Journal of palliative medicine
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In imminently dying patients, mechanical ventilation withdrawal is often a comfort measure and avoids prolonging the dying process. ⋯ Palliative withdrawal of mechanical ventilation was performed in only half of dying mechanically ventilated patients. Because clinical service rather than physiologic parameters are associated with withdrawal, targeted interventions may improve withdrawal decisions. Considering FIO2 and vasopressor requirements may facilitate counseling families about anticipated time to death.
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Chinese family caregivers in the United States experience high rates of burden. Studies in this population require culturally appropriate and valid instruments. ⋯ This study suggests that the BASC-C is a valid measure of caregiver burden among Chinese family caregivers.
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Multicenter Study
Polypharmacy and drug omissions across hospices in Northern Ireland.
Polypharmacy and drug omissions (DO) (i.e., drugs prescribed but not administered) may impact on quality of life of hospice inpatients. ⋯ Polypharmacy is prevalent among hospice inpatients. Drugs omitted amounted to 8.8%, with the frequency of DO increasing in those who were dying. Documentation justifying DO was lacking. Daily focused drug chart review, pharmacy support, and electronic prescribing may all help to reduce and rationalize medication burden and aid prompt and effective management of DO.
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Comparative Study
Association between hospice care and psychological outcomes in Alzheimer's spousal caregivers.
Dementia care giving can lead to increased stress, physical and psychosocial morbidity, and mortality. Anecdotal evidence suggests that hospice care provided to people with dementia and their caregivers may buffer caregivers from some of the adverse outcomes associated with family caregiving in Alzheimer's Disease (AD). ⋯ These data suggest that hospice enrollment may ameliorate the detrimental psychological effects in caregivers who have lost a spouse with Alzheimer's Disease. Based on these pilot data, further prospective investigation is warranted.
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Observational Study
Is it appropriate to withdraw antibiotics in terminal patients with cancer with infection?
Antibiotic administration is frequent in terminal patients with cancer, yet the effects on survival are still under debate. ⋯ The results suggest that with good communication between patients, families, and medical staff, withdrawal of antibiotics should be considered if signs of death appear, in order to avoid unnecessary risks. The possible benefit of prolonged survival should be in line with the goal of care, and also take into account preparing the patient for a dignified death.