Palliative medicine
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Palliative medicine · Apr 2015
What's in a name? A qualitative exploration of what is understood by "palliative care" in the emergency department.
The understanding of what palliative care is, and which patients may benefit from palliative care, has important implications for optimal patient care in all areas of health provision. ⋯ There are entrenched contradictions and tensions surrounding the term "palliative care"; confronting these is likely to require more than re-branding, and will promote better care for this vulnerable patient group in the emergency department.
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Palliative medicine · Apr 2015
Doctors' and nurses' views and experience of transferring patients from critical care home to die: a qualitative exploratory study.
Dying patients would prefer to die at home, and therefore a goal of end-of-life care is to offer choice regarding where patients die. However, whether it is feasible to offer this option to patients within critical care units and whether teams are willing to consider this option has gained limited exploration internationally. ⋯ There are evidenced individual and policy drivers promoting high-quality care for all adults approaching the end of life encompassing preferred place of death. While there is evidence of this choice being honoured and delivered for some of the critical care population, it remains debatable whether this will become a conventional practice in end of life in this setting.
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Palliative medicine · Apr 2015
Multicenter StudyAdmission of the very elderly to the intensive care unit: family members' perspectives on clinical decision-making from a multicenter cohort study.
Little is known about the perspectives and experiences of family members of very elderly patients who are admitted to the intensive care unit. ⋯ There is incongruity between family values and preferences for end-of-life care and actual care received for very elderly patients who are admitted to the intensive care unit. Deficiencies in communication and decision-making may be associated with prolonged use of life-sustaining treatments in very elderly critically ill patients, many of whom ultimately die.
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Palliative medicine · Apr 2015
ReviewPatients' perception of implantable cardioverter defibrillator deactivation at the end of life.
Individualised care at the end of life requires professional understanding of the patient's perception of implantable cardioverter defibrillator deactivation. ⋯ Patients regard the implantable cardioverter defibrillator as a complex and solely beneficial device, with little insight regarding its potential impact on a peaceful death. This review confirms the need for professionals to discuss with patients and families implantable cardioverter defibrillator functionality and deactivation at appropriate opportunities.