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Hospice care

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https://www.readbyqxmd.com/read/28073292/health-care-utilization-after-hospice-enrollment-in-patients-with-heart-failure-and-cancer
#1
Meredith A MacKenzie, Alexandra Hanlon
This study aimed to examine the role of diagnosis in health-care utilization patterns after hospice enrollment. Using 2007 National Home and Hospice Care Survey data from hospice patients with heart failure (n = 311) and cancer (n = 946), we analyzed emergency service use and discharge to hospital via logistic regression pre- and postpropensity score matching. Prematching, patients with heart failure had twice the odds of emergency services use than patients with cancer ( P < .001) and twice the odds of discharge to hospital ( P = ...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28072478/the-difficulties-experienced-by-nurses-and-healthcare-staff-involved-in-the-process-of-breaking-bad-news
#2
Clare Warnock, Jean Buchanan, Angela Mary Tod
AIMS: To explore the difficulties experienced by nurses and healthcare professionals when engaging in the process of breaking bad news BACKGROUND: The challenges faced by staff when breaking bad news have previously been researched in relation to particular settings or subjects. This study involved staff from diverse settings and roles to develop broader insights into the range of difficulties experienced in clinical practice. DESIGN: The study used a descriptive survey design involving self-reported written accounts and framework analysis...
January 10, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28063867/-it-s-like-heart-failure-it-s-chronic%C3%A2-and-it-will-kill-you-a-qualitative-analysis-of-burnout-among-hospice-and-palliative-care-clinicians
#3
Dio Kavalieratos, Daniel E Siconolfi, Karen E Steinhauser, Janet Bull, Robert M Arnold, Keith M Swetz, Arif H Kamal
CONTEXT: Although prior surveys have identified rates of self-reported burnout among palliative care clinicians as high as 62%, limited data exist to elucidate the causes, ameliorators, and effects of this phenomenon. OBJECTIVES: We explored burnout among palliative care clinicians, specifically their experiences with burnout, their perceived sources of burnout, and potential individual, interpersonal, organizational, and policy-level solutions to address burnout...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28063859/assessing-palliative-care-content-in-dementia-care-guidelines-a-systematic-review
#4
REVIEW
Pamela Durepos, Abigail Wickson-Griffiths, Afeez Abiola Hazzan, Sharon Kaasalainen, Vasilia Vastis, Lisa Battistella, Alexandra Papaioannou
CONTEXT: Families of persons with dementia continue to report unmet needs during end-of-life. Strategies to improve care and quality of life for persons with dementia include development of clinical practice guidelines (CPG) and an integrative palliative approach. OBJECTIVES: We aimed to assess palliative care content in dementia CPGs in order to identify the presence or limitations of recommendations and discussion pertaining to common issues or domains affected by illness as described by the Canadian Hospice Palliative Care 'Square of Care'...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28062473/treatment-targeted-at-underlying-disease-versus-palliative-care-in-terminally-ill-patients-a-systematic-review
#5
Tea Reljic, Ambuj Kumar, Farina A Klocksieben, Benjamin Djulbegovic
OBJECTIVE: To assess the efficacy of active treatment targeted at underlying disease (TTD)/potentially curative treatments versus palliative care (PC) in improving overall survival (OS) in terminally ill patients. DESIGN: We performed a systematic review and meta-analysis of randomised controlled trials (RCT). Methodological quality of included RCTs was assessed using the Cochrane risk of bias tool. DATA SOURCES: Medline and Cochrane databases were searched, with no language restriction, from inception to 19 October 2016...
January 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28062341/implementation-and-impact-of-patient-lay-navigator-led-advance-care-planning-conversations
#6
Gabrielle B Rocque, J Nicholas Dionne-Odom, Chao-Hui Sylvia Huang, Soumya J Niranjan, Courtney P Williams, Bradford E Jackson, Karina I Halilova, Kelly M Kenzik, Kerri S Bevis, Audrey S Wallace, Nedra Lisovicz, Richard A Taylor, Maria Pisu, Edward E Partridge, Linda A Briggs, Elizabeth A Kvale
CONTEXT: Advance care planning (ACP) improves alignment between patient preferences for life-sustaining treatment and care received at end of life (EOL). OBJECTIVES: To evaluate implementation of lay navigator-led ACP. METHODS: A convergent, parallel mixed-methods design was employed to evaluate implementation of navigator-led ACP across 12 cancer centers. Data collection included: (1) electronic navigation records, (2) navigator surveys (n=45), (3) claims-based patient outcomes (n=820), and (4) semi-structured navigator interviews (n=26)...
January 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28057703/advance-directives-and-end-of-life-care-among-nursing-home-residents-receiving-maintenance-dialysis
#7
Manjula Kurella Tamura, Maria E Montez-Rath, Yoshio N Hall, Ronit Katz, Ann M O'Hare
BACKGROUND AND OBJECTIVES: Little is known about the relation between the content of advance directives and downstream treatment decisions among patients receiving maintenance dialysis. In this study, we determined the prevalence of advance directives specifying treatment limitations and/or surrogate decision-makers in the last year of life and their association with end-of-life care among nursing home residents. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using national data from 2006 to 2007, we compared the content of advance directives among 30,716 nursing home residents receiving dialysis to 30,825 nursing home residents with other serious illnesses during the year before death...
January 5, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28056515/race-ethnicity-as-a-predictor-for-location-of-death-in-patients-with-acute-neurovascular-events
#8
Say Salomon, Elizabeth Chuang, Deepa Bhupali, Daniel Labovitz
BACKGROUND: Site of death is an important quality indicator for patients with terminal illness. Racial and ethnic disparities exist in the quality of end-of-life care. This study explores the site of death of patients admitted for and dying of complications of acute neurovascular events in a hospital network in an urban, low-income, predominantly minority community. METHODS: This is a retrospective cohort study of patients admitted to 1 of 3 general hospitals that are part of an academic medical center in Bronx, New York, with the diagnosis of acute ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage who died during the index admission or were discharged with hospice services...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28056514/race-as-a-predictor-of-palliative-care-referral-time-hospice-utilization-and-hospital-length-of-stay
#9
Brooke Worster, Declan Kennedy Bell, Vibin Roy, Amy Cunningham, Marianna LaNoue, Susan Parks
BACKGROUND: Palliative care is associated with significant benefits, including reduced pain and suffering, an increased likelihood of patients dying in their preferred location, and decreased health-care expenditures. Racial and ethnic disparities are well-documented in hospice use and referral patterns; however, it is unclear whether these disparities apply to inpatient palliative care services. OBJECTIVE: To determine if race is a significant predictor of time to inpatient palliative care consult, patient enrollment in hospice, and patients' overall hospital length of stay among patients of an inpatient palliative care service...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28056185/a-trial-of-concurrent-care-shedding-light-on-the-gray-zone
#10
Annemarie Hargadon, Quy Tran, Karen Stephen, Howard Homler
BACKGROUND: Patients are hospice eligible when they have an estimated prognosis of 6 months and the readiness to forgo attempts at disease-modifying treatments related to their terminal illness. The decision to enroll in hospice is relatively clear when the prognosis is based on an incurable illness for which there are no further life-prolonging therapies. However, when the prognosis is based on a serious chronic illness for which possible interventions remain but must be forgone to access hospice support, the decision process is more complex...
February 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28056184/feasibility-of-retrospective-pharmacovigilance-studies-in-hospice-care-a-case-study-of-antibiotics-for-the-treatment-of-urinary-tract-infections
#11
Jon P Furuno, Brie N Noble, David T Bearden, Erik K Fromme
No abstract text is available yet for this article.
January 5, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28043807/on-the-ground-floor-looking-up-managing-trainees-uncertainty-at-the-end-of-life
#12
Ravi B Parikh, Dhruv Khullar
Recent US healthcare policy changes set the stage for integrating palliative and end-of-life care into routine medicine. However, these changes may not affect the daily practice of medical trainees-fellows, residents, and medical students-who as front-line care providers are not always equipped with the skills needed to treat terminally ill patients. We review evidence on trainees' discomfort with end-of-life care and highlight limitations of recent policy changes. Key barriers to proficiency include inadequate conversational training, prognostic uncertainty, and unfamiliarity with hospice and palliative care...
December 30, 2016: Healthcare
https://www.readbyqxmd.com/read/28042068/empowering-bereaved-parents-through-the-development-of-a-comprehensive-bereavement-program
#13
Jennifer M Snaman, Erica C Kaye, Deena R Levine, Brittany Cochran, Robin Wilcox, Charlene K Sparrow, Nancy Noyes, Lisa Clark, Wendy Avery, Justin N Baker
Parents who experience the loss of a child have unique and valuable insights into the grief journey and can help healthcare providers identify key components intrinsic to the development, implementation, and maintenance of a comprehensive bereavement program. The bereavement program at St. Jude Children's Research Hospital was developed by pediatric palliative care experts in collaboration with bereaved parents to standardize and improve the institutional support provided to families around and after the death of a child...
December 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28042066/repurposing-medications-for-hospice-palliative-care-symptom-control-is-no-longer-sufficient-a-manifesto-for-change
#14
David C Currow, Amy P Abernethy, Marie Fallon, Russell K Portenoy
The World Health Organisation (WHO) essential medications list for hospice / palliative care reflects that, with the judicious use of currently available medications, the majority of symptoms can be lessened, and some controlled completely. Even with optimal use of current medications, symptom control is still unacceptable for many people. Currently available medications offer great benefit to a minority of patients, some benefit to an additional group, and no benefit or harms to others. In symptom control, development of new drugs is advancing at a glacial pace, contrasting to the rapid advances seen in many other disciplines...
December 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28039504/end-of-life-care-for-head-and-neck-cancer-patients-a-population-based-study
#15
Tzu-Lung Kuo, Ching-Heng Lin, Rong-San Jiang, Ting-Ting Yen, Chen-Chi Wang, Kai-Li Liang
PURPOSE: Head and neck cancers (HNCs) usually present a poor prognosis and cause high morbidity rates. Recent surveys have demonstrated that HNC incidence rates are still on the increase in many countries. Our study objective was to assess the end-of-life care for patients with HNCs in Taiwan. METHODS: Data was retrieved from Taiwan's National Health Insurance Research Database, where we identified patients who had been diagnosed with HNCs from January 1997 to December 2010...
December 30, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28038669/development-and-validation-of-a-new-patient-experience-tool-in-patients-with-serious-illness
#16
Karl M Fernstrom, Nathan D Shippee, Alissa L Jones, Heather R Britt
BACKGROUND: Patients with serious chronic illnesses face increasingly complex care and are at risk of poor experience due to a fragmented health system. Most current patient experience tools are not designed to address the unique care aspects of this population and the few that exist are delivered too late in the disease trajectory and are not administered longitudinally which makes them less useful across settings. METHODS: We developed a new tool designed to address these gaps...
December 30, 2016: BMC Palliative Care
https://www.readbyqxmd.com/read/28031417/serious-illness-conversations-in-esrd
#17
Ernest I Mandel, Rachelle E Bernacki, Susan D Block
Dialysis-dependent ESRD is a serious illness with high disease burden, morbidity, and mortality. Mortality in the first year on dialysis for individuals over age 75 years old approaches 40%, and even those with better prognoses face multiple hospitalizations and declining functional status. In the last month of life, patients on dialysis over age 65 years old experience higher rates of hospitalization, intensive care unit admission, procedures, and death in hospital than patients with cancer or heart failure, while using hospice services less...
December 28, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28029712/caregiver-patient-and-nurse-visit-communication-patterns-in-cancer-home-hospice
#18
Maija Reblin, Margaret Clayton, Jiayun Xu, Jennifer Hulett, Seth Latimer, Gary Donaldson, Lee Ellington
OBJECTIVE: Few studies have examined the triadic communication between patients, spouse caregivers, and nurses in the home hospice setting. Thus, little is known about the types of communication patterns that unfold. The goals of the study were to first, identify common patterns of communication in home hospice nurse-patient-caregiver home hospice visits and second, to identify nurse, caregiver-patient dyad, and visit characteristics that predict visit communication patterns. METHOD: Nurses (n = 58) and hospice cancer patient and spouse caregiver dyads (n = 101; 202 individuals) were recruited from 10 hospice agencies...
December 28, 2016: Psycho-oncology
https://www.readbyqxmd.com/read/28029586/social-determinants-multimorbidity-and-patterns-of-end-of-life-care-in-older-adults-dying-from-cancer
#19
Siran M Koroukian, Nicholas K Schiltz, David F Warner, Charles W Given, Mark Schluchter, Cynthia Owusu, Nathan A Berger
OBJECTIVE: Most prior studies on aggressive end-of-life care in older patients with cancer have accounted for social determinants of health (e.g., race, income, and education), but rarely for multimoribidity (MM). In this study, we examine the association between end-of-life care and each of the social determinants of health and MM, hypothesizing that higher MM is associated with less aggressive care. METHODS: From the linked 1991-2008 Health and Retirement Study, Medicare data, and the National Death Index, we identified fee-for-service patients age ≥66years who died from cancer (n=835)...
October 28, 2016: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28029300/hospice-utilization-and-its-effect-on-acute-care-needs-at-the-end-of-life-in-medicare-beneficiaries-with-hepatocellular-carcinoma
#20
Hanna K Sanoff, YunKyung Chang, Melissa Reimers, Jennifer L Lund
INTRODUCTION: Hepatocellular carcinoma (HCC) is a poor-prognosis cancer with a high symptom burden. Multidisciplinary HCC care is complex and unique in cancer medicine. We sought to determine whether the distinct process affects hospice use and how hospice affects end-of-life acute care utilization. PATIENTS AND METHODS: Patients dying after HCC diagnosed from 2004 to 2011 were identified within SEER-Medicare. Hospice use and associated factors were described using logistic regression...
December 28, 2016: Journal of Oncology Practice
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