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Advance care planning, end of life

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https://www.readbyqxmd.com/read/27916344/advance-care-discussions-with-young-people-affected-by-life-limiting-neuromuscular-diseases-a-systematic-literature-review-and-narrative-synthesis
#1
Andy Hiscock, Isla Kuhn, Stephen Barclay
End of life care policy in the UK advocates open discussions between health professionals and patients as the end of life approaches. Despite well documented understanding of the progression of life-limiting neuromuscular diseases, the majority of patients affected by such conditions die without a formal end of life plan in place. We performed a systematic review to investigate conversations regarding end of life care between healthcare professionals and younger adult patients with life-limiting neuromuscular diseases...
November 21, 2016: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/27915265/the-ethics-of-unilateral-implantable-cardioverter-defibrillators-and-cardiac-resynchronization-therapy-with-defibrillator-deactivation-patient-perspectives
#2
Margaret Daeschler, Ralph J Verdino, James N Kirkpatrick
AIMS: Decisions about deactivation of implantable cardioverter defibrillators (ICDs) are complicated. Unilateral do-not-resuscitate (DNR) orders (against patient/family wishes) have been ethically justified in cases of medical futility. Unilateral deactivation of ICDs may be seen as a logical extension of a unilateral DNR order. However, the ethical implications of unilateral ICD deactivation have not been explored. METHODS AND RESULTS: Sixty patients who had an ICD or cardiac resynchronization therapy with defibrillator (CRT-D) were interviewed at a quaternary medical centre outpatient electrophysiology practice...
December 2, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27911489/palliative-care-interventions-in-advanced-dementia
#3
REVIEW
Edel Murphy, Katherine Froggatt, Sheelah Connolly, Eamon O'Shea, Elizabeth L Sampson, Dympna Casey, Declan Devane
BACKGROUND: Dementia is a chronic, progressive and ultimately fatal neurodegenerative disease. Advanced dementia is characterised by profound cognitive impairment, inability to communicate verbally and complete functional dependence. Usual care of people with advanced dementia is not underpinned universally by a palliative approach. Palliative care has focused traditionally on care of people with cancer but for more than a decade, there have been increased calls worldwide to extend palliative care services to include all people with life-limiting illnesses in need of specialist care, including people with dementia...
December 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27909034/advance-care-planning-in-patients-with-incurable-cancer-study-protocol-for-a-randomised-controlled-trial
#4
Stephanie Johnson, Josephine Clayton, Phyllis N Butow, William Silvester, Karen Detering, Jane Hall, Belinda E Kiely, Jonathon Cebon, Stephen Clarke, Melanie L Bell, Martin Stockler, Phillip Beale, Martin H N Tattersall
INTRODUCTION: There is limited evidence documenting the effectiveness of Advance Care Planning (ACP) in cancer care. The present randomised trial is designed to evaluate whether the administration of formal ACP improves compliance with patients' end-of-life (EOL) wishes and patient and family satisfaction with care. METHODS AND ANALYSIS: A randomised control trial in eight oncology centres across New South Wales and Victoria, Australia, is designed to assess the efficacy of a formal ACP intervention for patients with cancer...
December 1, 2016: BMJ Open
https://www.readbyqxmd.com/read/27893884/effect-of-the-goals-of-care-intervention-for-advanced-dementia-a-randomized-clinical-trial
#5
Laura C Hanson, Sheryl Zimmerman, Mi-Kyung Song, Feng-Chang Lin, Cherie Rosemond, Timothy S Carey, Susan L Mitchell
Importance: In advanced dementia, goals of care decisions are challenging and medical care is often more intensive than desired. Objective: To test a goals of care (GOC) decision aid intervention to improve quality of communication and palliative care for nursing home residents with advanced dementia. Design, Setting, and Participants: A single-blind cluster randomized clinical trial, including 302 residents with advanced dementia and their family decision makers in 22 nursing homes...
November 28, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27891024/palliative-care-and-the-indian-neurologist
#6
REVIEW
Roop Gursahani
End-of-life care is an integral part of neurology practice, and neuropalliative medicine is an emerging neurology subspeciality. This begins with serious illness communication as a protocol-based process that depends on an evaluation of patient autonomy and accurate prognostication. Communication needs vary between chronic, life-limiting neurologic illnesses and acute brain injury. In an ideal situation, the patient's wishes are spelled out in advance care plans and living wills, and surrogates have only limited choices for implementation...
October 2016: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/27883315/the-need-for-accurate-risk-prediction-models-for-road-mapping-shared-decision-making-and-care-planning-for-the-elderly-with-advanced-chronic-kidney-disease
#7
Marijke Stryckers, Evi V Nagler, Wim Van Biesen
As people age, chronic kidney disease becomes more common, but it rarely leads to end-stage kidney disease. When it does, the choice between dialysis and conservative care can be daunting, as much depends on life expectancy and personal expectations of medical care. Shared decision making implies adequately informing patients about their options, and facilitating deliberation of the available information, such that decisions are tailored to the individual's values and preferences. Accurate estimations of one's risk of progression to end-stage kidney disease and death with or without dialysis are essential for shared decision making to be effective...
November 1, 2016: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/27881828/-hope-for-the-best-prepare-for-the-worst-a-qualitative-interview-study-on-parents-needs-and-fears-in-pediatric-advance-care-planning
#8
Julia Desiree Lotz, Marion Daxer, Ralf J Jox, Gian Domenico Borasio, Monika Führer
BACKGROUND: Pediatric advance care planning is advocated by healthcare providers because it may increase the chance that patient and/or parent wishes are respected and thus improve end-of-life care. However, since end-of-life decisions for children are particularly difficult and charged with emotions, physicians are often afraid of addressing pediatric advance care planning. AIM: We aimed to investigate parents' views and needs regarding pediatric advance care planning...
November 23, 2016: Palliative Medicine
https://www.readbyqxmd.com/read/27878605/-special-medical-problems-in-end-of-life-care-crisis-at-the-end-of-life-which-therapy-is-adequate-and-when-is-redefining-treatment-goals-appropriate
#9
Gesine Benze, Bernd Alt-Epping, Friedemann Nauck
Crisis at the end of life are exceptional challenges for patients, relatives and therapists. With respect to the individual treatment goals and the patients' autonomy, therapeutic action should be commenced in an adequate manner in order to preserve the patients' quality of life as much as possible. Advance care planning for specific critical scenarios may be helpful in order to treat patients according to their wishes and values even if they are not capable to express themselves. Furthermore, a crisis plan can define the scope of action for therapists in emergency situations...
November 23, 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/27852819/factors-influencing-advance-care-planning-among-older-adults-in-two-socioeconomically-diverse-living-communities
#10
Jennifer L Tripken, Cathy Elrod, Susan Bills
BACKGROUND/OBJECTIVES: Advance care planning (ACP) is an iterative, complex, and dynamic process of discussion, decision-making, and documentation about end-of-life care. The extent to which this process takes place in older adults in diverse socioeconomic settings is not well documented. The aim of this study was to assess the knowledge, attitudes, and beliefs about ACP among older adults in two socioeconomically diverse settings to identify the individual and contextual factors that influence behaviors regarding end-of-life care...
November 15, 2016: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/27850185/545-end-of-life-care-for-children-with-medical-complexity-does-advance-care-planning-matter
#11
Danielle DeCourcey, Melanie Silverman, Adeolu Oladunjoye, Joanne Wolfe
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27836946/heart-transplantation-in-adult-congenital-heart-disease
#12
REVIEW
Luke J Burchill
Heart failure (HF) in adult congenital heart disease (ACHD) is vastly different to that observed in acquired heart disease. Unlike acquired HF in which pharmacological strategies are the cornerstone for protecting and improving ventricular function, ACHD-related HF relies heavily upon structural and other interventions to achieve these aims. patients with ACHD constitute a small percentage of the total adult heart transplant population (∼3%), although the number of ACHD heart transplant recipients is growing rapidly with a 40% increase over the last two decades...
December 1, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27834803/advance-care-planning-in-glioblastoma-patients
#13
REVIEW
Lara Fritz, Linda Dirven, Jaap C Reijneveld, Johan A F Koekkoek, Anne M Stiggelbout, H Roeline W Pasman, Martin J B Taphoorn
Despite multimodal treatment with surgery, radiotherapy and chemotherapy, glioblastoma is an incurable disease with a poor prognosis. During the disease course, glioblastoma patients may experience progressive neurological deficits, symptoms of increased intracranial pressure such as drowsiness and headache, incontinence, seizures and progressive cognitive dysfunction. These patients not only have cancer, but also a progressive brain disease. This may seriously interfere with their ability to make their own decisions regarding treatment...
November 8, 2016: Cancers
https://www.readbyqxmd.com/read/27830645/thoughts-about-dying-in-america-enhancing-the-impact-of-one-s-life-journey-and-legacy-by-also-planning-for-the-end-of-life
#14
Philip A Pizzo
This Perspective offers a summary of the recommendations in the Institute of Medicine report Dying in America How we die is a deeply personal issue that each of us will face. However, the approach to end-of-life (EOL) care in the United States needs improvement. Too frequently, healthcare delivery is uncoordinated and has many providers who are not adequately prepared to have meaningful conversations about EOL planning. This is amplified by payment systems and policies that create impediments, misunderstanding, and sometimes misinformation...
November 8, 2016: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/27829425/evaluation-of-a-pilot-of-nurse-practitioner-led-gp-supported-rural-palliative-care-provision
#15
Geoffrey Keith Mitchell, Hugh Edgar Senior, Michael Peter Bibo, Blessing Makoni, Sharleen Nicole Young, John Patrick Rosenberg, Patsy Yates
BACKGROUND: Providing end of life care in rural areas is challenging. We evaluated in a pilot whether nurse practitioner (NP)-led care, including clinical care plans negotiated with involved health professionals including the general practitioner(GP), ± patient and/or carer, through a single multidisciplinary case conference (SMCC), could influence patient and health system outcomes. METHODS: Setting - Australian rural district 50 kilometers from the nearest specialist palliative care service...
November 9, 2016: BMC Palliative Care
https://www.readbyqxmd.com/read/27829409/-i-just-think-that-we-should-be-informed-a-qualitative-study-of-family-involvement-in-advance-care-planning-in-nursing-homes
#16
Lisbeth Thoresen, Lillian Lillemoen
BACKGROUND: As part of the research project "End-of-life Communication in Nursing Homes. Patient Preferences and Participation", we have studied how Advance Care Planning (ACP) is carried out in eight Norwegian nursing homes. The concept of ACP is a process for improving patient autonomy and communication in the context of progressive illness, anticipated deterioration and end-of-life care. While an individualistic autonomy based attitude is at the fore in most studies on ACP, there is a lack of empirical studies on how family members' participation and involvement in ACP- conversations may promote nursing home patients' participation in decisions on future treatment and end-of-life care...
November 10, 2016: BMC Medical Ethics
https://www.readbyqxmd.com/read/27822458/advance-care-planning-in-patients-with-primary-malignant-brain-tumors-a-systematic-review
#17
REVIEW
Krystal Song, Bhasker Amatya, Catherine Voutier, Fary Khan
Advance care planning (ACP) is a process of reflection and communication of a person's future health care preferences, and has been shown to improve end-of-life (EOL) care for patients. The aim of this systematic review is to present an evidence-based overview of ACP in patients with primary malignant brain tumors (pmBT). A comprehensive literature search was conducted using medical and health science electronic databases (PubMed, Cochrane, Embase, MEDLINE, ProQuest, Social Care Online, Scopus, and Web of Science) up to July 2016...
2016: Frontiers in Oncology
https://www.readbyqxmd.com/read/27821714/end-of-life-care-a-scoping-review-of-experiences-of-advance-care-planning-for-people-with-dementia
#18
Kerry Jones, Giles Birchley, Richard Huxtable, Linda Clare, Tony Walter, Jeremy Dixon
Despite increasing attention given to dementia by international governments and policy makers, the focus of end of life care has been on the dying trajectory of malignant disease. People with severe dementia have complex physical and psychological needs, yet the disease is not always recognised as terminal. Advance Care Planning involving people with dementia and their families can provide opportunities to discuss and later, initiate timely palliative care.We conducted a scoping review of studies exploring decisions associated with the EoLC of people with dementia...
November 7, 2016: Dementia
https://www.readbyqxmd.com/read/27815498/racial-differences-in-associations-of-perceived-health-and-social-and-physical-activities-with-advance-care-planning-end-of-life-concerns-and-hospice-knowledge
#19
Hyunjin Noh, Junghyun Kim, Omar T Sims, Shaonin Ji, Patricia Sawyer
Associations of perceived health and social and physical activities with end-of-life (EOL) issues have been rarely studied, not to mention racial disparities in such associations. To address this gap, this study examined racial differences in the associations of perceived health and levels of social and physical activities with advance care planning, EOL concerns, and knowledge of hospice care among community-dwelling older adults in Alabama. Data from a statewide survey of 1044 community-dwelling older adults on their long-term care needs were analyzed using descriptive statistics and logistic and linear regressions...
November 4, 2016: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/27803566/clinical-impact-of-education-provision-on-determining-advance-care-planning-decisions-among-end-stage-renal-disease-patients-receiving-regular-hemodialysis-in-university-malaya-medical-centre
#20
Albert Hing Wong, Loh Ee Chin, Tan Li Ping, Ng Kok Peng, Lim Soo Kun
INTRODUCTION: Advance care planning (ACP) is a process of shared decision-making about future health-care plans between patients, health care providers, and family members, should patients becomes incapable of participating in medical treatment decisions. ACP discussions enhance patient's autonomy, focus on patient's values and treatment preferences, and promote patient-centered care. ACP is integrated as part of clinical practice in Singapore and the United States. AIM: To assess the clinical impact of education provision on determining ACP decisions among end-stage renal disease patients on regular hemodialysis at University Malaya Medical Centre (UMMC)...
October 2016: Indian Journal of Palliative Care
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