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https://www.readbyqxmd.com/read/28918550/advance-care-planning-challenges-at-the-emergency-department-of-a-cancer-care-center
#1
Maria T Cruz-Carreras, Patrick Chaftari, Jayne Viets-Upchurch
INTRODUCTION: Code status discussions form an important part of advance care planning (ACP) as it enables physicians to respect the patient's wishes for end-of-life care. However, in some cases, code status discussions can be challenging causing the physician to go against the patient's wishes and the code of medical ethics. This is especially true in an emergency setting. In this paper, we will discuss three cases of advanced cancer patients, where code status discussions posed challenges to healthcare providers...
September 16, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28918428/modification-of-cardiovascular-pharmacotherapy-in-palliative-care-patients-with-cancer-narrative-review
#2
Tomasz Pasierski
Palliative care cancer patients are treated with many drugs especially at the end of life. Limiting of polypharmacy a decreases the risk of associated adverse effects, medical errors and harmful drug interactions The time lag to benefit of many medications used for cardiovascular diseases or risk factors like hypertension, hypercholesterolemia is frequently longer than palliative care cancer patient's life expectancy. It is ethically appropriate to modify, even to discontinue cardiovascular pharmacotherapy when there is no prospect of benefit...
September 13, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28917611/end-of-life-practice-patterns-at-u-s-adult-cystic-fibrosis-care-centers-a-national-retrospective-chart-review
#3
Elaine Chen, Karen Homa, Jessica Goggin, Kathryn A Sabadosa, Sarah Hempstead, Bruce C Marshall, Albert Faro, Elisabeth P Dellon
BACKGROUND: There are many challenges to providing end-of-life care (EOLC) to people with cystic fibrosis (CF). METHODS: Chart abstraction was used to examine EOLC in adults with CF who died between 2011 and 2013. RESULTS: We reviewed 248 deaths from 71 CF care centers. Median age at death was 29years (range 18-73). While median FEV1 was in the severe lung disease category (FEV1<40%), 38% had mild or moderate lung disease in the year preceding death...
September 13, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28916415/home-to-die-from-the-intensive-care-unit-a-qualitative-descriptive-study-of-the-family-s-experience
#4
Amy L Hutchinson, Kim A Van Wissen
BACKGROUND: Many people would choose to die at home, and this can be an option for intensive care patients. However, there is limited exploration of the impact on the family. AIM: To gain insight into family members' experiences when an adult intensive care unit patient is taken home to die. METHODS: Methodology is qualitative description, utilising purposeful sampling, unstructured interviews and thematic analysis. Four participants, from two different families were interviewed...
September 12, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28916294/characteristics-of-older-adults-in-primary-care-who-may-benefit-from-primary-palliative-care-in-the-united-states
#5
Nancy Dudley, Christine S Ritchie, Margaret I Wallhagen, Kenneth E Covinsky, Bruce A Cooper, Kanan Patel, Irena Stijacic-Cenzer, Susan A Chapman
CONTEXT: Older adults with advanced illness and associated symptoms may benefit from primary palliative care, but limited data exist to identify older adults in U.S. primary care to benefit from this care. OBJECTIVES: To describe U.S. primary care visits among adults 65 years and older with advanced illness. METHODS: Cross-sectional analysis of the National Ambulatory and Hospital Ambulatory Medical Care Surveys (2009-2011) was conducted using chi-square tests to compare visits without and with advanced illness to U...
September 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28916293/is-there-ever-a-role-for-the-unilateral-do-not-attempt-resuscitation-order-in-pediatric-care
#6
Jonathan M Marron, Emma Jones, Joanne Wolfe
Care for children as they near the end of life is difficult and very complex. More difficult still are the decisions regarding what interventions are and are not indicated during these trying times. Occasionally, families of children who are nearing the end of life disagree with the assessment of the medical team regarding these interventions. In rare cases, the medical team can be moved to enact a do not attempt resuscitation (DNAR) order against the wishes of the patient's parents. This manuscript presents one such illustrative case and discusses the ethical issues relevant to such challenging clinical scenarios...
September 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28915078/pediatric-specific-end-of-life-care-quality-measures-an-unmet-need-of-a-vulnerable-population
#7
Emily E Johnston, Abby R Rosenberg, Arif H Kamal
We must ensure that the 20,000 US children (age 0 to 19 years) who die as a result of serious illness annually receive high-quality end-of-life care. Ensuring high-quality end-of-life care requires recognition that pediatric end-of-life care is conceptually and operationally different than that for adults. For example, in-hospital adult death is considered an outcome to be avoided, whereas many pediatric families may prefer hospital death. Because pediatric deaths are comparatively rare, not all centers offer pediatric-focused palliative care and hospice services...
September 15, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28914440/olaratumab-in-combination-with-doxorubicin-for-the-treatment-of-advanced-soft-tissue-sarcoma-an-evidence-review-group-perspective-of-a-national-institute-for-health-and-care-excellence-single-technology-appraisal
#8
REVIEW
Irina A Tikhonova, Tracey Jones-Hughes, James Dunham, Fiona C Warren, Sophie Robinson, Peter Stephens, Martin Hoyle
The manufacturer of olaratumab (Lartruvo(®)), Eli Lilly & Company Limited, submitted evidence for the clinical and cost effectiveness of this drug, in combination with doxorubicin, for untreated advanced soft tissue sarcoma (STS) not amenable to surgery or radiotherapy, as part of the National Institute for Health and Care Excellence (NICE) Single Technology Appraisal process. The Peninsula Technology Assessment Group, commissioned to act as the Evidence Review Group (ERG), critically reviewed the company's submission...
September 15, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28914076/integrative-review-of-the-literature-on-hispanics-and-hospice
#9
Margaret L Rising, Dena S Hassouneh, Kristin F Lutz, Chris S Lee, Pat Berry
The provision of optimal end-of-life care to Hispanics receiving hospice care requires familiarity with hospice-specific variables. For example, a preference for nondisclosure of terminal prognosis in some Hispanics is incongruous with traditional hospice practice. In addition, the Spanish word for hospice, "hospicio," has negative connotations about abandonment of loved ones. Added to cultural considerations are socioeconomic considerations. Many marginalized Hispanic individuals may experience distinct challenges when enrolling in hospice due to socioeconomic hardships relating to poverty, citizenship, and lack of insurance...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28912616/decision-making-in-neonatal-end-of-life-scenarios-in-low-income-settings-1
#10
James McTavish
The challenge of decision making in end-of-life scenarios is exacerbated when the patient is a newborn and in a low-income setting. The principle of proportionate care is a helpful guide but needs to be applied. The complex interplay of benefit, burden, and cost of various treatments all need to be considered. In patients with severe neonatal encephalopathy, prognosis can be hard to determine, and a team approach to decision making can help. In low-income settings, or where there are limited resources, the ideal care needs to be incarnated in the real context...
August 2017: Linacre Quarterly
https://www.readbyqxmd.com/read/28912610/a-guide-for-religious-for-end-of-life-decision-making
#11
James McTavish
No abstract text is available yet for this article.
August 2017: Linacre Quarterly
https://www.readbyqxmd.com/read/28912058/translation-and-cultural-adaptation-of-the-quality-of-communication-questionnaire-for-icu-family-members-in-korea
#12
Minjeong Jo, Mi-Kyung Song, Marcia Van Riper, Yang-Sook Yoo, George J Knafl, Linda Beeber
BACKGROUND: There are no Korean instruments to assess the concepts associated with end-of-life communication quality. OBJECTIVES: To translate and culturally adapt the Quality of Communication (QOC) questionnaire into Korean and evaluate its acceptability and internal consistency. METHODS: We first translated the QOC from English into Korean, then back-translated from Korean to English, and evaluated the cultural appropriateness of the items...
September 11, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28911084/the-critical-mass-survey-of-palliative-care-programme-at-esmo-designated-centres-of-integrated-oncology-and-palliative-care
#13
D Hui, N Cherny, N Latino, F Strasser
Background: The ESMO Designated Centres (ESMO-DCs) of Integrated Oncology and Palliative Care (PC) Incentive Programme has grown steadily. We aimed to characterise the level of PC clinical services, education and research at ESMO-DCs. Methods: We sent all 184 ESMO-DCs an electronic survey consisting of 78 questions examining the DC characteristics, palliative care clinical programme (structure, processes, and outcomes), primary PC delivery by oncologists, education, research and attitudes and beliefs towards the ESMO-DC programme...
September 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28906197/teaching-to-the-affective-domain-an-end-of-life-simulation
#14
Cynthia Isabell, Barbara Banfield, Gail Lis
No abstract text is available yet for this article.
October 2017: Western Journal of Nursing Research
https://www.readbyqxmd.com/read/28905647/the-challenge-pathway-a-mixed-methods-evaluation-of-an-innovative-care-model-for-the-palliative-and-end-of-life-care-of-people-with-dementia-innovative-practice
#15
Emily Harrop, Annmarie Nelson, Helen Rees, Dylan Harris, Simon Noble
An innovative service for the palliative and end-of-life care of people with dementia was introduced at a UK hospice. This evaluation involved analysis of audit data, semi-structured interviews with project staff (n=3) and surveys of family carers (n=15) and professionals (n=20). The service has increased access to palliative, end-of-life care and other services. Improvements were reported in the knowledge, confidence and care skills of family carers and professionals. Carers felt better supported and it was perceived that the service enabled more patients to be cared for at home or in their usual place of care...
January 1, 2017: Dementia
https://www.readbyqxmd.com/read/28905637/recent-changes-in-end-of-life-decisions-for-newborns-in-a-korean-hospital
#16
Myo-Jing Kim, Jin-Hyeok Lee, Hyoung-Doo Lee
INTRODUCTION: Despite recent advances in neonatal intensive care in Korea, few studies exist on the end-of-life decisions in newborns. In this study, we sought to examine the status of end-of-life decisions in neonates, changes over time, and affecting factors. METHODS: This is a retrospective study of neonates who died between 2001 and 2015 in the neonatal intensive care unit of Dong-A University Hospital in Busan. The types of end-of-life decisions were divided into active resuscitation, withholding treatment, and withdrawing treatment...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28904030/approach-to-advanced-heart-failure-at-the-end-of-life
#17
REVIEW
Leah Steinberg, Meghan White, Jennifer Arvanitis, Amna Husain, Susanna Mak
OBJECTIVE: To outline symptom management in, as well as offer a home-based protocol for, patients with advanced heart failure (HF). SOURCES OF INFORMATION: The terms palliative care and heart failure were searched in PubMed and relevant databases. All articles were reviewed. The specific medical management protocol was developed by the "HeartFull" collaborative team at the Temmy Latner Centre for Palliative Care in Toronto, Ont. MAIN MESSAGE: Educating patients about advanced HF and helping them understand their illness and illness trajectory can foster end-of-life discussions...
September 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28904011/continuation-of-non-essential-medications-in-actively-dying-hospitalised-patients
#18
Beverly Rosa Williams, F Amos Bailey, Elizabeth Kvale, Neal Steil, Patricia S Goode, Richard E Kennedy, Kathryn L Burgio
OBJECTIVE: The objective of this analysis was to examine the use of 11 non-essential medications in actively dying patients. METHODS: This was a planned secondary analysis of data from the Best Practices for End-of-Life Care for Our Nation's Veterans trial, a multicentre implementation trial of an intervention to improve processes of end-of-life care in inpatient settings. Supported with an electronic comfort care decision support tool, intervention included training hospital staff to identify actively dying patients, communicate the prognosis to patients/families and implement best practices of traditionally home-based hospice care...
September 13, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28902070/contending-with-preplanned-death-questions-for-clinicians
#19
Joel Yager
BACKGROUND AND OBJECTIVES: The goal of this column is to assist readers in reflecting on their attitudes and responses toward clinical and nonclinical situations involving preplanned deaths by decisionally capable individuals. Such circumstances range from encountering individuals in one's personal and professional lives who desire and intend to end their lives under their own terms, to having such individuals request assistance with predeath and postdeath arrangements. METHODS: Attending to pertinent literature, this essay uses Socratic inquiry to question conventional assumptions and attitudes, push readers' thoughts beyond typical comfort zones, and consider alternative modes of responding to challenges posed by preplanned death...
September 8, 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/28901973/identifying-palliative-care-needs-in-people-with-dementia
#20
Mari Lloyd-Williams, Caroline Mogan, Karen Harrison Dening
PURPOSE OF REVIEW: Dementia is now recognized as a progressive life-limiting illness where many patients can benefit from access to palliative care. RECENT FINDINGS: The present review has focused on three areas namely, advanced care planning in supporting palliative care for dementia, hospice provision for people with dementia and provision of care within family home. In advanced care planning, there is little research on systematically developed and implemented advance care planning interventions or whether they achieve desired outcomes for end-of-life care...
September 8, 2017: Current Opinion in Supportive and Palliative Care
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