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Advance care planning, end of life

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https://www.readbyqxmd.com/read/29328354/end-of-life-conversations-as-a-legacy
#1
Jeanne M Sorrell
Advance directives such as living wills and health care powers of attorney are important documents that offer patients ways to avoid unwanted care when they are unable to express their wishes. Although health care professionals have increased focus on advance care planning in recent years, approximately two thirds of American adults do not have advance medical directives. In addition, 90% of individuals believe that talking to loved ones about end-of-life wishes is important, but only 27% have done so. It is important for nurses to understand the complex factors that influence how individuals make health care decisions and identify ways to encourage conversations with family, friends, and health care providers to help clarify patients' wishes for endof-life care...
January 1, 2018: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/29314264/a-practical-guide-for-the-care-of-patients-with-end-stage-renal-disease-near-the-end-of-life
#2
Amar D Bansal, Jane O Schell
Most patients who rely on dialysis for treatment of end-stage renal disease (ESRD) never receive a kidney transplant. Therefore, it is important for nephrology providers to feel comfortable discussing the role of dialysis near the end of life (EOL). Advance care planning (ACP) is an ongoing process of learning patient values and goals in an effort to outline preferences for current and future care. This review presents a framework for how to incorporate ACP in the care of dialysis patients throughout the kidney disease course and at the EOL...
January 3, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29302603/what-are-the-ethical-dimensions-in-the-profession-of-intensive-care-specialist
#3
REVIEW
Jean-Pierre Quenot, Fiona Ecarnot, Nicolas Meunier-Beillard, Auguste Dargent, Jean-Pierre Eraldi, François Bougerol, Audrey Large, Pascal Andreu, Jean-Philippe Rigaud
Two essential components of the profession of a medical doctor are the constant review of the patient's therapeutic project, and collaboration between healthcare professionals. The profession of intensive care unit (ICU) physician goes further in terms of responsibility, vis-à-vis the intensive treatments dispensed to the patients, and the physician's responsibilities towards the patient's family and the caregiving team, also bearing in mind that ICU care is costly in terms of human and financial resources...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29298109/the-progression-of-end-of-life-wishes-and-concordance-with-end-of-life-care
#4
Jennifer Hopping-Winn, Juliette Mullin, Laurel March, Michelle Caughey, Melissa Stern, Jill Jarvie
Since 2013, Kaiser Permanente Northern California has engaged in a systematic effort to elicit, document, and honor the care preferences of patients as they near the end of life. This is done through its Advanced Steps program, in which selected patients discuss their preferences for future medical care with their healthcare agent during a structured conversation with a trained advance care planning facilitator. The facilitator then translates the patient's wishes into an actionable medical order set using a Physician's Order for Life-Sustaining Treatment (POLST) form...
January 3, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29298104/associations-between-mild-cognitive-dysfunction-and-end-of-life-outcomes-in-patients-with-advanced-cancer
#5
Keiko Kurita, M Cary Reid, Eugenia L Siegler, Eli L Diamond, Holly G Prigerson
BACKGROUND: Cognitive function of patients with advanced cancer is frequently compromised. OBJECTIVE: To determine the extent that patients' cognitive screening scores was associated with their end-of-life (EoL) treatment preferences, advance care planning (ACP), and care. DESIGN: Patients were interviewed at baseline and administered a cognitive screen. Caregivers completed a postmortem assessment. SETTING/SUBJECTS: Patients with distant metastases and disease progression after first-line chemotherapy and their caregivers (n = 609) were recruited from outpatient clinics and completed baseline and postmortem assessments...
January 3, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29290278/validation-of-the-decisional-conflict-scale-for-evaluating-advance-care-decision-conflict-in-community-dwelling-older-adults
#6
JinShil Kim, Shinmi Kim, Sun Woo Hong, Se-Won Kang, Minjeong An
PURPOSE: Decisional conflict is a significant and important barrier in end-of-life care planning, and it is often encountered in health professionals' discussions with patients and their families. Little is known about the measurement of decisional conflict, and existing measures are not suitable for all contexts. In this study, psychometric properties of the Decisional Conflict Scale, which was translated for the first time into Korean [Korean version of DCS (K-DCS)], were examined. METHODS: A sample of 273 community-dwelling elders was surveyed (mean age: 77...
December 2017: Asian Nursing Research
https://www.readbyqxmd.com/read/29288287/a-contemporary-paradigm-integrating-spirituality-in-advance-care-planning
#7
Katie Lutz, Stefan R Rowniak, Prabjot Sandhu
In the 25 years since advance care planning first drew the attention of the national healthcare and legal systems, gains in the rate of advance care directive completion have been negligible despite the effort of researchers, ethicists, and lawmakers. With the benefit of sophisticated healthcare technology, patients are living longer. Despite the benefits of increased longevity, it is widely acknowledged that enough has not been done to adequately address end-of-life care decisions at the crossroads between medical futility and quality of life...
December 29, 2017: Journal of Religion and Health
https://www.readbyqxmd.com/read/29283871/resources-for-educating-training-and-mentoring-all-physicians-providing-palliative-care
#8
James Downar
This article presents a rapid review of the published literature and available resources for educating Canadian physicians to provide palliative and end-of-life care. Several key messages emerge from the review. First, there are many palliative care educational resources already available for Canadian physicians. Second, the many palliative care education resources are often not used in physician training. Third, we know that some palliative care educational interventions are inexpensive and scalable, while others are costly and time-consuming; we know very little about which palliative care educational interventions impact physician behavior and patient care...
January 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29283867/the-impact-of-public-health-awareness-campaigns-on-the-awareness-and-quality-of-palliative-care
#9
Jane Seymour
OBJECTIVE: The right to health includes a right of access to good quality palliative care, but inequalities persist. Raising awareness is a key plank of the public health approach to palliative care, but involves consideration of subjects most of us prefer not to address. This review addresses the question: "do public health awareness campaigns effectively improve the awareness and quality of palliative care"? BACKGROUND: The evidence shows that public awareness campaigns can improve awareness of palliative care and probably improve quality of care, but there is a lack of evidence about the latter...
January 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29282112/religious-leaders-perceptions-of-advance-care-planning-a-secondary-analysis-of-interviews-with-buddhist-christian-hindu-islamic-jewish-sikh-and-bah%C3%A3-%C3%A3-leaders
#10
Amanda Pereira-Salgado, Patrick Mader, Clare O'Callaghan, Leanne Boyd, Margaret Staples
BACKGROUND: International guidance for advance care planning (ACP) supports the integration of spiritual and religious aspects of care within the planning process. Religious leaders' perspectives could improve how ACP programs respect patients' faith backgrounds. This study aimed to examine: (i) how religious leaders understand and consider ACP and its implications, including (ii) how religion affects followers' approaches to end-of-life care and ACP, and (iii) their implications for healthcare...
December 28, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29235422/-the-importance-of-planning-for-the-future-burden-and-unmet-needs-of-caregivers-in-advanced-heart-failure-a-mixed-methods-study
#11
Sonja McIlfatrick, Leanne C Doherty, Mary Murphy, Lana Dixon, Patrick Donnelly, Kenneth McDonald, Donna Fitzsimons
BACKGROUND: While studies have evaluated caregiver outcomes in heart failure, the burden and support needs when caring for someone with advanced heart failure at the end of life have yet to be outlined. AIM: To identify psychosocial factors associated with caregiver burden and evaluate the support needs of caregivers in advanced heart failure. DESIGN: A sequential mixed methods study comprising two phases: (1) postal survey with advanced heart failure patients and their caregivers and (2) interviews with current and bereaved caregivers...
December 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29206578/wellness-in-sickness-and-health-the-w-i-s-h-project-advance-care-planning-preferences-and-experiences-among-elderly-latino-patients
#12
Lauren Y Maldonado, Ruth B Goodson, Matthew C Mulroy, Emily M Johnson, Jo M Reilly, Diana C Homeier
OBJECTIVE: To assess advance care planning (ACP) preferences, experiences, and comfort in discussing end-of-life (EOL) care among elderly Latinos. METHODS: Patients aged 60 and older from the Los Angeles County and University of Southern California (LAC+USC) Medical Center Geriatrics Clinic (n = 41) participated in this intervention. Trained staff conducted ACP counseling with participants in their preferred language, which included: (a) pre-counseling survey about demographics and EOL care attitudes, (b) discussion of ACP and optional completion of an advance directive (AD), and (c) post-session survey...
October 25, 2017: Clinical Gerontologist
https://www.readbyqxmd.com/read/29206553/development-of-imminent-mortality-predictor-for-advanced-cancer-impac-a-tool-to-predict-short-term-mortality-in-hospitalized-patients-with-advanced-cancer
#13
Kerin Adelson, Donald K K Lee, Salimah Velji, Junchao Ma, Susan K Lipka, Joan Rimar, Peter Longley, Teresita Vega, Javier Perez-Irizarry, Edieal Pinker, Rogerio Lilenbaum
PURPOSE: End-of-life care for patients with advanced cancer is aggressive and costly. Oncologists inconsistently estimate life expectancy and address goals of care. Currently available prognostication tools are based on subjective clinical assessment. An objective prognostic tool could help oncologists and patients decide on a realistic plan for end-of-life care. We developed a predictive model (Imminent Mortality Predictor in Advanced Cancer [IMPAC]) for short-term mortality in hospitalized patients with advanced cancer...
December 5, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29201947/older-adults-more-likely-to-discuss-advance-care-plans-with-an-attorney-than-with-a-physician
#14
Mercedes Bern-Klug, Elizabeth A Byram
Adults are encouraged to discuss their end-of-life health care preferences so that their wishes will be known and hopefully honored. The purpose of this study was to determine with whom older adults had communicated their future health care wishes and the extent to which respondents themselves were serving as a surrogate decision maker. Results from the cross-sectional online survey with 294 persons aged 50 and older reveal that among the married, over 80% had a discussion with their spouse and among those with an adult child, close to two thirds (64%) had...
January 2017: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/29200118/palliative-care-end-of-life-care-and-advance-care-planning-in-neuro-oncology
#15
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/29198094/-from-pastoral-care-to-spiritual-care-transforming-the-conception-of-the-role-of-the-spiritual-care-provider
#16
REVIEW
Michael Schultz, Netta Bentur, Ziv Rei Koren, Gil Bar Sela
Spirituality is a difficult concept to define, one that is often understood differently by different cultures and religious communities. Illness constitutes a dramatic change in the ongoing flow and norms of a person's life, raising questions of the value or meaning of life, questions of self-worth, and questions of forgiveness, to ourselves and others. The profession of spiritual care comes to provide support in these areas. Originally focused on religious care, the profession has shifted to providing care for general spiritual well-being, where professionals care for all patients regardless of religion...
November 2017: Harefuah
https://www.readbyqxmd.com/read/29191183/an-economic-model-of-advance-care-planning-in-australia-a-cost-effective-way-to-respect-patient-choice
#17
Kim-Huong Nguyen, Marcus Sellars, Meera Agar, Sue Kurrle, Adele Kelly, Tracy Comans
BACKGROUND: Advance care planning (ACP) is a process of planning for future health and personal care. A person's values and preferences are made known so that they can guide decision making at a future time when that person cannot make or communicate his or her decisions. This is particularly relevant for people with dementia because their ability to make decisions progressively deteriorates over time. This study aims to evaluate the cost-effectiveness of delivering a nationwide ACP program within the Australian primary care setting...
December 1, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29189085/sharing-end-of-life-care-preferences-with-family-members-who-has-the-discussion-and-who-does-not
#18
Lindsay J Peterson, Debra Dobbs, Hongdao Meng, Alyssa Gamaldo, Kevin O'Neil, Kathryn Hyer
BACKGROUND: Research suggests that greater engagement in family discussions concerning end-of-life (EOL) care preferences could improve advance care planning and EOL outcomes. However, a substantial number of people have not had such discussions. OBJECTIVE: The study's objective was to understand attitudes and experiences influencing engagement in discussions of EOL care preferences with family members, including the role of healthcare providers in such discussions...
November 30, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29183927/challenges-to-discussing-palliative-care-with-people-experiencing-homelessness-a-qualitative-study
#19
Briony F Hudson, Caroline Shulman, Joseph Low, Nigel Hewett, Julian Daley, Sarah Davis, Nimah Brophy, Diana Howard, Bella Vivat, Peter Kennedy, Patrick Stone
OBJECTIVES: To explore the views and experiences of people who are homeless and those supporting them regarding conversations and approaches to palliative care SETTING: Data were collected between October 2015 and October 2016 in homeless hostels and day centres and with staff from primary and secondary healthcare providers and social care services from three London boroughs. PARTICIPANTS: People experiencing homelessness (n=28), formerly homeless people (n=10), health and social care providers (n=48), hostel staff (n=30) and outreach staff (n=10)...
November 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/29172890/challenges-to-advance-care-planning-among-multidisciplinary-health-professionals-in-china
#20
Mei Ching Lee, Roger Auth, Katherine A Hinderer, Carla S Alexander
BACKGROUND: Advance care planning (ACP) is a critical component of quality end-of-life care. Little is known regarding the cultural influences on health professionals' attitudes toward the discussion of ACP in China. OBJECTIVE: To better understand attitudes toward ACP among Chinese healthcare professionals in China and the influence of cultural factors such as filial piety, or xiào. METHODS: A mixed methods study was used. This study reports the results of a descriptive cross-sectional survey of physicians, nurses and social workers with experience in palliative and end-of-life care...
November 2, 2017: International Journal of Palliative Nursing
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