Journal of palliative medicine
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The Institute of Medicine recommends people with serious advanced illness have access to skilled palliative care. However, the predominant delivery model of nonhospice palliative care is inpatient, consultative care focused on the end of life, with a small specialist palliative care workforce. ⋯ Incentives such as performance measures and collaboration with local VHA providers and leaders could improve adoption and scale-up of outpatient palliative care.
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Observational Study
ICU versus Non-ICU Hospital Death: Family Member Complicated Grief, Posttraumatic Stress, and Depressive Symptoms.
Family members of patients who die in an ICU are at increased risk of psychological sequelae compared to those who experience a death in hospice. ⋯ Psychological distress of family members did not differ by hospital setting, but the most distressing experiences encountered at end of life in each setting highlight potentially unique interventions to reduce distress post-bereavement for family members.
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Neutrophil-lymphocyte count ratio (NLR) is a prognostic factor in cancer, although its prognostic significance in terminally ill cancer patients is not clear. ⋯ Our results suggest that elevated NLR was an independent prognostic factor for poor survival in patients with terminal cancer.