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Advance care planning, end of life

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https://www.readbyqxmd.com/read/29148907/impact-of-patients-expressed-wishes-on-their-surrogate-decision-makers-preferred-decision-making-roles-in-japan
#1
Shuji Tsuda, Mieko Nakamura, Shigeru Aoki, Hiroshi Ono, Mitsuru Takagi, Hiroki Ohashi, Junichiro Miyachi, Yoshinori Matsui, Toshiyuki Ojima
BACKGROUND: Home medical care (HMC) patients and their families are expected to prepare for end-of-life decision making. OBJECTIVE: We investigated the decision readiness of HMC patients and their family surrogates. DESIGN: Cross-sectional survey. SETTING/SUBJECTS: We collected data from dyads, consisting of a HMC patient aged 65 years or older and a family member of the patient, recruited at four Japanese primary care clinics from January 2016 to November 2016...
November 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29145731/decline-of-physical-activity-in-terminally-ill-patients-could-be-useful-for-predicting-short-term-survival
#2
Hiroki Yasui, Satoru Iwase, Keisuke Ariyoshi, Masanori Nojima, Kazuhiro Yoshiuchi
BACKGROUND: Although it is recommended that all terminally ill patients receive advance care planning (ACP), this is occasionally challenging because of the difficulty in predicting survival. There are some indexes for predicting survival, but few are accurate, especially at the terminal stages of illness. METHODS: Twenty-two patients at the terminal stages of cancer were retrospectively analyzed. We assessed their physical activity and condition using activities of daily living (ADL) scores for 1 month before the death...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29135524/a-palliative-approach-for-heart-failure-end-of-life-care
#3
Jane Maciver, Heather J Ross
PURPOSE OF REVIEW: The current review discusses the integration of guideline and evidence-based palliative care into heart failure end-of-life (EOL) care. RECENT FINDINGS: North American and European heart failure societies recommend the integration of palliative care into heart failure programs. Advance care planning, shared decision-making, routine measurement of symptoms and quality of life and specialist palliative care at heart failure EOL are identified as key components to an effective heart failure palliative care program...
November 10, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29132946/an-interview-study-of-patient-and-caregiver-perspectives-on-advance-care-planning-in-esrd
#4
Marcus Sellars, Josephine M Clayton, Rachael L Morton, Tim Luckett, William Silvester, Lucy Spencer, Carol A Pollock, Rowan G Walker, Peter G Kerr, Allison Tong
BACKGROUND: Advance care planning (ACP) empowers patients to consider and communicate their current and future treatment goals. However, it can be an emotionally charged process for patients with kidney disease and their caregivers. This study aimed to describe the perspectives and attitudes of patients with end-stage renal disease (ESRD) and their caregivers toward ACP. STUDY DESIGN: Qualitative study. SETTING & PARTICIPANTS: Patients with ESRD (n=24) and their caregivers (n=15) aged 36 to 91 years at various stages of ACP ("not commenced," "in progress," or "completed") from 3 renal services...
November 10, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29129177/copd-x-australian-and-new-zealand-guidelines-for-the-diagnosis-and-management-of-chronic-obstructive-pulmonary-disease-2017-update
#5
Ian A Yang, Juliet L Brown, Johnson George, Sue Jenkins, Christine F McDonald, Vanessa M McDonald, Kirsten Phillips, Brian J Smith, Nicholas A Zwar, Eli Dabscheck
Chronic obstructive pulmonary disease (COPD) is characterised by persistent respiratory symptoms and chronic airflow limitation, and is associated with exacerbations and comorbidities. Advances in the management of COPD are updated quarterly in the national COPD guidelines, the COPD-X plan, published by Lung Foundation Australia in conjunction with the Thoracic Society of Australia and New Zealand and available at http://copdx.org.au. Main recommendations: Spirometry detects persistent airflow limitation (post-bronchodilator FEV1/FVC < 0...
November 20, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/29106536/the-intersection-of-intellectual-disability-and-dementia-report-of-the-international-summit-on-intellectual-disability-and-dementia
#6
Karen Watchman, Matthew P Janicki
An International Summit on Intellectual Disability and Dementia, held in Glasgow, Scotland (October 13-14, 2016), drew individuals and representatives of numerous international and national organizations and universities with a stake in issues affecting adults with intellectual disability (ID) affected by dementia. A discussion-based consensus process was used to examine and produce a series of topical reports examining three main conceptual areas: (a) human rights and personal resources (applications of the Convention for Rights of People with Disabilities and human rights to societal inclusion, and perspectives of persons with ID), (b) individualized services and clinical supports (advancing and advanced dementia, post-diagnostic supports, community supports and services, dementia-capable care practice, and end-of-life care practices), and (c) advocacy, public impact, family caregiver issues (nomenclature/terminology, inclusion of persons with ID in national plans, and family caregiver issues)...
November 2, 2017: Gerontologist
https://www.readbyqxmd.com/read/29097287/palliative-and-end-of-life-care-of-people-with-diabetes-issues-challenges-and-strategies
#7
REVIEW
Trisha Dunning, Peter Martin
Palliative and end of life care are essential, but largely overlooked, aspects of comprehensive, personalised diabetes care. Life expectancy is lower in people with diabetes than in the general population due to complications and comorbidities, especially those associated with obesity such as cardiovascular disease, frailty and cancer. This paper makes the case for early initiation of palliative care and proactive planning for end of life. Early use of palliative care improves symptom management, comfort and quality of life, and often improves function...
October 30, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29072148/patient-family-eol-communication-and-its-predictors-reports-from-caregivers-of-latino-patients-in-the-rural-u-s-mexico-border-region
#8
Eunjeong Ko, Jaehoon Lee, Carlos Ramirez, Denicka Lopez, Stephanie Martinez
OBJECTIVE: Family caregivers play an important role in end-of-life (EoL) decision making when the patient is unable to make his/her own decisions. While communication about EoL care between patients and family is perhaps a first step toward advance care planning (ACP)/EoL decisions, not every culture puts great value on open communication about this topic. The aims of the present study were to explore EoL communication and the aspects of communication among caregivers of Latino patients in the rural United States (U...
October 26, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29067876/australian-doctors-knowledge-of-and-compliance-with-the-law-relating-to-end-of-life-decisions-implications-for-lgbti-patients
#9
Colleen Cartwright, Ben White, Lindy Willmott, Malcolm Parker, Gail Williams
In most developed countries, competent patients have the legal right to refuse any medical treatment; Advance Care Planning mechanisms extend this right to non-competent patients. However, some groups, including lesbian, gay, bisexual, transgender and intersex (LGBTI) people, risk their wishes not being respected if they lose capacity, more than others. Little is known about medical practitioners' knowledge of, or attitudes to, the law in this area, especially in relation to LGBTI people, or how the law influences their decision-making...
October 25, 2017: Culture, Health & Sexuality
https://www.readbyqxmd.com/read/29066257/disparity-of-end-of-life-care-in-cancer-patients-with-and-without-schizophrenia-a-nationwide-population-based-cohort-study
#10
Huei-Kai Huang, Ying-Wei Wang, Jyh-Gang Hsieh, Chia-Jung Hsieh
BACKGROUND: Cancer patients with schizophrenia may face disparities in end-of life care, and it is unclear whether schizophrenia affects their medical care and treatment. METHODS: We conducted a nationwide population-based cohort study based on the National Health Insurance Research Database of Taiwan. The study population included patients >20years old who were newly diagnosed as having one of six common cancers between 2000 and 2012 (schizophrenia cohort: 1911 patients with both cancer and schizophrenia; non-schizophrenia cohort: 7644 cancer patients without schizophrenia)...
October 21, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/29063601/community-based-palliative-care-and-advance-care-planning-documentation-evidence-from-a-multispecialty-group
#11
Ming Tai-Seale, Yan Yang, Ellis Dillon, Sharon Tapper, Steve Lai, Peter Yu, Heather Allore, Christine Ritchie
BACKGROUND/OBJECTIVES: With the growing public demand for access to critical health data across care settings, it is essential that advance care planning (ACP) information be included in the electronic health record (EHR) so that multiple clinicians can access it and understand individuals' preferences for end-of-life care. Community-based palliative care programs often incorporate ACP services. This study examined whether a community-based palliative care program is associated with digitally extractable ACP documentation in the EHR...
October 24, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29052656/initial-efficacy-testing-of-an-autobiographical-memory-intervention-on-advance-care-planning-for-patients-with-terminal-cancer
#12
Cheryl Brohard
PURPOSE/OBJECTIVES: To test the efficacy of a novel intervention to facilitate advance care planning.
. DESIGN: Exploratory, quasiexperimental pilot study with two independent groups.
. SETTING: A large hospice located in the southwestern United States. 
. SAMPLE: A convenience sample of 50 participants with terminal cancer enrolled in hospice.
. METHODS: An autobiographical memory (ABM) intervention used the participants' experiences with cancer and end of life for the purpose of directing advance care planning...
November 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/29045631/implementation-of-advance-care-planning-in-israel-a-convergence-of-top-down-and-bottom-up-processes
#13
Netta Bentur, Shelley Sternberg
Although public health has traditionally been concerned with primary, secondary, and tertiary prevention, more attention needs to be focused on patient-centered care at the end of life. Improved access to quality end-of-life care can be achieved by advance care planning (ACP). In this article, we present an example of the processes of change regarding ACP and preparing advance directives (ADs) that have begun to take place in Israel in recent years. We argue that these processes derive from the synergy between legislation on the one hand, and initiatives and action by health organizations on the other...
October 13, 2017: Gerontologist
https://www.readbyqxmd.com/read/29045355/complexity-of-chronic-conditions-impact-on-end-of-life-expense-trajectories-of-medicare-decedents
#14
Suzanne S Sullivan, Junxin Li, Yow-Wu Bill Wu, Sharon Hewner
OBJECTIVE: The aim of this study is to determine if the pattern of monthly medical expense can be used to identify individuals at risk of dying, thus supporting providers in proactively engaging in advanced care planning discussions. BACKGROUND: Identifying the right time to discuss end of life can be difficult. Improved predictive capacity has made it possible for nurse leaders to use large data sets to guide clinical decision making. METHODS: We examined the patterns of monthly medical expense of Medicare beneficiaries with life-limiting illness during the last 24 months of life using analysis of variance, t tests, and stepwise hierarchical linear modeling...
November 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/29034688/end-of-life-characteristics-and-palliative-care-provision-for-patients-with-motor-neuron-disease
#15
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/29033560/proactive-palliative-care-for-patients-with-copd-prolong-a-pragmatic-cluster-controlled-trial
#16
R G Duenk, C Verhagen, E M Bronkhorst, Pjwb van Mierlo, Meac Broeders, S M Collard, Pnr Dekhuijzen, Kcp Vissers, Y Heijdra, Y Engels
BACKGROUND AND AIM: Patients with advanced chronic obstructive pulmonary disease (COPD) have poor quality of life. The aim of this study was to assess the effects of proactive palliative care on the well-being of these patients. TRIAL REGISTRATION: This trial is registered with the Netherlands Trial Register, NTR4037. PATIENTS AND METHODS: A pragmatic cluster controlled trial (quasi-experimental design) was performed with hospitals as cluster (three intervention and three control) and a pretrial assessment was performed...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29033267/palliative-care-in-interstitial-lung-disease-living-well
#17
REVIEW
Michael Kreuter, Elisabeth Bendstrup, Anne-Marie Russell, Sabrina Bajwah, Kathleen Lindell, Yochai Adir, Crystal E Brown, Greg Calligaro, Nicola Cassidy, Tamera J Corte, Klaus Geissler, Azza Adel Hassan, Kerri A Johannson, Ronaldo Kairalla, Martin Kolb, Yasuhiro Kondoh, Sylvia Quadrelli, Jeff Swigris, Zarir Udwadia, Athol Wells, Marlies Wijsenbeek
Progressive fibrotic interstitial lung diseases (ILDs) are characterised by major reductions in quality of life and survival and have similarities to certain malignancies. However, palliative care expertise is conspicuously inaccessible to many patients with ILD. Unmet patient and caregiver needs include effective pharmacological and psychosocial interventions to improve quality of life throughout the disease course, sensitive advanced care planning, and timely patient-centred end-of-life care. The incorrect perception that palliative care is synonymous with end-of-life care, with no role earlier in the course of ILD, has created a culture of neglect...
October 12, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29030806/palliative-care-in-the-management-of-patients-with-advanced-heart-failure
#18
Susan E Lowey
Globally, there are 18-million individuals living with heart failure, a disease that is responsible for 12-15 million office visits and 6.5 million inpatient hospitalizations each year. As HF becomes advanced or end-stage, patients often live in a cycle of frequent transitions between care settings, and with unmet needs, including distress from inadequately managed symptoms. Prognostication in patients with heart failure can be challenging due to the unpredictable exacerbating-remitting illness trajectory that is associated with this progressive disease...
October 14, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29029757/palliative-care-and-end-of-life-care-for-polypathological-patients
#19
E Martinez-Litago, M C Martínez-Velasco, M P Muniesa-Zaragozano
Patients with advanced chronic diseases receive fragmented care, which entails high resource consumption and a poor quality of life. Uncertainty in the prognosis and scarce investigation into the importance of symptomatic control in this patient group hinders a proper therapeutic approach. Palliative care teams optimise the use of resources through comprehensive patient care, the optimization of the patient's environment, communication, the preparation of early care plans and the creation of coordinated healthcare circuits, which improve the quality of the patient's care in advanced stages of the disease...
October 10, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28993286/spirit-trial-a-phase-iii-pragmatic-trial-of-an-advance-care-planning-intervention-in-esrd
#20
Mi-Kyung Song, Mark L Unruh, Amita Manatunga, Laura C Plantinga, Janice Lea, Manisha Jhamb, Abhijit V Kshirsagar, Sandra E Ward
Advance care planning (ACP) is a central tenet of dialysis care, but the vast majority of dialysis patients report never engaging in ACP discussions with their care providers. Over the last decade, we have developed and iteratively tested SPIRIT (Sharing Patient's Illness Representation to Increase Trust), a theory-based, patient- and family-centered advance care planning intervention. SPIRIT is a six-step, two-session, face-to-face intervention to promote cognitive and emotional preparation for end-of-life decision making for patients with ESRD and their surrogates...
October 6, 2017: Contemporary Clinical Trials
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