International progress in creating palliative medicine as a specialized discipline and the development of palliative care

2015 ◽  
Author(s):  
Sheila Payne ◽  
Tom Lynch
Keyword(s):  
Palliative Care ◽  
Palliative Medicine ◽  
Advanced Disease ◽  
Regional Organizations ◽  
Care Services ◽  
The United Kingdom ◽  
Global Spread ◽  
Palliative Care Services ◽  
The 1960S ◽  
Further Development

This chapter provides an overview of the development of palliative medicine as a specialized discipline, and seeks to trace the development of international initiatives that have promoted and facilitated the growth of palliative care services. The focus is on palliative care services for adults with life-limiting conditions and advanced disease. A chronological narrative is traced from the first hospices developed in Dublin, Ireland, to the emergence of the modern hospices in the United Kingdom in the 1960s. The global spread of the principles of palliative care is traced in the formation of national and regional organizations. The chapter offers evidence on the progress of educational initiatives, both within medicine and for other members of the multidisciplinary team, at undergraduate and post-qualification level. The proposal for ten core common interdisciplinary competencies defines the essential foundations of palliative care. Finally, the chapter considers what areas of palliative medicine require further development.

Volunteering in hospice and palliative care in the United Kingdom

2018 ◽  
Author(s):  
Ros Scott
Keyword(s):  
Palliative Care ◽  
United Kingdom ◽  
Care Services ◽  
The United Kingdom ◽  
Strategic Direction ◽  
Palliative Care Services ◽  
History Of ◽  
The Uk ◽  
Hospice And Palliative Care ◽  
Changing Role

This chapter explores the history of volunteers in the founding and development of United Kingdom (UK) hospice services. It considers the changing role and influences of volunteering on services at different stages of development. Evidence suggests that voluntary sector hospice and palliative care services are dependent on volunteers for the range and quality of services delivered. Within such services, volunteer trustees carry significant responsibility for the strategic direction of the organiszation. Others are engaged in diverse roles ranging from the direct support of patient and families to public education and fundraising. The scope of these different roles is explored before considering the range of management models and approaches to training. This chapter also considers the direct and indirect impact on volunteering of changing palliative care, societal, political, and legislative contexts. It concludes by exploring how and why the sector is changing in the UK and considering the growing autonomy of volunteers within the sector.

Diagnosis, assessment, and treatment of depression in advanced disease

2018 ◽  
Author(s):  
Matthew Hotopf
Keyword(s):  
Palliative Care ◽  
Advanced Disease ◽  
Antidepressant Treatment ◽  
Population Level ◽  
Care Staff ◽  
Care Services ◽  
Treatment Of Depression ◽  
Assessment And Treatment ◽  
Palliative Care Services ◽  
Key Issues

Depression in palliative care is common, under-recognised and has significant impacts for sufferers. There are effective treatments but often a shortage of staff to provide them. This chapter sets out a number of key issues to consider when assessing and treating individual patients and considers the way in which palliative care services can innovate to provide a population level response to depression. Palliative care staff can be trained to deliver basic depression care and follow simple protocols to initiate, monitor and adjust antidepressant treatment. These approaches have been tested in trials in cancer care but the challenge is to take these approaches from research trials conducted in centres of excellence with good resources, to other settings.

scholarly journals The Impact Of COVID-19 On Out-Of-Hours Adult Hospice Care: An Online Survey

2021 ◽  
Author(s):  
Felicity Hasson ◽  
Paul Slater ◽  
Anne Fee ◽  
Tracey McConnell ◽  
Sheila Payne ◽  
...  
Keyword(s):  
Palliative Care ◽  
United Kingdom ◽  
Personal Protective Equipment ◽  
Protective Equipment ◽  
Community Based ◽  
Out Of Hours ◽  
Care Services ◽  
The United Kingdom ◽  
Palliative Care Services ◽  
The Impact

Abstract BackgroundGlobally COVID-19 has had a profound impact on the provision of healthcare, including palliative care. However, there is little evidence about the impact of COVID-19 on delivery of out-of-hours specialist palliative care services in the United Kingdom. The aim of the study is to investigate the impact of the COVID-19 pandemic on the delivery of out-of-hours community-based palliative care services.Methods A national online census survey of managers of adult hospices in the United Kingdom was undertaken. Survey were emailed to managers of adult hospices (n=150) who provided out-of-hours community palliative care services. Fifteen questions related specifically to the impact of COVID-19 and data were analysed thematically.ResultsEighty-one responses to the survey were returned (54% response rate); 59 were complete of which 47 contained COVID-19 data. Findings indicated that COVID-19 impacted on out-of-hours community-based palliative care. To meet increased patient need, hospices reconfigured services; redeployed staff; and introduced new policies and procedures to minimize virus transmission. Lack of integration between charitably and state funded palliative care providers was reported. The interconnected issues of the use and availability of Personal Protective Equipment (n=21) and infection control screening (n=12) resulted in changes in nursing practices due to fear of contagion for patients, carers and staff. Conclusions Survey findings suggest that due to increased demand for community palliative care services, hospices had to rapidly adapt and reconfigure services. Even though this response to the pandemic led to some service improvements, in the main, out-of-hours service reconfiguration resulted in challenges for hospices, including workforce issues, and availability of resources such as Personal Protective Equipment. These challenges were exacerbated by lack of integration with wider healthcare services. More research is required to fully understand the implications of such changes on the quality of care provided.

In our own words …

2018 ◽  
Author(s):  
Ros Scott
Keyword(s):  
United States ◽  
Palliative Care ◽  
United Kingdom ◽  
United States Of America ◽  
Care Services ◽  
The United Kingdom ◽  
Palliative Care Services ◽  
Hospice And Palliative Care ◽  
Original Story ◽  
The Impact

This chapter explores the experience of volunteers in hospice and palliative care their own words. Frequently we hear about the work of volunteers from paid staff, from research, but not always from the volunteers themselves in their own words. In this chapter we have tried to explore what happens in the unique place that volunteers have within hospice and palliative care services; somewhere between staff, patients, and families. The stories in this chapter have all come directly from volunteers from Italy, Australia, Romania, India, United States of America (USA), and the United Kingdom (UK) in their own words. Translation, where required, has tried to remain true to the original story and all volunteers have agreed the translation to ensure that it has not changed the essence of the story. Volunteers have described their roles, what volunteering means to them, and the impact that it has on their lives.

The modern context of palliative care

2018 ◽  
Author(s):  
Sheila Payne ◽  
Sara Morris
Keyword(s):  
Palliative Care ◽  
United Kingdom ◽  
Health Care Systems ◽  
Organizational Boundaries ◽  
Care Services ◽  
The United Kingdom ◽  
Health And Social Care ◽  
Palliative Care Services ◽  
Care Systems ◽  
Hospice And Palliative Care

Evidence suggests that in the past support services for patients and family carers of terminally ill people have often been unavailable or inadequate in addressing their needs. This chapter will briefly summarize the context of hospice and palliative care services. The chapter argues that definitions of palliative care are culturally and temporally dependent, exemplified by the changing terminology used in the United Kingdom. One of the challenges facing service deliverers is the necessity to work collaboratively across health and social care services, and statutory and voluntary sector organizational boundaries. The funding and organizational positioning of hospice and palliative care services are often contingent upon health care systems and resources. All roles require careful recruitment, dedicated training, and consistent support to provide effective contributions from volunteers. The chapter ends by providing a short description of three studies investigating the role of volunteers undertaken in the United Kingdom.

‘The horse has bolted I suspect’: A qualitative study of clinicians’ attitudes and perceptions regarding palliative rehabilitation

2016 ◽  
Vol 31 (7) ◽  
pp. 642-650 ◽  
Author(s):  
Fiona Runacres ◽  
Heidi Gregory ◽  
Anna Ugalde
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
Palliative Medicine ◽  
Evidence Base ◽  
Structured Interviews ◽  
Care Services ◽  
Attitudes And Perceptions ◽  
Palliative Care Services ◽  
Palliative Care Units ◽  
Rehabilitation Needs

Background: Palliative care patients have numerous rehabilitation needs that increase with disease progression. Palliative rehabilitation practices and perceptions of palliative medicine physicians towards the role of rehabilitation are largely unstudied. Aim: To explore palliative medicine physicians’ attitudes and perceptions towards rehabilitation delivered within inpatient palliative care units. Design: Qualitative study utilizing semi-structured interviews. Transcribed interviews were analysed using thematic analysis and major themes reported as results. Participants: Australian palliative medicine physicians working in inpatient palliative care units. Results: In total, 20 physicians participated, representing specialist palliative care services across Australia. A total of 11 (55%) were males with an average of 12.5 years’ experience working in palliative care. Most participants believed rehabilitation was an important aspect of palliative care; however, few felt adequate rehabilitation programmes were available. Participants varied in their concepts of what palliative rehabilitation entailed. The term rehabilitation was seen by some as helpful (fostering hope and aiding transitions) and by others to be misleading (creating unrealistic expectations). Four key themes emerged when describing physicians’ attitudes, including (1) integrating rehabilitation within palliative care, (2) the intervention, (3) possibilities and (4) the message of rehabilitation. Conclusion: A lack of consensus exists among palliative medicine specialists regarding the definition and scope of palliative rehabilitation. Participants generally expressed a wish to offer enhanced rehabilitation interventions, however described resource and skill-set limitations as significant barriers. Further research is required to establish an evidence base for palliative rehabilitation, to support its acceptance and widespread integration within specialist inpatient palliative care.

Palliative Care Across the Continuum of Cancer Care

2009 ◽  
Vol 7 (4) ◽  
pp. 481-487 ◽  
Author(s):  
Tara B. Sanft ◽  
Jamie H. Von Roenn
Keyword(s):  
Palliative Care ◽  
Cancer Care ◽  
Palliative Medicine ◽  
The United States ◽  
Fully Integrated ◽  
Disease Trajectory ◽  
Care Services ◽  
Palliative Care Services ◽  
Oncology Care ◽  
The Continuum

Optimal oncology care requires the integration of palliative medicine into oncology care across the disease trajectory. All patients require screening for palliative care services at the initial oncologic visit and reassessment throughout the continuum of care. As a result of the increasing attention focused on palliative care nationally and internationally, the domains of palliative cancer care have been elucidated and have fostered the development of guidelines for quality palliative care. The recent recognition of palliative medicine as a subspecialty in the United States, the growing number of hospital-based palliative care programs, and the accreditation of palliative medicine fellowship programs by the Accreditation Council for Graduate Medical Education highlight the increased visibility of palliative medicine. This provides hope for the future of oncologic care. The palliative approach is subsumed in cancer care—it provides assistance with decision-making, symptom management, and access to financial, emotional, and spiritual services. A fully integrated program of oncology and palliative care provides the greatest opportunity for care and cure.

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