J Palliat Care
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An important aim of palliative care is to ensure the highest possible quality of life (QoL) for the family members of patients. ⋯ Family support is a cornerstone of palliative care. Palliative care professionals should focus on at-risk family members--the life partners of patients, the unemployed, younger people, and those whose ill loved one has a poor functional status.
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Many cancer patients die in institutional settings despite their preference to die at home. A longitudinal, prospective cohort study was conducted to comprehensively assess the determinants of home death for patients receiving home-based palliative care. ⋯ Patients who lived alone were less likely to die at home than those who cohabitated (OR: 0.4; CI: 0.2-0.8), and those with a high propensity for a home-death preference were more likely to die at home than those with a low propensity (OR: 5.8; CI: 1.1-31.3). An understanding of the predictors of place of death may contribute to the development of effective interventions that support home death.
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The aim of this study was to describe the changes in quality of life and in levels of anxiety and depression experienced by caregivers of patients with brain tumour 18 months after their bereavement. ⋯ Our study underscores the necessity of supporting caregivers and monitoring their suffering levels; such suffering can compromise their social and work lives, not only during the disease trajectory but also in bereavement. Providing psychological and emotional support for caregivers of patients with brain tumour during both periods could lessen the suffering and unhappiness of these caregivers.
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A wealth of literature and economic analyses has shown that palliative care is associated with significant cost reductions compared to nonpalliative care. However, no one has assessed the impact of an inpatient palliative care consultation service on costs at the very end of life (48 to 72 hours before death). ⋯ Our study shows that patients who receive palliative care consultations are associated with significantly lower costs in the final 48 to 72 hours of life than their nonpalliative counterparts. Another significant finding was that the degree of cost reduction at the very end of life appears to be relative to how soon after the patient's admission the palliative care consultation was initiated.