The American journal of hospice & palliative care
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Am J Hosp Palliat Care · Sep 2010
Characteristics of the last hospital stay in terminal patients at an acute care hospital in Colombia.
In Colombia, most palliative care is provided in acute care hospitals. In those settings, a palliative care approach could be limited because of a disease-oriented approach instead of patient-centered care. ⋯ In acute hospitals, palliative care teams should participate in the care of patients at the start of treatment.
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Nausea and vomiting are often encountered in palliative care patients. Multiple medications are available to provide relief. However, several drug combinations are usually used to treat emesis. ⋯ It blocks multiple neurotransmitters dopaminergic, serotonergic, adrenergic (alpha(1)), histaminergic, and muscarinic receptors. Most of these receptors are also involved in causing emesis. Studies have shown that olanzapine could be used to treat nausea and vomiting with promising results.
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Am J Hosp Palliat Care · Sep 2010
Dementia, goals of care, and personhood: a study of surrogate decision makers' beliefs and values.
Surrogate decision makers for persons with advanced dementia play a key role in making decisions about medical treatments for their loved ones. We conducted in-depth interviews of 20 surrogates to examine their goals of care preferences and beliefs about personhood. ⋯ Qualitative findings demonstrated diverse beliefs regarding the impact of dementia on factors related to personhood, for example, dignity, respect from others, and having a life worth living. In conclusion, the surrogates we interviewed expressed diverse preferences regarding goals of care and diverse assessments about the impact of dementia on personhood.
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Am J Hosp Palliat Care · Sep 2010
Comparative StudyThe triad that matters: palliative medicine, code status, and health care costs.
Delayed discussion of a patient's code status can lead to shortsighted care plans that increase hospital length of stay (LOS) and costs. ⋯ The amount of time that expires until the issue of code status was settled to clearly related to utilization of hospital resources.
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Am J Hosp Palliat Care · Sep 2010
Implementing evidence-based practices: considerations for the hospice setting.
With increased regulation and scrutiny of outcomes, hospice programs are being challenged to consider the implementation of evidence-based practices (EBPs). This study reports findings from hospice director interviews and staff focus groups, which occurred following the completion of a multifaceted translating research into practice (TRIP) intervention designed to promote evidence-based pain management practices. ⋯ Three areas for evaluation prior to implementing an EBP initiative in hospices were identified: community, agency, and staff cultures. Recommendations for implementation of EBPs in hospices are provided.