Journal of palliative medicine
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A knowledge transfer program was carried out to improve knowledge in end-of-life care staff at all levels in residential care homes for the elderly, using a model similar to that developed for a non-acute care hospital setting. ⋯ Considerable knowledge and service gaps exist among staff and residents of RCHEs, which can be improved by the hospital geriatric team providing services to RCHEs.
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Advance care planning (ACP) is thought to enhance patient autonomy and improve end-of-life care. However, there is evidence that when patients engage in ACP, the resultant plans are often not implemented. This has been attributed to either nonadherence by health professionals or inadequacies in ACP such as inaccessibility of the plans, plans providing ambiguous or conflicting instructions, and inappropriate focus on the completion of documents rather than communication. However, it is not known whether these postulated reasons are consistent with the experiences and views of health care professionals providing end-of-life care in the community. ⋯ Problems in implementation of ACPs are multifactorial and not necessarily due to deliberate nonadherence by health professionals. Potential solutions to improve the clinical impact of ACP are discussed.
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The provision of complementary therapy in palliative care is rare in Canadian hospitals. An Ontario hospital's palliative care unit developed a complementary therapy pilot project within the interdisciplinary team to explore potential benefits. Massage, aromatherapy, Reiki, and Therapeutic Touch™ were provided in an integrated approach. This paper reports on the pilot project, the results of which may encourage its replication in other palliative care programs. ⋯ An integrated complementary therapy program enhances regular symptom management, increases comfort, and is a valuable addition to interdisciplinary care.
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Very little information exists on the number of resources utilized by individuals living with and dying of pediatric life-threatening diseases (LTDs). This study quantifies end of life (EOL) resource utilization among the pediatric population in British Columbia, Canada. ⋯ Resource utilization was very high for all three age groups, demonstrating the intense need for care by children dying of disease. These findings call for the strengthening of palliative care services in the province.