Journal of palliative medicine
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Use of medical device technologies for diabetes mellitus, including continuous glucose monitoring devices, is becoming more frequently encountered in end-of-life care. Good communication is paramount to determine patient and carer preferences for if, when, and how blood glucose monitoring should occur in the end-of-life setting. We present two differing cases of how continuous glucose monitoring in an Australian setting impacted end-of-life care for the patients and their carers.
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Observational Study
Associations between Family Satisfaction with End-of-Life Care and Chart-Derived, Process-Based Quality Indicators in Intensive Care Units.
Background/Objective: Evidence linking process-based, high-quality end-of-life (EOL) care indicators to family satisfaction with EOL care in intensive care units (ICUs) remains limited. This study aimed to fill this gap. Design/Setting/Subjects/Measures/Statistical Analysis: For this exploratory, prospective, longitudinal observational study, 278 family members were consecutively recruited from medical ICUs at two medical centers in Taiwan. ⋯ Family members' satisfaction with decision making was positively associated with documentation of social worker involvement (4.767 [0.663 to 8.872]), a DNR order issued (10.499 [0.223 to 20.776]), and withdrawal of life-sustaining treatments (LSTs) before death (2.252 [1.834 to 2.670]). Conclusions: EOL care processes are associated with family satisfaction with EOL care in ICUs. Bereaved family members' satisfaction with EOL care in ICUs may be improved by promoting physician-family prognostic communication and psychosocial support, facilitating a DNR order and death without CPR, and withdrawing LSTs for patients dying in ICUs.