Journal of palliative medicine
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The combined symptoms of urinary frequency, urgency, nocturia, and incontinence (overactive bladder) are common symptoms within an elderly population but are also seen in palliative care patients and are most often due to detrusor muscle overactivity. These symptoms can lead to a marked reduction in quality of life and pharmacological management is traditionally with anticholinergic drugs. These medications carry a high risk of side effects and are often poorly tolerated by palliative care patients. Other management approaches, however, such as the use of urisheaths may markedly improve quality of life without adding to symptom burden in patients nearing the end of life. ⋯ The discussion will give an overview of treatment strategies to help aid the clinician in managing these difficult symptoms in patients with a terminal illness.
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Helping families make end-of-life decisions requires close collaboration between physicians and nurses. However, medical and nursing students have little formal training in how to collaborate in this task, and few instruments are available to measure collaborative behaviors. ⋯ Development of an end-of-life CBOAT clarified the important collaborative behaviors needed by physician and nurse. The resulting instruments provide a helpful guide for teaching interprofessional sessions related to the end of life and measuring student outcomes using an objective strategy.