scholarly journals Insights from the Northern Territory on factors that facilitate effective palliative care for Aboriginal peoples

2009 ◽  
Vol 33 (4) ◽  
pp. 636 ◽  
Author(s):  
Emma L Phillips ◽  
Pam D McGrath
Keyword(s):  
Palliative Care ◽  
Health Care Providers ◽  
Health Professionals ◽  
Traditional Healers ◽  
Cultural Safety ◽  
Aboriginal Peoples ◽  
Care Providers ◽  
Remote Communities ◽  
Care Services ◽  
Palliative Care Services

This article aims to assist remote communities to develop their own palliative care services by providing findings on successful strategies identified through a 2-year research project which developed an innovative model for Indigenous palliative care. The discussion is set in the context of an understanding of the notion of cultural safety and discusses the positive experiences of the benefits of palliative care from the perspectives of both consumers and health professionals. The findings show that successful outcomes are derived from generic factors associated with palliative care philosophy and practice and from more specific factors, including the provision of pragmatic support to overcome practical problems, and community visits by health professionals. Factors specific to cultural respect are important, including familiarity and continuity of health care providers, cultural respect for grieving practices, provision of comfort food and bush tucker, development of culturally appropriate built environments, use of traditional healers and respect for spiritual practices.

Policy in palliative care

2015 ◽  
Author(s):  
David C. Currow ◽  
Stein Kaasa
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Health Care Providers ◽  
World Health ◽  
Care Providers ◽  
Care Services ◽  
Palliative Care Services ◽  
Organization Policy ◽  
Health Organization ◽  
Hospice Palliative Care

Hospice and palliative care services have developed in very different ways around the world. Most have been built on the momentum of visionary clinicians and funders who have responded to perceived needs from health-care providers, patients, families, and communities rather than in response to well-formed national policies with an adequately funded planning and development phase. This chapter describes the work that is being done at pan-national, national, and sub-national levels to create effective policies that can further the key work of hospice/palliative care, often after a large number of apparently unconnected local services have been well established. The chapter highlights that there are particular challenges in forming public policy on hospice/palliative care, especially the end-of-life component, and notes the importance of ‘patients’ voices’-the voice of the community which helps to inform health policies including end-of-life care. The chapter ends by describing a variety of country-specific and World Health Organization policy documents and legislation.

Ethnicity as a Factor

2015 ◽  
Author(s):  
Kimberly S. Johnson ◽  
Ramona L. Rhodes
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
African Americans ◽  
Health Care Providers ◽  
Cultural Beliefs ◽  
Ethnic Disparities ◽  
Care Providers ◽  
Care Services ◽  
Palliative Care Services ◽  
Advance Care

This chapter examines how race or ethnicity affects access to, and the quality of, palliative care by focusing on the experience of African Americans and Hispanics. More specifically, it considers how cultural beliefs, values, and preferences may influence care. It begins by looking at racial and ethnic disparities that exist throughout the health-care continuum, from disease prevention, early diagnosis, and curative treatment, to communication and pain management, lower rates of advance care planning, and lower utilization of hospice and palliative care services. It then explores the preferences of African Americans and Hispanics when it comes to end-of-life care, as well as the role of spirituality and faith in how they cope with illness. The chapter concludes by suggesting strategies and future directions for health-care providers, organizations, policymakers, and researchers on how to improve care for patients of diverse racial and ethnic backgrounds.

Palliative medicine and care of the elderly

2015 ◽  
Author(s):  
Meera Agar ◽  
Jane L. Phillips
Keyword(s):  
Palliative Care ◽  
Health Care Providers ◽  
Adult Child ◽  
The Elderly ◽  
Adverse Outcomes ◽  
Care Providers ◽  
Older Person ◽  
Medical Problems ◽  
Care Services ◽  
Palliative Care Services

Palliative care in the older person occurs in the context of chronic disease and multimorbidity. Coexisting conditions include musculoskeletal, psychiatric, cognitive, and chronic pain-related problems, each associated with substantive symptomatology and disability. Most crucial is to avoid management within disease ‘silos’ and the risks associated with polypharmacy, which both contribute to adverse outcomes. The complexity of older people’s care demands the formation of a collaborative partnership between primary care, geriatric, and palliative care services, together with other health-care providers in accordance with need. The caregiver of the older person warrants specific mention, often an older spouse with their own medical problems or an adult child juggling other life and work commitments. Planning for care in advance is crucial to avoid decisions being made in crisis, and is particularly crucial if cognitive decline is predicted. Physiological changes, and the frequency of falls, frailty, depression, and delirium are important when planning care and prescribing.

Awareness as a dimension of health care access: exploring the case of rural palliative care provision in Canada

2019 ◽  
Vol 24 (2) ◽  
pp. 108-115 ◽  
Author(s):  
Arlanna Pugh ◽  
Heather Castleden ◽  
Melissa Giesbrecht ◽  
Colleen Davison ◽  
Valorie Crooks
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Providers ◽  
Care Delivery ◽  
Local Health ◽  
Care Providers ◽  
Five Dimensions ◽  
Care Services ◽  
Palliative Care Services ◽  
Communication And Coordination

Objectives In Canada, the rural elderly population is increasing in size, as is their need for palliative care services in these settings. This analysis aims to identify awareness-associated barriers to delivering rural palliative care services, along with suggestions for improving service delivery from the perspective of local health care providers. Methods A total of 40 semi-structured interviews with various formal and informal health care providers were conducted in four rural and/or remote Canadian communities with limited palliative care resources. Interview data were thematically coded using Penchansky and Thomas’ five dimensions of access (i.e. availability, (geographic) accessibility, accommodation, acceptability and affordability). Saurman’s recently added sixth dimension of access – awareness – was also identified while coding and subsequently became the primary focus of this analysis. Results Identified barriers to palliative care awareness and suggestions on how to enhance this awareness, and ultimately palliative care delivery, corresponded with three key themes arising from the data: limited palliative care knowledge/education, communication and coordination. Participants recognized the need for more palliative care education, open lines of communication and better coordination of palliative care initiatives and local resources in their communities. Conclusions These findings suggest that identifying the barriers to palliative care awareness in rural communities may be foundational to addressing barriers to the other five dimensions of access. A thorough understanding of these three areas of awareness knowledge, communication and coordination, as well as the connections between them, may help enhance how rural palliative care is delivered in the future.

scholarly journals Advance care planning in palliative care: a national survey of health professionals and service managers

2015 ◽  
Vol 39 (2) ◽  
pp. 146 ◽  
Author(s):  
Marcus Sellars ◽  
William Silvester ◽  
Malcolm Masso ◽  
Claire E. Johnson
Keyword(s):  
Palliative Care ◽  
Advance Care Planning ◽  
National Survey ◽  
Health Professionals ◽  
Care Planning ◽  
The Past ◽  
Care Services ◽  
Palliative Care Services ◽  
Advance Care ◽  
Service Managers

Objective To identify the attitudes, knowledge and practices regarding advance care planning (ACP) in palliative care. Methods A nationwide online survey was distributed to Australian palliative care services associated with the Palliative Care Outcomes Collaboration (n = 105). Seventy-three health professionals (HPs) and 59 service managers completed the survey. Results Regarding ACP, 51% of service managers reported relevant policies and procedures were in place in their service and 44% included ACP in job descriptions. Most HPs were confident in undertaking ACP, including initiating discussions with patients and complying with documents; however, only 44% reported receiving ACP specific training. Although 58% of HPs reported having conversations about ACP with more than 11 patients in the past 6 months, only 44% of managers report that it is offered to most patients. Thirty per cent of HPs were aware of others not adhering to patient wishes in the past 6 months and only 43% of HPs (and 37% of managers) believed ACP is done well within their service. Conclusions This first national survey examining ACP in palliative care services demonstrates there is a need to improve systems to support ACP and to understand circumstances in which ACP wishes are not followed. What is known about the topic? ACP is increasingly recognised as an important part of care of people in hospital and community settings. However, currently there is no empirical evidence about the national uptake and quality of ACP in palliative care settings specifically. What does this paper add? This nationwide survey shows improvements on past small-scale research showing that ACP is supported by palliative care health professionals; however, the organisational ACP processes and systems did not support best practice in this regard. What are the implications for practitioners? Palliative care organisations should incorporate ACP systems (including greater access to ACP policies and guidelines) that support health professionals to complete ACP with clients who want to. Greater access to support, such as ACP training and resources, would assist with development of ACP documentation and adherence.

scholarly journals Use of telehealth in the provision of after-hours palliative care services in rural and remote Australia: A scoping review protocol

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0261962
Author(s):  
Pathmavathy Namasivayam ◽  
Dung T. Bui ◽  
Christine Low ◽  
Tony Barnett ◽  
Heather Bridgman ◽  
...  
Keyword(s):  
Palliative Care ◽  
Systematic Reviews ◽  
Scoping Review ◽  
Grey Literature ◽  
Rural And Remote ◽  
Remote Communities ◽  
Care Services ◽  
Scoping Reviews ◽  
Palliative Care Services ◽  
After Hours

Introduction After-hours services are essential in ensuring patients with life limiting illness and their caregivers are supported to enable continuity of care. Telehealth is a valuable approach to meeting after-hours support needs of people living with life-limiting illness, their families, and caregivers in rural and remote communities. It is important to explore the provision of after-hours palliative care services using telehealth to understand the reach of these services in rural and remote Australia. A preliminary search of databases failed to reveal any scoping or systematic reviews of telehealth in after-hours palliative care services in rural or remote Australia. Aim To review and map the available evidence about the use of telehealth in providing after-hours palliative care services in Australian rural and remote communities. Methods The proposed scoping review will be conducted using the Arksey and O’Malley methodological framework and in accordance with the Joanna Briggs Institute methodology for scoping reviews. The reporting of the scoping review will be guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). This review will consider research and evaluation of after-hours services using telehealth for palliative care stakeholders in rural and remote Australia. Peer reviewed studies and grey literature published in English from 2000 to May 2021 will be included. Scopus, Web of Science, CINAHL Complete, Embase via Ovid, PsycINFO via Ovid, Emcare via Ovid, Medline via Ovid, and grey literature will be searched for relevant articles. Titles and abstracts will be screened by two independent reviewers for assessment against the inclusion criteria. Data will be extracted and analysed by two reviewers using an adapted data extraction tool and thematic analysis techniques. Diagrams, tables, and summary narratives will be used to map, summarise and thematically group the characteristics of palliative care telehealth services in rural and remote Australia, including stakeholders’ perceptions and benefits and challenges of the services.

The Snog and Grog Club

2012 ◽  
Vol 23 (2) ◽  
pp. 147-155 ◽  
Author(s):  
Allison Kabel
Keyword(s):  
Palliative Care ◽  
Health Professionals ◽  
Day Care ◽  
The United States ◽  
Care Staff ◽  
Staff Members ◽  
Care Services ◽  
Life Threatening Illness ◽  
Palliative Care Services ◽  
End Stage

The popularity of British hospice day care signals the expanding boundaries of palliative care beyond end-stage illness. In this article, I examine the ways hospice philosophy was interpreted and implemented in an outpatient day therapy setting run by a multidisciplinary team of health professionals. Findings suggest that hospice day care staff members used several strategies to help patients cope and retain a sense of personhood while facing numerous emotional and physical challenges associated with life-threatening illness. Health professionals in the United States will need to prepare for patients accessing hospice and palliative care services earlier in the illness trajectory to take advantage of these opportunities for patient support and advocacy.

“You either need help…you feel you don't need help…or you don't feel worthy of asking for it:” Receptivity to bereavement support

2018 ◽  
Vol 17 (2) ◽  
pp. 172-185 ◽  
Author(s):  
Pippa Blackburn ◽  
Caroline Bulsara
Keyword(s):  
Palliative Care ◽  
Western Australia ◽  
Health Professionals ◽  
Psychosocial Support ◽  
Critical Factor ◽  
Aboriginal Health ◽  
Bereavement Support ◽  
Care Services ◽  
Provider Perspectives ◽  
Palliative Care Services

AbstractObjectiveAlthough the needs of the bereaved have been identified widely in the literature, how these needs translate into meaningful, appropriate, and client-centered programs needs further exploration. The application of receptivity to support is a critical factor in participation by the bereaved in palliative care bereavement programs. Receptivity is a complex multifactorial phenomenon influenced by internal and external factors that ultimately influences engagement in psychosocial support in bereavement. This study explored factors that influence receptivity to bereavement support from palliative care services in rural, regional, and remote Western Australia.MethodThe study comprised a qualitative descriptive research design using semistructured interviews with 24 bereaved individuals, nine palliative care health professionals, and four Aboriginal Health Professionals. Participants were recruited via palliative care services in country Western Australia. Interviews were transcribed verbatim and thematically analyzed.ResultFindings revealed that a range of individual, social, and geographical factors influence receptivity to bereavement support and can impact on utilization of bereavement support services.Significance of resultsReceptivity provides a frame of reference to enhance understanding of factors influencing engagement in psychosocial support in bereavement. Receptivity promotes a shift of service provider perspectives of effective supportive care to consumer-centric reasons for engagement.

The Role of Home Care in Palliative Care Services

2004 ◽  
Vol 5 (3) ◽  
pp. 151-157 ◽  
Author(s):  
Eileen Hanley
Keyword(s):  
Palliative Care ◽  
Staff Development ◽  
Home Care ◽  
End Of Life Care ◽  
Care Providers ◽  
Care Services ◽  
Palliative Care Services ◽  
Key Topics ◽  
Home Care Providers

This article addresses the increasing interest in end of life care and the need for improving access to palliative care services in patients/families served by the home care industry. The author discusses factors leading to this growing demand as well as some of the recent research conducted in the field of palliative care. The benefits of and underutilization of hospice services are discussed. The author addresses a variety of options for home care providers to consider expanding access to palliative care services including recent changes in regulation that allow for collaboration with Medicare certified hospice programs. A discussion of key topics to include in staff development initiatives related to palliative care is included as are education and clinical practice resources.

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