Articles: palliative-care.
-
Internal medicine journal · Oct 2021
Intentional hastening of death through medication: A case series analysis of Victorian deaths prior to the Voluntary Assisted Dying Act 2017.
Voluntary assisted dying is lawful in Victoria in limited circumstances and commences in Western Australia in mid-2021. There is evidence that in rare cases, unlawful assisted dying practices occur in Australia. ⋯ Unlawful assisted dying practices seem to have occurred in a small number of deaths in Victoria prior to commencement of the VAD Act. These practices typically occurred within the context of palliative or terminal sedation and may be difficult to distinguish from lawful palliative care practice. Some survey responses possibly reflect ambiguity in doctors' intentions when providing medication.
-
Palliative medicine · Oct 2021
Variation in end-of-life care and hospital palliative care among hospitals and local authorities: A preliminary contribution of big data.
Many studies explore the clinical and ethical dimensions of care at the end-of-life, but fewer use administrative data to examine individual and geographic differences, including the use of palliative care. ⋯ The variation we document in end-of-life and hospital palliative care across different categories of hospitals and 95 local authorities raises important questions as to what constitutes appropriate hospital use and intensity at the end-of-life.
-
Observational Study
Choice of access route for artificial nutrition in cancer patients: 30 y of activity in a home palliative care setting.
Malnutrition negatively affects the quality of life, survival, and clinical outcome of patients with cancer. Home artificial nutrition (HAN) is an appropriate nutritional therapy to prevent death from cachexia and to improve quality of life, and it can be integrated into a home palliative care program. The choice to start home enteral nutrition (HEN) or home parenteral nutrition (HPN) is based on patient-specific indications and contraindications. The aim of this observational study was to analyze the changes that occurred in the criteria for choosing the access route to artificial nutrition during 30 y of activity of a nutritional service team (NST) in a palliative home care setting, as well as to compare indications, clinical nutritional outcomes, and complications between HEN and HPN. ⋯ Over 30 y of nutritional service team activity, the choice of central venous catheters as an access route to HAN increased progressively and significantly due to personalized patient decision-making choices. Nutritional efficacy was comparable between HEN and HPN. In patients who maintained food oral intake, supplemental parenteral nutrition improved weight, performance status, and survival better than other types of HAN.
-
Palliative medicine · Oct 2021
Development and validation of a prediction model of poor performance status and severe symptoms over time in cancer patients (PROVIEW+).
Predictive cancer tools focus on survival; none predict severe symptoms. ⋯ The model accurately predicted changing cancer risk for low performance status and severe symptoms over time.
-
There are still many cases where traditional medical care does not provide a realistic solution for patients with devastating diseases so other interventions should be adopted. We present a case report of a 76 year-old woman admitted to a Palliative Care unit due to stage IV colon adenocarcinoma, and we describe the contribution of a six-year-old Yorkshire terrier in her symptom management. Animal-assisted therapy can be of great use in palliative care, contributing to the patients' pain management, relief from suffering and improvement of quality of life.