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Chaplain, Palliative Care, Hospice

Rebecca A Ferrer, Michelle Mollica, Grace Huang, Angela Falisi, Wen-Ying Sylvia Chou
40 Background: Existing literature on the epistemology of palliative care has mostly centered on patient/family perspectives. Understanding how multi-disciplinary healthcare providers themselves define palliative care is a critical step towards addressing barriers and harnessing facilitators that affect optimal delivery. METHODS: Semi-structured key informant interviews (N = 19) were conducted with members of healthcare provider teams as part of a qualitative study on goals of care for cancer patients enrolled in clinical trials...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Joanne Spetz, Nancy Dudley, Laura Trupin, Maggie Rogers, Diane E Meier, Tamara Dumanovsky
The predominant model for palliative care delivery, outside of hospice care, is the hospital-based consultative team. Although a majority of US hospitals offer palliative care services, there has been little research on the staffing of their program teams and whether those teams meet national guidelines, such as the Joint Commission's standard of including at least one physician, an advanced practice or other registered nurse, a social worker, and a chaplain. Data from the 2012-13 annual surveys of the National Palliative Care Registry indicate that only 25 percent of participating programs met that standard based on funded positions, and even when unfunded positions were included, only 39 percent of programs met the standard...
September 1, 2016: Health Affairs
Ann Kutney-Lee, Dawn Smith, Joshua Thorpe, Cindy Del Rosario, Said Ibrahim, Mary Ersek
BACKGROUND: Few studies have examined comprehensively racial/ethnic variations in quality of end-of-life care. OBJECTIVE: Examine end-of-life care quality received by Veterans and their families, comparing racial/ethnic minorities to nonminorities. RESEARCH DESIGN: This is a retrospective, cross-sectional analysis of chart review and survey data. SUBJECTS: Nearly all deaths in 145 Veterans Affairs Medical Centers nationally (n=94,697) in addition to Bereaved Family Survey (BFS) data (n=51,859) from October 2009 to September 2014...
April 2017: Medical Care
Debjit Saha, Carlos Moreno, Marc Csete, Elizabeth Kury Perez, Luigi Cubeddu, David Farcy, Steven Henry, Zachary Glazer, Lisa A Moreno-Walton, Robert C Goldszer
Admission of patients who have do not resuscitate (DNR) status to an intensive care unit (ICU) is potentially a misallocation of limited resources to patients who may neither need nor want intensive care. Yet, patients who have DNR status are often admitted to the ICU. This is a retrospective review of patients who had a valid DNR status at the time that they were admitted to an ICU in a single hospital over an eighteen-month period. Thirty-five patients met the criteria for inclusion in the study. The primary reasons for admission to the ICU were respiratory distress (54...
2016: Scientifica
Alexander K Smith, Christine S Ritchie, Margaret L Wallhagen
CONTEXT: Age-related hearing loss can impair patient-provider communication about symptom management, goals of care, and end-of-life decision-making. OBJECTIVES: To determine whether hospice and palliative care providers screen for or received training about hearing loss, believe it impacts patient care, and use strategies to optimize communication. METHODS: This was a national survey of hospice and palliative care providers conducted via email and social media...
August 2016: Journal of Pain and Symptom Management
Frances R Nedjat-Haiem, Iraida V Carrion, Krystana Gonzalez, Kathleen Ell, Beti Thompson, Shiraz I Mishra
Numerous factors impede effective and timely end-of-life (EOL) care communication. These factors include delays in communication until patients are seriously ill and/or close to death. Gaps in patient-provider communication negatively affect advance care planning and limit referrals to palliative and hospice care. Confusion about the roles of various health care providers also limits communication, especially when providers do not coordinate care with other health care providers in various disciplines. Although providers receive education regarding EOL communication and care coordination, little is known about the roles of all health care providers, including nonphysician support staff working with physicians to discuss the possibility of dying and help patients prepare for death...
May 2017: American Journal of Hospice & Palliative Care
Erica M Tuggey, Warren Harris Lewin
Patients living with a diagnosis of an advanced life-limiting malignancy often have concerns regarding symptom burden, physical and psychosocial impact on life, and questions surrounding end-of-life processes. Due to the complex care needs of patients with advanced life-limiting illness it is our experience that both a multidisciplinary and interdisciplinary approach to care can optimize the patient and family illness experience for this vulnerable population. Progressive metastatic illness often necessitates care in multiple settings including an ambulatory clinic, inpatient hospital ward, at home, and at an in-patient hospice or palliative care unit...
July 2014: Annals of Palliative Medicine
Mary Ersek, Joshua Thorpe, Hyejin Kim, Arwin Thomasson, Dawn Smith
OBJECTIVES: To compare quality of end-of-life (EOL) care indicators and family evaluation of care in community living centers (CLCs) with that of EOL care in acute, intensive, and hospice and palliative care units. DESIGN: Retrospective chart review and survey with next of kin of recently deceased inpatients. SETTING: Inpatient Veterans Affairs (VA) Medical Centers (N = 145), including 132 CLCs, across the United States. PARTICIPANTS: The chart review included all individuals who died in VA inpatient units (n = 57,397)...
April 2015: Journal of the American Geriatrics Society
Rebecca L Sudore, David Casarett, Dawn Smith, Diane M Richardson, Mary Ersek
CONTEXT: Most patients will lose decision-making capacity at the end of life. Little is known about the quality of care received by patients who have family involved in their care. OBJECTIVES: To evaluate differences in the receipt of quality end-of-life care for patients who died with and without family involvement. METHODS: We retrospectively reviewed the charts of 34,290 decedents from 146 acute and long-term care Veterans Affairs facilities between 2010 and 2011...
December 2014: Journal of Pain and Symptom Management
Maxine de la Cruz, Akhila Reddy, Eduardo Bruera
BACKGROUND: Intrathecal analgesia and radiofrequency techniques for tumor ablation are employed for palliation of symptoms. These interventions are efficacious in a select number of patients for controlling pain and improving quality of life. Careful selection of an appropriate candidate must be performed to prevent needless, invasive, and costly interventions, as interventional pain management alone will not treat total pain in cancer patients. We describe here a patient who experienced intractable pain and unsuccessfully underwent cordotomy but responded to the interdisciplinary (IDT) palliative care approach in an acute palliative care unit (APCU)...
April 2015: Palliative & Supportive Care
Joan Harrold, Elena Byhoff, Pamela Harris, Robertina Szolarova, Laura Bender, Teresa Craig, David Casarett
BACKGROUND: Although hospices need to be able to anticipate patient acuity, there are currently no published models that predict the frequency of visits that a new hospice patient is likely to receive. OBJECTIVES: To identify patient characteristics that are associated with the frequency of health care provider visits in the first 8 days of hospice care. METHODS: An electronic health record (EHR)-based retrospective cohort study was conducted in seven hospice programs in the United States...
February 2014: Journal of Palliative Medicine
Hillel Bodek
In 1948, Dame Cicely Saunders, the founder of the modem hospice movement, established a core principle of palliative care, Total Pain, which is defined as physical, spiritual, psychological, and social suffering. In 2009, a consensus panel (Puchalski, Ferrell, Virani, Otis-Green, Baird, Bull, et al., 2009) was convened to address the important issue of integrating spirituality in palliative care, which led to renewed efforts to focus on spiritual care as a critical component of quality palliative care. This project is a combination of advocacy for the importance of spiritual care, training chaplains, seminarians, community clergy, and healthcare professionals in palliative care, and creating a spiritual care curriculum which can be self-taught or taught to members of transdisciplinary teams...
2013: Omega
J Jhutti-Johal
In the healthcare sector, race, ethnicity and religion have become an increasingly important factor in terms of patient care due to an increasingly diverse population. Health agencies at a national and local level produce a number of guides to raise awareness of cultural issues among healthcare professionals and hospitals may implement additional non-medical services, such as the provision of specific types of food and dress to patients or the hiring of chaplains, to accommodate the needs of patients with religious requirements...
September 2013: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
Brian T Joyce, Denys T Lau
BACKGROUND: Hospice providers need to ensure that informal, unpaid caregivers can safely manage medications to alleviate pain and distressing symptoms in patients near the end of life. AIM: This study characterizes hospice providers' self-reported experiences and approaches to helping caregivers' medication management for home hospice patients. DESIGN: Survey with mixed-method analysis. SETTING/PARTICIPANTS: Surveys were administered to a convenience sample of 98 hospice providers (74 nurses, 6 physicians, 11 social workers, 7 chaplains) from 5 Chicago-based agencies in the United States...
April 2013: Palliative Medicine
Michele Dugan Day
Hospice teams may address multidimensional pain through the synergistic interaction of team members from various professional disciplines during regularly scheduled team meetings. However, the occurrence of that critical exchange has not been adequately described or documented. The purpose of this qualitative study was to explore two processes in team pain palliation: communication and collaboration. Data were gathered through individual interviews and a 1-year observation of team members from two hospices (physicians, nurses, aides, chaplains, social workers)...
2012: Journal of Social Work in End-of-life & Palliative Care
Martha R Jacobs
No abstract text is available yet for this article.
November 2008: Hastings Center Report
Esmé Finlay, Hien L Lu, Hope R Henderson, Hope Henderson, Peter J O'Dwyer, David J Casarett
BACKGROUND: Phase 1 oncology trial participants often are excluded from hospice. However, it is not known whether they would benefit from hospice services. The objectives of the current study were to define the palliative care needs of these patients and to determine whether their needs are greater than those of other cancer patients. METHODS: Two hundred ninety-seven patients who were undergoing cancer therapy and 69 patients who were enrolled in phase 1 trials at 7 oncology clinics in an urban cancer network were recruited and consented to participate in interviews...
January 15, 2009: Cancer
Ronald S Schonwetter, Leah D Clark, Stephen A Leedy, Mary Jo Quinn, Mary Azer, Sehwan Kim
BACKGROUND: One goal of quality palliative care in hospice is to limit emergency room visits and/or hospitalizations (ERVH). PURPOSE: The purpose of this study was to determine predisposing factors that contribute to ERVH and devise a model to predict the probability of hospice cardiac disease patients having ERVH after hospice admission. METHODS: The study was a retrospective chart review of hospice cardiac patients comparing those with ERVH (n = 65) and those who died in their homes (n = 80)...
October 2008: Journal of Palliative Medicine
Leah Clark, Stephen Leedy, Laurie McDonald, Barbara Muller, Cheryl Lamb, Tracy Mendez, Sehwan Kim, Ronald Schonwetter
As a continuing effort to enhance the quality of palliative care for the dying, this study examined (1) the prevalence of spirituality among hospice interdisciplinary team (IDT) members; (2) whether spirituality is related to job satisfaction; and (3) the structural path relationships among four variables: spiritual belief, integration of spirituality at work, self actualization and job satisfaction. The study surveyed 215 hospice IDT members who completed the Jarel Spiritual Well-Being Scale, the Chamiec-Case Spirituality Integration and Job Satisfaction Scales...
December 2007: Journal of Palliative Medicine
W George Kernohan, Mary Waldron, Caroline McAfee, Barbara Cochrane, Felicity Hasson
Palliative care encompasses spiritual as well as physical, social and psychological aspects. Spiritual care has been identified as a key concern of dying patients. During an audit of the Northern Ireland Hospice chaplaincy service against the national Standards for Hospice and Palliative Care Chaplaincy (2003), 62 patients' spiritual needs along with their interactions with the hospice chaplains were assessed by using a questionnaire survey and reviewing data recorded on their pastoral care notes. Findings suggest that the Standards were useful for assessing and addressing spiritual needs...
September 2007: Palliative Medicine
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