Articles: palliative-care.
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J Pain Symptom Manage · Aug 2020
Comparing symptom ratings by staff and family carers in residents dying in long-term care facilities in three European countries, results from a PACE-survey.
Symptom management is essential in the end-of-life care of long-term care facility residents. ⋯ There is a need for improved communication between staff and family and discussion about symptom burden in the dying phase in long-term care facilities.
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J Pain Symptom Manage · Aug 2020
LGBTQ+ Inclusive Palliative Care in the Context of COVID-19:Pragmatic Recommendations for Clinicians.
As coronavirus disease 2019 (COVID-19) continues to impact the seriously ill and their families on a global scale, considerations given to marginalized groups amid the pandemic are essential to ensure the provision of high-quality and dignified care. Lesbian, gay, bisexual, transgender, gender-nonconforming, and queer/questioning-identified (LGBTQ+) persons are particularly vulnerable to health inequities across settings, including palliative care and at the end of life. ⋯ We aim to fill this gap by providing essential health inequity and social support background pertaining to LGBTQ+ persons and practical recommendations for immediate implementation that support inclusive and respectful care for these populations. Using these recommendations is a pragmatic pathway to promote trust, transparency, patient and family engagement, and value concordant care amid the health system strain caused by COVID-19.
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J Pain Symptom Manage · Aug 2020
Development and Implementation of a Clinician-facing Prognostic Communication Tool for Patients with COVID-19 and Critical Illness.
Effective prognostication for a novel disease presents significant challenges, especially given the stress induced during a pandemic. We developed a point-of-care tool to summarize outcome data for critically ill patients with COVID-19 and help guide clinicians through a thoughtful prognostication process. Two authors reviewed studies of outcomes of patients with critical illness due to COVID-19 and created a visual infographic tool based on available data. ⋯ The tool also included prompts for clinician reflection designed to enhance awareness of cognitive biases that may affect prognostic accuracy. This online, open-source COVID-19 Prognostication Tool has been made available to all clinicians at our institution and is updated weekly to reflect evolving data. Our COVID-19 Prognostication Tool may provide a useful approach to promoting consistent and high-quality prognostic communication across a health care system.
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J Pain Symptom Manage · Aug 2020
Challenges in the Provision of End-of-life and Palliative Care to Ethnic Nepali Refugees.
After over a decade of resettlement of ethnic Nepali refugees in the U. S., a significant population of seriously ill refugees will require palliative care and hospice care. ⋯ Culturally competent care of ethnic Nepali refugees can be accomplished through respectful exploration of patients' and families' preferences regarding the challenges identified. This article presents recommendations that can guide primary and specialist palliative care for this population.
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Background: Little is known about the provision of palliative care to people with dementia (PWD). Objective: To examine demographic and clinical characteristics of PWD versus nondementia serious illnesses receiving community-based palliative care. Design: Retrospective study of people 65+ receiving an initial consultation from a community-based palliative care practice between September 2014 and February 2018 using registry data entered by clinicians into the Quality Data Collection Tool for Palliative Care. ⋯ Conclusions: This is the first comparison of a large cohort of people with and without dementia receiving a community-based palliative care consult in the United States. Alternative measures of symptom burden should be used in registries to capture data for PWD. Understanding the unique characteristics of PWD will guide future services for this growing population.