Articles: palliative-care.
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Palliative medicine · Dec 2020
Persistent socioeconomic inequalities in location of death and receipt of palliative care: A population-based cohort study.
Providing equitable care to patients in need across the life course is a priority for many healthcare systems. ⋯ Key measures of end-of-life care are not achieved equally across socioeconomic groups. These data can be used to inform policy strategies to improve delivery of palliative and end-of-life services.
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J Pain Symptom Manage · Dec 2020
Using Grounded Theory to Inform the Human-Centered Design of Digital Health in Geriatric Palliative Care.
Digital health offers innovative mechanisms to engage in palliative care, yet digital systems are typically designed for individual users, rather than integrating the patient's caregiving "social convoy" (i.e., family members, friends, neighbors, formal caregiving supports) to maximize benefit. As older adults with serious illness increasingly rely on the support of others, there is a need to foster effective integration of the social convoy in digitally supported palliative care. ⋯ Digital health provides an opportunity to expand the reach of geriatric palliative care interventions. This paper documents human-centered preferences of geriatric palliative care digital health to ensure technologies are relevant and meaningful to health care providers, patients, and the caregiving social convoy.
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Palliative medicine · Dec 2020
The preferences of patients with chronic obstructive pulmonary disease are to discuss palliative care plans with familiar respiratory clinicians, but to delay conversations until their condition deteriorates: A study guided by interpretative phenomenological analysis.
Chronic obstructive pulmonary disease is associated with an uncertain trajectory, which challenges prognostication and means that most patients are not involved in advance care planning and do not receive palliative and end-of-life care. ⋯ Different perceptions, competing priorities and service rationing inhibit patients from initiating early discussions with clinicians, so palliative care conversations should be initiated by respiratory-expert clinicians who know the patient well. After a sudden deterioration in the patient's condition may be a suitable time.
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J Pain Symptom Manage · Dec 2020
Trends of utilization of palliative care and aggressive end-of-life care for patients who died of cancers and those who died of non-cancer diseases in hospitals.
Patients who died of cancers and those who died of noncancer diseases may receive different end-of-life care. ⋯ Utilization of palliative care is increasing. Patients who died of noncancer diseases received less palliative care but more aggressive end-of-life care than those who died of cancers.
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J Pain Symptom Manage · Dec 2020
Palliative and end-of-life care in a small Caribbean country: A mortality follow-back study of home deaths.
Empirical information on circumstances of dying from advanced illness in developing countries remains sparse. Evidence indicates that out-of-hospital end-of-life care can have significant benefits such as increased satisfaction for the patient and caregivers and cost-effective for a health-care system. Services that are aimed to deliver care at private homes may be a good model for low- and middle-income countries or other low-resourced settings. ⋯ The largest part of end-of-life care at home in Trinidad and Tobago is provided by family members, whereas professional caregivers feature less prominently. To ensure quality in end-of-life care, better access to analgesics is needed, and adequate support and education for family members as well as general practitioners are highly recommended.