Journal of palliative medicine
-
This study sought to explore the stories of long-term palliative care workers to generate an understanding of their experiences of working in palliative care for an extended period of time. Six health professionals participated in the study, each of whom were currently working in a palliative care service, and each of whom had been working continuously in palliative care services for a minimum of 5 years. ⋯ Results from this study may be helpful to educators and administrators who endeavour to develop and support this workforce. Furthermore, the descriptions provided in this study may provide direction for individuals working in palliative care who may be called on to reflect on their own work trajectory and their commitment to the field.
-
Despite the fact that our institution has approximately 40 inpatient deaths per month, until recently virtually no support was provided to families/friends of the deceased. We developed and implemented a comprehensive bereavement program to prepare individuals for the loss and also to support them through the grieving process.
-
Hospice at the California Medical Facility (CMF) Vacaville dates back to the mid-1980s, when the acquired immune deficiency syndrome (AIDS) epidemic began to be felt throughout California's Department of Corrections. Vacaville has served for decades as the principal location for delivering health services to California's incarcerated men. Informal hospice-like services were inspired by Elisabeth Kubler-Ross and through inmate and community calls for more humane care for dying inmates. ⋯ Training for physicians, staff and PCS volunteers is provided by the University of California, Davis faculty of the West Coast Center for Palliative Education. Bereavement services are provided for PCS volunteers, other inmate "family" and staff. Family and friends of the deceased in the free community are followed by phone, mail, and primarily through referral to resources in their local area.
-
Identifying objectives for advance care planning (ACP) is an important step toward improving care at the end of life. Previous studies of ACP have used many different measures of success. However, there has been no consensus on what should be the objectives for ACP. ⋯ Clarifying objectives from various perspectives is an important step toward achieving the level of understanding necessary to make these difficult decisions. It is time for physicians to reconsider the way in which they think about and discuss ACP with patients. If we are to improve care at the end of life, future patient care, research, and education about ACP should proceed with specific objectives in mind.
-
Confusion is common among ill patients and has broad consequences for their care and well-being. The prevalence of confusion in hospice patients is unknown. ⋯ Confusion among hospice patients was common, frequently severe, and usually problematic.