Choosing Educational Resources to Build Interprofessional, Palliative Care Competency: A Replicable Review Methodology.
CONCLUSION: This review process provided information which can inform a provincial interprofessional palliative education plan. The methodology may be used by others to assess and choose between competency-based education resources with a palliative population focus and other patient population foci. PMID: 32611258 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - July 4, 2020 Category: Palliative Care Tags: J Palliat Care Source Type: research

Are You Prepared for End-of-Life Care? A Content Review of Canadian End-of-Life Care Standards and Competencies for Saskatchewan.
CONCLUSIONS: Health professional associations need to ensure end-of-life care standards and competencies are in place for the provision of appropriate and holistic care. Aligning standards and competencies across professions improves the preparedness of health professionals to provide interprofessional end-of-life care. PMID: 32571155 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - June 24, 2020 Category: Palliative Care Tags: J Palliat Care Source Type: research

Attitude and Barriers in Palliative Care and Advance Care Planning in Nonmalignant Chronic Lung Disease: Results From a Danish National Survey.
CONCLUSION: The attitude toward PC and ACP conversations was positive and implementation was regarded as important, but only a minority performed these conversations in practice. Main barriers were lack of time and staff. Palliative care guidelines were known but only scarcely used. Structural changes at the organizational level to improve access to palliation for patients with nonmalignant chronic lung diseases are needed. PMID: 32573354 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - June 24, 2020 Category: Palliative Care Tags: J Palliat Care Source Type: research

Translating Pediatric Hospital Interpreters' Feedback From Difficult Conversations into Improved Communication.
CONCLUSIONS: As experts in cultural dynamics and message transmission, the insights of medical interpreters can improve communication with families. PMID: 32527189 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - June 14, 2020 Category: Palliative Care Tags: J Palliat Care Source Type: research

Hearing and Heeding the Voices of those With Advanced Illnesses.
CONCLUSION: The results suggest that the primary participants who completed the study benefited by significantly increasing their QOL, SWB, EWB, and SC. PMID: 32466734 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - May 31, 2020 Category: Palliative Care Tags: J Palliat Care Source Type: research

Canada's Evolving Medicare: End-of-Life Care.
Authors: MacPherson N, Montague T, Aylen J, Martin L, Gogovor A, Baxter S, Nemis-White J Abstract A challenging issue in contemporary Canadian Medicare is the evolution of end-of-life care. Utilizing data from the 2016 and 2018 Health Care in Canada (HCIC) surveys, this paper compares the support and priorities of the adult public (n = 1500), health professionals (n = 400), and administrators (n = 100) regarding key components for end-of-life care just prior to and post legalization of medical assistance in dying (MAiD) in Canada. In 2016 and 2018, the public, health professionals and administrators strongly suppor...
Source: Journal of Palliative Care - May 15, 2020 Category: Palliative Care Tags: J Palliat Care Source Type: research

Trends and Utilization of Inpatient Palliative Care Among Patients With Metastatic Bladder Cancer.
Authors: Han H, Yu F, Wu C, Dai L, Ruan Y, Cao Y, He J Abstract OBJECTIVE: To explore the trends and utilization of palliative care (PC) service among inpatients with metastatic bladder cancer (MBC). METHODS: A retrospective, cross-sectional analysis was performed using data from the 2003 to 2014 National Inpatient Sample. Palliative care was identified through International Classification of Diseases, Ninth Revision code V66.7. Demographics, comorbidities, hospital characteristics, tumor-related, and treatment-related factors were compared between patients with and without PC. Multivariable logistic regression...
Source: Journal of Palliative Care - May 15, 2020 Category: Palliative Care Tags: J Palliat Care Source Type: research

Death and End of Life: Perceptions Throughout The Career About Death, Palliative Care, and Educational Process.
CONCLUSIONS: Medical education plays a fundamental role in the development of knowledge and skills on death, dying, and PC. Such practices should extend throughout the course and be continuously improved after graduates move to clinical practice. PMID: 32390540 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - May 12, 2020 Category: Palliative Care Tags: J Palliat Care Source Type: research

Evaluation of a Video Decision Aid to Reduce Decisional Conflict in Physician Orders for Life-Sustaining Treatment (POLST) Decision-Making.
Authors: Gallegos JV, Edelstein B, Moss AH Abstract BACKGROUND/OBJECTIVES: Physician Orders for Life-Sustaining Treatment (POLST) is recommended as a preferred practice for advance care planning with seriously ill patients. Decision aids can assist patients in advance care planning, but there are limited studies on their use for POLST decisions. We hypothesized that after viewing a POLST video, decision aid participants would demonstrate increased knowledge and satisfaction and decreased decisional conflict. DESIGN: Pre-and postintervention with no control group. SETTING/PARTICIPANTS: Fifty community-dwelli...
Source: Journal of Palliative Care - May 8, 2020 Category: Palliative Care Tags: J Palliat Care Source Type: research

Building a Medical Undergraduate Palliative Care Curriculum: Lessons Learned.
We describe building a comprehensive palliative and end-of-life care curriculum for medical undergraduates at our university. As with recent European and US studies, we found that the process of university curriculum renewal provided a critical opportunity to integrate palliative care content, but needed a local palliative care champion already in place as an energetic and tireless advocate. The development and integration of a substantive bilingual (English and French) palliative and end-of-life care curriculum over the 4-year medical undergraduate program at our university has occurred over the course of 14 years, and re...
Source: Journal of Palliative Care - April 15, 2020 Category: Palliative Care Tags: J Palliat Care Source Type: research

The Role of Hospice Palliative Care Volunteers With Respect to Conversations About Medical Assistance in Dying (MAiD).
Authors: Claxton-Oldfield S PMID: 32264756 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - April 10, 2020 Category: Palliative Care Tags: J Palliat Care Source Type: research

Palliative Care and the Tragedy of the Commons.
This article outlines the way in which applying frameworks from economics to end-of-life care can contribute to conversations about reform, particularly in terms of how to reform palliative care to harness its full potential to limit overtreatment, improve quality of life, and lower costs. The authors use principles from economics and political science to propose a series of possible reforms to end-of-life care, starting with reimbursement bundling and ending with pause points and more conscious ownership of care decisions by patients and their teams of providers. PMID: 32131680 [PubMed - as supplied by publisher] (Sou...
Source: Journal of Palliative Care - March 8, 2020 Category: Palliative Care Tags: J Palliat Care Source Type: research

To What Extent Does Clinically Assisted Nutrition and Hydration Have a Role in the Care of Dying People?
Authors: Carter AN Abstract The question over whether to administer clinically assisted nutrition and hydration (CANH) to a dying patient is controversial, with much debate concerning this sensitive issue. The administration of CANH poses clinical and ethical dilemmas, with supporting and opposing views. Proposed positive effects of CANH include preventing thirst, delirium, hypercalcemia, and opioid toxicity. However, CANH has been shown to increase the risk of aspiration, pressure ulcers, infections, and hospital admissions as well as potentially causing discomfort to the patient. Guidance from several national bo...
Source: Journal of Palliative Care - March 6, 2020 Category: Palliative Care Tags: J Palliat Care Source Type: research

Transitioning to Life in a Nursing Home: The Potential Role of Palliative Care.
This article describes the perceptions of NH PC-eligible residents and families transitioning to life in a NH. METHODS: Residents at 3 NHs in Northern California (N = 228) were screened for PC eligibility. A convenience sample of PC-eligible residents and their family members (n = 28) participated in qualitative interviews that explored the experience of living as a NH resident with serious illness. Data were analyzed using grounded theory methodology. RESULTS: Our study provides insights into the experiences of transitioning to a NH from the perspectives of PC-eligible residents and their families. These data desc...
Source: Journal of Palliative Care - March 1, 2020 Category: Palliative Care Tags: J Palliat Care Source Type: research

Gender Differences in End-of-Life Care in Older Mexican American Adults.
Authors: Ortiz-Dowling EM, Crist JD, Shea K, Phillips LR Abstract Mexican Americans (MAs), 1 of 10 subgroups of Latinos, are the largest and fastest growing Latino subgroup in the United States; yet, their access to end-of-life (EOL) care using hospice services is low. An investigation was needed into extant research-based knowledge about factors influencing EOL care decisions among MAs to guide health-care professionals in assisting MAs to make timely, acceptable, and satisfactory EOL care decisions. To determine whether gender was an influence on EOL decision-making among older MAs, CINAHL and PubMed were searche...
Source: Journal of Palliative Care - February 27, 2020 Category: Palliative Care Tags: J Palliat Care Source Type: research

Hospice Utilization Among Residents in Long-Term Care Facilities.
CONCLUSION: Only a small proportion of residents in LTCFs received hospice care. Further investigation of standardized assessment of terminal status is needed as accuracy of end-stage diagnosis continues to be challenging and criteria for hospice eligibility are narrow. Special attention should be paid to improve access to hospice care among residents with dementia or other progressive chronic diseases with severe and complex clinical needs. PMID: 32093589 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - February 27, 2020 Category: Palliative Care Tags: J Palliat Care Source Type: research

Engaging Specialist Palliative Care in the Management of Amyotrophic Lateral Sclerosis: A Patient-, Family-, and Provider-Based Approach.
CONCLUSION: Key stakeholders readily identified a meaningful role for specialist palliative care in ALS management. Integration of specialist palliative care into existing systems of support would be facilitated by a more comprehensive understanding of the service among patients, family caregivers, and health-care providers. PMID: 32066316 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - February 20, 2020 Category: Palliative Care Tags: J Palliat Care Source Type: research

Sustainability of Palliative Care in a Rural Hospital in Tanzania: A Longitudinal and Prospective 4-Year Study.
CONCLUSIONS: A sustainable palliative care service can be built in a Tanzanian rural hospital if an advanced planning and budgeting are made. In Tanzania, the biggest group of palliative care patients are still HIV-infected individuals. There is a lack of opioids in the country. PMID: 31973645 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - January 26, 2020 Category: Palliative Care Tags: J Palliat Care Source Type: research

Life, Love, Hope, Faith, and Death-Too Complex for Likert.
This article outlines a failed attempt to quantify some of the motivators in medical decision-making for African American families faced with a decision to pursue or forego a percutaneous endoscopic gastrostomy in a loved one at the end of life. It explores the complexities of spirituality, history, culture, and death in our patient population in Charleston, South Carolina, where health-care disparities are well-documented, and distrust has deep historical roots. It outlines the need for qualitative research, where the defining role of the researcher is to practice the paramount palliative skill of listening. PMID: 319...
Source: Journal of Palliative Care - January 9, 2020 Category: Palliative Care Tags: J Palliat Care Source Type: research

A Retrospective Study Reviewing Interprofessional Advance Care Planning Group Discussions in Pulmonary Rehabilitation: A Proof-of-Concept and Feasibility Study.
CONCLUSION: Discussing issues relevant to ACP, including providing information about ACP, sharing fears, wishes, and tradeoffs, were well-received in a group-support environment. Future studies should assess the impact of ACP group discussion on the individual, such as identifying a POA, having discussions regarding wishes and values with the SDM/POA, and examining the clinical impact of such sessions. PMID: 31888416 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - January 2, 2020 Category: Palliative Care Tags: J Palliat Care Source Type: research

Social and Health System Complexities Impacting on Decision-Making for Utilization of Oncology and Palliative Care in an African Context: A Qualitative Study.
CONCLUSION: This article offers insights into the role of the health-care system, as organized currently in Nigeria, as "autoinhibitory" and not adequately prepared to address the increasing burden of cancer. We therefore argue that there is a need to restructure the Nigerian health-care system to better meet the needs of patients with cancer and their families as failure to do so will strengthen the existing inequalities, discourage usage, and increase mortality. PMID: 31842664 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - December 19, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

An Environmental Scan of Caregiver Support Resources Provided by Hospice Organizations.
CONCLUSION: Caregiver support programs are a valuable service provided by some but not all hospice organizations across British Columbia, Canada. Future studies are needed to determine best methods for hospice organizations to formally assess caregivers' needs and to determine the success and effectiveness of such programs in support of program expansion and evaluation. PMID: 31838934 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - December 17, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Sowing Across a State: Development and Delivery of a Grassroots Pediatric Palliative Care Nursing Curriculum.
CONCLUSION: Grassroots curricular initiatives and ongoing educational mentorship can grow pediatric palliative and hospice services in rural regions. PMID: 31771423 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - November 29, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Caregiver Decision-Making for Terminally Ill Children: A Qualitative Study.
CONCLUSION: Decision-making by caregivers of terminally ill children is complex, and supporting families in this process is a critical role of all medical providers. A trusting relationship with medical team members was identified as an effective tool for well-supported decision-making, which can potentially alleviate the suffering of the child and distress of the caregivers during this emotionally charged time. PMID: 31722609 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - November 16, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Symptom Burden in Patients With Home Care Who Are at Risk for Malnutrition: A Cross-Sectional Study.
This study adds a more detailed picture of the symptom burden in older patients at risk for malnutrition. Such information is needed to identify risk for malnutrition earlier and improve patients' health. PMID: 31722615 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - November 16, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Design and Preliminary Testing of the Caregiver-Centered Communication Questionnaire (CCCQ).
Authors: Demiris G, DeKeyser Ganz F, Han CJ, Pike K, Parker Oliver D, Washington K Abstract The study objective was to develop and test a new survey instrument that measures caregiver-centered communication. We developed a questionnaire inspired by the National Cancer Institute framework on patient-centered communication, focusing on family caregiver communication for this tool. The questionnaire includes 5 subscales: exchange of information, relationship with team, emotions, managing care, and decision-making. The initial questionnaire was reviewed by domain experts for face validity and edited further to include ...
Source: Journal of Palliative Care - November 9, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Nebulized Vasopressin for the Control of Hematemesis and Hemoptysis in a Child With Recurrent, Refractory Stage III Burkitt Lymphoma.
CONCLUSION: There are many treatments for hemorrhage; however, given the challenges of goals of care, administration, side-effects and tolerability, further investigation into nebulized vasopressin as a potential therapy for hemoptysis and hematemesis at the end-of-life is warranted. PMID: 31680640 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - November 6, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Is a Spectrum the Best Metaphor for Leading Advance Care Planning Discussions?
Discussions? J Palliat Care. 2019 Oct 10;:825859719880518 Authors: Marks S Abstract Being able to elicit the fundamental values, hopes, and care preferences that drive clinical decision-making for patients with a life-limiting illness is considered a core clinical skill for many specialist and generalist clinicians. Such clinical skills have been described as a crucial component of patient-centered care, especially for those with serious illness who often are confronted with complex and immediate medical decisions. Yet, being able to identify what matters most to a patient or what brings a patient the ...
Source: Journal of Palliative Care - October 13, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Congenital Cardiothoracic Surgeons and Palliative Care: A National Survey Study.
CONCLUSIONS: While a majority of pediatric cardiothoracic surgeons are familiar with palliative care, there is variation in perception of appropriate timing of consultation. Significant barriers to consultation still exist, including concern that parents will think they are "giving" up, undermining parental hope, and influence of palliative care on the medical care team's approach. PMID: 31597507 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - October 11, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Family Outcomes and Perceptions of End-of-Life Care in the Intensive Care Unit: A Mixed-Methods Review.
Authors: Chen C, Michaels J, Meeker MA Abstract The purpose of this review was to evaluate end-of-life care (EOLC) in the intensive care unit (ICU) from the perspective of family members. Sandelowski's segregated approach from Joanna Briggs Institute (JBI) Mixed-Methods Systematic Reviews guided this review. A search was conducted in PubMed, CINAHL, PsycINFO, EMBASE, and ProQuest databases and identified 50 papers (33 quantitative, 15 qualitative, and 2 mixed-methodology studies). Five synthesized themes (distressing emotions, shared decision-making, proactive communication, personalized end-of- life care, and valu...
Source: Journal of Palliative Care - September 24, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Pharmacist-Delivered Patient Care in an Interdisciplinary Team-Based Institutional Palliative Care Clinic, 2012 to 2018.
Authors: Dayer LE, McDade ER, Harrington S Abstract Palliative care services offered in the United States have grown substantially since the year 2000. These types of services have been shown to improve a patient's quality of life when presented with a serious or life-threatening disease or illness. An important characteristic of a quality palliative care service is the presence of an interdisciplinary team to utilize different areas of expertise to address multiple aspects of patient care. An important member of this team is the pharmacist. The services presented in this interprofessional education and practice gu...
Source: Journal of Palliative Care - September 10, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Cocreating Meaning Through Expressive Writing and Reading for Cancer Caregivers.
CONCLUSIONS: Expressive writing and reading can be a safe and cost-effective supportive intervention for caregivers of patients with cancer. PMID: 31476955 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - September 4, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Utilization and Costs of Health Care in a Kidney Supportive Care Program.
Authors: Sowa PM, Purtell L, Hoy WE, Healy HG, Bonner A, Connelly LB Abstract Kidney supportive care (KSC) is a patient-centered model of multidisciplinary care designed for patients with advanced chronic kidney disease (CKD) and end-stage kidney disease (ESKD). Our goal was to characterize the types, frequencies, and costs of services accessed by patients enrolled in a KSC program. We analyzed health care utilization data prospectively collected from 102 patients who enrolled in the KSC program during the first 52 weeks of its existence. The data comprised program appointments, emergency department presentations, ...
Source: Journal of Palliative Care - August 30, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Safety and Efficacy of Venting Gastrostomy in Malignant Bowel Obstruction: A Systematic Review.
Authors: Thampy S, Mullan D, Najran P, Laasch HU Abstract Malignant bowel obstruction (MBO) is a common manifestation in patients with advanced intra-abdominal malignancy. It is especially common with bowel or gynecological cancers and produces distressing symptoms, including nausea, vomiting, and pain. Medical management options are less effective than decompressive strategies for symptom control. Surgery is the gold-standard treatment but is unsuitable for most patients with high complication rates. Consensus guidelines recommend nonsurgical management with a venting gastrostomy in those unsuitable for surgery or...
Source: Journal of Palliative Care - August 28, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Inpatient Palliative Care Consult: A Marker for High Risk of Readmission or Death in Discharged Oncology Inpatients.
CONCLUSIONS: These data suggest that the need for a palliative care consult identifies inpatients at very high risk for early deterioration and underlines the critical importance of advance care planning/goals-of-care discussions by the oncology and palliative care teams to ensure patients and families understand their disease process and have the opportunity to direct their care decisions. PMID: 31438769 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - August 24, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Hospice Palliative Care (HPC) and Medical Assistance in Dying (MAiD): Results From a Canada-Wide Survey.
CONCLUSION: The new complexities of MAiD present unique challenges to those working in the health-care field. There needs to be an increased focus on educating/training providers as without proper support, health-care workers will be unable to perform to their full potential/scope of practice while also providing patients with holistic and accessible care. PMID: 31411105 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - August 15, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Administering Neostigmine as a Subcutaneous Infusion: A Case Report of a Patient Dying With Myasthenia Gravis.
CONCLUSION: Undertreated myasthenia gravis can lead to a rapid deterioration in a patient's clinical condition, and such patients may be mistakenly diagnosed as dying. Undertreated myasthenia gravis should therefore be considered as a potentially reversible cause of acute deterioration, especially in patients with complex comorbidities. The use of neostigmine as a continuous subcutaneous infusion may have a role in the management of such patients, particularly when enteral administration of acetylcholinesterase inhibitors is no longer possible. PMID: 31411109 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - August 15, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Prognostication Accuracy, Confidence, and Decisional Conflict Across Training Levels of Internal Medicine Providers.
CONCLUSIONS: Provider confidence increases and decisional conflict decreases as one increases their level of training. However, the degree in which the provider is correct in their prognosis does not change as one increases their level of training. These findings have broad implications on patients, providers, and the health-care system. PMID: 31405315 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - August 14, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Would You Be Surprised if This Patient Died in the Next 12 Months? Using the Surprise Question to Increase Palliative Care Consults From the Emergency Department.
The objectives of this study were to increase awareness of hospice and palliative care medicine (HPM) among emergency medicine (EM) providers and to evaluate whether this heightened awareness increased palliative care consults among participating emergency medicine providers. METHODS: We conducted an anonymous convenience sample survey and two educational interventions about HPM including the surprise question among emergency medicine resident and attending physicians at a large urban public academic quaternary care center from July to November 2018. A report of palliative care consults ordered between August 1, 2017 a...
Source: Journal of Palliative Care - August 11, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Reality, Delays, and Challenges within Pain Prevalence and Treatment in Palliative Care Patients: A Survey of First-Time Patients at the National Cancer Institute in Mexico.
CONCLUSIONS: As most patients in our study presented pain, there is a need of strengthening public policy about opioid treatments. PMID: 31379254 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - August 7, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Impact of Poetry on Empathy and Professional Burnout of Health-Care Workers: A Systematic Review.
CONCLUSION: There is evidence that poetry as part of a NM intervention may increase empathy and limited evidence that it may reduce professional burnout among health-care workers. PMID: 31354038 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - July 31, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Critical Care Nurses' Perceptions of Parenteral and Enteral Nutrition at the End-of-Life in South Korea.
CONCLUSION: Discussions about making the withdrawal and withholding of artificial nutrition legal should be initiated. Moreover, education regarding evidence about the outcomes of EN and PN during end-of-life care and up-to-date clinical guidelines about it should be provided. PMID: 31315495 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - July 19, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Management of Cancer-Associated Intestinal Obstruction in the Final Year of Life.
We describe the management of cancer-associated IO near the end of life in a population-based cohort with universal health coverage. METHODS: Patients who died of gastric, colorectal, ovarian, and pancreatic cancers from 2002 to 2015 were identified from the Ontario Cancer Registry. Those with ≥1 hospital admission for IO in the final year of life were identified from administrative data. Management of IO at index admission was categorized as surgery, gastrostomy, stent, feeding jejunostomy, and medical management. Trends in management over the study period were assessed by the Cochran-Armitage test. RESULTS: Th...
Source: Journal of Palliative Care - July 18, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Documentation of Advance Directives and Code Status in Electronic Medical Records to Honor Goals of Care.
Authors: Weaver MS, Anderson B, Cole A, Lyon ME Abstract Advance care planning is a process that supports conversations about the values that matter most to patients and their family members. The documentation of advance directives and code status in a patient's electronic health record (EHR) is a critical step to ensure treatment preferences are honored in the medical care received. The current approach to advanced care planning documentation in electronic medical records often remains disparate within and across EHR systems. Without a standardized format for documentation or centralized location for documentation...
Source: Journal of Palliative Care - July 11, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Programmed Death 1 Inhibitor-Induced Hypothyroidism on the Palliative Care Unit: Case Report.
We present a case of pembrolizumab-induced hypothyroidism causing extreme fatigue and persistent hypoglycemia. PMID: 31284835 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - July 11, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Issues Regarding End-of-Life Care in Pakistan: A Review.
Authors: Ali MM, Khokhar MA PMID: 31271103 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - July 5, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Longer Duration of Palliative Care in Patients With COPD Is Associated With Death Outside the Hospital.
CONCLUSION: Few patients with COPD received palliative care, similar to national trends. Initial outpatient palliative contact had the longest duration of care and death in the preferred home environment. The extent of emphysema (DLCO reduction) and more frequent disease exacerbations identified in patients were more likely to receive palliative care. Our study begins to define the benefits of palliative care in advanced COPD and confirms underutilization in the years before death, where a prolonged impact on the quality of life may be realized. PMID: 31262230 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - July 4, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Palliative Use of Nitroglycerin to Improve Microvascular Circulation.
CONCLUSION: Following decision for comfort care measures, management for patient care goes beyond the realm of pain control. Dignified dying is an active process that requires clinicians to navigate care for both patient and patients' families. By reversing the digital ischemia associated with vasopressors, patients' families have the opportunity to give meaningful touch in setting of which it may be needed most. PMID: 31232181 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - June 25, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

The Impact of Socioeconomic Status on Place of Death Among Patients Receiving Home Palliative Care in Toronto, Canada: A Retrospective Cohort Study.
Authors: Wales J, Kalia S, Moineddin R, Husain A Abstract BACKGROUND: Socioeconomic disparities in home death have been noted in the literature. Home-based palliative care increases access to home death and has been suggested as a means to decrease these disparities. AIM: Our study examines the association between socioeconomic status and other demographic factors on place of death in a population receiving home palliative care in Toronto, Canada. DESIGN: This is a retrospective chart review of patients who died between August 2013 and August 2015 when admitted to a home-based palliative care service. Multi...
Source: Journal of Palliative Care - June 19, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research

Anticancer Therapy at the End of Life: Lessons From a Community Cancer Institute.
CONCLUSION: Our findings demonstrate those enrolled in the OCM and those with hematologic malignancies have a higher risk of receiving anticancer therapy in the last 14 days of life. These observations highlight the need for better identifying the needs of high-risk patients and providing good quality care throughout the disease trajectory to better align end-of-life care with patients' wishes. PMID: 31187695 [PubMed - as supplied by publisher] (Source: Journal of Palliative Care)
Source: Journal of Palliative Care - June 14, 2019 Category: Palliative Care Tags: J Palliat Care Source Type: research