Journal of palliative medicine
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Parenting children with life-threatening illness (LTI) and their healthy siblings requires parents to consider their various needs. ⋯ Future research can further examine trade-offs and associated effects, how to support parent problem-solving and decision-making around trade-offs, and how to best offer social services alongside illness-directed care.
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Timely identification of patients in need of palliative care is especially challenging in a geriatric population because of prognostic uncertainty. The Supportive and Palliative Care Indicators Tool (SPICT™) aims at facilitating this identification, yet has not been validated in a geriatric population. ⋯ SPICT seems to be valuable for identifying geriatric patients in need of palliative care as it demonstrates significant association with one-year mortality and with clinical survival predictions of experienced geriatricians, as reflected by TLDs given.
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The interpretation of do-not-resuscitate orders (DNRs) may vary in nonarrest situations. To reduce ambiguity, many hospitals allow patients to elect partial DNRs. ⋯ A partial DNR made our respondents more willing to provide nonarrest procedures, but also CPR. These findings suggest an ongoing need to develop better means of incorporating patients' goals of care into orders that more faithfully guide care for both nonarrest and arrest situations.