Articles: palliative-care.
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Compared with standard care alone, early integration of specialist palliative care in the treatment of patients with advanced cancer offers significant benefit with respect of symptom control, healthrelated quality of life and survival. The early integration of specialist palliative care means that patients receive palliative care concurrent with, or shortly after, the diagnosis of advanced cancer. ⋯ Over half of the cancer patients in general practice who are referred for specialist palliative care are done so very late. General practitioners appear to need encouragement for the early integration of palliative care for patients with advanced cancer and to initiate early referrals to palliative care teams.
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The corona virus disease 2019 (COVID-19) pandemic has required specialist palliative care (SPC) services to respond by: (I) integrating infection prevention/control measures into care for their usual caseloads and (II) providing consultations and/or care for people dying from a new disease entity. The aim of the current study was to learn about the response of Australian SPC services to COVID-19 and its consequences in order to inform pandemic practice and policy. ⋯ Meeting COVID-19-related challenges requires SPC to be agile and responsive. Advocacy is required to ensure the needs of people dying and their families are supported as well as people requiring acute care for COVID-19. Expansion of telehealth during the pandemic presents an opportunity for leveraging to benefit palliative care longer term.
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Palliative medicine · Mar 2021
The determinants of the intensity of home-based informal care among cancer patients in receipt of home-based palliative care.
Understanding the determinants of the intensity of informal care may assist policy makers in the identification of supports for informal caregivers. Little is known about the utilization of informal care throughout the palliative care trajectory. ⋯ The intensity of informal care was determined by predisposing, enabling, and needs-based factors. This study provides a reference for the planning and targeting of supports for the provision of informal care.
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J Pain Symptom Manage · Mar 2021
Observational StudyThe Impact of COVID-19 Surge on Clinical Palliative Care: A Descriptive Study from a New York Hospital System.
In spring 2020, New York experienced a surge of patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or COVID-19) disease, as part of a global pandemic. There are limited data on populations of COVID-19-infected patients seen by palliative care services. ⋯ During the initial surge of the COVID-19 pandemic in New York, palliative care services experienced a large surge of patients who tended to be healthier at baseline and more acutely ill at the time of admission than pre-COVID-19 palliative patients.
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Over 140,000 people in the United States have died as a result of infection with COVID-19. These patients have varying death experiences based on their location of death, the availability and utilization of various medical technologies, the amount of strain on the local health care system, the involvement of specialist palliative care (PC) teams, and access to essential medications to alleviate symptoms at the end of life. The objective of this report is to describe the death experiences of four patients cared for in an urban academic medical center who received very different degrees of medical interventions and to examine the interventions of our interdisciplinary PC team. We conclude that PC teams must adapt to this new landscape by creating best practices for ensuring adequate symptom control, modifying approaches for withdrawal of life-sustaining medical technologies, and gaining facility with communication through teleconferencing platforms to meet the challenge of alleviating suffering for people dying from COVID-19.