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Hospice Care, Palliative Care, End of Life Care, General Practice, Primary Care

Dorothy McCaughan, Eve Roman, Alexandra G Smith, Anne Garry, Miriam Johnson, Russell Patmore, Martin Howard, Debra A Howell
OBJECTIVES: Current UK health policy promotes enabling people to die in a place they choose, which for most is home. Despite this, patients with haematological malignancies (leukaemias, lymphomas and myeloma) are more likely to die in hospital than those with other cancers, and this is often considered a reflection of poor quality end-of-life care. This study aimed to explore the experiences of clinicians and relatives to determine why hospital deaths predominate in these diseases. METHODS: The study was set within the Haematological Malignancy Research Network (HMRN-www...
March 2018: BMJ Supportive & Palliative Care
Kay De Vries, Marek Plaskota
OBJECTIVE: Palliative sedation is a method of symptom management frequently used in hospices to treat uncontrolled symptoms at the end of life. There is a substantial body of literature on this subject; however, there has been little research into the experiences of hospice nurses when administering palliative sedation in an attempt to manage the terminal restlessness experienced by cancer patients. METHOD: Semistructured interviews were conducted with a purposive sample of seven hospice nurses who had cared for at least one patient who had undergone palliative sedation within the past year in a hospice in the south of England in the United Kingdom...
April 2017: Palliative & Supportive Care
F Amos Bailey, Beverly R Williams, Lesa L Woodby, Patricia S Goode, David T Redden, Thomas K Houston, U Shanette Granstaff, Theodore M Johnson, Leslye C Pennypacker, K Sue Haddock, John M Painter, Jessie M Spencer, Thomas Hartney, Kathryn L Burgio
BACKGROUND: Widespread implementation of palliative care treatment plans could reduce suffering in the last days of life by adopting best practices of traditionally home-based hospice care in inpatient settings. OBJECTIVE: To evaluate the effectiveness of a multi-modal intervention strategy to improve processes of end-of-life care in inpatient settings. DESIGN: Implementation trial with an intervention staggered across hospitals using a multiple-baseline, stepped wedge design...
June 2014: Journal of General Internal Medicine
Clare Gardiner, Merryn Gott, Christine Ingleton, Philippa Hughes, Michelle Winslow, Michael I Bennett
CONTEXT: Opioid therapy is central to the management of pain in the field of generalist palliative and end-of-life care, and international guidelines highlight the need for opioids to be used as part of a comprehensive strategy to treat pain. However, evidence suggests that the use of opioids in palliative care is suboptimal, and many patients do not receive adequate pain control at the end of life. OBJECTIVES: This study aimed to explore the attitudes of health care professionals to opioid prescribing in generalist end-of-life care...
August 2012: Journal of Pain and Symptom Management
Greg A Sachs, Joseph W Shega, Deon Cox-Hayley
While great strides have been made recently in improving end-of-life care in the United States, people with dementia often die with inadequate pain control, with feeding tubes in place, and without the benefits of hospice care. In this paper, we discuss the most important and persistent challenges to providing excellent end-of-life care for patients with dementia, including dementia not being viewed as a terminal illness; the nature of the course and treatment decisions in advanced dementia; assessment and management of symptoms; the caregiver experience and bereavement; and health systems issues...
October 2004: Journal of General Internal Medicine
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