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End-of-life

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https://www.readbyqxmd.com/read/28329829/-end-of-life-care-i-m-not-going-to-worry-about-that-yet-health-literacy-gaps-and-end-of-life-planning-among-elderly-dialysis-patients
#1
Keren Ladin, Katie Buttafarro, Emily Hahn, Susan Koch-Weser, Daniel E Weiner
Purpose: Between 2000 and 2012, the incident dialysis population in the United States increased by nearly 60%, most sharply among adults 75 years and older. End-of-life (EOL) conversations among dialysis patients are associated with better patient-centered outcomes and lower use of aggressive interventions in the last month of life. This study examined how health literacy may affect engagement, comprehension, and satisfaction with EOL conversations among elderly dialysis patients. Design and Methods: Qualitative/descriptive study with semi-structured interviews about health literacy, EOL conversations, and goals of care with 31 elderly dialysis patients at 2 centers in Boston...
March 10, 2017: Gerontologist
https://www.readbyqxmd.com/read/28329822/it-s-all-about-the-relationship-cognitively-intact-mother-daughter-care-dyads-in-hospice-at-home
#2
Diane N Solomon, Lissi Hansen, Judith G Baggs
Purpose of the Study: Adult daughters providing care to aging, ill mothers comprise the most prevalent caregiving dyad. Little is known, however, regarding relationship quality and its impact on care in these dyads, particularly in the context of cognitively intact patients at end of life in hospice. This interpretive descriptive work privileges voices of terminally ill mothers and care-partnering daughters in the home hospice context. Specific aims were to describe and interpret how mothers and daughters: (a) perceive relationship quality and (b) perceive how relationships have developed over time through health, chronic illness, and hospice...
March 10, 2017: Gerontologist
https://www.readbyqxmd.com/read/28329430/maintaining-family-life-balance-while-facing-a-child-s-imminent-death-a-mixed-methods-study
#3
Katri Eskola, Eva Bergstraesser, Karin Zimmermann, Eva Cignacco
AIM: To understand parents' experiences and needs during a child's end-of-life care at home and to identify systemic factors that influence its provision. BACKGROUND: A child's end-of-life phase is an extremely difficult time for the whole family. Parents have specific needs, especially when they care for a dying child at home. DESIGN: Concurrent embedded mixed methods design. METHODS: This sub-study of the nationwide survey, 'Paediatric End-of-Life Care Needs in Switzerland' (2012-2015) included 47 children who received EOL care at home from 2011-2012...
March 22, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28328763/induration-at-injection-or-infusion-site-may-reduce-bioavailability-of-parenteral-phenobarbital-administration
#4
Hirokazu Nakayama, Hirotoshi Echizen, Ryuichi Ogawa, Atsuya Akabane, Toshiaki Kato, Takao Orii
BACKGROUND: Phenobarbital is well tolerated and effective for controlling agitation or preventing convulsion at the end of life. No information is available concerning parenteral bioavailability of phenobarbital when induration develops at injection or infusion site. We investigated whether induration at injection or infusion site is related to phenobarbital bioavailability via parenteral routes of continuous subcutaneous infusion and intermittent subcutaneous or intramuscular injection...
March 21, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28328270/end-of-life-care-guidelines-and-care-plans-in-the-intensive-care-unit
#5
Alison Luckett
The aim of this literature review was to examine end-of-life (EoL) care practice in the intensive care unit (ICU). By exploring the literature, it is hoped to suggest how national guidance can be integrated into the ICU setting. Delivering high-quality, patient-centred EoL care is high priority on the UK health agenda. The highly technological environment within the ICU can create barriers to recognising death and initiating EoL care planning. Despite recommendations in the literature for the integration of standardised guidance, implementation, compliance and evaluation are yet to be widely reported...
March 9, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28327919/chemotherapy-in-end-of-life-care
#6
Reino Heikkilä, Stein Kaasa
No abstract text is available yet for this article.
February 28, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28327033/patients-with-cancer-want-more-research-on-end-of-life-care
#7
(no author information available yet)
Palliative and end of life care should be top priorities for future cancer research, a study suggests.
March 22, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28327018/quality-community-care
#8
David Ditchfield
In response to your story about district nursing shortages (online news, 14 March), I can't speak for elsewhere but the district nurses in my cluster provide prompt, high-quality end of life care and symptom control.
March 22, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28326200/the-anaesthesiologist-and-palliative-care-in-a-newborn-with-the-adam-sequence
#9
Alberto Vieira Pantoja, Maria Emília Gonçalves Estevez, Bruno Lima Pessoa, Fernando de Paiva Araújo, Bruno Mendonça Barcellos, Ciro Augusto Floriani, Marco Antonio Cardoso de Resende
Reports focusing on biomedical principlism and the role of anaesthesiologists in palliative care are rare. We present the case of a newborn with multiple craniofacial anomalies and a diagnosis of ADAM "sequence," in which surgical removal of placental adhesions to the dura mater and the correction of meningocele was not indicated due to the very short life expectancy. After 48 hours, the odor from the placenta indicted a necrotic process, which prevented the parents from being close to the child and increased his isolation...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28325745/aid-in-dying-laws-and-the-physician-s-duty-to-inform
#10
Mara Buchbinder
On 19 July 2016, three medical organisations filed a federal lawsuit against representatives from several Vermont agencies over the Patient Choice and Control at End of Life Act. The law is similar to aid-in-dying (AID) laws in four other US states, but the lawsuit hinges on a distinctive aspect of Vermont's law pertaining to patients' rights to information. The lawsuit raises questions about whether, and under what circumstances, there is an ethical obligation to inform terminally ill patients about AID as an end-of-life option...
March 21, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28324205/levels-of-intervention-how-are-they-used-in-quebec-hospitals
#11
Marjolaine Frenette, Jocelyne Saint-Arnaud, Karim Serri
In order to promote better practices and communication around end-of-life decision-making, several Canadian hospitals in the province of Quebec have developed a tool called "Levels of Intervention" (LOI). No work to date has been published demonstrating improvement since these forms were implemented. The purpose of the present study was to obtain information about the use of LOI forms across Quebec hospitals and to identify gaps in practice as well as areas for improvement. A retrospective study was undertaken of 299 charts of patients who had died in three Quebec hospitals with a LOI ordered...
March 21, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28322634/end-of-life-decision-support-in-the-icu
#12
Grant Pignatiello, Ronald L Hickman, Breanna Hetland
Determining effective decision support strategies that enhance quality of end-of-life decision making in the intensive care unit is a research priority. This systematic review identified interventional studies describing the effectiveness of decision support interventions administered to critically ill patients or their surrogate decision makers. We conducted a systematic literature search using PubMed, CINAHL, and Cochrane. Our search returned 121 articles, 22 of which met the inclusion criteria. The search generated studies with significant heterogeneity in the types of interventions evaluated and varied patient and surrogate decision-maker outcomes, which limited the comparability of the studies...
November 1, 2016: Western Journal of Nursing Research
https://www.readbyqxmd.com/read/28320024/-therapeutic-decisions-concerning-severe-neurological-diseases-and-at-the-end-of-life
#13
Christoph Burkhard Lücking
Modern medicine increasingly enables survival of life-threatening diseases. On the other side, however, especially in Neurology, the questions have to be addressed how intensive the initial treatment should be and how to deal with residual states when severe functional or cognitive deficits are expected. In these cases, it is not only important to decide which medical measures are appropriate for the patient, but also whether, given the prognosis, the patient would agree with the suggested measures. This article first describes the basis for each medical action, i...
March 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28318209/end-of-life-care-managing-common-symptoms
#14
REVIEW
Ross H Albert
Physicians should be proficient at managing symptoms as patients progress through the dying process. When possible, proactive regimens that prevent symptoms should be used, because it is generally easier to prevent than to treat an acute symptom. As swallowing function diminishes, medications are typically administered sublingually, transdermally, or via rectal suppository. Opiates are the medication of choice for the control of pain and dyspnea, which are common symptoms in the dying process. Delirium and agitation may be caused by reversible etiologies, which should be identified and treated when feasible...
March 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28317617/companion-animal-owner-perceptions-knowledge-and-beliefs-regarding-pain-management-in-end-of-life-care
#15
Roschelle Heuberger, Michael Petty, Janice Huntingford
The senior companion animal is the fastest growing segment of the pet population. End-of-life care, quality of life, and pain management (PM) are extremely important to pet owners. Research into PM and end-of-life care is essential due to lack of information on owner knowledge, attitudes, and beliefs. A survey was developed to gather information from owners. Surveys were developed using expert focus groups, and participants were recruited through social media. Survey validation employed emergent themes and grounded theory...
December 2016: Topics in Companion Animal Medicine
https://www.readbyqxmd.com/read/28315547/how-can-i-change-my-patients-treatment-decision-making-by-becoming-a-nurse-scientist-%C3%A2
#16
Tamryn F Gray
"What would you do?" I have heard this question numerous times throughout my nursing career by patients and families affected by cancer. As a pediatric blood and marrow transplantation nurse, I have often seen patients and their families wrestle with difficult treatment decisions. I have witnessed parents struggle between beginning end-of-life care for their child, or pursuing a risky but potentially life-saving clinical trial. With science driving advances in cancer treatments and patients playing more active roles in their care, uncertainty around cancer treatment decisions will only become more complicated...
April 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28315478/improving-palliative-care-trough-teamwork-impactt-in-nursing-homes-study-design-and-baseline-findings
#17
Helena Temkin-Greener, Susan Ladwig, Zhiqiu Ye, Sally A Norton, Dana B Mukamel
BACKGROUND: The 2014 Institute of Medicine report recommended that healthcare providers caring for individuals with advanced illness have basic palliative care competencies in communication, inter-professional collaboration, and symptom management. Nursing homes, where one in three American decedents live and die, have fallen short of these competency goals. We implemented an intervention study to examine the efficacy of nursing home-based integrated palliative care teams in improving the quality of care processes and outcomes for residents at the end of life...
March 14, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28314840/end-of-life-care-matters-palliative-cancer-care-results-in-better-care-and-lower-costs
#18
Shalini Dalal, Eduardo Bruera
No abstract text is available yet for this article.
March 17, 2017: Oncologist
https://www.readbyqxmd.com/read/28306661/referring-patients-to-hospice-or-palliative-care
#19
Kathleen Broglio, Anne Walsh
NPs care for patients with chronic diseases such as heart failure, chronic obstructive pulmonary disease, cancer, and dementia. As the disease progresses or patients age, disease-related symptoms may become increasingly burdensome, and these patients may benefit from hospice or palliative care. NPs can guide individuals in this process to optimize care and support at the end of life.
April 16, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28304263/battling-a-tangled-web-the-lived-experience-of-nurses-providing-end-of-life-care-on-an-acute-medical-unit
#20
Irene Oliveira, Frances Fothergill-Bourbonnais, Christine McPherson, Brandi Vanderspank-Wright
Meeting the heath care needs of patients at the end of life is becoming more complex. In Canada, most patients with life-limiting illness will die in hospitals, many on medical units. Yet, few studies have qualitatively investigated end-of-life care (EOLC) in this context, or from the perspectives of nurses providing EOLC. The purpose of this study was to seek to understand the lived experience of nurses on a medical unit providing EOLC to patients. Interpretive phenomenology guided the method and analysis...
November 1, 2016: Research and Theory for Nursing Practice
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