Palliative care, end of life care, hospice

BACKGROUND: Deficiencies or imbalances in a person's intake of nutrients are referred to as malnutrition. Malnutrition remains a significant public health concern in the United States, with potential consequences ranging from chronic disease to mortality. This study aims to assess the disparities in place of death due to malnutrition in the United States from 1999 to 2020, based on variables like age, gender, race, and location, utilizing the Centers for Disease Control and Prevention Information and Communication Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database...

PURPOSE: To gather sufficient qualitative data to create an intervention that would prevent direct care workers (DCWs) from sending residents with do-not-hospitalize (DNH) orders to the hospital. METHOD: This was a qualitative study with eight participants that included a descriptive survey followed by semi-structured interviews. RESULTS: DCWs were unfamiliar with DNH orders and their thinking on end-of-life care was binary (hospice or hospital) and protocol driven...

OBJECTIVES: Interventions for patients with death rattle remain under consideration, and their families strongly acknowledge the need for improved care. However, few reports exist concerning specific and comprehensive nursing practices for them. This study aimed to clarify nursing practices for patients with death rattle and their families in hospital wards and examine each practice's importance. METHODS: We used a modified Delphi method with expert nurses with extensive experience in end-of-life care...

BACKGROUND: End-of-life (EoL) care volunteers in hospitals are a novel approach to support patients and their close ones. The iLIVE Volunteer Study supported hospital volunteer coordinators from five European countries to design and implement an EoL care volunteer service on general wards in their hospitals. This study aimed to identify and explore barriers and facilitators to the implementation of EoL care volunteer services in the five hospitals. METHODS: Volunteer coordinators (VCs) from the Netherlands (NL), Norway (NO), Slovenia (SI), Spain (ES) and United Kingdom (UK) participated in a focus group interview and subsequent in-depth one-to-one interviews...

BACKGROUND: There is a dearth of studies evaluating the utility of reporting prognostication among nursing home (NH) residents with cancer. OBJECTIVE: To study factors associated with documented less than six-month prognosis, and its relationship with end-of-life (EOL) care quality measures among residents with cancer. METHODS: The Surveillance, Epidemiology, and End Results linked with Medicare, and the Minimum Data Set databases was used to identify 20,397 NH residents in the United States with breast, colorectal, lung, pancreatic, or prostate cancer who died between July 2016 and December 2018...

Creutzfeldt-Jacob disease (CJD) is a rare neurodegenerative disorder that typically progresses rapidly and unrelentingly. Providing comfort and support for patients with CJD presents significant challenges for clinicians and caregivers. In comparison to the more typical disease progression experienced in dementias, the trajectory of CJD differs significantly. This case report delves into these differences and emphasizes the need for the development of guidelines for healthcare professionals and families who care for individuals with CJD...

Racial disparities in hospice use are a longstanding concern in the U.S. Asian Americans are among the least likely to receive hospice care and to be included in studies on this topic. This study examined the knowledge, attitudes, and preferences related to hospice care among older Chinese immigrants and associated factors. A sample of 262 Chinese immigrants age 60+ was recruited from six older adult centers in NYC. In-person interviews were conducted in Mandarin and Cantonese. Non-English-speaking older Chinese immigrants had very limited knowledge about hospice care...

BACKGROUND: As many patients are spending their last days in critical care units, it is essential that they receive appropriate end-of -life care. However, cultural differences, ethical dilemmas and preference practices can arise in the intensive care settings during the end of life. Limiting therapy for dying patients in intensive care is a new concept with no legal definition and therefore there may be confusion in interpreting the terms 'no resuscitation' and 'comfort care' among physicians in Middle East...

Harmful use of illicit drugs and/or alcohol is linked to life-limiting illness and complex health and social care needs, but people who use substances and have complex needs do not receive timely palliative care and fail to achieve quality standards for a good death. They and their families often require support from multiple health and social care services which are shown to be poorly integrated and fail to deliver interdisciplinary care. This study aimed to identify the existing barriers and facilitators within and between services in providing this population with a good death...

OBJECTIVE: To determine which groups of children with cancer for whom to apply the newly developed quality measures for end-of-life (EOL) care. STUDY DESIGN: In a series of nominal groups, panelists answered the question: "Which children, diagnoses, conditions, or prognoses should be included when examining the quality of EOL care for children with cancer?" In each group, individual panelists proposed answers to the question. After collating individual responses, each panelist ranked their 5 top answers and points were assigned (5 pts for the best answer, 4 pts the second best, etc...

We conducted a survey of Jewish attitudes towards, and experiences with, end-of-life care. Questions fell into three areas: (1) Expectations for Jewish end-of-life care; (2) Experiences with such care; and (3) Attitudes toward the "right to die." Examining denominational differences in belief in, and adherence to, Halakha (Jewish law), we confirm many expectations described in the literature. We find notable nuances in specific areas of need across Jewish denomination, and in terms of acceptance of the withdrawal of life support vs assisted suicide...

In the German context, research is lacking on the support experiences and unmet needs of informal caregivers in end-of-life situations who are geographically distanced from their ill relatives. The current study aimed at deepening our understanding of the specific end-of-life support experiences and needs of informal long-distance caregivers. The study employed an explorative design, applying qualitative interviews. Thirty-three long-distance family caregivers participated in the study (December 2021-October 2022)...

BACKGROUND: So far, there have been many studies on end-of-life nursing care education around the world, and in many cases, according to the cultural, social, and spiritual contexts of each country, the results have been different. The present study intends to gain general insight into the main components of end-of-life care in nursing education programs by reviewing scientific texts and the results of investigations. METHODS: This study was a scoping review conducted with the Arksey and O'Malley methodology updated by Peters et al...

Recognized as one of the deadliest cancers, pancreatic cancer underscores an urgent need for palliative care. We surveyed palliative care directors at all 65 National Cancer Institute (NCI) cancer centers to assess the utilization and timing of palliative care involvement in pancreatic cancer patients. 1) Does your palliative care team have a policy to get involved with every pancreatic cancer patient? a. Yes b. No 2) When palliative care is involved with pancreatic cancer patients, in what setting are you typically/primarily first asked to be involved? a...

BACKGROUND: Nurses play a unique and critical role in palliative care, and it is noteworthy that nurses often encounter ethical dilemmas in this field. OBJECTIVE: This review aims to conduct a summarised synthesis of the latest research on the ethical considerations nurses faced in palliative care. METHODS: We conducted a rigorous systematic review of relevant existing studies published in high-quality English peer-reviewed journals from January 2017 to July 2023...

OBJECTIVES: As workload increases, surgical care for patients with bone metastases is increasingly decentralised, with a shift in management away from primary bone tumour units to local centres. We must ensure that patients have similar outcomes regardless of where they receive their treatment. The aim was to develop and validate a set of quality outcome indicators (QOIs) to evaluate treatment success for patients undergoing surgery for bone metastases. METHODS: Outcome recommendations were adapted from the literature and field tested in a retrospective patient cohort to determine feasibility...

BACKGROUND: One of the challenges experienced by new graduate nurses during the transition into practice is caring for dying patients. This study aimed to determine new graduate nurses' approaches to death and dying patients and the relationship between death anxiety and death awareness. METHODS: This descriptive, cross-sectional study was conducted with 226 new graduate nurses in Istanbul, Türkiye. A personal and work environment characteristics form, the Approach to Death and Dying Patients Attitude Scale, Templer's Death Anxiety Scale, and Multidimensional Mortality Awareness Measure were used to collect data...

This article describes a quality improvement project implemented by a national postacute long-term care organization aimed at enhancing the provision of palliative care to nursing home residents. The project focused on improving advance care planning, end-of-life care, symptom management, and care of people living with serious illness. Both generalist and specialist palliative care training were provided to nurse practitioners in addition to implementing a system to identify residents most likely to benefit from a palliative approach to care...

Palliative care focuses on improving the quality of life for people with serious illnesses and their loved ones. This article introduces considerations including barriers to care, intersectionality, minority stress, microaggressions, and social safety that may impact the experience and openness of people to receive this care. The authors outline tools to address these challenges including trauma-informed care and how to recognize bias and earn trust. The authors conclude by offering a model for incorporating these assessments and tools with sample scripts to provide patient-centered and holistic palliative care...

BACKGROUND: The World Health Organization identifies pharmacists as a key resource in palliative care. However, the roles of these professionals in end-of-life care at home remain poorly understood, and community pharmacists themselves sometimes struggle to recognize their true role in this care. The aim of our study was to analyze community pharmacists' representations of their roles in palliative care at home in France. METHODS: The methodology was qualitative and based on semi-structured interviews with community pharmacists (n = 26)...