Ristevski
BACKGROUND: Anticipatory medications (AM) have been widely used in various settings across many countries in people approaching end of life. Access to palliative care in rural and remote areas of Australia is lacking as are other medical services when compared with the metropolitan setting. Our aim is to identify challenges with the administration and access to AM in rural and remote communities with outcomes to guide improved delivery of care. METHODS: An online survey administered using Qualtrics, a secure survey platform was distributed to a total of 18 managers from 18 rural and remote organizations across the South East of Victoria in Australia...
November 14, 2018: Journal of Palliative Medicine
Maria Jose Armendariz Dyer
Ecuador, located in South America, has a population of 16 million people. According to the National Institution of Statistics in Ecuador, every year 8 out of a 1000 individuals die due to various causes. Palliative care and hospice are relatively new concepts for the Ecuadorian society. In Ecuador people usually die at home, in hospitals, or in nursing homes. In 2012, the first Ecuadorian hospice was created. According to symbolic interactionism theory, research needs to study participants' world in order to understand the dynamic nature of human behavior...
November 14, 2018: Omega
Ian Koper, H Roeline W Pasman, Bregje D Onwuteaka-Philipsen
BACKGROUND: Generals practitioners (GPs) and district nurses (DNs) play a leading role in providing palliative care at home. Many services and facilities are available to support them in providing this complex care. This study aimed to examine the extent to which GPs and DNs involve these services, what their experiences are, and how involvement of these services and facilities can be improved. METHODS: Sequential mixed methods consisting of an online questionnaire with structured and open questions completed by 108 GPs and 258 DNs, followed by three homogenous online focus groups with 8 GPs and 19 DNs, analyzed through open coding...
November 8, 2018: BMC Health Services Research
K Rizza, G Mathis
BACKGROUND: Due to the demographic development the need for palliative care in the outpatient setting will increase and challenge general practitioners and community nurses. AIM: This study investigated the state of outpatient palliative care in Vorarlberg, Austria from the perspective of outpatient community nurses. The key points of the survey covered the burden of symptoms suffered by palliative patients. Another key focus was the cooperation and communication between community nurses and general practitioners...
November 6, 2018: Zeitschrift Für Gerontologie und Geriatrie
Erica C Kaye, Melanie Gattas, Ashley Kiefer, Jason Reynolds, Kristina Zalud, Chen Li, Zhaohua Lu, Justin N Baker
CONTEXT: Approximately 500,000 children in the United States suffer from life-limiting illnesses each year, many of whom are hospice eligible each year. Few hospice agencies, however, offer formal pediatric programs. OBJECTIVE: To determine the levels of experience and comfort of hospice nurses who provide care to children and families in the community. METHODS: A cross-sectional survey was developed to assess hospice nurse experience/comfort across the domains of symptom management, end-of-life care, goals of care, family-centered care, and bereavement...
October 31, 2018: Journal of Pain and Symptom Management
Aaron K Wong, Juli A Moran
Palliative patients who cannot go home are placed into nursing homes. This involves moving between up to five locations in the final weeks of life. We censored all inpatients on a single day from a large tertiary centre to investigate the feasibility of a proposed extended care unit to accommodate patients with a prognosis of less than 90 days, unable to return home, and with nursing home referral process commenced. This study identifies a present demand for an extended care unit (15 patients identified), outlines admission criteria, and proposes a funding model that is predicted to save hospital costs (savings of $207...
November 2018: Internal Medicine Journal
Michael Connolly, Karen Charnley, Rita Collins, Catriona Barry, Sonja McIlfatrick, Philip Larkin, Maria Brenner, Bridget Johnston
BACKGROUND: A key aspect to the provision of palliative care is maintaining the dignity of the individual being cared for. Nurses working in the community setting need knowledge and skills to meet the needs of individuals who need palliative care and their families. Dignity Care Intervention Ireland is a community-based pilot project designed to implement a dignity care intervention for individuals with a life-limiting condition living in their own home. As part of the overall intervention, an education programme was developed for nurses working in the community...
October 2, 2018: International Journal of Palliative Nursing
Karen Harrison Dening, Jaqueline Crowther, Sadaf Adnan
Addressing palliative care needs of people with dementia appropriately, identifying the end-of-life stage, meeting the needs of family carers as well as supporting the preferences and wishes of the person with the diagnosis can all present challenges to generalist health and social care providers. In partnership with Dementia UK and Kirkwood Hospice in West Yorkshire embarked upon a two-year pilot to introduce the first end-of-life care Admiral Nurse to their Specialist Community Palliative Care Team to identify and support people with dementia who required palliative and end-of-life care...
October 22, 2018: Dementia
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
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