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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Peripherally inserted central catheter, midline, and "short" midline in palliative care: Patient-reported outcome measures to assess impact on quality of care. J Vasc Access. 2018 Dec 03;:1129729818814732 Authors: Magnani C, Calvieri A, Giannarelli D, Espino M, Casale G Abstract OBJECTIVES:: A prospective, observational study was conducted in our palliative care unit to assess the impact of peripherally inserted central catheters (PICCs), midline, and "short" midline catheters on the quality of care in cancer and non-cancer patients. The secondary objective was to assess pain and di...
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research
Abstract OBJECTIVE: Although palliative care is critical to managing symptoms, pain, and transitions to end-of-life care among those facing serious or chronic illness, it is often underused, which may be due to stigma associated with palliative care representing giving up fighting one's illness. The goal of the present studies was to test the theoretical framework of stigma within the context of palliative care to inform future work on intervention development that addresses potential barriers to palliative care utilization. METHOD: In study 1, participants (n = 152) had an oncologist describe two treatment o...
Source: Palliative and Supportive Care - Category: Palliative Care Authors: Tags: Palliat Support Care Source Type: research
CONCLUSION:: In all settings, sedated patients have significantly more pain problems compared to patients not receiving sedation. Large differences between settings seem to indicate different patient populations, different levels of professionals' palliative care experience and different availability of treatment options. Our study suggests that certain patient groups who may be as vulnerable to refractory pain and symptoms as others are less likely to receive continuous deep sedation until death when warranted. PMID: 30516090 [PubMed - as supplied by publisher]
Source: Palliative Medicine - Category: Palliative Care Authors: Tags: Palliat Med Source Type: research
Despite recent advances in palliative medicine, some symptoms are refractory to intensive palliative care, and then palliative sedation therapy is sometimes performed 1, 2. Continuous deep sedation until death (CDS) is regarded as one type of palliative sedation therapy, and it has recently become a focus of intense debate 3-8. While dying in one ’s sleep is regarded as one type of good death in some cultures 9, CDS may be labeled as a continuum of euthanasia, especially when performed for patients with relatively longer predicted survival 3-8, 10.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
Abstract IntroductionCancer-related drowsiness (CRD) is a distressing symptom in advanced cancer patients (ACP). The aim of this study was to determine the frequency and factors associated with severity of CRD. We also evaluated the screening performance of Edmonton Symptom Assessment Scale-drowsiness (ESAS-D) item against the Epworth Sedation Scale (ESS). METHOD: We prospectively assessed 180 consecutive ACP at a tertiary cancer hospital. Patients were surveyed using ESAS, ESS, Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Hospital Anxiety Depression Scale.ResultNinety of 150 evaluable patients had...
Source: Palliative and Supportive Care - Category: Palliative Care Authors: Tags: Palliat Support Care Source Type: research
People with advanced dementia often experience suboptimal end of life care (EoLC) with inadequate pain control, increased hospitalisation, and fewer palliative care interventions compared to those with cancer....
Source: BMC Geriatrics - Category: Geriatrics Authors: Tags: Research article Source Type: research
A, Noël G Abstract PURPOSE: The cost of radiotherapy is a concern for health systems. The conventional non fractionated or multifractionated schemes have shown the same efficacy in terms of pain relief but a non fractionated treatment seems less expensive. However, in general practice, multifractionated treatments are still the majority, which represents an additional cost for society. Moreover, the use of stereotactic body radiotherapy becomes more democratic and offers new curative perspectives, but at what price? MATERIAL AND METHODS: A monocentric retrospective study was conducted in a French radiot...
Source: Cancer Radiotherapie - Category: Cancer & Oncology Authors: Tags: Cancer Radiother Source Type: research
Journal of Palliative Medicine, Ahead of Print.
Source: Journal of Palliative Medicine - Category: Palliative Care Authors: Source Type: research
A patient's family is in the front row during their illness, as well as the period surrounding their death. The experience lived by family members during the palliative care period, between the diagnosis of a cancer and the death of their loved one, has too often been reduced to the concept of anticipatory grief. This concept is widely criticized because of its overgeneralization, and its limited capacity to explain the complex and socially grounded experience lived prior to the death of a loved one.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
This study evaluated the natural history of advanced colon cancer and determined prognosis after discontinuation of chemotherapy and introduction of palliative care for such patients. We also sought to determine if there are prognostic factors that predict survival in advanced colon cancer.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
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