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Palliative care, end of life care, hospice

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https://www.readbyqxmd.com/read/27920549/management-of-hypoglycemia-in-nondiabetic-palliative-care-patients-a-prognosis-based-approach
#1
REVIEW
Victor C Kok, Ping-Hsueh Lee
Hypoglycemia due to underlying terminal illness in nondiabetic end-of-life patients receiving palliative care has not been fully studied. For example, we do not have adequate information on the frequency of spontaneous hypoglycemia in patients as occurs during the different stages of palliative care. Depending on the case-mix nature of the palliative care ward, at least 2% of palliative care patients may develop hypoglycemia near the end of life when the remaining life expectancy counts down in days. As many as 25%-60% of these patients will neither have autonomic response nor have neuroglycopenic symptoms during a hypoglycemic episode...
2016: Palliative Care
https://www.readbyqxmd.com/read/27918778/efficacy-of-oral-risperidone-haloperidol-or-placebo-for-symptoms-of-delirium-among-patients-in-palliative-care-a-randomized-clinical-trial
#2
Meera R Agar, Peter G Lawlor, Stephen Quinn, Brian Draper, Gideon A Caplan, Debra Rowett, Christine Sanderson, Janet Hardy, Brian Le, Simon Eckermann, Nicola McCaffrey, Linda Devilee, Belinda Fazekas, Mark Hill, David C Currow
Importance: Antipsychotics are widely used for distressing symptoms of delirium, but efficacy has not been established in placebo-controlled trials in palliative care. Objective: To determine efficacy of risperidone or haloperidol relative to placebo in relieving target symptoms of delirium associated with distress among patients receiving palliative care. Design, Setting, and Participants: A double-blind, parallel-arm, dose-titrated randomized clinical trial was conducted at 11 Australian inpatient hospice or hospital palliative care services between August 13, 2008, and April 2, 2014, among participants with life-limiting illness, delirium, and a delirium symptoms score (sum of Nursing Delirium Screening Scale behavioral, communication, and perceptual items) of 1 or more...
December 5, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27900726/survey-on-german-palliative-care-specialists-experiences-with-advance-directives
#3
Julia Zenz, Michael Zenz
INTRODUCTION: Advance directives (AD) play a central role in end-of-life treatments, intensive care, and palliative care. However, little is known about the experiences of healthcare professionals with ADs. This study reports on palliative care professionals' views on advance directives (AD). METHODS: A questionnaire was handed out to attendants of a palliative care symposium. RESULTS: Complete answers were obtained from 126 physicians and 276 nurses...
November 29, 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27896388/-dying-and-death-in-societal-transformation
#4
Andreas Heller, Klaus Wegleitner
Dying and death in modern societies are subject to profound social, professional and cultural-religious changes. Secularization and a stronger differentiation of societies have led to a change in the way humans handle the dying process. Normatively ritualized collective behaviour has been replaced by an individual, subjectivized approach. In late modern societies there are many different views of what "successful" or "good" dying means.In the article this change is described by the following seven theses: 1...
November 28, 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/27892676/palliative-care-for-patients-with-gynecologic-cancer-in-japan-a-japan-society-of-gynecologic-palliative-medicine-jsgpm-survey
#5
Masayuki Futagami, Yoshihito Yokoyama, Tetsumi Sato, Kazuyoshi Hirota, Muneaki Shimada, Etsuko Miyagi, Nao Suzuki, Masaki Fujimura
Purpose: To evaluate palliative care for patients with gynecologic cancer in Japan. Materials and Method: A questionnaire asking facility characteristics, systems to coordinate palliative care, current status of end-of-life care, provision of symptom relief, palliative radiation therapy and chemotherapy, and cases of death from gynecological cancer, was mailed to facilities treating gynecologic cancer. Results: A total of 115 facilities (29.3% of the total) responded to the questionnaire. Of these, 33.0 (29...
January 10, 2016: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/27878330/-volunteering-in-end-of-life-care-challenges-problems-and-perspectives
#6
Werner Schneider
Volunteering in the hospice movement has had a profound impact on generating awareness of hospice work and palliative care in the context of supporting dying persons and their relatives as well as on integrating respective services in the existing health care system. This paper focuses on two specific questions: First, it asks how society is changing with respect to dealing with dying and death, and more precisely with dying persons, which is recognizable by the integration of hospice work and palliative care in the healthcare system and related to the relevance of volunteering in the sense of a citizens' movement...
November 22, 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/27875835/the-relevance-of-palliative-care-in-hiv-and-aging
#7
Jacqueline Shorthill, Rosanna F DeMarco
The connection between palliative care and HIV infection has deep and wide roots in the United States that go back to the time when many gay men in the early 1980s were dying from a disease we knew little about, and there was no way to help but to alleviate symptoms in hospice and end of life centers across the United States. More individuals (adults and children), families, and communities attribute the success of antiretroviral therapies and other therapeutic approaches to advancing quality of life and life itself today...
2017: Interdisciplinary Topics in Gerontology and Geriatrics
https://www.readbyqxmd.com/read/27871287/perspectives-on-death-and-dying-a-study-of-resident-comfort-with-end-of-life-care
#8
Jessica M Schmit, Lynne E Meyer, Jennifer M Duff, Yunfeng Dai, Fei Zou, Julia L Close
BACKGROUND: Despite the benefits to early palliative care in the treatment of terminal illness, barriers to timely hospice referrals exist. Physicians who are more comfortable having end-of-life (EOL) conversations are more likely to refer to hospice. However, very little is known about what factors influence comfort with EOL care. METHODS: An anonymous survey was sent to all the residents and fellows at a single institution. Self-reported education, experience and comfort with EOL care was assessed...
November 21, 2016: BMC Medical Education
https://www.readbyqxmd.com/read/27824514/30-day-readmission-rates-in-patients-admitted-for-heart-failure-exacerbation-with-and-without-palliative-care-consultation-a-retrospective-cohort-study
#9
Elizabeth Chuang, Gina Kim, Arthur E Blank, William Southern, James Fausto
BACKGROUND: Palliative care consultation improves quality of care through symptom management, communication, care coordination, and earlier hospice referral, and it may decrease burdensome hospital readmissions at the end of life. OBJECTIVES: To compare 30-day readmission rates for patients admitted with exacerbation of congestive heart failure (CHF) receiving palliative care consultation services compared with controls. DESIGN: Retrospective cohort study using propensity score matching...
November 8, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27821313/systematic-versus-on-demand-early-palliative-care-a-randomised-clinical-trial-assessing-quality-of-care-and-treatment-aggressiveness-near-the-end-of-life
#10
Marco Maltoni, Emanuela Scarpi, Monia Dall'Agata, Stefania Schiavon, Claudia Biasini, Carla Codecà, Chiara Maria Broglia, Elisabetta Sansoni, Roberto Bortolussi, Ferdinando Garetto, Luisa Fioretto, Maria Teresa Cattaneo, Alice Giacobino, Massimo Luzzani, Giovanna Luchena, Sara Alquati, Silvia Quadrini, Vittorina Zagonel, Luigi Cavanna, Daris Ferrari, Paolo Pedrazzoli, Giovanni Luca Frassineti, Antonella Galiano, Andrea Casadei Gardini, Manlio Monti, Oriana Nanni
AIM: Early palliative care (EPC) in oncology has shown sparse evidence of a positive impact on patient outcomes, quality of care outcomes and costs. PATIENTS AND METHODS: Data for this secondary analysis were taken from a trial of 207 outpatients with metastatic pancreatic cancer randomly assigned to receive standard cancer care plus on-demand EPC (standard arm) or standard cancer care plus systematic EPC (interventional arm). After 20 months' follow-up, 149 (80%) had died...
November 4, 2016: European Journal of Cancer
https://www.readbyqxmd.com/read/27801708/pediatric-critical-care-transport-as-a-conduit-to-terminal-extubation-at-home-a-case-series
#11
Corina Noje, Meghan L Bernier, Philomena M Costabile, Bruce L Klein, Sapna R Kudchadkar
OBJECTIVES: To present our single-center's experience with three palliative critical care transports home from the PICU for terminal extubation. DESIGN: We performed a retrospective chart review of patients transported between January 1, 2012, and December 31, 2014. SETTING: All cases were identified from our institutional pediatric transport database. PATIENTS: Patients were terminally ill children unable to separate from mechanical ventilation in the PICU, who were transported home for terminal extubation and end-of-life care according to their families' wishes...
October 28, 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27781097/understanding-the-relationship-transitions-and-associated-end-of-life-clinical-needs-of-young-adults-with-life-limiting-illnesses-a-triangulated-longitudinal-qualitative-study
#12
Bridget Johnston, Divya Jindal-Snape, Jan Pringle, Libby Gold, Jayne Grant, Raymond Dempsey, Ros Scott, Pat Carragher
BACKGROUND: Care of young adults with life-limiting illnesses can often be complex due to the fact that they are growing and developing within the continuing presence of their illness. There is little research conducted nationally and internationally, which has examined the life issues of young adults or taken a longitudinal approach to understand such issues over a period of time. AIM: To gain clear understanding of one particular and pertinent life issue-relationship transition-occurring in the context of being a young adult with a life-limiting illness and the clinical needs arising from this...
2016: SAGE Open Medicine
https://www.readbyqxmd.com/read/27763399/vsed-death-with-dignity-or-without
#13
Mark Corbett
Conceivably, in an ideal world, all patients with a life-limiting illness would receive optimal hospice and palliative care so that no one would ever wish to hasten their own death. The reality, however, is that despite provision of optimal hospice and palliative care, individuals with terminal illness experience suffering, loss of meaning, or deterioration in quality of life to the extent where they express the desire to expedite the dying process. While there has been extensive discussion surrounding physician-assisted death (PAD), there has been less attention paid to the practice of voluntary stopping eating and drinking (VSED) near the end of life...
2016: Narrative Inquiry in Bioethics
https://www.readbyqxmd.com/read/27758809/dying-with-a-left-ventricular-assist-device-as-destination-therapy
#14
Shannon M Dunlay, Jacob J Strand, Sara E Wordingham, John M Stulak, Angela J Luckhardt, Keith M Swetz
BACKGROUND: Despite the ability of left ventricular assist device as destination therapy (DT-LVAD) to prolong survival for many patients with advanced heart failure, little is known about the eventual end-of-life care that patients with DT-LVAD receive. METHODS AND RESULTS: All patients undergoing DT-LVAD at the Mayo Clinic in Rochester, Minnesota, from January 1, 2007, to September 30, 2014, who subsequently died before July 1, 2015, were included. Information about end-of-life care was obtained from documentation in the electronic medical record...
October 2016: Circulation. Heart Failure
https://www.readbyqxmd.com/read/27742606/uk-end-of-life-care-services-in-dementia-initiatives-and-sustainability-results-of-a-national-online-survey
#15
Sarah Amador, Claire Goodman, Louise Robinson, Elizabeth L Sampson
BACKGROUND: People living and dying with non-cancer diagnoses, including dementia, have poorer access to generalist and specialist palliative care than people with cancer, and experience worse outcomes in terms of pain and symptom control, and quality and experience of care. In the UK, the National Council for Palliative Care (NCPC) ran a national survey of services for end-of-life care for people with dementia (2008) in which 16 services were identified, and reported on case studies and examples of good practice...
October 14, 2016: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/27712335/we-need-to-attract-more-students-to-palliative-care
#16
(no author information available yet)
A good palliative care service is responsive, available to families where they want it, provided round the clock, and co-ordinated by a lead healthcare professional or team. This is the view of one hospice director of care in response to a draft good practice guideline on end of life care from the National Institute for Health and Care Excellence.
October 7, 2016: Nursing Children and Young People
https://www.readbyqxmd.com/read/27710829/eliciting-regret-improves-decision-making-at-the-end-of-life
#17
Benjamin Djulbegovic, Athanasios Tsalatsanis, Rahul Mhaskar, Iztok Hozo, Branko Miladinovic, Howard Tuch
INTRODUCTION: Management choices at the end of life are high-stake decisions fraught with emotions, chief among is regret. Our objective in this paper is to test the utility of a regret-based model to facilitate referral to hospice care while helping patients clarify their preferences on how they wish to spend the remaining days of their lives. METHODS: A prospective cohort study that enrolled consecutive adult patients (n = 178) aware of the terminal nature of their disease...
October 3, 2016: European Journal of Cancer
https://www.readbyqxmd.com/read/27697783/conservative-management-and-end-of-life-care-in-an-australian-cohort-with-esrd
#18
Rachael L Morton, Angela C Webster, Kevin McGeechan, Kirsten Howard, Fliss E M Murtagh, Nicholas A Gray, Peter G Kerr, Michael J Germain, Paul Snelling
BACKGROUND AND OBJECTIVES: We aimed to determine the proportion of patients who switched to dialysis after confirmed plans for conservative care and compare survival and end of life care among patients choosing conservative care with those initiating RRT. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A cohort study of 721 patients on incident dialysis, patients receiving transplants, and conservatively managed patients from 66 Australian renal units entered into the Patient Information about Options for Treatment Study from July 1 to September 30, 2009 were followed for 3 years...
October 3, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27693902/the-effect-of-pediatric-palliative-care-policy-on-hospice-utilization-among-california-medicaid-beneficiaries
#19
Lisa C Lindley
CONTEXT: California implemented pediatric palliative care legislations that allowed children to receive curative and supportive care from diagnosis of a life-threatening serious illness in 2010. Palliative care policies may improve access to hospice care as children near end of life. OBJECTIVES: The aim of this study was to examine the effect of the palliative care policy on hospice utilization for children and their families was investigated. METHODS: Using 2007 and 2010 California Medicaid data, a difference-in-difference analysis was conducted to analyze hospice use (i...
November 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/27685363/2016-aaha-iaahpc-end-of-life-care-guidelines
#20
Gail Bishop, Kathleen Cooney, Shea Cox, Robin Downing, Kathy Mitchener, Amir Shanan, Nancy Soares, Brenda Stevens, Tammy Wynn
End-of-life (EOL) care and decisionmaking embody the critical final stage in a pet's life and are as important and meaningful as the sum of the clinical care provided for all prior life stages. EOL care should focus on maximizing patient comfort and minimizing suffering while providing a collaborative and supportive partnership with the caregiver client. Timely, empathetic, and nonjudgmental communication is the hallmark of effective client support. Veterinarians should not allow an EOL patient to succumb to a natural death without considering the option of euthanasia and ensuring that other measures to alleviate discomfort and distress are in place...
November 2016: Journal of the American Animal Hospital Association
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