Multidisciplinary palliative care at the end of life of critically ill patient

2019 ◽  
Vol 43 (2) ◽  
pp. 61-62
Author(s):  
Á. Estella ◽  
T. Velasco ◽  
I. Saralegui ◽  
J.M. Velasco Bueno ◽  
O. Rubio Sanchiz ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Critically Ill ◽  
Critically Ill Patient

scholarly journals Correction to: End of life in the critically ill patient: evaluation of experience of end of life by caregivers (EOLE study)

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
◽  
Nadia Aissaoui ◽  
Virginie Amilien ◽  
Nadiejda Antier ◽  
Adrien Auvet ◽  
...  
Keyword(s):  
End Of Life ◽  
Critically Ill ◽  
Critically Ill Patient ◽  
Patient Evaluation

Are Health-Care Providers Well Prepared in Providing Optimal End-of-Life Care to Critically Ill Patients? A Cross-Sectional Study at a Tertiary Care Hospital in the United States

2018 ◽  
Vol 35 (10) ◽  
pp. 1080-1094 ◽  
Author(s):  
Kartikeya Rajdev ◽  
Nina Loghmanieh ◽  
Maria A. Farberov ◽  
Seleshi Demissie ◽  
Theodore Maniatis
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
End Of Life ◽  
Critically Ill ◽  
Health Care Providers ◽  
Critically Ill Patients ◽  
The United States ◽  
Care Providers ◽  
Strongly Agree ◽  
Eol Care

It is important for health-care providers to be comfortable in providing end-of-life (EOL) care to critically ill patients and realizing when continuing aggressive measures would be futile. Therefore, there is a need to understand health-care providers’ self-perceived skills and barriers to providing optimum EOL care. A total of 660 health-care providers from medicine and surgery departments were asked via e-mail to complete an anonymous survey assessing their self-reported EOL care competencies, of which 238 responses were received. Our study identified several deficiencies in the self-reported EOL care competencies among health-care providers. Around 34% of the participants either disagreed (strongly disagree or disagree) or were neutral when asked whether they feel well prepared for delivering EOL care. Around 30% of the participants did not agree (agree and strongly agree) that they were well prepared to determine when to refer patients to hospice. 51% of the participants, did not agree (agree and strongly agree) that clear and accurate information is delivered by team members to patients/family. The most common barrier to providing EOL care in the intensive care unit was family not accepting the patient’s poor prognosis. Nursing staff (registered nurse) had higher knowledge and attitudes mean competency scores than the medical staff. Attending physicians reported stronger knowledge competencies when compared to residents and fellows. More than half of the participants denied having received any previous training in EOL care. 82% of the participants agreed that training should be mandatory in this field. Most of the participants reported that the palliative care team is involved in EOL care when the patient is believed to be terminally ill. Apart from a need for a stronger training in the field of EOL care for health-care providers, the overall policies surrounding EOL and palliative care delivery require further evaluation and improvement to promote better outcomes in caring patients at the EOL.

The right to become an organ and tissue donor at the end of life of critically ill patient

2020 ◽  
Vol 44 (1) ◽  
pp. 59-60
Author(s):  
D. Daga-Ruiz ◽  
J.M. Perez-Villares ◽  
L. Martín-Villén ◽  
J.J. Egea-Guerrero
Keyword(s):  
End Of Life ◽  
Critically Ill ◽  
Critically Ill Patient ◽  
Tissue Donor ◽  
The Right

scholarly journals Biopsychosocial and Spiritual Implications of Patients with COVID-19 Dying in Isolation

2020 ◽  
Author(s):  
Thushara Galbadage ◽  
Brent M. Peterson ◽  
David C. Wang ◽  
Jeffrey S. Wang ◽  
Richard S. Gunasekera
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Well Being ◽  
Care Staff ◽  
Integrative Approach ◽  
Healthcare Teams ◽  
Use Of Technology ◽  
Spiritual Well Being

Critically ill patients with the Coronavirus disease 2019 (COVID-19) are dying in isolation without the comfort of their family or other social support in unprecedented numbers. Recently, healthcare teams at COVID-19 epicenters have been inundated with critically ill patients. Patients isolated for COVID-19 have had no contact with their family or loved ones and may have likely experienced death without closure. This situation highlights concerns about the psychological and spiritual well-being of patients with COVID-19 and their families, as they permanently part ways. While palliative care has advanced to address these patients' needs adequately, the COVID-19 pandemic presents several barriers that force healthcare teams to deprioritize these essential aspects of patient care. The severe acute respiratory syndrome (SARS) outbreak in 2003 gave us a glimpse of these challenges as these patients were also isolated in hospitals. Here, we discuss the importance of the biopsychosocial spiritual model in end-of-life care and its implications on patients dying with COVID-19. Furthermore, we outline an integrative approach to address the unique and holistic needs of critically ill patients dying with COVID-19. These include intentional and increased coordination with trained palliative care staff, early and frequent goals of care including discussion of end-of-life plans, broader use of technology to improve connectedness and shared decision making with patients’ families.

Decision Making and End-of-Life Care in Critically Ill Children

2000 ◽  
Vol 16 (1_suppl) ◽  
pp. S45-S52 ◽  
Author(s):  
Christian Masri ◽  
Catherine Ann Farrell ◽  
Jacques Lacroix ◽  
Graeme Rocker ◽  
Sam D. Shemie
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Intensive Care ◽  
End Of Life ◽  
Critically Ill ◽  
End Of Life Care ◽  
Critically Ill Children ◽  
Life Care ◽  
End Of Life Decisions ◽  
Life Therapy

Objectives 1) To comment on the medical literature on decision making regarding end-of-life therapy, 2) to analyze the data on disagreement about such therapy, including palliative care, and withholding and withdrawal practices for critically ill children in the pediatric intensive care unit (PICU), and 3) to make some general recommendations. Data Sources and Study Selection All papers published in peer-reviewed journals, and all chapters on end-of-life therapy, or on conflict between parents and caregivers about end-of-life decisions in the PICU were retrieved. Results We found three case series, three systematic descriptive studies, two qualitative studies, four surveys, and many legal opinions, editorials, reviews, guidelines, and book chapters. The main determinants of end-of-life decisions are the child's age, premorbid cognitive condition and functional status, pain or discomfort, probability of survival, and quality of life. Risk factors in persistent conflict between parents and caregivers about end-of-life care include a grave underlying condition or an unexpected and severe event. Conclusion Making decisions about end-of-life care is a frequent event in the PICU. Children may need both intensive care and palliative care concurrently at different stages of their illness. Disagreements are more likely to be resolved if the root cause of the conflict is better understood.

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