The Eighth Domain of Palliative Care

2018 ◽  
Author(s):  
E. Alessandra Strada
Keyword(s):  
Palliative Care ◽  
Partner Violence ◽  
Care Setting ◽  
Ethical Issues ◽  
Complex Case ◽  
Advanced Illness ◽  
Family Conflicts ◽  
Palliative Care Setting ◽  
Case Vignettes ◽  
Terminal Prognosis

This chapter discusses palliative psychology competencies in the eighth domain of palliative care, which addresses the legal and ethical aspects of palliative care. Firstly, the chapter reviews psychology ethical standards and principles discussing their application and relevance to the palliative care setting. Palliative psychology competencies are presented. Additionally, principles of medical ethics related to decision making are discussed. Complex case scenarios are discussed with the aid of clinical case vignettes. In particular, the discussion focuses on the ethical issues related to disclosure of a terminal prognosis, family conflicts, and intimate partner violence of patients with advanced illness. Psychological approaches and interventions are discussed in the context of the interdisciplinary palliative care tem approach.

Palliative Psychology

2018 ◽  
Author(s):  
E. Alessandra Strada
Keyword(s):  
Palliative Care ◽  
Psychological Assessment ◽  
Care Setting ◽  
Clinical Aspects ◽  
Advanced Illness ◽  
Palliative Care Setting ◽  
Licensed Psychologists ◽  
The Us ◽  
Case Vignettes ◽  
Essential Knowledge

Palliative Psychology: Clinical Perspectives on an Emerging Specialty is the first book that proposes palliative psychology as a new specialty defining the roles and competencies of psychologists working in the palliative care setting in the US context. As proposed and defined in this book, palliative psychology is a specialty for licensed psychologists interested in providing psychological assessment and interventions to patients with serious and advanced illness and their family caregivers. The psychologist’s involvement can begin after a diagnosis of serious illness and continue during treatment, transition of care, during the dying process, and in bereavement. This book follows the framework developed by the Clinical Practice Guidelines for Quality Palliative Care, which identifies eight domains of specialist palliative care. The chapters of the book explore each of the domains, describing some of the essential knowledge, skills, and attitudes that palliative psychologists should develop to become competent palliative care professionals. Tables and clinical case vignettes are used throughout the book to illustrate important clinical aspects related to the work of palliative psychologists.

Communicating a terminal prognosis in a palliative care setting: Deficiencies in current communication training protocols

2008 ◽  
Vol 66 (11) ◽  
pp. 2356-2365 ◽  
Author(s):  
Elaine M. Wittenberg-Lyles ◽  
Joy Goldsmith ◽  
Sandra Sanchez-Reilly ◽  
Sandra L. Ragan
Keyword(s):  
Palliative Care ◽  
Care Setting ◽  
Communication Training ◽  
Palliative Care Setting ◽  
Terminal Prognosis ◽  
Training Protocols

Opioid therapy: managing risks of abuse, addiction, and diversion

2015 ◽  
Author(s):  
Julie R. Price ◽  
Alric D. Hawkins ◽  
Steven D. Passik
Keyword(s):  
Palliative Care ◽  
Drug Use ◽  
Care Setting ◽  
Opioid Therapy ◽  
Prescription Drug Abuse ◽  
Advanced Illness ◽  
Medical Problems ◽  
Medically Ill ◽  
Palliative Care Setting ◽  
Major Impediment

Given the complex and chronic medical problems that are seen in the palliative care setting, there is an ever increasing need for awareness of prescription drug abuse. Providers must balance the potential for abuse of prescribed opioids with the need to provide appropriate analgesia for patients in the palliative care setting. In addition, the presence of aberrant drug use amongst patients with advanced illness represents a major impediment to appropriate care. In order to maximize patient outcomes and to prescribe needed medication both safely and fairly, the clinician should work to develop appropriate controls and monitoring. Aberrant drug-related behaviour is a complex phenomenon that can occur in the chronic medically ill patient and needs to be approached in an empathetic manner that allows for recognition of the biological, chemical, psychological, and social aspects, with the ultimate goal of safely managing patients’ pain, while addressing other issues that are leading to their distress and perpetuating their aberrant drug use.

Refractory hyperactive delirium in the dying: pharmacological management

2021 ◽  
pp. bmjspcare-2021-003139
Author(s):  
Kathryn Tham ◽  
Angela Shiu ◽  
Leeroy William ◽  
Grace Walpole ◽  
Saly Rashed
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Care Setting ◽  
Clinical Presentation ◽  
Eastern Health ◽  
Advanced Illness ◽  
Pharmacological Management ◽  
Clinical Notes ◽  
Retrospective Audit ◽  
Palliative Care Setting

BackgroundDelirium is a prevalent clinical presentation in advanced illness. The hyperactive phase can cause severe symptoms at the end of life. There is no published study of the pharmacological management of this symptom in Australian palliative medicine practice.ObjectivesTo describe the pharmacological management of hyperactive delirium at the end of life in an Australian inpatient palliative care setting.MethodsRetrospective audit of deaths from October 2019 where a medication of interest (MOI) was used following admission to the palliative care unit (PCU) of Eastern Health. The clinical notes of those included were reviewed to further describe the clinical details surrounding the use of the MOI.ResultsForty patients were included. Midazolam was the most common medication used (57.5%). The most common dual agent combination was midazolam plus levomepromazine.ConclusionsThis audit is the first description of pharmacological management of severe hyperactive delirium at the end of life requiring sedation in an Australian PCU.

Adapting Meaning-Centered Psychotherapy in the Palliative Care Setting

2017 ◽  
Author(s):  
Melissa Masterson ◽  
Barry Rosenfeld ◽  
Hayley Pessin ◽  
Natalie Fenn
Keyword(s):  
Palliative Care ◽  
Meaning In Life ◽  
Care Setting ◽  
Death And Dying ◽  
Terminally Ill ◽  
Health Needs ◽  
Mental Health Needs ◽  
Serious Illness ◽  
Palliative Care Setting ◽  
Case Vignettes

Meaning-centered psychotherapy (MCP) has demonstrated effectiveness in aiding patients with advanced cancer search for and attain a sense of meaning in life despite serious illness. Work with MCP and decades of research focused on the mental health needs of palliative care patients led to the development of an abbreviated version of MCP specifically tailored to palliative care patients. This chapter describes the development of a three-session adaptation of MCP called meaning-centered psychotherapy—palliative care (MCP-PC), along with an overview of the session content. Session transcripts and case vignettes are used to highlight results from the initial pilot study. These preliminary results provide support for the feasibility, acceptability, and effectiveness of this intervention in helping terminally ill patients in hospice or palliative care settings better cope with the challenges inherent in confronting death and dying.

Validation of the Phase II Feasibility Study in a Palliative Care Setting

2012 ◽  
Vol 30 (8) ◽  
pp. 752-758 ◽  
Author(s):  
Cindy Lee ◽  
Ryash Vather ◽  
Anne O’Callaghan ◽  
Jackie Robinson ◽  
Briar McLeod ◽  
...  
Keyword(s):  
Palliative Care ◽  
Feasibility Study ◽  
Phase Ii ◽  
Care Setting ◽  
Palliative Care Setting

Outcome measures for holistic, complex interventions within the palliative care setting

2008 ◽  
Vol 14 (1) ◽  
pp. 25-32 ◽  
Author(s):  
Elizabeth Anita Thompson ◽  
Tina Quinn ◽  
Charlotte Paterson ◽  
Helen Cooke ◽  
Deidre McQuigan ◽  
...  
Keyword(s):  
Palliative Care ◽  
Outcome Measures ◽  
Care Setting ◽  
Complex Interventions ◽  
Palliative Care Setting

scholarly journals Bereaved spouses' adjustment after the patients' death in palliative care

2007 ◽  
Vol 5 (4) ◽  
pp. 397-404 ◽  
Author(s):  
Maria E. Carlsson ◽  
Ingrid M. Nilsson
Keyword(s):  
Palliative Care ◽  
Sleep Disturbance ◽  
Care Setting ◽  
Significant Decline ◽  
First Year ◽  
Inclusion Criteria ◽  
Life Situation ◽  
Palliative Care Setting ◽  
Advanced Home Care ◽  
Grief Reactions

ABSTRACTObjectives:To improve the support to bereaved spouses during the year after the patient's death, a project was started consisting of three visits by a nurse (after 1, 3, and 13 months) with conversations about the patient's death and the spouse's life situation. The aim of this study was to describe the bereaved spouse's situation and adaptation during the first year after the loss.Methods:Spouses of patients cared for by The Advanced Home Care Team (APHCT) in Uppsala, Sweden, were invited to participate in the project. Each participant was encouraged to talk freely about his or her situation, but enough direction was given to ensure that all items listed on a standardized questionnaire were covered.Results:Fifty-one spouses met the inclusion criteria and were invited to participate and 45 accepted. The subjects felt quite healthy but were tired and suffered from sleep disturbance. The grief reactions had initially been high but showed a significant decline from 1 to 13 months (p < .01). Forty-nine percent had experienced postbereavement hallucinations.Significance of results:This study showed that the bereaved spouses felt quite healthy and adjusted quite well to their new life situation, after the patient's death in a palliative care setting. The grief reactions had initially been high but showed a significant decline during the year.

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