Aust Fam Physician
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Ensuring access for all Australians to high quality palliative care requires an understanding of special considerations for specific populations, including children, older persons, and Indigenous Australians. ⋯ The complex clinical and support needs of children needing palliative care requires a well coordinated multidisciplinary team, inclusion of parents and siblings as part of the unit of care, and the use of developmentally appropriate communication strategies. Older people too may have different palliative needs. These include the need for careful assessment to ensure that reversible conditions, and emotional and existential concerns are not overlooked. Where the preferences and wishes of the person cannot be obtained, various clinical, ethical and legal principles will guide decisions. To ensure culturally appropriate care is provided to Indigenous Australians requiring palliative care, both Indigenous organisations and people should be included in the planning and provision of care.
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To describe the demographics of patients presenting with skin cancer to general practitioners in rural North Queensland, the sites from which skin cancers are removed, and their histology. ⋯ In this sample of Mackay GPs, there was a very high yield of skin cancers from all excisions. We could consider lowering our threshold for excision of pigmented lesions.
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The stress associated with advancing and incurable illness inevitably causes distress for patients, families and caregivers. A palliative approach to care aims to improve the quality of life for patients with a life limiting illness by reducing suffering through early identification, assessment and optimal management of pain, physical, cultural, psychological, social, and spiritual needs. ⋯ There is much that can be done by GPs, in collaboration with other services, to alleviate distress and suffering in people with a life limiting illness. In order to provide support for dying patients and their families, GPs also need to care for themselves.
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Case histories are based on actual medical negligence claims or medicolegal referrals, however, certain facts have been omitted or changed by the author to ensure the anonymity of the parties involved. The aim of this article is to outline the legislative framework in relation to advance health directives and enduring powers of attorney or guardianship, with a particular focus on the medical and legal issues of relevance with respect to an assessment of mental capacity.
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Symptoms other than pain are a heavy burden for patients with either malignant or progressive nonmalignant disease and significantly reduce quality of life. ⋯ The approach to management of the symptoms of malignant or progressive nonmalignant disease is the same, regardless of the diagnosis. Management includes evaluation, treatment--depending on the underlying pathological mechanism, explanation for both the patient and their family, and ongoing review of goals of care.