Articles: palliative-care.
-
Background and Objectives: Anesthesiologists come into contact with patients under palliative care in different clinical settings. They also routinely encounter these patients in their primary field of work, the operating room. Patients receiving palliative care who are scheduled for surgery will pose unique challenges in perioperative management, often presenting with advanced disease and with different psychosocial and ethical issues. ⋯ Conclusions: In this study, the complex problems of patients under palliative care are not sufficiently taken into account in a preoperative anesthesiological interview. To improve treatment of the medical problems, therapists who have palliative medicine expertise, should be involved in the perioperative medical care, ideally as a multi-professional team. The discussion about perioperative limitations of treatment should be held beforehand, for example, as part of a structured advanced care planning discussion.
-
Leptomeningeal disease (LMD), spread of cancer to the lining of the brain and its protective coverings, is a feared complication of many different types of cancer. LMD negatively affects prognosis across tumor types. ⋯ An understanding of pathophysiology, symptomatology, prognosis, and treatment options is essential in providing optimal care. This article, written by clinicians who work across the cancer spectrum, uses an accessible "ten tips" format to help increase PC providers' confidence and competence around caring for people with LMD.
-
J Pain Symptom Manage · Sep 2024
Implementing the WHO Indicators for assessing palliative care development in three countries: a Do-It-Yourself approach.
Palliative care is an essential health service, with over 56.8 million people needing it yearly, particularly in low- and middle-income countries. The World Health Assembly has recognized palliative care as an ethical responsibility and called for comprehensive primary health care. The World Health Organization has published a technical report titled "Assessing the Development of Palliative Care Worldwide," as a crucial first step in addressing palliative care. The report includes 14 indicators to help decision-makers identify service provision gaps and inform health priorities, piloted by WHO's ATLANTES in Benin, Morocco, and Uruguay as part of a global assessment. ⋯ The WHO approach has proven effective in identifying health system deficiencies and disseminating information about palliative care evaluation processes. The report provides a 'Do-it-yourself' approach, encouraging self-management without expert guidance.