The Transition to End-of-Life Care in End-Stage Liver Disease

2013 ◽  
Vol 15 (4) ◽  
pp. 209-215 ◽  
Author(s):  
Paula Cox-North ◽  
Ardith Doorenbos ◽  
Sarah E. Shannon ◽  
John Scott ◽  
Jared Randall Curtis
Keyword(s):  
Liver Disease ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
End Stage Liver Disease ◽  
End Stage

What do we know about patients’ perspectives and expectations relating to palliative and end-of-life care in advanced liver disease? A systematic review of qualitative literature using ENTREQ guidelines

2021 ◽  
pp. bmjspcare-2021-003057
Author(s):  
Debasish Das ◽  
Mafas Ali ◽  
Ithsham Ali Hussain ◽  
Josh Thomas Nigel Ingram ◽  
Rachel Sarah Johnstone ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Liver Disease ◽  
End Of Life ◽  
End Of Life Care ◽  
Community Support ◽  
Life Care ◽  
Advanced Liver Disease ◽  
End Stage Liver Disease ◽  
End Stage

BackgroundLiver disease, a major cause of death worldwide, affects younger people compared with other major causes of death. Palliative and end-of-life care for these patients are often overlooked. Guidelines are emerging on what good end-of-life care in liver disease should look like, but there is a dearth of research into patients’ perspectives even though they are most affected by these guidelines.AimTo explore current knowledge and understanding of patients’ lived experiences, perspectives and expectations in relation to palliative and end-of-life care in advanced liver disease.DesignSystematic review with thematic synthesis complying to the enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) statement.Setting and participantsDatabase searches (Ovid Medline, 1946–2021 and Web of Science, 1970–2021) to identify qualitative studies exploring patients’ perspectives of palliative and end-of-life care in advanced liver disease.FindingsOnly eight articles met all criteria. Themes demonstrated repeated hospital admissions towards the end of life, lack of coordinated care in community and barriers in discussion about palliative care in end-stage liver disease due to lack of confidence among professionals and a negative view about palliative care among patients and carers. Emotional, financial and disability-related needs of patients and their carers are often neglected.ConclusionThere is a dearth of studies exploring patients’ perspectives about care in advanced liver disease relating to palliative and end-of-life care. Lack of coordinated community support and honest conversations around palliative care leads to reduced quality of life. More primary research from diverse population is needed to improve palliative care and end-of-life care in end-stage liver disease.

End-of-life care in a case of severe anorexia nervosa and end-stage liver disease

2016 ◽  
Vol 6 (1) ◽  
pp. e000017
Author(s):  
Martin Curtice ◽  
Wasan Bajallan ◽  
Caroline Winkle
Keyword(s):  
Anorexia Nervosa ◽  
Liver Disease ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
End Stage Liver Disease ◽  
End Stage

Abstract 12 Assessing the Quality of End-of-Life Care for Patients With End-Stage Liver Disease in a Safety-Net Hospital

2017 ◽  
Vol 153 (2) ◽  
pp. 592
Author(s):  
Zachary P. Fricker ◽  
Anna M. Leszczynski ◽  
Katherine T. Brunner ◽  
Reid Hopkins ◽  
Harini Naidu ◽  
...  
Keyword(s):  
Liver Disease ◽  
End Of Life ◽  
End Of Life Care ◽  
Safety Net ◽  
Life Care ◽  
End Stage Liver Disease ◽  
Safety Net Hospital ◽  
End Stage

Assessing the Quality of End of Life Care for Patients with End Stage Liver Disease in a Safety-Net Hospital

2017 ◽  
Vol 152 (5) ◽  
pp. S97
Author(s):  
Zachary P. Fricker ◽  
Anna M. Leszczynski ◽  
Katherine T. Brunner ◽  
Reid Hopkins ◽  
Harini Naidu ◽  
...  
Keyword(s):  
Liver Disease ◽  
End Of Life ◽  
End Of Life Care ◽  
Safety Net ◽  
Life Care ◽  
End Stage Liver Disease ◽  
Safety Net Hospital ◽  
End Stage

scholarly journals Palliative long-term abdominal drains in refractory ascites due to end-stage liver disease: A case series

2016 ◽  
Vol 31 (7) ◽  
pp. 671-675 ◽  
Author(s):  
Lucia Macken ◽  
Deepak Joshi ◽  
Jenny Messenger ◽  
Mark Austin ◽  
Jeremy Tibble ◽  
...  
Keyword(s):  
Liver Disease ◽  
End Of Life Care ◽  
Case Series ◽  
Refractory Ascites ◽  
Life Care ◽  
Abdominal Drain ◽  
End Stage Liver Disease ◽  
Large Volume Paracentesis ◽  
End Stage

Background: Ascites, the commonest complication of cirrhosis, leads to frequent hospitalisations. Refractory ascites confers a median survival of 6 months without liver transplantation. In many, the management remains palliative (large-volume paracentesis). Despite calls for improvement, palliative and end-of-life care is not yet integrated into end-stage liver disease. Long-term abdominal drains are a palliative strategy in malignant ascites, but not end-stage liver disease. Case presentation: A retrospective, single centre, case series review was performed of patients undergoing long-term abdominal drain placement for refractory ascites secondary to end-stage liver disease at a large teaching hospital between August 2011 and March 2013. Case management: Patients with end-stage liver disease and refractory ascites, where liver transplantation was not an option, were considered for long-term abdominal drains. Seven patients underwent successful long-term abdominal drain insertion after multi-professional assessment. Case outcome: Following long-term abdominal drain insertion, mean hospital attendances reduced to 1 (0–4) from 9 (4–21), with none for ascites management. Median survival after long-term abdominal drain insertion was 29 days (8–219). The complication rate was low and none life threatening. Conclusion: Palliative and end-of-life care needs in end-stage liver disease remain under-addressed. Our data suggest that long-term abdominal drains may be a safe and effective palliative intervention in end-stage liver disease. Prospective randomised controlled trials comparing large-volume paracentesis versus long-term abdominal drains in refractory ascites secondary to end-stage liver disease are warranted.

Serious Mental Illness and Hospice Care

2021 ◽  
pp. 082585972110220
Author(s):  
Gwen Levitt
Keyword(s):  
Mental Health ◽  
End Of Life ◽  
End Of Life Care ◽  
Psychiatric Illness ◽  
Hospice Care ◽  
Treatment Options ◽  
Life Care ◽  
Case Review ◽  
Health Community ◽  
End Stage

There are a small number of articles in the literature discussing palliative and end-of-life care in the SMI population. Most tackle the questions relating to competency to refuse care in end-stage anorexia or terminal medical conditions. This is a case review of a 55 year old patient with a complex psychiatric and medical history, who despite extensive treatment and long hospitalizations has failed to regain any ability to care for her basic needs. She has exhausted all available treatment options and her prognosis is extremely poor. The mental health community is resistant to discussing and/ or confronting the fact that such a patient faces with the need for end-of-life care directly related to chronic psychiatric illness.

scholarly journals Preferences for Advance Directives in Korea

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
So-Sun Kim ◽  
Won-Hee Lee ◽  
JooYoung Cheon ◽  
Jung-Eun Lee ◽  
KiSun Yeo ◽  
...  
Keyword(s):  
End Of Life ◽  
Advance Directives ◽  
End Of Life Care ◽  
Healthcare Providers ◽  
Tube Feeding ◽  
Life Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Korean People ◽  
End Stage

Background. The goal of advance directives is to help patients retain their dignity and autonomy by making their own decisions regarding end-stage medical treatment. The purpose of this study was to examine preferences of advance directives among general population in Korea.Method. A descriptive cross-sectional survey was performed from October 2007 to June 2008 in Seoul, Korea. A total of 336 city-dwelling adults self-administered the questionnaire and returned it via mail. Data analyses were conducted using SPSS 17.0.Results. Subjects reported the need for healthcare providers' detailed explanations and recommendations regarding end-of-life care. When there is no hope of recovery and death is imminent, most subjects did not want to receive cardiopulmonary resuscitation nor an IV or tube feeding. However, most of the subjects wanted pain management care.Conclusions. The present study showed that many Korean people have an interest in advance directives. The results show that the autonomy and dignity of patient have increased in importance. To provide better end-of-life care, there is a need to educate patients on the definition and intent of an advance directive. Additional proactive communication between patients and their caregivers should be educated to healthcare providers.

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