Articles: palliative-care.
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Case Reports
Pharmacological Prophylaxis of Venous Thromboembolism in Terminally Ill Patients: A Need or Futility?
The aim of this case is to clarify the need to maintain the terminally ill oncological patients who have had a thrombotic event in the course of their underlying disease under antithrombotic therapy. This case addresses a 63-year-old man with stage IV gastric antrum adenocarcinoma, completely bed-ridden and anticoagulated with subcutaneous enoxaparin for more than a year, following deep venous thrombosis of the left lower limb. After reviewing the literature, it was found that, for end-of-life patients, anticoagulation seems to have little benefit as the main objective is not the extension of life itself, but rather the preservation of the best quality of life through practices that are well established in the relief of suffering.
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Multicenter Study
Does Urinary Catheterization Affect the Quality of Death in Patients with Advanced Cancer? A Secondary Analysis of Multicenter Prospective Cohort Study.
Background: Patients with life-limiting illnesses frequently experience urinary difficulties, and urinary catheterization is one of the interventions for managing them. However, evidence supporting the effects of urinary catheters on the quality of death (QoD) is lacking in this population. Objectives: To investigate whether urinary catheterization affects QoD in patients with advanced cancer in palliative care units. ⋯ In subgroup analyses stratified by sex, age, and length of palliative care unit stay, urinary catheterization was associated with higher total GDS scores in patients younger than 65 years of age and those who died after a palliative care unit stay of 21 days or fewer. Conclusions: This study suggested that urinary catheterization during a palliative care unit stay may have a positive impact on overall QoD in patients with advanced cancer. This study was registered in the UMIN Clinical Trials Registry (UMIN000025457).
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Palliative medicine · Feb 2022
Interventions to support family caregivers of people with advanced dementia at the end of life in nursing homes: A mixed-methods systematic review.
Most people with dementia transition into nursing homes as their disease progresses. Their family caregivers often continue to be involved in their relative's care and experience high level of strain at the end of life. ⋯ The findings provide useful information on which interventions may benefit family caregivers of people with advanced dementia at the end of life and where, when, and how they should be provided.
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Palliative medicine · Feb 2022
Which factors influence the quality of end-of-life care in interstitial lung disease? A systematic review with narrative synthesis.
People dying from interstitial lung disease experience considerable symptoms and commonly die in an acute healthcare environment. However, there is limited understanding about the quality of their end-of-life care. ⋯ There is inadequate knowledge regarding the most appropriate location for end-of-life care for people with interstitial lung disease. Early palliative care involvement can improve accordance with end-of-life care wishes. Future research should consider symptom management at the end-of-life and association with location of death.
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Palliative medicine · Feb 2022
Care practices of specialized outpatient pediatric palliative care teams in collaboration with parents: Results of participatory observations.
Collaboration between parents and professional care providers is an essential part of pediatric palliative care. As children are embedded in family systems and many of the patients are not able to communicate verbally, their parents are the primary interaction partners for palliative care providers. International standards for pediatric palliative care in Europe state that parents should be supported, acknowledged as the primary carers and involved as partners in all care and decisions. ⋯ Care practices in pediatric palliative care require time, communication skills, and a high level of psychosocial competence, to develop a trusting, collaborative relationship with parents. This should be taken into consideration when establishing pediatric palliative care structures, preparing guidelines, training staff, and deciding upon appropriate remuneration.