Journal of pain and symptom management
-
J Pain Symptom Manage · Aug 2013
Intranasal fentanyl in the palliative care of newborns and infants.
Perinatal palliative care is an area of increasing focus among clinicians supporting newborns and their families. Although not every newborn will survive the neonatal period, assuring their comfort and quality of life remains an imperative for their care providers. It can be challenging to administer medications such as opioids in a minimally invasive yet effective manner. ⋯ We found IN fentanyl, which can be administered in a variety of care settings, to be a minimally invasive means of palliating distress in dying newborns and infants. No adverse events related to its use were noted.
-
J Pain Symptom Manage · Aug 2013
Association between referral-to-death interval and location of death of patients referred to a hospital-based specialist palliative care service.
The time interval between palliative care referral and death may play a role in determining the last place of care and location of death of patients referred to palliative care teams. ⋯ Longer referral-to-death interval was associated with death outside the hospital for patients enrolled in a hospital-based service. The study highlights the importance of early referral in predicting the last place of care and location of death of palliative care patients.
-
J Pain Symptom Manage · Aug 2013
Community-based palliative care: the natural evolution for palliative care delivery in the U.S.
Palliative care in the U. S. has evolved from a system primarily reliant on community-based hospices to a combined model that includes inpatient services at most large hospitals. However, these two dominant approaches leave most patients needing palliative care-those at home (including nursing homes) but not yet ready for hospice-unable to access the positive impacts of the palliative care approach. ⋯ Furthermore the examination of how to operationalize CPC is needed before widespread implementation can be realized. This article describes the key characteristics of CPC, highlighting its role in longitudinal care across patient transitions. Distinguishing features include consistent care across the disease trajectory independent of diagnosis and prognosis; inclusion of inpatient, outpatient, long-term care, and at-home care delivery; collaboration with other medical disciplines, nursing, and allied health; and full integration into the health care system (rather than parallel delivery).