International journal of palliative nursing
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This paper reports on a study which took place in a 15-bed hospice and provides an account of the views of registered nurses (n = 12) and health support workers (n = 10) in relation to cardiopulmonary resuscitation (CPR) within a hospice setting. The study was part of a larger ethnographic research project being conducted in the hospice when the British Medical Association/Royal College of Nursing and the Resuscitation Council UK (Resuscitation Council UK, 2001) published guidelines urging all establishments that face decisions about attempting CPR to develop local policies. ⋯ Semi-structured interviews were conducted on a purposive sample of hospice staff. The findings raise issues about the implementation of CPR in a context where it was felt that the patient should be allowed to die a natural death.
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Biography Historical Article
A reflection on Cicely Saunders' views on a good death through the philosophy of Charles Taylor.
In her writings, Cicely Saunders has developed a total framework of caring for seriously ill people. Saunders' reaction to what she has experienced as bad contemporary post-war health care is to be found in her hospice philosophy. In this article this philosophy is analysed through the writings of Charles Taylor. ⋯ By focusing on Saunders' writings from Taylor's perspective it becomes apparent that Saunders has created a very modern theory. The author has found that different aspects of a good and authentic life are important values in Saunders' good and authentic death. These findings are followed by one question: is Saunders' hospice philosophy too focused on values such as individuality, control and autonomy, giving too little attention to fragility and dependency?
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Research suggests that many minority ethnic patients who receive palliative care in the UK are satisfied with the service they are given. However, various studies have revealed that minority ethnic groups' experiences of care are far from perfect. The most significant problem for these patients centres on communication. ⋯ The main issues were found to be the need to inform South Asian populations of the availability of palliative care services and the need to improve communication between patients and service providers. This article describes the communication problems that service providers and users face. It also identifies possible policy improvements aimed at developing the 'cultural competency' of services.
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In one inpatient palliative care unit falls were identified as a frequent and distressing, yet potentially avoidable, concern. The unit had the highest rate of falls in this long-term care setting, exceeding even that of dementia care units. No literature could be identified that examined falls in the palliative care population. ⋯ Analysis was conducted comparing risk factors of those patients who fell once and those who fell multiple times. It was found that advanced age, longer length of stay and a previous history of falls might be risk factors for future falls. Patients who fell multiple times had less symptom distress than patients who fell once.
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The dominant professional understanding of good death is death where symptoms are controlled, the inevitability of death has been accepted and preparations have been made leading to peace for all involved. It seems surprising, in a pluralistic society, that there might be such a clear common understanding of good death. ⋯ The concept of good death is perhaps a reduction of the acceptable way to care for a dying person. The concept of 'personally ideal death' is proposed as a refinement of good death that recognizes that the beliefs and values of each individual influences what they understand to be acceptable death.