Articles: palliative-care.
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Delirium is a frequent and serious clinical problem in the terminally ill cancer patient. Multiple dimensions of delirium make definition, measurement, and assessment of it challenging in clinical nursing practice. ⋯ Four delirium assessment scales determined to be useful in assessing patients with terminal illness are reviewed. The use of a delirium assessment instrument in routine nursing assessments would be important for the nurse's early detection of delirium so that interventions to reverse the causes of delirium could immediately be implemented.
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Caring for the patient with end-stage renal disease poses many challenges for the bedside nurse. Yet, how do we care for patients who continue to seek hemodialysis with a guarded prognosis? A discussion about palliative care and specific interventions used to help improve quality of life for the end-stage renal patient is provided. A case example accompanies this article, and highlights the interventions used successfully for one such patient.
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This article outlines the position statement agreed by the Midlands Palliative Care Teachers' Professional Forum. Written by a member of the group, it includes suggestions from other members and was submitted for publication before the recent announcement of funds being available for palliative education for district nurses. ⋯ Emphasis is placed on the provision of holistic multiprofessional and uniprofessional courses dedicated to enhancing the quality of palliative care. The article confirms the commitment of palliative care educationalists to this end and looks to continued commitment of adequate funding from NHS trusts and regions in supporting existing palliative care education and its ongoing development in response to clinical need.
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Ethical Theory Moral Pract · Jun 2001
Desires in palliative medicine. Five models of the physician-patient interaction on palliative treatments related to Hellenistic therapies of desires.
In this paper, we explore the desires that play a role at the palliative stage and relate them to various approaches to patient autonomy. What attitude can physicians and other caregivers take to the desires of patients at the palliative stage? We examine this question by introducing five physicians who are consulted by Jackie, an imaginary patient with metastic lung carcinoma. ⋯ The story of Jackie shows that desires are to a certain extent responsive to reasoning. In the palliative process, that can be a reason to devote attention to the desires of patients and caregivers and to determine which desires need to be fulfilled, which are less important, and how they are linked to emotions the patient has.