Warming Hearts, Cloaking Grief

By Lori RuderHe moves over and she snuggles in close to her fianc é. She pulls their blanket over them. A special blanket made just for this moment. “I love you” she murmurs, soaking in his face and his warmth. “Goodnight lovebirds,” his mother teases as she turns out the lights.This moment is both tender and tragic: tender because they are demonstrating their love for each other, tragic because this is happening in the ICU. Her fianc é is on life support and he is dying. He moved over because I moved him over to make room for her in his narrow hospital bed. I repositioned his ventilator tubing and central lines out of her way, closed the side rail behind her for support, and helped her pull their blanket over them. This blanket was made by ICU nurses for moments like this: to have something to offer when medicine doesn’t.Using our own time and money, we gather together to make blankets. We make them in many colors and patterns, to match the many styles that come from all walks of life. They are simple fleece tie blankets, the kind a Girl Scout might make, but they are soft and warm. They are something soft amidst the harsh reality of critical illness and death, and something to provide warmth and comfort--to touch a loved one during last moments as if to capture their essence before they are gone. The blankets are a memento of touch to take with them when they leave this place and their loved one behind.We give our blankets wh...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: blanket cancer comfort icu lori ruder Source Type: blogs

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Authors: Swarm RA, Dans M Abstract The NCCN Framework aims to provide adapted guidelines for low- and middle-resource countries to improve the experience of patients with cancer. In particular, the NCCN Frameworks for Adult Cancer Pain and Palliative Care and were designed to help expand access to pain management and palliative care for patients in low-resource countries. The NCCN Framework is one of several tools that can improve cancer care in the developing world. The NCCN Harmonized Guidelines for Sub-Saharan Africa, a collaborative effort between NCCN, American Cancer Society, Clinton Health Access Initiative,...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research
Palliative care is a proven approach to enhance quality of life and care both for people with severe chronic obstructive pulmonary disease (COPD) [1] and those with lung cancer [2], and it is encouraged to start palliative care early in the disease trajectory [3, 4]. Similar symptoms occur in both diseases, such as pain, insomnia, fatigue, low mood and dyspnoea [5], with a study reporting even worse physical and emotional functioning for COPD than for lung cancer [6]. These symptoms signal palliative care needs [6], and require treatment focused on symptom management and psychosocial support for more than just the terminal...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Original Articles: Research letters Source Type: research
Andeep Ramesh Kukkar, Harsha Panchal, Asha AnandIndian Journal of Cancer 2017 54(3):556-559 Primary neuroendocrine tumors of the thymus are unusual anterior mediastinal tumors with a variable prognosis. A retrospective analysis of five patients with primary neuroendocrine tumors of the thymus admitted to the Gujarat Cancer and Research Institute, Ahmedabad, between 2012 and 2016, was done to study the clinical profile and outcome of these patients. The role of various prognostic factors such as surgical resection, histological grade, and Masaoka-Koga staging was also analyzed. Majority of the patients present with signs a...
Source: Indian Journal of Cancer - Category: Cancer & Oncology Authors: Source Type: research
The California attorney general has filed an emergency request with the state court of appeals to reverse a lower court ruling to invalidate the End of Life Option Act. The End of Life Option Act remains in effect until further notice. Similar to laws in Washington, D.C. and six other states, the California law gives mentally capable, terminally ill adults with six months or less to live to the option to request prescription medication they can decide to take to end unbearable suffering and die peacefully in their sleep. Last Tuesday, Riverside County Superior Court Judge Daniel Ottolia invalidated the law ...
Source: blog.bioethics.net - Category: Medical Ethics Authors: Tags: Health Care syndicated Source Type: blogs
By SAURABH JHA Of my time arguing with doctors, 30 % is spent convincing British doctors that their American counterparts aren’t idiots, 30 % convincing American doctors that British doctors aren’t idiots, and 40 % convincing both that I’m not an idiot. A British doctor once earnestly asked whether American physicians carry credit card reading machines inside their white coats. Myths about the NHS can be equally comical. British doctors don’t prostate every morning in deference to the NHS, like the citizens of Oceania sang to Big Brother in Orwell’s dystopia. Nor, in their daily rounds, do the...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: OP-ED Uncategorized AlfieEvans Source Type: blogs
The recent passing of former first lady Barbara Bush, an American icon, also brought a commonly debated discussion to light, palliative, and end of life care. Many articles were published regarding her last days, mentioning she was “foregoing further medical care” or “no longer pursuing medical treatment.” These types of statements are not only inaccurate, they also minimize the incredible medical care provided by palliative care and hospice teams. To realize the utility of these aspects of medical care, it is important to understand them. Palliative care and hospice both focus on managing symptoms....
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Physician Geriatrics Hospital-Based Medicine Palliative Care Source Type: blogs
Immune checkpoint inhibitors (ICI) have opened an exciting chapter in the treatment of patients with advanced cancer. For the palliative care clinician, however, ICI present several new challenges, including new ways to define treatment success, as well as treatment-related toxicities which differ in nature and timing from traditional chemotherapy. In this article, we review the mechanism of action of immune checkpoint inhibitors, as well as selected published data supporting the efficacy of ICI in patients with advanced cancer.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
Authors: Ida T, Goto T, Motoi T, Nagai I, Matsubara S, Fujiwara H, Kohyama A Abstract A bone metastasis from uterine cervical cancer normally indicates short life expectancy. Resection of the lesion is therefore palliative. The authors consider herein whether surgical resection can promote disease control while improving quality of life. A 33-year-old woman -presenting FIGO Stage IB 1 uterine cervical squamous cell carcinoma underwent a radical hysterectomy and pelvic irradiation. Twenty-two-months later, a solitary femoral metastasis was detected. Given the pain, imminent bone fracture, the patient's relative yout...
Source: European Journal of Gynaecological Oncology - Category: OBGYN Tags: Eur J Gynaecol Oncol Source Type: research
Conclusions Approximately two-thirds of patients who undergo treatment with radium-223 will experience an improvement in pain and, if it occurs, it will most likely occur within the first two cycles. Patients should be counseled about this timeline and, if pain improvement isn't achieved, palliative radiation and oral analgesic readjustment should be considered. Pain response is not associated with survival and should not be used to evaluate the effectiveness of treatment.
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research
Authors: Andreano A, Ansarin M, Alterio D, Bruschini R, Valsecchi MG, Russo AG Abstract SUMMARY: Head and neck (H&N) tumours are a heterogeneous group of neoplasms with 5-year relative survival ranging from about 25% for the hypopharynx to 60% for the larynx in Europe. To improve survival rates, along with therapeutic improvements, it is important to standardise and optimise care received by patients with H&N tumours across different healthcare providers. To reach this goal, it is necessary to evaluate adherence to standards of received care at a population level. Published guidelines can serve as the basis to deve...
Source: Acta Otorhinolaryngologica Italica - Category: ENT & OMF Tags: Acta Otorhinolaryngol Ital Source Type: research
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