Articles: palliative-care.
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BMC palliative care · Feb 2021
Systematic adaptation of the Thai version of the supportive and palliative care indicators tool for low-income setting (SPICT-LIS).
Identification of patients who might benefit from palliative care among countries with different socioeconomic and medical contexts is challenging. The Supportive and Palliative Care Indicators Tool for a Low-income Setting (SPICT-LIS) was designed to help physicians identify patients in low-income setting who might benefit from palliative care. We aimed to systematically adapt and refine the SPICT-LIS for Thai general palliative care providers. ⋯ The study found that the Thai SPICT-LIS could be an applicable, acceptable, and reliable tool for general palliative care providers in Thailand to identify patients who might benefit from palliative care.
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Am J Hosp Palliat Care · Feb 2021
Advance Care Planning Shared Decision-Making Tools for Non-Cancer Chronic Serious Illness: A Mixed Method Systematic Review.
Shared decision-making tools can facilitate advance care planning and goals of care conversations in non-cancer serious illness. More information on integrating these tools in ambulatory care could better support clinicians and patients/caregivers in these conversations. ⋯ This mixed-methods review concludes that when integrating palliative care into ambulatory care for serious illness and conditions other than cancer, advance care planning shared decision-making tools may improve patient satisfaction and advance directive documentation.
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Frailty, which is a geriatric syndrome that affects 5% to 17% of older adults, is a state of increased vulnerability across multiple health domains that leads to adverse health outcomes. Frail older adults are at increased risk of falls, disability, hospitalizations, and death. Frailty may initially be overlooked or incorrectly identified as part of the normal aging process because of the variable nature of the presentation and diagnosis. ⋯ The management of frail patients must be individualized and tailored to each patient's goals of care and life expectancy. Physical activity and balance exercises may be suitable for patients who are less frail. Palliative care and symptom control may be appropriate for those who are more frail.
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Adults increasingly live and die with chronic progressive conditions into advanced age. Many live with multimorbidity and an uncertain illness trajectory with points of marked decline, loss of function and increased risk of end of life. Intermediate care units support mainly older adults in transition between hospital and home to regain function and anticipate and plan for end of life. This study examined the patient characteristics and the factors associated with mortality over 1 year post-admission to an intermediate care unit to inform priorities for care. ⋯ One in four patients died within 1 year. Indicators for palliative care assessment are respiratory conditions, dementia, liver disease, cancer and rising multimorbidity. The traditional emphasis on rehabilitation and recovery in intermediate care units has changed with an ageing population and the need for greater integration of palliative care.