Journal of palliative medicine
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How do health care consumers, private sector organizations, professionals, and government agencies work toward ensuring quality end-of-life care? This challenge is by no means uniquely Canadian; our approach may thus have applications that extend well beyond our national borders. Raising the profile of palliative care in Canada has occurred on many fronts. Local, provincial, and national efforts in end-of-life care have long been underway. ⋯ Their report, Quality End-of-Life Care: The Right of Every Canadian has seen Canadian palliative care gain unprecedented momentum. The federal government recently took the unprecedented step of creating a new office to represent palliative care within the federal cabinet. In Canada, it would appear that palliative care is an idea whose time has come.
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In the United States, the majority of deaths occur in the hospital but the dying process there is at best unsatisfactory and more likely inadequate for both patients and caregivers. The development of hospital-based palliative care programs (HBPCPs) can vastly improve inpatient end-of-life care. This study is the first to examine the prevalence and characteristics of HBPCPs in the United States, thus providing a snapshot of the characteristics of these HBPCPs. ⋯ They tend to be based in oncology, general medicine, and geriatrics. We also assessed reasons for consultation, patient characteristics, and future development needs. These findings can help guide future funding, educational, and programming efforts in hospital-based palliative care.
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At Children's Hospital of Wisconsin there is a pediatric palliative care consultation service that serves a diverse patient population, including infants. However, the value of a palliative care consultation for infants has not been well evaluated. We performed a retrospective, case series, descriptive chart review of infants in our neonatal intensive care unit (NICU) who received palliative care consults between January 1996 and June 1998. ⋯ Recommendations that the palliative care staff made fell into four categories: advance directive planning, the optimal environment for supporting neonatal death, comfort and medical care, and psychosocial support. This series is a description of what a palliative care service can offer for terminally ill infants in an NICU. We speculate that such consults can more consistently and comprehensively provide appropriate end-of-life care for these patients and their families.