Palliative medicine
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Palliative medicine · Dec 2015
Comparative StudyAn international comparison of costs of end-of-life care for advanced lung cancer patients using health administrative data.
Patterns of end-of-life cancer care differ in Canada and the United States; yet little is known about differences in service-specific and overall costs. ⋯ Costs for nonsmall cell lung cancer patients were slightly higher in the United States than Ontario until 1 month before death. Administrative data allow exploration and international comparisons of reimbursement policies, health-care delivery, and costs at the end of life.
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Palliative medicine · Dec 2015
Delirium as letting go: An ethnographic analysis of hospice care and family moral experience.
Delirium is extremely common in dying patients and appears to be a major threat to the family's moral experience of a good death in end-of-life care. ⋯ Within hospice culture, there is usefulness to deemphasizing delirium as a pathological neuropsychiatric complication, in favor of acknowledging delirious changes as signs of normal dying. This has implications for how we understand the role of nurses and other caregivers with respect to delirium assessment and care, which to date has focused largely on practices of screening and management.
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Palliative medicine · Dec 2015
Results of a transparent expert consultation on patient and public involvement in palliative care research.
Support and evidence for patient, unpaid caregiver and public involvement in research (user involvement) are growing. Consensus on how best to involve users in palliative care research is lacking. ⋯ For involvement in palliative care research to succeed, early and flexible involvement is required. Researchers should advertise opportunities for involvement and promote impact of involvement via dissemination plans. Users should prioritise adding value to research through enhancing productivity, quality and relevance. More research is needed not only to inform implementation and ensure effectiveness but also to investigate the cost-effectiveness of involvement in palliative care research.
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Palliative medicine · Dec 2015
Enabling a family caregiver-led assessment of support needs in home-based palliative care: Potential translation into practice.
Systematic assessment of family caregivers' support needs and integrating these into service planning according to evidence-based research are vital to improving caregivers' outcomes and their capacity to provide care at end of life. ⋯ Our study has successfully addressed the call for alternatives to the professional assessment paradigm using the Carer Support Needs Assessment Tool approach as a caregiver-led intervention facilitated by health professionals. Integrating the Carer Support Needs Assessment Tool in existing practice is fundamental to achieving better caregiver outcomes.
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Palliative medicine · Dec 2015
Estimating the cost of caring for people with cancer at the end of life: A modelling study.
People with advanced cancer require a range of health, social and informal care during the final phases of life. The cost of providing care to this group as they approach the end of their lives is unknown, but represents a significant cost to health and social care systems, charities patients and their families. ⋯ The cost to society of providing care to people at the end of their lives is significant. Much of this cost is borne by informal care givers. The cost to formal care services of replacing this care with paid care giving would be significant and demand for care will increase as the demographic profile of the population ages.