The American journal of hospice & palliative care
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Am J Hosp Palliat Care · Dec 2014
Noncomfort medication use in acute care inpatients comanaged by palliative care specialists near the end of life: a cohort study.
To examine comfort medication (CM) and noncomfort (NC) medication use in inpatients comanaged by palliative care (PC) near the end of life. ⋯ Inpatients comanaged by PC continue to receive NC medications as they near the end of life.
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Am J Hosp Palliat Care · Dec 2014
A survey of patients who were referred to our palliative care division from other hospitals and appeared to have obvious indications for cancer chemotherapies.
Higashi Sapporo Hospital is a cancer-specific hospital with palliative care doctors and certified oncologists. During case conferences held twice a week, we routinely evaluate the referred patients. In our case conferences, we selected patients who were referred to our palliative care division from other hospitals, with possible indications for cancer chemotherapies. ⋯ Among them, we identified 4 cases as having indications for standard cancer chemotherapies. All 4 patients tolerated the therapies well, responded to chemotherapy, and survived for more than 1 year. Conferences in which oncologists and palliative care doctors can discuss cases frequently and intimately are thought to be important.
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Am J Hosp Palliat Care · Dec 2014
Perceived barriers and enablers to referrals to community-based hospice palliative care volunteer programs in Canada.
Two separate studies were conducted to identify perceived barriers and enablers to referrals to community-based hospice palliative care volunteer programs in 2 Atlantic Canadian provinces. In study 1, a physician, home support nurse manager, social worker, and volunteer coordinator (VC) were interviewed. ⋯ In study 2, a total of 10 VCs completed the PBEQ and (1) rated the extent to which they perceived 18 items to be barriers to referrals; (2) rated the extent to which they perceived 12 items to be enablers to referrals; and (3) described additional barriers and enablers. A Tips for Referrals sheet was created.
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Am J Hosp Palliat Care · Dec 2014
Similarities and differences in perspectives on interdisciplinary collaboration among hospice team members.
This study surveyed 4 core hospice professionals (physicians, nurses, social workers, and chaplains) on their perceived level of interdisciplinary collaboration, the influences of interdisciplinary collaboration, and job satisfaction to determine potential similarities and differences based on profession and various demographic characteristics of the members or member hospices. Analysis found that there are overall no differences based on demographic characteristics. ⋯ Difference between professions was also found in job satisfaction. Implications for hospice practice and interdisciplinary education are discussed.
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Am J Hosp Palliat Care · Dec 2014
Case ReportsHigh-dose neuroleptics and neuroleptic rotation for agitated delirium near the end of life.
Agitated delirium presents unique challenges for hospice and palliative care clinicians. Haloperidol, the recommended neuroleptic, may be ineffective at low dose, or poorly tolerated at higher doses. ⋯ Agitated delirium is a palliative care emergency. High doses of neuroleptic medications, with rotation to an alternate neuroleptic when side effects occur with standard haloperidol, may effectively palliate agitated delirium. This remedy can provide the patient with a peaceful dying in a place of their choosing.