End-of-Life Palliative Care Practices and Referrals in Uganda

Purpose In Korea, hospice palliative care (HPC) provision for cancer patients has increased recently. However, whether end of life (EoL) care practices have improved along with the development of HPC is unclear. We intended to investigate the changes in EoL care practices and their association with HPC referral. Materials and Methods Retrospective medical record review of adult cancer patients who died at National Cancer Center Korea from 1 January 2009 to 31 December 2014 was performed. Changes of EoL practices including chemotherapy within 2 weeks from death, death in intensive care unit (ICU), documentation of “do not resuscitate (DNR)” within 7 days from death and referral to HPC from 2009 to 2014 were analyzed as well as the association between referral to HPC and other practices. Results A total of 2,377 cases were included in the analysis. Between 2009 and 2014, referral to HPC increased and DNR documentation within 7 days from death decreased significantly. Cases for chemotherapy within 2 weeks from death and death in ICU didn’t change over the study period. Patients referred to HPC were less likely to receive chemotherapy within 2 weeks from death, die in ICU and document DNR within 7 days from death. Conclusion During the study period, EoL practices among cancer patients partly changed toward less aggressive in our institution. HPC referral was associated with less aggressive cancer care at the EoL. Policies to promote EoL discussion are necessary to improve the EoL practices of cancer patients.

Download Full-text

Realidades do mundo do trabalho de uma equipa comunitária de suporte em cuidados paliativos e as suas implicações nos cuidados aos doentes em trajetórias de fim de vida

Sociologia Revista da Faculdade de Letras da Universidade do Porto ◽

10.21747/08723419/soc40a2 ◽

2020 ◽

Vol 40 ◽

pp. 35-56

Author(s):

Tatiana Filipa Silva Mestre ◽

Carlos Alberto da Silva

Keyword(s):

Palliative Care ◽

End Of Life ◽

Healthcare Professionals ◽

Life Trajectories ◽

Preventive Work ◽

Support Team ◽

Life Trajectory ◽

Care Practices ◽

The Voice ◽

Care Support

Discovering the readings of health professionals on home care practices for patients at the end of their life, through a sociological prism, is one way to better understanding the nature of palliative care. In this article, we have explored the voice of healthcare professionals from a Community Palliative Care Support Team (ECSCP), analyzing the implicit textuality of their discourse and perspectives on the nature of palliative, curative and preventive work, challenges of work on end of life process, logic of communication and translation to solve problems at work as part of the patient's end of life trajectory. This article has been prepared on the basis of preliminary data analysis collected between 2019 and 2020, as part of the project funded by the Foundation for Science and Technology (FCT), entitled ETIC (End-of-Life Trajectories In Care) - Managing end-of-life trajectories in palliative care: a study on the work of healthcare professionals.

Download Full-text

Broadening End-of-Life Comfort to Improve Palliative Care Practices in Long Term Care

Canadian Journal on Aging / La Revue canadienne du vieillissement ◽

10.1017/s0714980817000253 ◽

2017 ◽

Vol 36 (3) ◽

pp. 306-317 ◽

Cited By ~ 12

Author(s):

Tamara Sussman ◽

Sharon Kaasalainen ◽

Susan Mintzberg ◽

Shane Sinclair ◽

Laurel Young ◽

...

Keyword(s):

Palliative Care ◽

End Of Life ◽

Long Term Care ◽

Soins Palliatifs ◽

Term Care ◽

Fin De Vie ◽

Sont Encore ◽

Care Practices ◽

Groupes De Discussion

RÉSUMÉCette étude qualitative canadienne rapporte les résultats de 19 groupes de discussion comprenant 117 participants, incluant des bénéficiaires, des familles et des membres du personnel. Elle avait pour objectifs : 1) d’explorer les soins palliatifs offerts en soins de longue durée (SLD) en vue de faire face aux tensions associées à la prestation de soins aux personnes qui sont encore bien vivantes et celles en fin de vie dans une même communauté de soins et 2) d’identifier des améliorations qui pourraient être apportées aux pratiques en soins palliatifs afin de mieux répondre aux besoins de tous les bénéficiaires en vie ou mourants dans les établissements de SLD, ainsi que celles des familles et du personnel qui leur apportent du soutien. Notre étude a montré que les perspectives liées au confort en fin de vie du personnel en SLD, celles des bénéficiaires et de leurs familles étaient appliquaient à ceux qui se trouvaient en fin de vie ou aux familles qui les soutenaient. Cette compréhension du confort limitait l’intégration des principes de soins palliatifs lors des derniers jours de vie des bénéficiaires. Les résultats de notre étude ont aussi suggéré que le fait de recueillir les perceptions des bénéficiaires liées au confort en fin de vie, de partager l’information à propos de la mort d’un bénéficiaire d’une manière plus personnelle, et de s’assurer que les bénéficiaires, leurs familles et le personnel aient des occasions de participer dans les soins de confort pour les bénéficiaires mourants pouvaient accroître le confort en fin de vie et soutenir une plus grande intégration des principes de soins palliatifs en SLD.

Download Full-text

End-of-life Care for Hematological Malignancies: The ‘Technological Imperative’ and Palliative Care

Journal of Palliative Care ◽

10.1177/082585970201800107 ◽

2002 ◽

Vol 18 (1) ◽

pp. 39-47 ◽

Cited By ~ 28

Author(s):

Pam Mcgrath

Keyword(s):

Palliative Care ◽

End Of Life ◽

End Of Life Care ◽

Hematological Malignancies ◽

Life Care ◽

Doctoral Research ◽

Care Practices ◽

Desire To Die ◽

Patients Experience ◽

Hospice Palliative Care

Recent research indicates that hospice/ palliative care practices have not yet been integrated into the care of patients with hematological malignancies. As research in relation to palliative care and hematological malignancies is in its infancy, many of the end-of-life care practices with these diagnostic groups are based on unexamined ideas. The findings presented in this article, which are taken from recent post-doctoral research on hematological malignancies and palliative care, make a contribution to documenting information on what is happening to patients and their families in this area. In particular, the findings provide insights on issues associated with the patient and carer awareness that the patient is dying, understanding of prognosis, and the desire to die at home. Such insights are placed in the context of descriptions of the patients’ experience with treatment during the terminal stage.

Download Full-text

Much Ado About Fried Chicken: Abetting Aspiration or Respecting Autonomy?

American Journal of Speech-Language Pathology ◽

10.1044/2019_ajslp-18-0207 ◽

2019 ◽

Vol 28 (3) ◽

pp. 1356-1362

Author(s):

Laurence Tan Lean Chin ◽

Yu Jun Lim ◽

Wan Ling Choo

Keyword(s):

Palliative Care ◽

End Of Life ◽

Multidisciplinary Team ◽

Biopsychosocial Model ◽

Family Members ◽

Clinical Decisions ◽

Goals Of Care ◽

Complex Needs ◽

Aspiration Risk ◽

Patient Centric

Purpose Palliative care is a philosophy of care that encompasses holistic, patient-centric care involving patients and their family members and loved ones. Palliative care patients often have complex needs. A common challenge in managing patients near their end of life is the complexity of navigating clinical decisions and finding achievable and realistic goals of care that are in line with the values and wishes of patients. This often results in differing opinions and conflicts within the multidisciplinary team. Conclusion This article describes a tool derived from the biopsychosocial model and the 4-quadrant ethical model. The authors describe the use of this tool in managing a patient who wishes to have fried chicken despite aspiration risk and how this tool was used to encourage discussions and reduce conflict and distress within the multidisciplinary team.

Download Full-text