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End of life care

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https://www.readbyqxmd.com/read/29040427/what-is-the-end-of-life-period-trajectories-and-characterization-based-on-primary-caregiver-reports
#1
Jiska Cohen-Mansfield, Rinat Cohen, Michal Skornick-Bouchbinder, Shai Brill
BACKGROUND: As the population lives longer, end of life (EOL) is emerging as a distinct life phase, about which there is still limited understanding. Characterizing this important period is vital for clarifying issues regarding trajectory and decline at EOL and for health service planning on an institutional, communal, and societal level. In this paper we aim to characterize the EOL period, examining the duration and number of EOL stages, as well as the functional, attitudinal and emotional trajectories...
October 12, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29036856/informal-care-employment-and-quality-of-life-barriers-and-facilitators-to-combining-informal-care-and-work-participation-for-healthcare-professionals
#2
Eveline Heitink, Yvonne Heerkens, Josephine Engels
BACKGROUND: In The Netherlands, one out of six Dutch employees has informal care tasks; in the hospital and healthcare sector, this ratio is one out of four workers. Informal carers experience problems with the combination of work and informal care. In particular, they have problems with the burden of responsibility, a lack of independence and their health. These problems can reveal themselves in a variety of mental and physical symptoms that can result in absenteeism, reduction or loss of (work) participation, reduction of income, and even social isolation...
October 8, 2017: Work: a Journal of Prevention, Assessment, and Rehabilitation
https://www.readbyqxmd.com/read/29036302/a-prospective-observational-study-to-investigate-utility-of-the-delirium-observational-screening-scale-doss-to-detect-delirium-in-care-home-residents
#3
E A Teale, T Munyombwe, M Schuurmans, N Siddiqi, J Young
Background: care home residents are particularly at risk of delirium due to high prevalence of dementia. The Delirium Observation Screening Scale (DOSS) identifies behavioural changes associated delirium onset that nursing staff are uniquely placed to recognise. We tested the psychometric properties of the DOSS in UK care homes compared with the Confusion Assessment Method (CAM). Design: prospective observational cohort study performed between 1 March 2015 and 30 June 2016...
October 5, 2017: Age and Ageing
https://www.readbyqxmd.com/read/29034688/end-of-life-characteristics-and-palliative-care-provision-for-patients-with-motor-neuron-disease
#4
Hon Wai Benjamin Cheng, Oi Man Iman Chan, Chun Hung Red Chan, Wan Hung Chan, Koon Sim Fung, Kar Yin Wong
Motor neuron disease (MND) is a neurodegenerative disease and manifested as progressive decline in physical, respiratory, swallowing and communication function, and ultimately death. Traditional model of care was fragmented and did not match with multifacet needs of patients and carers. Furthermore, there could be lack of integrated care at end of life for patients with MND in most lower- and middle-income countries or in places with inadequate palliative care (PC) coverage. In view of this, a special workgroup for patients with MND, which includes neurologist, respiratory physician, rehabilitation specialist, and PC physician was formed in Hong Kong since year 2011...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29034687/predictors-of-placement-of-inpatient-palliative-care-consult-orders-among-patients-with-breast-lung-and-colon-cancer-in-a-safety-net-hospital-system
#5
Lauren N Smith, Ramona L Rhodes, Lei Xuan, Ethan A Halm
BACKGROUND: The provision of palliative and end-of-life care to patients who are underrepresented and underserved provides unique challenges and opportunities. OBJECTIVES: To examine predictors of placement of inpatient palliative care consult orders among patients with breast, lung, and colorectal cancer hospitalized in a safety net hospital in 2010. METHODS: Simple and multivariable logistic regression of data on selected patients with cancer was performed to identify predictors of placement of inpatient palliative care consult orders...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29034083/the-effect-of-cognitive-behavioral-counseling-on-anxiety-in-the-mothers-of-infants-in-the-nicu-%C3%A2-a-randomized-controlled-trial
#6
Massumeh Koochaki, Zohreh Mahmoodi, Sara Esmaelzadeh-Saeieh, Kourosh Kabir, Maryam Tehranizadeh, Mahrokh Dolatian
Background: Pressures and tensions in everyone's life can cause a wide range of mental disorders such as anxiety. One of these tensions is the birth of a baby who requires special care, which can cause personal and social problems for the mother if no appropriate measures are taken to help them. The present study was conducted to determine the effect of cognitive-behavioral counseling on anxiety in the mothers of infants in the Neonatal Intensive Care Unit. Methods: This randomized controlled trial recruited 90 women presenting to Kowsar Hospital in Qazvin in 2016...
2017: F1000Research
https://www.readbyqxmd.com/read/29033560/proactive-palliative-care-for-patients-with-copd-prolong-a-pragmatic-cluster-controlled-trial
#7
R G Duenk, C Verhagen, E M Bronkhorst, Pjwb van Mierlo, Meac Broeders, S M Collard, Pnr Dekhuijzen, Kcp Vissers, Y Heijdra, Y Engels
BACKGROUND AND AIM: Patients with advanced chronic obstructive pulmonary disease (COPD) have poor quality of life. The aim of this study was to assess the effects of proactive palliative care on the well-being of these patients. TRIAL REGISTRATION: This trial is registered with the Netherlands Trial Register, NTR4037. PATIENTS AND METHODS: A pragmatic cluster controlled trial (quasi-experimental design) was performed with hospitals as cluster (three intervention and three control) and a pretrial assessment was performed...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29033549/reliability-of-patient-reported-outcome-instruments-in-us-adults-with-hemophilia-the-pain-functional-impairment-and-quality-of-life-p-fiq-study
#8
Christine L Kempton, Michael Wang, Michael Recht, Anne Neff, Amy D Shapiro, Amit Soni, Roshni Kulkarni, Tyler W Buckner, Katharine Batt, Neeraj N Iyer, David L Cooper
BACKGROUND: Hemophilia is marked by frequent joint bleeding, resulting in pain and functional impairment. OBJECTIVE: This study aimed to assess the reliability of five patient-reported outcome (PRO) instruments in people with hemophilia (PWH) in a non-bleeding state. METHODS: Adult male PWH of any severity and inhibitor status, with a history of joint pain or bleeding, completed a pain history and five PRO instruments (EQ-5D-5L, Brief Pain Inventory v2 [BPI], International Physical Activity Questionnaire [IPAQ], Short Form 36 Health Survey v2 [SF-36v2], and Hemophilia Activities List [HAL]) during their routine comprehensive care visit...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29033267/palliative-care-in-interstitial-lung-disease-living-well
#9
REVIEW
Michael Kreuter, Elisabeth Bendstrup, Anne-Marie Russell, Sabrina Bajwah, Kathleen Lindell, Yochai Adir, Crystal E Brown, Greg Calligaro, Nicola Cassidy, Tamera J Corte, Klaus Geissler, Azza Adel Hassan, Kerri A Johannson, Ronaldo Kairalla, Martin Kolb, Yasuhiro Kondoh, Sylvia Quadrelli, Jeff Swigris, Zarir Udwadia, Athol Wells, Marlies Wijsenbeek
Progressive fibrotic interstitial lung diseases (ILDs) are characterised by major reductions in quality of life and survival and have similarities to certain malignancies. However, palliative care expertise is conspicuously inaccessible to many patients with ILD. Unmet patient and caregiver needs include effective pharmacological and psychosocial interventions to improve quality of life throughout the disease course, sensitive advanced care planning, and timely patient-centred end-of-life care. The incorrect perception that palliative care is synonymous with end-of-life care, with no role earlier in the course of ILD, has created a culture of neglect...
October 12, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29032697/the-association-of-sitting-time-with-sarcopenia-status-and-physical-performance-at-baseline-and-18-month-follow-up-in-the-residential-aged-care-setting
#10
N Reid, J W Keogh, P Swinton, P A Gardiner, Timothy Henwood
This study investigated the association of sitting time with sarcopenia and physical performance in Residential Aged Care (RAC) residents at baseline and 18-month follow-up. Measures included the International Physical Activity Questionnaire (sitting time), European Working Group definition of sarcopenia, and the Short Physical Performance Battery (physical performance). Logistic regression and linear regression analyses were used to investigate associations. For each hour of sitting the unadjusted odds ratio of sarcopenia was 1...
October 16, 2017: Journal of Aging and Physical Activity
https://www.readbyqxmd.com/read/29032243/dna-methylation-patterns-are-related-to-co-morbidity-status-and-circulating-c-reactive-protein-levels-in-the-nursing-home-elderly
#11
Chris P Verschoor, Lisa M McEwen, Michael S Kobor, Mark B Loeb, Dawn M E Bowdish
Elderly residents of long-term care commonly exhibit a number of age-related health deficits, including impaired physical and cognitive function, chronic illnesses, and chronic inflammation. Given our previous data relating the phenotype and function of innate and adaptive leukocytes from the nursing home elderly to chronic conditions and inflammatory biomarkers, we hypothesized that these factors would influence the regulatory programming of immune cells, thereby contributing to immune dysfunction. Since DNA methylation represents both an important regulatory mechanism of cells as well as a biomarker of health and disease, we sought to characterize the methylome of peripheral blood mononuclear cells (PBMCs) from the nursing home elderly (n=23; 82-98years old, 70% female), and compare these patterns to pathological factors such as dementia, co-morbidity score and frailty, and immune-related factors such as serum C-reactive protein (CRP) and cytokine levels and varicella-zoster virus (VZV) vaccine responsiveness...
October 12, 2017: Experimental Gerontology
https://www.readbyqxmd.com/read/29032021/clinical-characteristics-and-survival-outcomes-of-terminally-ill-patients-undergoing-withdrawal-of-mechanical-ventilation
#12
Yu-Shin Hung, Shu-Hui Lee, Chia-Yen Hung, Chao-Hui Wang, Chen-Yi Kao, Hung-Ming Wang, Wen-Chi Chou
BACKGROUND: Withdrawal of mechanical ventilation is an important, but rarely explored issue in Asia during end-of-life care. This study aimed to describe the clinical characteristics and survival outcomes of terminally ill patients undergoing withdrawal of mechanical ventilation in Taiwan. METHODS: One-hundred-thirty-five terminally ill patients who had mechanical ventilation withdrawn between 2013 and 2016, from a medical center in Taiwan, were enrolled. Patients' clinical characteristics and survival outcomes after withdrawal of mechanical ventilation were analyzed...
October 11, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29030806/palliative-care-in-the-management-of-patients-with-advanced-heart-failure
#13
Susan E Lowey
Globally, there are 18-million individuals living with heart failure, a disease that is responsible for 12-15 million office visits and 6.5 million inpatient hospitalizations each year. As HF becomes advanced or end-stage, patients often live in a cycle of frequent transitions between care settings, and with unmet needs, including distress from inadequately managed symptoms. Prognostication in patients with heart failure can be challenging due to the unpredictable exacerbating-remitting illness trajectory that is associated with this progressive disease...
October 14, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29030210/continuous-cardiac-inotropes-in-patients-with-end-stage-heart-failure-an-evolving-experience
#14
Kasey Malotte, Agafe Saguros, Hunter Groninger
Heart failure experts recommend initiation of continuous inotrope therapy, such as milrinone or dobutamine, for clinically decompensating patients with stage D heart failure. Although originally intended to serve solely as a bridge to more definitive surgical therapies, more and more patients are receiving inotrope therapy for purely palliative purposes. In these cases, questions arise regarding care at the end of life. What criteria determine ongoing clinical benefit? Should the inotrope be continued until death? Should inotrope dosing be increased within recommended guidelines to improve symptoms? What is the role of inotropes in hospice care? Here, we describe such a case as a springboard to contemplate the evolving role of inotrope therapies and how hospice and palliative providers may interface with this rapidly developing face of advanced heart failure care...
October 10, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29030206/the-impact-of-supporting-family-caregivers-pre-bereavement-on-outcomes-post-bereavement-adequacy-of-end-of-life-support-and-achievement-of-preferred-place-of-death
#15
Samar M Aoun, Gail Ewing, Gunn Grande, Chris Toye, Natasha Bear
OBJECTIVES: This study investigated the extent to which using the Carer Support Needs Assessment Tool (CSNAT) intervention during the caregiving period has affected bereaved family caregivers' perceptions of adequacy of support, their grief and wellbeing and achievement of their preferred place of death. METHOD: All family caregivers who participated in a stepped wedge cluster trial of the CSNAT intervention in Western Australia (2012-14) and completed the pre-bereavement study (n=322) were invited to take part in a caregiver survey by telephone 4-6 months post-bereavement (2015)...
October 10, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29029757/palliative-care-and-end-of-life-care-for-polypathological-patients
#16
E Martinez-Litago, M C Martínez-Velasco, M P Muniesa-Zaragozano
Patients with advanced chronic diseases receive fragmented care, which entails high resource consumption and a poor quality of life. Uncertainty in the prognosis and scarce investigation into the importance of symptomatic control in this patient group hinders a proper therapeutic approach. Palliative care teams optimise the use of resources through comprehensive patient care, the optimization of the patient's environment, communication, the preparation of early care plans and the creation of coordinated healthcare circuits, which improve the quality of the patient's care in advanced stages of the disease...
October 10, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/29029668/the-de-pharm-project-a-pharmacist-driven-deprescribing-initiative-in-a-nursing-facility
#17
Jennifer Pruskowski, Steven M Handler
OBJECTIVE: Many residents with life-limiting illnesses are being prescribed and taking potentially inappropriate medications (PIMs) and questionably beneficial medications either near or at the end of life. These medications can contribute to adverse drug reactions, increase morbidity, and increase unnecessary burden and cost. It is crucial that the process of deprescribing be incorporated into the care of these residents. After developing a clinical pharmacist-driven deprescribing initiative in the nursing facility, the objective of this project was to reduce the number of PIMs via accepted recommendations from the clinical pharmacist to the primary team...
August 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29028914/trajectory-of-total-cholesterol-in-the-last-years-of-life-over-age-80-years-cohort-study-of-99-758-participants
#18
Judith Charlton, Rathi Ravindrarajah, Shota Hamada, Stephen H Jackson, Martin C Gulliford
Background: Epidemiological studies suggest that lower total cholesterol (TC) may be associated with higher mortality. This study aimed to evaluate whether a decline in total cholesterol before death might account for the association of TC with mortality over age 80 years. Methods: Cohort study using primary care electronic health records of 99,758 participants aged 80 to 105 years from the UK Clinical Practice Research Datalink (CPRD). Hazard ratios (HR) for all-cause mortality were adjusted for age, gender, frailty, comorbidity, blood pressure and smoking...
September 27, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29028421/medical-student-reflections-on-geriatrics-moral-distress-empathy-ethics-and-end-of-life
#19
Mary E Camp, Haekyung Jeon-Slaughter, Anne E Johnson, John Z Sadler
INTRODUCTION: Medical students' early clinical encounters may influence their perceptions of geriatrics. This study examines reflective essays written by 3rd year medical students on required clinical rotations. METHODS: Using content analysis, the authors analyzed the essays' thematic content. The authors then used chi-square analysis to compare themes with geriatric patients (age 60+) to themes with other age groups. RESULTS: 120 out of 802 essays described a geriatric patient...
October 13, 2017: Gerontology & Geriatrics Education
https://www.readbyqxmd.com/read/29027835/identifying-the-types-of-support-needed-by-interprofessional-teams-providing-pediatric-end-of-life-care-a-thematic-analysis
#20
Clare O Riotte, Stephanie K Kukora, Patricia M Keefer, Janice I Firn
BACKGROUND: Despite the number of interprofessional team members caring for children at the end of life, little evidence exists on how institutions can support their staff in providing care in these situations. OBJECTIVE: We sought to evaluate which aspects of the hospital work environment were most helpful for multidisciplinary team members who care for patients at the end of life and identify areas for improvement to better address staff needs. DESIGN: Qualitative thematic analysis was completed of free-text comments from a survey distributed to interprofessional staff members involved in the care of a recently deceased pediatric patient...
October 13, 2017: Journal of Palliative Medicine
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