Talking and Working with Dying Patients

2015 ◽  
Author(s):  
Lisa Humphrey
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Hospice Care ◽  
Lessons Learned ◽  
Good Death ◽  
Dying Patients ◽  
Personal Experiences ◽  
Life Issues ◽  
End Of Life Issues

This article reflects on the lessons about grief and dying acquired by a palliative care and hospice physician over the course of her training and career. The article describes how she views, engages, and incorporates grief into her work as a health-care provider based on her personal experiences and lessons learned from mentors, patients, and families. It describes ways to better understand the types of loss one can personally experience and need to “tag your baggage” as a way of loss experiences before patient discussions. The article then emphasizes the importance of managing one’s expectations when working with a patient and/or family facing end-of-life issues, citing a pervasive concept in palliative and hospice care known as the “good death.” Finally, it discusses the role of communication and supportive skills in dealing with dying patients and their families, along with debriefing and self-care.

Leader Interview: End-of-Life and Palliative Care: barriers, myths and misconceptions

2004 ◽  
Vol 10 (2) ◽  
pp. 4-9
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
End Of Life ◽  
Hospice Care ◽  
Health Care Environment ◽  
Hospice Nurses ◽  
Life Issues ◽  
Journal Editorial ◽  
End Of Life Issues

In today’s health care environment, end-of-life issues frequently recur with patients, families and those who care for them. And, as with many such issues, some health care teams address them well and others do not. Accordingly, we gathered three hospice nurses, an ICU nurse and a retired internist to discuss the myths, misconceptions and obstacles to patients receiving appropriate palliative care. Hospice care veteran Jane Robles, a member of the Creative Nursing Journal editorial board, led the roundtable discussion.

scholarly journals Palliative Care of the Infant and Child in the Paediatric Intensive Care Unit

2021 ◽  
Author(s):  
Maeve McAllister ◽  
Ann-Marie Crowe ◽  
Roisin Ni Charra ◽  
Julie Edwards ◽  
Suzanne Crowe
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Paediatric Intensive Care Unit ◽  
Paediatric Intensive Care ◽  
Life Issues ◽  
Advance Care ◽  
End Of Life Issues ◽  
Individualised Care

In this chapter we discuss the delivery of palliative care in the paediatric intensive care unit environment. Illustrated by challenging cases, we describe the role of intensive care in symptom management for the child with terminal or life-limiting illness. We detail the importance of a multidisciplinary team and their roles in the provision of individualised care for the child and their family. The importance of family-centred care and advance care planning is expanded upon. In addition, we explore end of life issues that are particular to children in intensive care such as withdrawal of life-sustaining therapies and organ donation. Finally, we discuss how to ensure the delivery of high-quality palliative care in the paediatric intensive care environment.

scholarly journals Talking About End-of-Life Care: How Should Physicians Act

2021 ◽  
Vol 9 (1) ◽  
pp. 38-42
Author(s):  
Abu Sadat Mohammad Nurunnabi ◽  
Nezamuddin Ahmad ◽  
Shuchana Chakma ◽  
- Md Asaduzzaman ◽  
Arif Mohammad
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Review Paper ◽  
Good Death ◽  
Life Care ◽  
Dying Patients ◽  
Life Issues ◽  
End Of Life Issues ◽  
Common Understanding ◽  
Dying Patient

Physicians should be adept in communication and familiar with the various end-of-life issues and their implications. However, physicians in Bangladesh usually receive very little training or guidance on how to communicate with the dying patients and their families. Since death is a common phenomenon, for physicians in their day-to-day practice, it sometimes becomes difficult to engage in end-of-life discussions in a death-averse society. This review paper aims to discuss a pragmatic step-by-step approach to discussing end-of-life care in a Bangladeshi context maintaining local social and cultural views. Specifically outlined in each of these four steps, a physician should seek a common understanding with the patient and family. Moreover, if any disagreement arises, overt conflict can often be avoided by reviewing what was discussed earlier with the patient or family. We all know that providing a supportive care for a dying patient is challenging. However, when it is done well, it becomes a meaningful and gratifying experience for the physician. As we know, helping someone die in comfort and with dignity signifies a good death and one of the best gifts of life that theoretically leads him/her to rest in peace. CBMJ 2020 January: Vol. 09 No. 01 P: 38-42

scholarly journals E.06 Developing and evidence-based palliative care curriculum for neurology resident trainees

2016 ◽  
Vol 43 (S2) ◽  
pp. S17-S17
Author(s):  
JY Laiwah ◽  
A Sarpal ◽  
V Schulz ◽  
TE Gofton
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Learning Style ◽  
Health Care Team ◽  
Evidence Based ◽  
Structured Interviews ◽  
Learning Style Inventory ◽  
Qualitative Thematic Analysis ◽  
Life Issues ◽  
End Of Life Issues

Background: Graduating neurology residents require general palliative care skills. This study aims to develop an evidence-based palliative care curriculum to provide neurology residents with the general palliative care skills required for providing patient care along the continuum of life. Methods: A needs assessment of the palliative skills necessary for a neurology resident was performed. Focus groups were held with physicians, allied health care and senior residents. Semi-structured interviews were held with patients and their caregivers. Interviews analysed using qualitative thematic analysis techniques. The Kolb learning style inventory will determine the learning style of neurology residents and inform the curricular design. Results: Qualitative analysis identified 3 overarching challenges for neurology residents: 1) uncertainty regarding disease trajectory in neurology and timing of palliative care discussions; 2) cohesiveness of the health care team regarding end of life issues; 3) the role of the resident in initiating palliative care. Other principals identified for inclusion were: symptom management, communication, psychosocial aspects of care, care coordination and access, and myths and pitfalls in palliative care. Conclusions: This project will identify the current best evidence and expert opinion in palliative care neurology. The data will be used to develop a novel Canadian neurological palliative care curriculum.

scholarly journals Demonstrating the vital role of physiatry throughout the health care continuum: Lessons learned from the impacts of the COVID‐19 pandemic on inpatient rehabilitation

PM&R ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 554-562
Author(s):  
Jonathan H. Whiteson ◽  
Miguel Xavier Escalón ◽  
Susan Maltser ◽  
Monica Verduzco‐Gutierrez
Keyword(s):  
Health Care ◽  
Inpatient Rehabilitation ◽  
Vital Role ◽  
Lessons Learned ◽  
Care Continuum

scholarly journals Interpretation for Discussions about End-of-Life Issues: Results from a National Survey of Health Care Interpreters

2012 ◽  
Vol 15 (9) ◽  
pp. 1019-1026 ◽  
Author(s):  
Yael Schenker ◽  
Alicia Fernandez ◽  
Kathleen Kerr ◽  
David O'Riordan ◽  
Steven Z. Pantilat
Keyword(s):  
Health Care ◽  
End Of Life ◽  
National Survey ◽  
Life Issues ◽  
End Of Life Issues

Palliative Care and End-of-Life Issues

2017 ◽  
pp. 621-633
Author(s):  
Rashmi Khadilkar ◽  
Hilary Yehling ◽  
Quill Timothy E.
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Life Issues ◽  
End Of Life Issues

scholarly journals Barriers in Implementing the Dying Patient Law: The Israeli Experience - A Qualitative Study

2020 ◽  
Author(s):  
Avi Zigdon ◽  
Rachel Nissanholtz-Gannot
Keyword(s):  
End Of Life ◽  
Family Doctor ◽  
Clinical Aspects ◽  
Human Aspects ◽  
Life Issues ◽  
End Of Life Issues ◽  
Medical Teams ◽  
Depth Interviews ◽  
Training Physicians

Abstract Background Coping with end-of-life issues is a major challenge for governments and health systems. Despite progress in legislation, many barriers exist to its full implementation. This study is aimed at identifying these end-of-life barriers in relation to Israel.Methods Qualitative in-depth interviews using professionals and decision makers in the health-care and related systems (n=37) were carried out, along with two focus groups based on brainstorming techniques consisting of nurses (n=10) and social workers (n=10). Data was managed and analyzed using Naralyzer software.Results Qualitative analysis showed identification of six primary barriers: 1) law, procedures, and forms; 2) clinical aspects; 3) human aspects; 4) knowledge and skills of medical teams; 5) communication; and 6) resource allocation. These were further divided into 44 sub area barriers.Conclusions This study highlights the role of the family doctor in end-of-life by training physicians in decision-making workshops and increasing their knowledge in the field of palliative medicine. Effectively channeling resources, knowledge, and support for medical teams, by accounting for the structure and response of the units for home treatment will improve patient's access to information on and support for end-of-life laws, as well as reduce legislative barriers in other countries that face the same issues.

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