Journal of palliative medicine
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Interviews with bereaved family carers to examine the end-of-life experience of the deceased are important tools for palliative care researchers, but the ethics of approaching the bereaved when they are grieving and vulnerable is often debated. ⋯ These findings indicate that interviews with the bereaved may be most fruitful for researchers and beneficial to family carers when they are allowed to make the choice about timing for themselves, beginning weeks after the death of their family member.
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To provide truly patient-centered palliative care services, there is a need to better understand the perspectives and experiences of patients and families. Increased understanding will provide insight into the development of health care team competencies and organizational changes necessary to improve patient care. ⋯ At end of life or during times of serious illness, patients and families identified behaviors of Presence, Reassurance, and Honoring Choices as important. According to patients/families, health care providers must be compassionate and empathetic and possess skills in listening, connecting, and interacting with patients and families.
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When counseling surrogates of massively injured elderly trauma patients, the prognostic information they desire is rarely evidence based. ⋯ ISS and preinjury comorbidities alone cannot be used to predict futility in massively injured elderly trauma patients. Future attempts to predict futility in these age groups may benefit from incorporating measures of physiologic distress.
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Palliative care (PC) has undergone incredible growth in the last 10 years, having gained subspecialty status and penetration into 85% of hospitals over 300 beds. The comprehensive services provided by multiple members of the PC team combined with low reimbursement for nonprocedural medical care challenges all PC teams to operate with financial sustainability. Accurately and compliantly documenting and coding services provided to patients can help to maximize PC programs' revenues and limit operating subsidies received from health care systems or hospice programs. ⋯ This will allow clinicians to more accurately communicate to payers the complex care provided to inpatients by the PC team. This fuller picture of the complexity of care provided can increase reimbursements received by your PC program from payers. Understanding how to accurately document, code, and receive appropriate reimbursement will allow our field to continue to grow, broadening the reach of PC nationally to improve quality of life for all patients and families in need.