J Palliat Care
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During the last 10 years interest in palliative care research has grown. This interest has brought about an awareness of the unique ethical issues related to research in this special population. Issues related to the vulnerability of patients and families, consent protocols, unstable mental status, and the invasiveness of assessments have been discussed. ⋯ However, until now, administrators, governments, and clinicians have planned palliative care programs to have only service and some teaching components. And traditional research-sponsoring agencies have not allocated priority to palliative care in their funding strategies. The palliative care community must take the initiative in this debate.
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This article outlines the approach to the management of delirium developed by the staff of the palliative care unit at the Edmonton General Hospital. Delirium occurs commonly in the terminally ill and is associated with a poor prognosis. Management requires a clear understanding of what delirium is, how to assess it, investigations for reversible causes, and the medical treatments that are most useful. If not well managed, delirium can be a very distressing symptom for the patient and family as well as having a very destructive impact on the functioning of a palliative care unit.
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Language is mainly a function of the left hemisphere of the brain; music is mainly a function of the right hemisphere. Using language and music together therapeutically with brain-impaired patients offers a greater chance of activating intact neurological pathways than using language alone. Music therapy also offers an alternate and creative way of communicating with these patients.