Journal of palliative medicine
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The aims of this study were to clarify (1) the quality of life (QOL) of community-dwelling patients with advanced cancer and their caregivers in home palliative care and day hospice settings, (2) the need for day hospice of home palliative care patients and caregivers, and (3) the satisfaction with day hospice by day hospice patients and caregivers. ⋯ This is the first study of day hospice in Japan. Although there are several day hospices in Japan, the initiation of day hospice would probably be successful. The dissemination of day hospice is an important issue for patients with advanced cancer and their caregivers in Japan.
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To provide an updated estimate of the extent and manner in which palliative care is incorporated in the curricula of U.S. medical schools. ⋯ A minority of U.S. medical schools from which information was obtained requires training in palliative care and evaluates students in their care of patients with advanced, incurable conditions. Most medical schools have chosen to include palliative care topics within existing courses. AAMC's existing database does not assess the scope or extent of coursework and rotations in palliative care. Guidelines are needed that address palliative care education and training of medical students.
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People with intellectual disabilities require access to compassionate, quality, and effective palliative and end-of-life care when facing serious, life-limiting illness. This study was designed to document the degree to which hospice and palliative care services were provided to New Jersey residents with intellectual disabilities, and the challenges in providing this care. Surveys were designed to assess the provision of hospice and palliative care services to this population, staff knowledge and training needs, experiential and communication challenges, and financial concerns. ⋯ Ninety-one percent of palliative care providers reported providing services to the community, with hospices providing care to approximately 3 individuals during the prior year. Challenges to providing services included: low levels of knowledge about palliative care among residential providers; need for knowledge about people with intellectual disabilities among hospice providers; communication difficulties; and costs concerns regarding reimbursement, staffing, and training. Results support the need to increase awareness and knowledge about intellectual disabilities, including provider communication skills; promote hospice outreach to residential providers; and develop innovative services and policies that address the challenges in caring for this population.
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Many children with life-limiting illnesses in the United States could benefit from pediatric palliative care. However, national, state, and local barriers exist that hinder provision. One national barrier is the Medicare hospice reimbursement regulation that limits the provision of government subsidized hospice care to the final 6 months of life. In response to the critical need to provide palliative care earlier in children's illnesses, Florida became the first state to develop and implement an innovative model of care that provides services from the point of diagnosis onward, thereby waiving the 6-month reimbursement rule. In July 2005, the Partners in Care: Together for Kids program began. The program relies on partnerships between state-employed care coordinators who identify the children for possible enrollment and hospice staff who provide home and community-based services. ⋯ Florida's program is the first in the nation to provide government-subsidized pediatric palliative care from the point of diagnosis onwards. Lessons learned from Florida's experiences will help guide other states and health plans that desire to implement a similar model of care.
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Family conferences are used to facilitate communication concerning end-of-life issues with patients and their families. The purpose of our study was to obtain preliminary information on the characteristics of family conferences that take place in an inpatient palliative care unit (PCU). ⋯ Family conferences involved a high degree of patient participation and occurred at the end of a patients stay in our PCU. A trend toward greater expression of emotional distress displayed by family members was found when patients did not participate in the meetings. Further prospective studies that use validated tools to assess the content of the meetings and their impact on alleviating distress in patients and their family are needed.