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Dying with dignity

M Roessler, N Eulitz
The scope of emergency calls for emergency medical services staffed by an emergency physician (EMS-EP) includes calls to patients with life-limiting diseases. Symptom exacerbation as well as psychosocial overburdening of caring relatives are the most frequent reasons for activation of an EMS-EP. Pain crises, acute dyspnea, massive bleeding and/or an impending or overt cardiac arrest are the most frequent symptom exacerbations. Under the conditions of a prehospital emergency physician mission, particular challenges are the evaluation of the overall situation, the prognosis and the presumed will of the patient...
March 21, 2018: Der Anaesthesist
Amanda Su, Lindsay Lief, David Berlin, Zara Cooper, Daniel Ouyang, John Holmes, Renee Maciejewski, Paul K Maciejewski, Holly G Prigerson
CONTEXT: Deaths in the Intensive Care Unit (ICU) are increasingly common in the United States, yet little is known about patients' experiences at the end-of-life in the ICU. OBJECTIVES: The objective of this study was to determine nurse assessment of symptoms experienced, and care received by ICU patients in their final week, and their associations with nurse-perceived suffering and dignity. METHODS: From September 2015 to March 2017, nurses who cared for 200 ICU patients who died were interviewed about physical and psychosocial dimensions of patients' experiences...
February 16, 2018: Journal of Pain and Symptom Management
V Pinchi, M Focardi, F Pradella, R Grifoni, M Palandri, G A Norelli
The migratory flows to Europe from the African countries, Asia and Middle East, have hugely intensified in the recent years. In 2016, more than 98,000 out of a total of 260,000 migrants across the Mediterranean Sea arrived in Italy and in May 2017, the trend of arrivals is: Italy +576%; Greece -39% compared to previous years. Some migrants die before touching the sole of the European continent, during the crossing, often afforded with ships, made available by unscrupulous smugglers or criminal organizations, which are unsuitable for this type of transportation...
December 1, 2017: Journal of Forensic Odonto-stomatology
M Isabel González-Méndez, Luís López-Rodríguez
The decrease in potential donation after brain death has resulted in a need to evaluate alternative sources. Donation after cardiac death is a good option. The objectives of this article are to describe the Maastricht type iii controlled organ donation characteristics and to determine end-of-life care and the role of nurses in the donation process. In this type of donation, cardiocirculatory arrest is predictable after the limitation of life sustaining treatments. These are patients for whom there are no effective therapy options and, in the context of an organised and planned practice involving all the professionals involved in the care of the patient, the decision is made, in consultation with the family, to withdraw life support measures...
December 11, 2017: Enfermería Clínica
Briony F Hudson, Caroline Shulman, Joseph Low, Nigel Hewett, Julian Daley, Sarah Davis, Nimah Brophy, Diana Howard, Bella Vivat, Peter Kennedy, Patrick Stone
OBJECTIVES: To explore the views and experiences of people who are homeless and those supporting them regarding conversations and approaches to palliative care SETTING: Data were collected between October 2015 and October 2016 in homeless hostels and day centres and with staff from primary and secondary healthcare providers and social care services from three London boroughs. PARTICIPANTS: People experiencing homelessness (n=28), formerly homeless people (n=10), health and social care providers (n=48), hostel staff (n=30) and outreach staff (n=10 )...
November 28, 2017: BMJ Open
Andrea Rodríguez-Prat, Albert Balaguer, Andrew Booth, Cristina Monforte-Royo
OBJECTIVES: Patients with advanced disease sometimes express a wish to hasten death (WTHD). In 2012, we published a systematic review and meta-ethnography of qualitative studies examining the experience and meaning of this phenomenon. Since then, new studies eligible for inclusion have been reported, including in Europe, a region not previously featured, and specifically in countries with different legal frameworks for euthanasia and assisted suicide. The aim of the present study was to update our previous review by including new research and to conduct a new analysis of available data on this topic...
September 29, 2017: BMJ Open
Daniel B Kramer, Daniel Habtemariam, Yaw Adjei-Poku, Michelle Samuel, Diane Engorn, Matthew R Reynolds, Susan L Mitchell
BACKGROUND: Implantable cardioverter-defibrillators (ICDs) are commonly implanted in older patients, including those with multiple comorbidities. There are few prospective studies assessing the clinical course and end-of-life circumstances for these patients. METHODS AND RESULTS: We prospectively followed 51 patients with ICDs for up to 18 months to longitudinally assess in terms of (1) advance care planning, (2) health status, (3) healthcare utilization, and (4) end-of-life circumstances through quarterly phone interviews and electronic medical record review...
September 22, 2017: Journal of the American Heart Association
William Rosa, Tarron Estes, Jean Watson
Caring science is an extant theory of human relationship, guiding the profession of nursing with the understanding and application of a moral-ethical praxis that promotes, protects, and provides human dignity throughout the life continuum. Over the past 30 or more years, caring science has transformed nursing by calling for a heightened ethical perspective of human dignity in how nurses practice, educate, research, and evolve the profession. Conscious dying is a framework rooted in a human caring ontology, which strives to deepen the nurse healer's awareness in tending to a patient's dying and death, returning death to its sacred place in the cycle of life...
January 2017: Nursing Science Quarterly
Helena Kisvetrová, Šárka Vévodová, David Školoudík
PURPOSE: Comfort promotion plays a significant role in end-of-life patient care. The objective of this study was to determine the utilization rate of comfort supporting nursing activities in end-of-life patients in an institutionalized environment in the Czech Republic in relation to the age of the registered nurses (RNs), length of work experience, education level, and type of workplace. DESIGN: A cross-sectional, descriptive study was designed. A questionnaire with Likert scales included 31 activities of dying care and spiritual support interventions...
September 4, 2017: Journal of Nursing Scholarship
Elaine Cole
Homeless people are dying in unsupported and unacceptable situations with inadequate access to palliative care, a recent study found.
August 30, 2017: Nursing Standard
Hsueh-Hsing Pan, Hsiu-Ling Shih, Li-Fen Wu, Yu-Chun Hung, Chi-Ming Chu, Kwua-Yun Wang
BACKGROUND: The Taiwanese government has promoted palliative care consultation services (PCCS) to support terminally ill patients in acute ward settings to receive palliative care since 2005. Such an intervention can enhance the quality of life and dignity of terminally ill patients. However, research focusing on the relationship between the knowledge, attitude and practice of a PCCS using path modelling in nursing staff is limited. Therefore, the aim of this study was to elucidate the effect of path modeling on the knowledge, attitude and practice toward PCCS in Taiwanese nursing staff...
August 17, 2017: BMC Palliative Care
Prahlad K Sethi, Nitin K Sethi
No abstract text is available yet for this article.
June 2017: Journal of the Association of Physicians of India
Frank Brennan
Significant developments have occurred in the discipline of palliative care in the modern era. This paper shall explore those developments, challenge some widely held misconceptions about the role and daily practice of the discipline, highlight the growing recognition of the role of palliative care in non-malignant diseases, briefly discuss innovations in symptom management and reflect on the underlying principles, maturation and challenges faced by the discipline.
August 2017: Internal Medicine Journal
Silvio A Ñamendys-Silva
No abstract text is available yet for this article.
November 2017: Journal of Palliative Medicine
Dana Hradcová
BACKGROUND: Autonomy has become a key organizing principle in the official and expert discourses of the social services focused on strengthening of clients' independence and self-sufficiency. While "caring" has been seen as a threat to the autonomy of an individual, the care dependency and need for palliative care for people with dementia living in residential institutions are growing. METHODS: Participatory action research was realized in 9 homes providing services for people with dementia with the aim to improve the quality of care...
October 2017: Annals of Palliative Medicine
Jorge O Selandari, María S Ciruzzi, Adriel J Roitman, Fernanda Ledesma, Célica Menéndez, Hernán O García
INTRODUCTION: The possibility of sustaining life functions makes it difficult to distinguish between a dying patient and a patient with chances of survival, raising a dilemma for everyone around them. On the one side, continuing with life support techniques that would only extend an irreversible process and result in physical and psychological damage and harm their dignity. On the other side, withholding or withdrawing life support without an adequate reflection and diagnostic-therapeutic effort which may lead to the death of a potentially recoverable child...
August 1, 2017: Archivos Argentinos de Pediatría
Daniel Burnier
This article analyzes the writings of Elisabeth Kübler-Ross through the discursive lens of the phrase "dying with dignity." For her, the phrase meant allowing someone to die comfortably his/her own death. This phrase has to be understood in relationship with the final "stage of acceptance" of her model. Describing this key part of her well-known scientific output, she often used, in the early 1970s, the phrase "dying in peace and dignity." An evaluation of the evidence suggests that because the concept of dignity was co-opted by the pro-euthanasia movement during this decade, the language of dignity was little by little abandoned by her...
January 1, 2017: Journal of Palliative Care
Andrea Rodríguez-Prat, Evert van Leeuwen
It is not uncommon for patients with advanced disease to express a wish to hasten death (WTHD). Qualitative studies of the WTHD have found that such a wish may have different meanings, none of which can be understood outside of the patient's personal and sociocultural background, or which necessarily imply taking concrete steps to ending one's life. The starting point for the present study was a previous systematic review of qualitative studies of the WTHD in advanced patients. Here we analyse in greater detail the statements made by patients included in that review in order to examine their moral understandings and representations of illness, the dying process and death...
July 1, 2017: Medicine, Health Care, and Philosophy
Rakhi Ghoshal, Deepa V, Sunita Simon Kurpad
No abstract text is available yet for this article.
July 2017: Indian Journal of Medical Ethics
Antje Gottschalk-Fleischer, Norbert Köhler, Elmar Brähler, Anja Mehnert, Heide Götze
Aim of the study The aim of the study was to assess the level of psychosocial distress and satisfaction with care in family caregivers after the death of a close relative. Method Anxiety and depression (HADS) of family caregivers were evaluated in both bereaved family caregivers and a comparable group from the general population. Furthermore, satisfaction with care (ZUF-8) and social support (HOPE-Module, ESSI) were assessed after the patients had died. Regression models were employed to analyze associations between psychological distress and sociodemographic and care-related variables...
May 12, 2017: Das Gesundheitswesen
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