The American journal of hospice & palliative care
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Am J Hosp Palliat Care · Nov 2015
The Cost of Inappropriate Care at the End of life: Implications for an Aging Population.
Elderly patients patients (older than 65 years) account for only 11% of the US population yet they account for 34% of health care expenditure. The disproportionate usage of health care costs by elderly patients is in striking contrast with that of other Western Nations. It is likely that these differences are largely due to variances in hospitalization and the use of high technology health care resources at the end of life. ⋯ We present the case of an 86-year-old female who spent almost 3 months in our ICU prior to her death. The fully allocated hospital costs for this patient were estimated to be US$254 945 (US$5100/d). With the increasing age of the population and the projected increased demand for ICU beds, we review the benefits and burdens of admitting elderly patients to the ICU.
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Am J Hosp Palliat Care · Sep 2015
ReviewPalliative Sedation: An Analysis of International Guidelines and Position Statements.
To describe the suggested clinical practice of palliative sedation as it is presented in the literature and discuss available guidelines for its use. ⋯ The development and implementation of institutional-based guidelines with clear stance on the discussed variances is necessary for consistency in practice. Data on provision of palliative sedation after implementation of guidelines needs to be collected and disseminated for a better understanding of the current practice in the United States.
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Am J Hosp Palliat Care · Sep 2015
Knowledge About Hospice Care and Beliefs About Pain Management: Exploring Differences Between Hispanics and Non-Hispanics.
Among Hispanics, incomplete knowledge about hospice care may explain low rates of utilization and culturally-specific beliefs about pain and pain treatments may contribute to disparities in pain management. ⋯ Despite the increasing knowledge of hospice care among Hispanics, specific information about the scope of services remains limited. Cultural beliefs about pain management, along with inadequate knowledge of the role of pain management at end of life, persist.
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Am J Hosp Palliat Care · Sep 2015
Chronic Pain and Risk Factors for Opioid Misuse in a Palliative Care Clinic.
To describe the prevalence of chronic pain and the risk of opioid misuse in a palliative care clinic. ⋯ Chronic pain and indicators of opioid misuse risk were prevalent. Outpatient palliative care practices should develop policies to address these issues.
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The effectiveness of the step II of the World Health Organization analgesic ladder including tramadol has been questioned recently. ⋯ The data suggest that tramadol may have a role to play in the treatment of pain in palliative care.