Omega
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Research has demonstrated that limited dialogue in end-of-life (EOL) care can negatively impact decision-making and place of death. Furthermore, when vulnerable populations are faced with EOL cancer care, they experience issues resulting from previous gaps in services attributed to sociocultural and economic issues that influence EOL care. These conditions place an additional burden on disadvantaged populations which can cause distress, especially as disparate conditions continue to persist. ⋯ The objective of this study is to explore Latinas' experiences with life-limiting cancer conditions to identify the EOL care concerns that impact their dying experience. This study used a phenomenological approach to explore the EOL care concerns of 24 Latinas receiving treatment for metastatic cancers in a public sector healthcare system in Los Angeles, California. In-depth interviews were recorded and transcribed, and qualitative analysis was performed using Atlas.ti software.
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As a response to the increasing numbers of Veterans utilizing the Veterans Affairs (VA) Contract Home Hospice Program, and with growing awareness of the increased stress at end-of-life, the social work leadership of the Louis Stokes Cleveland VA Medical Center implemented a unique approach to support Veterans and their families. The role of a grief/bereavement counselor was added to enhance the VA Contract Home Hospice Program, to assess the needs of the Veterans and family caregivers, and to create a program in response to these findings. A three-prong module evolved encompassing: Anticipatory Mourning Support for both the Veteran and caregiver/ family; Caregiver Support; and Bereavement Support. The components of this module are described along with findings in each module.
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New York-Presbyterian Hospital/Weill Cornell Medical Center is a large academic medical center that provided minimal, if any, bereavement support to families and loved ones of patients who died in the hospital. A comprehensive bereavement program was developed and implemented which included sending condolence cards to family members and friends, follow-up phone calls to screen for complicated grief, individual counseling, bereavement support groups, community referrals, and an annual memorial service for families and staff to provide an opportunity for shared mourning during the grieving process.
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A transdisciplinary team is an essential component of palliative and end-of-life care. This article will demonstrate how to develop a transdisciplinary approach to palliative care, incorporating nursing, social work, spiritual care, and pharmacy in an acute care setting. ⋯ After 1 year of implementation, the transdisciplinary palliative care team consisted of seven palliative care physicians, two social workers, two chaplains, a pharmacist, and End-of-Life Nursing Consortium (ELNEC) trained nurses. Palomar Health now has a palliative care service with a consistent process for transdisciplinary communication and intervention for adult critical care patients with advanced, chronic illness.
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This article presents attempts to improve the quality of spiritual care offered to palliative care patients by educating nursing and other staff about spiritual screening with the goal of increasing referrals to a board certified chaplain. Attention to patients' spiritual identity and spiritual needs upon admission and throughout a hospitalization through either a formalized screening tool or provider awareness and sensitivity can assist patients in naming their needs, thus triggering a referral to a board certified chaplain or other spiritual counselor. Along with a spiritual care plan based upon assessment of spiritual needs and resources facilitates the healing process.