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Palliative care, end of life care, hospice

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https://www.readbyqxmd.com/read/29244140/the-distress-and-benefit-to-bereaved-family-members-of-participating-in-a-post-bereavement-survey
#1
Mitsunori Miyashita, Maho Aoyama, Saki Yoshida, Yuji Yamada, Mutsumi Abe, Kazuhiro Yanagihara, Akemi Shirado, Mariko Shutoh, Yoshiaki Okamoto, Jun Hamano, Aoi Miyamoto, Misato Nakahata
Background: Few studies have simultaneously collected quantitative data regarding the positive and negative effects of participating in post-bereavement surveys. Methods: We conducted a cross-sectional postal questionnaire survey in October 2013. Potential participants were caregivers for family members who had died in four inpatient palliative care units, two home hospices, and a general hospital. We collected opinions regarding the distress and benefit of completing a post-bereavement survey...
December 13, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29244119/is-social-work-prepared-for-diversity-in-hospice-and-palliative-care
#2
Christine M Rine
The purpose of this article is to assess current and future trends in hospice and palliative care with the objective of informing culturally appropriate best practice for social work. Concern for the intersectionality of racial, ethnic, social, and other differences in end-of-life (EOL) care is imperative given the ever growing range of diversity characteristics among the increasing aging populations in the United States. A review of literature from the current decade that is pertinent to the profession contributes to the ability of social work to consider evidence and build agreement germane to EOL practice settings...
December 13, 2017: Health & Social Work
https://www.readbyqxmd.com/read/29221846/prevailing-ethical-dilemmas-encountered-by-physicians-in-terminal-cancer-care-changed-after-the-enactment-of-the-natural-death-act-fifteen-years-follow-up-survey
#3
Hsien-Liang Huang, Chien-An Yao, Wen-Yu Hu, Shao-Yi Cheng, Shinn-Jang Huang, Chih-Dao Chen, Wen-Yuan Lin, Yen-Chun Lin, Tai-Yuan Chiu
CONTEXT: Advance directive laws have influences on ethical dilemmas encountered by physicians caring for terminal cancer patients. OBJECTIVES: To identify the prevailing ethical dilemmas among terminal care physicians fifteen years after the Natural Death Act was enacted in Taiwan. METHODS: This study is a cross-sectional survey from April 2014 to February 2015 using the clustering sampling method and a well-structured questionnaire. Targeted participants included physicians at oncology and related wards or palliative care units where terminal cancer care may be provided in Taiwan...
December 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29218773/illness-and-end-of-life-experiences-of-children-with-cancer-who-receive-palliative-care
#4
Erica C Kaye, Courtney A Gushue, Samantha DeMarsh, Jonathan Jerkins, April Sykes, Zhaohua Lu, Jennifer M Snaman, Lindsay Blazin, Liza-Marie Johnson, Deena R Levine, R Ray Morrison, Justin N Baker
BACKGROUND: The field of pediatric palliative oncology is newly emerging. Little is known about the characteristics and illness experiences of children with cancer who receive palliative care (PC). METHODS: A retrospective cohort study of 321 pediatric oncology patients enrolled in PC who died between 2011 and 2015 was conducted at a large academic pediatric cancer center using a comprehensive standardized data extraction tool. RESULTS: The majority of pediatric palliative oncology patients received experimental therapy (79...
December 8, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29200118/palliative-care-end-of-life-care-and-advance-care-planning-in-neuro-oncology
#5
Tobias Walbert
PURPOSE OF REVIEW: Despite new therapeutic approaches, most patients with high-grade glioma face limited overall survival and have a high symptom burden throughout their disease trajectory, especially in the end-of-life phase. This article provides an overview of the role of palliative care in neuro-oncology. Management recommendations are made for neurologic symptoms in patients with advanced brain tumors, including headaches, nausea, and fatigue. Special attention is given to how and when to involve subspecialty palliative care and hospice services to improve symptom management during active tumor treatment and in the end-of-life phase of patients with brain tumors...
December 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29178866/a-scoping-review-of-palliative-care-for-children-in-low-and-middle-income-countries
#6
Hatoko Sasaki, Marie-Charlotte Bouesseau, Joan Marston, Rintaro Mori
BACKGROUND: Ninety-eight percent of children needing palliative care live in low- and middle-income countries (LMICs), and almost half of them live in Africa. In contrast to the abundance of data on populations in high income countries, the current data on populations in LMICs is woefully inadequate. This study aims to identify and summarize the published literature on the need, accessibility, quality, and models for palliative care for children in LMICs. METHODS: A scoping review was performed following the method of Arksey and O'Malley...
November 25, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29169346/social-and-clinical-determinants-of-preferences-and-their-achievement-at-the-end-of-life-prospective-cohort-study-of-older-adults-receiving-palliative-care-in-three-countries
#7
Irene J Higginson, Barbara A Daveson, R Sean Morrison, Deokhee Yi, Diane Meier, Melinda Smith, Karen Ryan, Regina McQuillan, Bridget M Johnston, Charles Normand
BACKGROUND: Achieving choice is proposed as a quality marker. But little is known about what influences preferences especially among older adults. We aimed to determine and compare, across three countries, factors associated with preferences for place of death and treatment, and actual site of death. METHODS: We recruited adults aged ≥65-years from hospital-based multiprofessional palliative care services in London, Dublin, New York, and followed them for >17 months...
November 23, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29153752/hospice-care-for-patients-with-dementia-in-the-united-states-a-longitudinal-cohort-study
#8
Aline De Vleminck, R Sean Morrison, Diane E Meier, Melissa D Aldridge
BACKGROUND: Patients with dementia form an increasing proportion of those entering hospice care. Little is known about the types of hospices serving patients with dementia and the patterns of hospice use, including timing of hospice disenrollment between patients with and without dementia. OBJECTIVES: To characterize the hospices that serve patients with dementia, to compare patterns of hospice disenrollment for patients with dementia and without dementia, and to evaluate patient-level and hospice-level characteristics associated with hospice disenrollment...
November 16, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29141458/the-selection-of-death-place-among-patients-receiving-hospital-based-palliative-care-service-in-taiwan
#9
Ching-Sung Ho
INTRODUCTION: To analyze the selection of a place to die and its related factors in patients who received hospice shared care service in Taiwan. METHODS: This study included patients who received hospice shared care service in a metropolitan hospital as the research participants. A total of 172 questionnaires were collected, and 146 of them were used as valid samples for analysis. This study applied the multivariate logistic regression analysis to assess the significance of independent variables associated with the selection of place of death...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29138955/the-impact-of-palliative-care-training-for-oncologists-and-integrative-palliative-service-in-a-public-funded-hospital-cluster-a-retrospective-cohort-study
#10
Pak-Lun Lam, Tai-Chung Lam, Cheuk-Wai Choi, Anne Wing-Mui Lee, Kwok-Keung Yuen, To-Wai Leung
PURPOSE: Oncological care of advanced cancer patients was provided by multiple departments in Hong Kong. One of these departments, the clinical oncology department (COD), introduced systematic palliative care training for its oncologists since 2002. The COD was recognized as a European Society for Medical Oncology (ESMO) Designated Centre of Integrated Oncology and Palliative Care since 2009. This retrospective cohort study aims to review the impact of integrative training and service on palliative care coverage and outcome...
November 14, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29123355/economics-of-palliative-and-end-of-life-care-in-india-a-concept-paper
#11
Arunangshu Ghoshal, Anuja Damani, Naveen Salins, Jayita Deodhar, M A Muckaden
Only a few studies have assessed the economic outcomes of palliative care in India. The major areas of interest include hospice care, the process and structure of care, symptom management, and palliative chemotherapy compared to best supportive care. At present, there is no definite health-care system followed in India. Medical bankruptcy is common. In situations where patients bear most of the costs, medical decision-making might have significant implications on economics of health care. Game theory might help in deciphering the underlying complexities of decision-making when considered as a two person nonzero sum game...
October 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29121789/a-descriptive-analysis-of-end-of-life-conversations-with-long-term-glioblastoma-survivors
#12
Stephen P Miranda, Rachelle E Bernacki, Joanna M Paladino, Andrew D Norden, Jane E Kavanagh, Marissa C Palmor, Susan D Block
BACKGROUND: Early, high-quality serious illness (SI) conversations are critical for patients with glioblastoma (GBM) but are often mistimed or mishandled. OBJECTIVE: To describe the prevalence, timing, and quality of documented SI conversations and evaluate their focus on patient goals/priorities. DESIGN/PARTICIPANTS: Thirty-three patients with GBM enrolled in the control group of a randomized controlled trial of a communication intervention and were followed for 2 years or until death...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29076605/palliative-care-for-advanced-dementia-knowledge-and-attitudes-of-long-term-care-staff
#13
I-Hui Chen, Kuan-Yu Lin, Sophia H Hu, Yeu-Hui Chuang, Carol O Long, Chia-Chi Chang, Megan F Liu
AIM AND OBJECTIVES: To investigate the knowledge of and attitudes toward palliative care for advanced dementia and their associations with demographics among nursing staff, including nurses and nursing assistants, in long-term care settings. BACKGROUND: Nursing facilities are places where persons with dementia die; therefore, providing quality end-of-life care to residents with advanced dementia is crucial. To date, little attention has been paid to palliative care practice for patients with advanced dementia DESIGN: A descriptive, cross-sectional, survey design was used...
October 27, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29058518/recent-evidence-on-the-inclusion-of-hospice-and-palliative-care-physicians-in-medicare-shared-savings-program-accountable-care-organization-networks
#14
Julia Driessen, Turner West
OBJECTIVE: To document the presence of hospice and palliative physicians in Medicare Shared Savings Program (MSSP) ACOs. BACKGROUND: End-of-life care exhibits extreme variation in quality, cost, and patient experience. This baseline creates opportunities for improvements that would be financially rewarded in the new value-based reimbursement environment, such as the accountable care organization (ACO) model. Little is known about how ACOs have responded to this opportunity by including hospice and palliative providers in their formal provider networks...
October 23, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29042070/geriatric-palliative-care-meeting-the-needs-of-a-growing-population
#15
Rebecca M Saracino, Mei Bai, Leslie Blatt, Larry Solomon, Ruth McCorkle
The implementation of effective geriatric palliative care (PC) services will be increasingly important as the number of patients ages ≥65 years continues to grow. However, literature characterizing the utilization of PC services by older adults remains scant. The objective of these analyses was to characterize the nature and outcomes of PC services for older adults. A retrospective analysis of records of inpatient PC consultations provided to patients ≥65 years at an academic hospital was performed (N = 743)...
October 14, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/29034688/end-of-life-characteristics-and-palliative-care-provision-for-patients-with-motor-neuron-disease
#16
Hon Wai Benjamin Cheng, Oi Man Iman Chan, Chun Hung Red Chan, Wan Hung Chan, Koon Sim Fung, Kar Yin Wong
Motor neuron disease (MND) is a neurodegenerative disease and manifested as progressive decline in physical, respiratory, swallowing and communication function, and ultimately death. Traditional model of care was fragmented and did not match with multifacet needs of patients and carers. Furthermore, there could be lack of integrated care at end of life for patients with MND in most lower- and middle-income countries or in places with inadequate palliative care (PC) coverage. In view of this, a special workgroup for patients with MND, which includes neurologist, respiratory physician, rehabilitation specialist, and PC physician was formed in Hong Kong since year 2011...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29030210/continuous-cardiac-inotropes-in-patients-with-end-stage-heart-failure-an-evolving-experience
#17
Kasey Malotte, Agafe Saguros, Hunter Groninger
Heart failure experts recommend initiation of continuous inotrope therapy, such as milrinone or dobutamine, for clinically decompensating patients with stage D heart failure. Although originally intended to serve solely as a bridge to more definitive surgical therapies, more and more patients are receiving inotrope therapy for purely palliative purposes. In these cases, questions arise regarding care at the end of life. What criteria determine ongoing clinical benefit? Should the inotrope be continued until death? Should inotrope dosing be increased within recommended guidelines to improve symptoms? What is the role of inotropes in hospice care? Here, we describe such a case as a springboard to contemplate the evolving role of inotrope therapies and how hospice and palliative providers may interface with this rapidly developing face of advanced heart failure care...
October 10, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28979824/when-the-opioid-medications-go-missing-confidentiality-and-safety-in-adolescents
#18
Muhammad Hassan Majeed
Patients receiving end-of-life or palliative care usually possess an ample supply of opioid pain medications to help alleviate their pain. The risk of these drugs being diverted is high because such patients often have an excess of these medications, and because they are typically unable to manage medications themselves. For example, adolescents might steal these medications for recreational use. The author presents a case in which a minor admitted stealing and using opioid pain medication belonging to her mother, who was in hospice home care...
May 2017: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/28977262/new-concepts-in-palliative-care-in-the-intensive-care-unit
#19
Cristina Bueno Terzi Coelho, James R Yankaskas
Some patients admitted to an intensive care unit may face a terminal illness situation, which usually leads to death. Knowledge of palliative care is strongly recommended for the health care providers who are taking care of these patients. In many situations, the patients should be evaluated daily as the introduction of further treatments may not be beneficial to them. The discussions among health team members that are related to prognosis and the goals of care should be carefully evaluated in collaboration with the patients and their families...
April 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28975242/ethics-and-the-legalization-of-physician-assisted-suicide-an-american-college-of-physicians-position-paper
#20
Lois Snyder Sulmasy, Paul S Mueller
Calls to legalize physician-assisted suicide have increased and public interest in the subject has grown in recent years despite ethical prohibitions. Many people have concerns about how they will die and the emphasis by medicine and society on intervention and cure has sometimes come at the expense of good end-of-life care. Some have advocated strongly, on the basis of autonomy, that physician-assisted suicide should be a legal option at the end of life. As a proponent of patient-centered care, the American College of Physicians (ACP) is attentive to all voices, including those who speak of the desire to control when and how life will end...
October 17, 2017: Annals of Internal Medicine
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