Projecting palliative and end-of-life care needs in Central Lancashire up to 2040: an integrated palliative care and public health approach

Public Health ◽  
2021 ◽  
Vol 195 ◽  
pp. 145-151
Author(s):  
J. Jeba ◽  
C. Taylor ◽  
V. O'Donnell
Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1615
Author(s):  
Samar M. Aoun     ◽  
Robyn Richmond ◽  
Leanne Jiang ◽  
Bruce Rumbold

Background: Consumer experience of palliative care has been inconsistently and selectively investigated. Methods: People in Western Australia who had experienced a life limiting illness in the past five years were recruited via social media and care organisations (2020) and invited to complete a cross sectional consumer survey on their experiences of the care they received. Results: 353 bereaved carers, current carers and patients responded. The winners, those who received the best quality end-of-life care, were those who were aware of palliative care as an end-of-life care (EOLC) option, qualified for admission to and were able to access a specialist palliative care program, and with mainly a cancer diagnosis. The losers, those who received end-of-life care that was adequate rather than best practice, were those who were unaware of palliative care as an EOLC option or did not qualify for or were unable to access specialist palliative care and had mainly a non-cancer diagnosis. Both groups were well supported throughout their illness by family and a wider social network. However, their family carers were not adequately supported by health services during caregiving and bereavement. Conclusions: A public health approach to palliative and end of life care is proposed to integrate tertiary, primary, and community services through active consumer engagement in the design and delivery of care. Therefore, suggested strategies may also have relevance in many other international settings.


Author(s):  
Aliki Karapliagou ◽  
Allan Kellehear ◽  
Klaus Wegleitner

This chapter briefly outlines the history, key concepts, and main practice methods from public health approaches to end-of-life care. Although linked to psychosocial care approaches, its main methods draw not from psychology or health services inspired approaches but rather from health promotion, community development, and civic engagement. Key methods covered include community volunteering, social networking, community engagement, and compassionate communities and cities. The aim of these kinds of approaches is to embed palliative care practice as a social and civic practice in all sectors of society and to ensure that palliative care as a policy is represented in all civic policies (e.g. schools, workplaces, faith groups, and cultural activities) and not solely in health care.


2021 ◽  
pp. bmjspcare-2021-003386
Author(s):  
Michael Bonares ◽  
Kenneth Mah ◽  
David Christiansen ◽  
John Granton ◽  
Andrea Weiss ◽  
...  

ObjectivesPatients with chronic respiratory disease have significant palliative care needs, but low utilisation of specialist palliative care (SPC) services. Decreased access to SPC results in unmet palliative care needs among this patient population. We sought to determine the referral practices to SPC among respirologists in Canada.MethodsRespirologists across Canada were invited to participate in a survey about their referral practices to SPC. Associations between referral practices and demographic, professional and attitudinal factors were analysed using regression analyses.ResultsThe response rate was 64.7% (438/677). Fifty-nine per cent of respondents believed that their patients have negative perceptions of palliative care and 39% were more likely to refer to SPC earlier if it was renamed supportive care. While only 2.7% never referred to SPC, referral was late in 52.6% of referring physicians. Lower frequency of referral was associated with equating palliative care to end-of-life care (p<0.001), male sex of respirologist (p=0.019), not knowing referral criteria of SPC services (p=0.015) and agreement that SPC services prioritise patients with cancer (p=0.025); higher referral frequency was associated with satisfaction with SPC services (p=0.001). Late referral was associated with equating palliative care to end-of-life care (p<0.001) and agreement that SPC services prioritise patients with cancer (p=0.013).ConclusionsPossible barriers to respirologists’ timely SPC referral include misperceptions about palliative care, lack of awareness of referral criteria and the belief that SPC services prioritise patients with cancer. Future studies should confirm these barriers and evaluate the effectiveness of strategies to overcome them.


Sexualities ◽  
2020 ◽  
pp. 136346072093238
Author(s):  
Claude Chidiac

The available evidence demonstrates that lesbian, gay, bisexual, and transgender (LGBT) people face challenges when accessing palliative care services, and receive suboptimal care at the end of life. This is mainly attributed to assumed heterosexuality, lack of knowledge and understanding of LGBT issues and specific healthcare needs, discrimination, homophobia, and transphobia. In Lebanon, legal and institutional support for LGBT individuals is minimal, and palliative care provision remains scarce and fragmented. This compounds the impact of social stigma and marginalisation, and results in unrecognised palliative and end of life care needs for the LGBT individual. This short commentary discusses the development of an LGBT palliative care workshop in Lebanon, which was the first initiative of its kind in the Middle East and North Africa (MENA) region. It also explores how this initiative has led to further developments, and how these efforts can be replicated in other countries in the MENA region.


2020 ◽  
Vol 19 (3) ◽  
pp. 203-211
Author(s):  
Jessica Blake ◽  
Anda Bayliss ◽  
Bethan Callow ◽  
Grace Futter ◽  
Navaneeth Harikrishnan ◽  
...  

Purpose Experiencing bereavement in childhood can cause profound changes to developmental trajectories. This paper aims to evaluate the feasibility of implementing a public health intervention in schools to encourage pupils aged 12-15 years to independently explore ideas of death, dying, loss and end of life care in a structured and creative format. Design/methodology/approach A co-produced storytelling intervention was implemented in an independent school in Norwich, UK. Pupils wrote up to 1,000 words in response to the title, “I Wish We’d Spoken Earlier”. Their participation was voluntary and extra-curricular. Stakeholder feedback was used in addition to the submissions as a measure of acceptability, appropriateness, adoption and feasibility. Findings In total, 24 entries were submitted. Pupils demonstrated their ability to engage thoughtfully and creatively with the subject matter. Feasibility for the storytelling intervention was demonstrated. Importantly, the intervention also prompted family conversations around preferences and wishes for end of life care. Research limitations/implications To determine whether the intervention has psychological and social benefits will require further study. Practical implications Educational settings can be considered as anchor institutions to support a public health approach to end of life care. Originality/value The positive response from all stakeholders in delivering and supporting the intervention indicates that schools are a community asset that could be further empowered to support children and families affected by death, dying and loss.


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