The American journal of hospice & palliative care
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Am J Hosp Palliat Care · Sep 2001
Case ReportsThe palliative use of high-dose corticosteroids in three terminally ill patients with pain.
Corticosteroids are valuable pharmacological adjuncts utilized in the management of the diverse symptoms observed in terminally ill patients, including bone, neuropathic, and hepatic pain, asthenia and fatigue, and anorexia, and serve as an adjunct for the treatment of nausea and vomiting. If relief of suffering is the goal and mandate of palliative care, high-dose corticosteroids should be utilized in terminally ill patients for quickly reducing pain and improving quality of life for both patients and family members. In patients with a limited life expectancy of days to several weeks, long-term side effects will not occur and therefore should not preclude the continuous use of corticosteroids until the patient's death. Three case studies are presented.
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Am J Hosp Palliat Care · Sep 2001
Dying in long-term care facilities: support needs of other residents, relatives, and staff.
This paper explores the support needs of residents, relatives, and care staff when someone dies in a facility for older people. The authors draw on the qualitative findings from an English study, which investigated the case for applying the principles and practices of palliative care to people dying in these settings. ⋯ Care staff members acknowledged needing practical and emotional support, but management was often unable to deliver it. Lack of training in recognizing and addressing needs in addition to financial and staffing constraints were factors that prevented managers from providing support for staff, residents, and relatives.
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Am J Hosp Palliat Care · Sep 2001
Needs and experiences of non-English-speaking hospice patients and families in an English-speaking country.
There is increasing evidence that, in practice, hospice care is predominantly accessed by white, middle-class patients, who live in stable home environments with available caregivers and other supports. The present challenge for researchers, administrators, and clinicians is to identify populations of terminally ill patients most in need of hospice care and to direct services to these patients. As a contribution to the development of this area, this paper presents the findings from a recent Australian hospice study that examines the needs and experiences of families from non-English-speaking backgrounds. The findings indicate that it is as important to focus on similarities as it is to highlight differences.
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Am J Hosp Palliat Care · Sep 2001
Management strategies for palliative care: promoting quality, growth and opportunity.
Over 20 years ago, hospice in the United States evolved to provide end-of-life care for terminally ill patients. However, three major barriers exist, which limit access to hospice care. The first two, cultural and regulatory barriers, are not under the direct control of hospices, although programs can be adapted to minimize their influence. ⋯ Every staff member understands and supports the mission. The many programs within the agency contribute to fulfillment of the goal to transform end-of-life care. They are presented here as an example of what can be done with mission-based management.