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Palliative AND (Nursing Home OR Community)

Tushti Bhardwaj
Background: Caring for a cancer patient is debilitating for caregivers, especially among Indian population, as culturally people prefer to care at home than at nursing home. Unavailability of palliative care services and professional caregivers adds to the family burden. Objectives: Caregiving difficulties need assessment, but cancer-specific burden instruments are rare in the Indian context. This article presents development and initial validation of Caregiver's Difficulty Rating Scale (CDRS) and highlights the nature of caregiving burden on primary caregivers...
July 2018: Indian Journal of Palliative Care
Cathy J Silloway, Toni L Glover, Brian J Coleman, Sheri Kittelson
Bereavement services are often provided as components of hospice and palliative care plans, including emotional, psychosocial, and spiritual support provided to individuals and families to assist with grief, loss, and adjustment after the death of a loved one. Patient- and family-centered care is a hallmark of palliative care. Moreover, bereavement counseling is offered as a hospice care benefit that is covered by Medicare and various private insurance plans. However, not all hospital-based palliative care programs offer bereavement support...
August 15, 2018: Journal of Social Work in End-of-life & Palliative Care
Domenica Disalvo, Tim Luckett, Georgina Luscombe, Alexandra Bennett, Patricia Davidson, Lynnette Chenoweth, Geoffrey Mitchell, Dimity Pond, Jane Phillips, Elizabeth Beattie, Stephen Goodall, Meera Agar
BACKGROUND: Prescribing medications for nursing home residents with advanced dementia should focus on optimizing function and comfort, reducing unnecessary harms and aligning care goals with a palliative approach. OBJECTIVE: The aim of the study was to estimate the proportion of Australian nursing home residents with advanced dementia receiving potentially inappropriate medications, and identify those most commonly prescribed and factors associated with their use...
August 14, 2018: Journal of Palliative Medicine
Rachel Wells, Macy L Stockdill, J Nicholas Dionne-Odom, Deborah Ejem, Kathryn L Burgio, Raegan W Durant, Sally Engler, Andres Azuero, Salpy V Pamboukian, Jose Tallaj, Keith M Swetz, Elizabeth Kvale, Rodney O Tucker, Marie Bakitas
BACKGROUND: Palliative care is specialized medical care for people with serious illness that is focused on providing relief from symptoms and stress and improving the quality of life (QOL) for patients and their families. To help the 6.5 million U.S. adults and families affected by heart failure manage the high symptom burden, complex decision-making, and risk of exacerbation and death, the early integration of palliative care is critical and has been recommended by numerous professional organizations...
August 6, 2018: Trials
Huong Q Nguyen, Nora Ruel, Mayra Macias, Tami Borneman, Melissa Alian, Mark Becher, Kathy Lee, Betty Ferrell
CONTEXT: A notable gap in the evidence-base for palliative care (PC) for cancer is that most trials were conducted in specialized centers with limited translation and further evaluation in "real-world" settings. Health systems are desperate for guidance on effective, scalable models. OBJECTIVE: Determine the effects of a nurse-led PC intervention for patients with non-small cell lung cancer (NSCLC) and their family caregivers (FCGs) in a community-based setting...
August 1, 2018: Journal of Pain and Symptom Management
Thomas F Hack, Susan E McClement, Harvey Max Chochinov, Brenden Dufault, Wendy Johnston, Murray W Enns, Genevieve N Thompson, Mike Harlos, Ronald W Damant, Clare D Ramsey, Sara Davison, James Zacharias, David Strang, Heather J Campbell-Enns
CONTEXT: It has become commonplace to use family caregivers as proxy responders where patients are unable to provide information about their symptoms and concerns to health care providers. OBJECTIVE: To determine the degree of concordance between patients' and family members' reports of patient symptoms and concerns at end-of-life. METHODS: Sample dyads included a mix of patients residing at home, in nursing homes, long term care, and hospice...
August 1, 2018: Journal of Pain and Symptom Management
Shaunna Siler, Iris Mamier, Betty Winslow
Despite significant progress in implementing palliative care interventions for patients with cancer, few intervention studies seek health care clinicians' input before implementation of these into the community. The purpose of this study was to explore palliative care and oncology clinicians' perspectives on the perceived facilitators and challenges in meeting the quality-of-life needs of patients with lung cancer and family caregivers in community-based settings. The Reach Effectiveness Adoption Implementation Maintenance model for implementation research was used as a framework...
August 2018: Journal of Hospice and Palliative Nursing: JHPN
Masako Mayahara, Arlene Michaels Miller, Sean OʼMahony
The purposes of this study were to describe the advance care planning process for nursing home residents and identify common concerns regarding advance care planning. We conducted a content analysis of video-conferenced advance care planning meetings in the nursing home. Fourteen nursing home residents and 10 family members were included in the analysis. Themes based on the participants' statements during the meetings were used to generate the Advance Care Planning Process Framework. The Advance Care Planning Process Framework has 3 primary phases: (1) assess resident's status regarding end-of-life care, which includes establishing common language; identifying resident's unrealistic goals and wishes; and identifying inconsistencies between resident's expressed wishes and the preferences documented in medical record; (2) negotiate realistic plan of care, which includes addressing inconsistencies between resident's and family's goals; rephrasing goals and wishes in hypothetical scenarios; and clarifying goals; and (3) create action plan, which includes complete advance directives and revisit/revise in the future as needed...
February 2018: Journal of Hospice and Palliative Nursing: JHPN
Rita Ferguson
Providing nursing care for an individual who is terminally ill is a complex endeavor. Understanding the different ways nurses who work in hospice agencies use knowing about and caring for persons receiving services becomes important because the actions of nurses are influenced by the nurses' perceptions. Hearing the narrative of nurses providing end-of-life care through phenomenological research can inform nursing education and institutions' methods to support the development of skills and characteristics to improve palliative and end-of-life nursing care...
February 2018: Journal of Hospice and Palliative Nursing: JHPN
Nancy Dudley, Susan Chapman, Joanne Spetz
To assess perspectives of US community-based palliative care program leaders on staffing, recruitment, and training, a qualitative descriptive study was conducted. Leaders (n = 20) from academic medical centers, large integrated and community health systems, home health and hospice organizations, and the Veterans Administration were recruited. Three major categories emerged that influence community-based palliative care workforce team composition across settings: (1) staffing models and recruitment are influenced by setting and workforce experience, (2) training varies by setting, and (3) demand exceeds supply of trained workforce...
April 2018: Journal of Hospice and Palliative Nursing: JHPN
Simone Stenekes, Jamie L Penner, Michael Harlos, Marie-Claude Proulx, Erin Shepherd, Stephen Liben, Genevieve Thompson, Grace MacConnell, Marie-Claude Grégoire, Harold Hal Siden
Perinatal palliative care is an emerging area of health care. To date, no published tools assess health-care provider's knowledge and level of comfort in providing such care. A 2-phase study was undertaken to develop and implement a survey to evaluate the self-assessed competency, attitudes, and knowledge of health-care providers working in perinatal palliative care. Phase 1 included a review of the literature and appraisal of palliative and death-related instruments to inform the initial draft of the Perinatal Palliative Care Survey (PPCS)...
July 31, 2018: Journal of Palliative Care
Lisa Martinsson, Staffan Lundström, Johan Sundelöf
INTRODUCTION: Globally, dementia is one of the leading causes of death. Given the growing elderly population in the world, the yearly number of deaths by dementia is expected to increase. Patients dying from dementia are reported to suffer from a burden of symptoms similar to that of patients with cancer, but receive less medication against symptoms, have a lower probability of palliative care planning and seldom have access to specialised palliative care. Studies investigating the quality of palliative care in dementia are scarce...
2018: PloS One
Anette Alvariza, Maja Holm, Inger Benkel, Maria Norinder, Gail Ewing, Gunn Grande, Cecilia Håkanson, Joakim Öhlen, Kristofer Årestedt
PURPOSE: The Carer Support Needs Assessment Tool (CSNAT) was developed for use among family caregivers in palliative care for assessment of their support needs. The purpose of this study was to translate and evaluate the validity and reliability of the CSNAT in a sample of Swedish family caregivers and nurses in a palliative care context. METHODS: Data for this validation study was collected during 2016 in the context of palliative home care in two larger Swedish cities...
August 2018: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
Pauline M S Anrys, Goedele C Strauven, Veerle Foulon, Jean-Marie Degryse, Séverine Henrard, Anne Spinewine
BACKGROUND/OBJECTIVES: Our aim was to describe the prevalence of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) in Belgian nursing homes and to identify characteristics of residents, general practitioners (GPs), and nursing homes (NHs) that are associated with the number of PIMs and PPOs. DESIGN: A cross-sectional study. SETTING: and Participants: Nursing home residents (NHRs), aged ≥65 years, not in palliative care were included in 54 Belgian NHs participating in the COME-ON study...
July 25, 2018: Journal of the American Medical Directors Association
Jan Shoenberger, Sangeeta Lamba, Rebecca Goett, Paul DeSandre, Kate Aberger, Suzanne Bigelow, Todd Brandtman, Garrett K Chan, Robert Zalenski, David Wang, Mark Rosenberg, Karen Jubanyik
Objectives: Emergency medicine (EM) physicians commonly care for patients with serious life-limiting illness. Hospice and palliative medicine (HPM) is a subspecialty pathway of EM. Although a subspecialty level of practice requires additional training, primary-level skills of HPM such as effective communication and symptom management are part of routine clinical care and expected of EM residents. However, unlike EM residency curricula in disciplines like trauma and ultrasound, there is no nationally defined HPM curriculum for EM resident training...
April 2018: AEM education and training
Peter Pype, Fien Mertens, Fleur Helewaut, Demi Krystallidou
BACKGROUND: Complexity science has been introduced in healthcare as a theoretical framework to better understand complex situations. Interdisciplinary healthcare teams can be viewed as Complex Adaptive Systems (CAS) by focusing more on the team members' interaction with each other than on the characteristics of individual team members. Viewing teams in this way can provide us with insights into the origins of team behaviour. The aim of this study is to describe the functioning of a healthcare team as it originates from the members' interactions using the CAS principles as a framework and to explore factors influencing workplace learning as emergent behaviour...
July 20, 2018: BMC Health Services Research
Jiwon Lee, Younghye Park, Kyounjoo Lim, Ari Lee, Hanul Lee, Jong-Eun Lee
BACKGROUND: As the population ages, the prevalence of various chronic diseases increases. Palliative care for patients at the end of life with a noncancer diagnosis is currently limited because of the difficulties of demarcating the boundaries of the end-of-life care period and of determining the various care needs of patients at the end of life. PURPOSE: This study aimed to investigate the levels of importance and difficulty of the multidimensional care needs for patients with a noncancer diagnosis during various end-of-life stages...
July 19, 2018: Journal of Nursing Research: JNR
Nisha Sutherland, Catherine Ward-Griffin, Carol McWilliam, Kelli Stajduhar
Background As home is a site where gendered attitudes, beliefs, and practices are reproduced, it is imperative that policies and practices promote gender equity in end-of-life care at home. Purpose The purpose of this study was to critically analyze gender relations in the sociopolitical context of hospice palliative home care. Methods Using a critical feminist perspective, we examined gender relations between and among clients with cancer, their family caregivers, and nurses in hospice palliative home care...
January 1, 2018: Canadian Journal of Nursing Research, Revue Canadienne de Recherche en Sciences Infirmières
Britt Viola Danielsen, Anne Marit Sand, Jan Henrik Rosland, Oddvar Førland
BACKGROUND: Norway has one of the lowest home death rates in Europe. However, it is the health authorities´ ambition to increase this by facilitating palliative care at home. The aim of this study was to achieve more insight, through home care nurses and general practitioners, of conditions that facilitate or hamper more time at home and more home deaths for patients with terminal disease and short life expectancy. METHODS: We used a qualitative research design with four focus groups with a total of 19 participants, of either home care nurses or general practitioners, using semi-structured question guides...
July 18, 2018: BMC Palliative Care
Clare Ellis-Smith, Irene J Higginson, Barbara A Daveson, Lesley A Henson, Catherine J Evans
BACKGROUND: Assessment of people with dementia is challenging; with undetected and under treated symptoms and concerns resulting in avoidable distress, and few evidence-based interventions to support this. We aimed to understand the mechanisms of action of a measure to support comprehensive assessment of people with dementia in care homes; and its acceptability, feasibility, and implementation requirements. METHODS: A qualitative study with an embedded quantitative component in three residential care homes, underpinned by an initial theoretical model of mechanisms of action...
2018: PloS One
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