Associations between the Veteran Health Administration's Life-Sustaining Treatment Decisions Initiative and Quality of Care at the End of Life

Author(s):  
Adam Batten ◽  
Jennifer H. Cohen ◽  
Mary Beth Foglia ◽  
David Alfandre
2020 ◽  
pp. bmjspcare-2020-00239
Author(s):  
Sandra Kurkowski ◽  
Johannes Radon ◽  
Annika R Vogt ◽  
Martin Weber ◽  
Stephanie Stiel ◽  
...  

BackgroundPalliative care strives to improve quality of life for patients with incurable diseases. This approach includes adequate support of the patients’ loved ones. Consequently, loved ones have personal experiences of providing end-of-life care for their next. This is a resource for information and may help to investigate the loved ones’ perspectives on need for improvements.AimTo identify further quality aspects considered important by loved ones to improve the quality of care at the end of life as an addition to quantitative results from the Care of the Dying Evaluation for the German-speaking area (CODE-GER) questionnaire.DesignWithin the validation study of the questionnaire ‘Care of the Dying Evaluation’ (CODETM) GER, loved ones were asked to comment (free text) in parallel on each item of the CODE-GER. These free-text notes were analysed with the qualitative content analysis method by Philipp Mayring.Setting/participantsLoved ones of patients (n=237), who had died an expected death in two university hospitals (palliative and non-palliative care units) during the period from April 2016 to March 2017.Results993 relevant paragraphs were extracted out of 1261 free-text notes. For loved ones, important aspects of quality of care are information/communication, respect of the patient’s and/or loved one’s will, involvement in decision-making at the end of life (patient’s volition) and having the possibility to say goodbye.ConclusionsIt is important for loved ones to be taken seriously in their sorrows, to be informed, that the caregivers respect the patients’ will and to be emotionally supported.Trial registration numberThis study was registered at the German Clinical Trials Register (DRKS00013916).


2008 ◽  
Vol 26 (23) ◽  
pp. 3860-3866 ◽  
Author(s):  
Craig C. Earle ◽  
Mary Beth Landrum ◽  
Jeffrey M. Souza ◽  
Bridget A. Neville ◽  
Jane C. Weeks ◽  
...  

The purpose of this article is to review the literature and update analyses pertaining to the aggressiveness of cancer care near the end of life. Specifically, we will discuss trends and factors responsible for chemotherapy overuse very near death and underutilization of hospice services. Whether the concept of overly aggressive treatment represents a quality-of-care issue that is acceptable to all involved stakeholders is an open question.


2019 ◽  
Vol 25 (7) ◽  
pp. 326-332
Author(s):  
Kanyanat Supaporn ◽  
Sang-arun Isaramalai ◽  
Wandee Suttharangsee

Background: Older people in Thailand receive general medical and social care at the end of life, and many rarely access palliative services. In light of this, improving the quality of care for the ageing population relies on addressing the needs of family caregivers, who provide the majority of care in a home setting. Understanding caregivers' perspectives when caring for a friend or relative will help to improve the quality of care that they provide. Aim: To explore caregivers' perspectives on improving care for older people in Thailand in the palliative stage. Methods: A qualitative study using in-depth interviews and observation of 10 older people in the palliative stage and their caregivers was undertaken. Data were analysed using content analysis. Findings: Data analysis revealed three themes: caregivers cared to repay the older person's previous kindness, caregivers cared and changed their caregiving behaviour to minimise the older person's perception of being abandoned or being a burden, and to follow Thai ancestral traditions, so that the older person could die peacefully. Conclusion: This study provides specific instructions for those who provide care for older Thai people in the palliative stage. Finding ways to address caregivers' perspectives on improving care quality could enhance the experience of care recipients.


2002 ◽  
Vol 42 (suppl_3) ◽  
pp. 71-80 ◽  
Author(s):  
Virginia P. Tilden ◽  
Susan Tolle ◽  
Linda Drach ◽  
Susan Hickman

CHEST Journal ◽  
2012 ◽  
Vol 142 (1) ◽  
pp. 128-133 ◽  
Author(s):  
Janice M. Leung ◽  
Edmunds M. Udris ◽  
Jane Uman ◽  
David H. Au

2004 ◽  
Vol 22 (14_suppl) ◽  
pp. 8529-8529
Author(s):  
J. W. Mack ◽  
J. M. Hilden ◽  
J. Watterson ◽  
H. E. Grier ◽  
J. C. Weeks ◽  
...  

2012 ◽  
Vol 8 (3S) ◽  
pp. e6s-e13s ◽  
Author(s):  
Carrie H. Colla ◽  
Nancy E. Morden ◽  
Jonathan S. Skinner ◽  
J. Russell Hoverman ◽  
Ellen Meara

Payment reform may be used to better align appropriate financial incentives with better quality of care.


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