Palliative care needs experienced by Danish patients with end‐stage kidney disease

2020 ◽  
Author(s):  
Julie Boje ◽  
Jens Kristian Madsen ◽  
Jeanette Finderup
Keyword(s):  
Palliative Care ◽  
Kidney Disease ◽  
End Stage Kidney Disease ◽  
Care Needs ◽  
End Stage ◽  
Palliative Care Needs

scholarly journals Unmet Palliative Care Needs Among Patients With End-Stage Kidney Disease: A National Registry Study About the Last Week of Life

2018 ◽  
Vol 55 (2) ◽  
pp. 236-244 ◽  
Author(s):  
Lena Axelsson ◽  
Anette Alvariza ◽  
Jenny Lindberg ◽  
Joakim Öhlén ◽  
Cecilia Håkanson ◽  
...  
Keyword(s):  
Palliative Care ◽  
Kidney Disease ◽  
National Registry ◽  
Registry Study ◽  
End Stage Kidney Disease ◽  
Care Needs ◽  
End Stage ◽  
Palliative Care Needs

scholarly journals Palliative care needs of patients living with end-stage kidney disease not treated with renal replacement therapy: An exploratory qualitative study from Blantyre, Malawi

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Maya J. Bates ◽  
Alex Chitani ◽  
Gavin Dreyer
Keyword(s):  
Palliative Care ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Qualitative Study ◽  
Replacement Therapy ◽  
Physical Symptoms ◽  
End Stage Kidney Disease ◽  
Care Needs ◽  
End Stage ◽  
Palliative Care Needs

Background: The burden of end-stage kidney disease (ESKD) in sub-Saharan Africa is increasing rapidly but the palliative care needs of patients living with ESKD are not well described. Resource limitations at both health system and patient level act as major barriers to patients receiving renal replacement therapy (RRT) in the form of dialysis. We undertook an exploratory qualitative study to describe the palliative care needs of patients with ESKD who were not receiving RRT, at a government teaching hospital in Blantyre, Malawi.Methods: A qualitative, explorative and descriptive design was used. Study participants were adults aged > 18 years with an estimated glomerular filtration rate < 15 ml/min on two separate occasions, three months apart, who either chose not to have or were not deemed suitable for RRT. Data were collected by means of semi-structured interviews.Results: In October and November 2013, interviews were conducted with 10 adults (7 women with median age of 60.5 years). All were hypertensive and four were on treatment for HIV. Four themes emerged from the data: changes in functional status because of physical symptoms, financial challenges impacting hospital care, loss of role within the family and the importance of spiritual and cultural beliefs.Conclusion: This study reports on four thematic areas which warrant further quantitative and qualitative studies both in Malawi and other low-resource settings, where a growing number of patients with ESKD unable to access RRT will require palliative care in the coming years.

End-stage kidney disease

2021 ◽  
pp. 1010-1019
Author(s):  
Fliss E. M. Murtagh
Keyword(s):  
Palliative Care ◽  
High Risk ◽  
Kidney Disease ◽  
Symptom Burden ◽  
Pharmacological Interventions ◽  
End Stage Kidney Disease ◽  
Care Needs ◽  
End Stage ◽  
Specific Symptoms ◽  
Palliative Care Needs

End-stage kidney disease accounts for 1–2% of all deaths. With ageing of the population, this proportion will grow steadily over the coming years. Symptom burden in end-stage kidney disease exceeds advanced cancer, with added renal-specific symptoms, such as itch and restless legs. Pain and depression are also more prevalent. Many renal symptoms go under-recognized and undertreated, especially as they arise from comorbid conditions, rather than the renal disease itself. The most useful intervention to address symptoms is regular assessment, followed by pharmacological interventions that take account of the constraints on using renally cleared drugs and the high risk of toxicity from accumulation of parent compounds or metabolites. The population with end-stage kidney disease have extensive palliative care needs, and require significant medical, nursing, psychological, and social care to address these as their illness advances towards the end of life.

End-stage kidney disease

2015 ◽  
Author(s):  
Fliss E. M. Murtagh
Keyword(s):  
Kidney Disease ◽  
Parent Compound ◽  
Symptom Burden ◽  
Pharmacological Interventions ◽  
End Stage Kidney Disease ◽  
Care Needs ◽  
End Stage ◽  
Specific Symptoms ◽  
Palliative Care Needs ◽  
Ageing Populations

End-stage kidney disease (ESKD) accounts for 1-2% of all deaths. Ageing populations means that this proportion will grow steadily over the coming years. Symptom burden in ESKD exceeds advanced cancer, with added renal-specific symptoms, such as itch and restless legs. Pain and depression are also more prevalent. Many renal symptoms go under-recognized and under-treated, especially as they arise from co-morbid conditions, rather than the renal disease itself. The most useful intervention to address symptoms is regular assessment of symptoms, using a valid and reliable global symptom score. Pharmacological interventions to alleviate symptoms need to take account of the severe constraints on using renally cleared drugs, and the high risk of toxicity from accumulation of parent compound or metabolites. The population with ESKD has extensive palliative care needs, and need significant medical, nursing, psychological, and social care to address these as their illness advances towards the end of life.

scholarly journals Patient and Family Caregiver Perspectives on Palliative Care Needs in End-Stage Liver Disease: A Qualitative Study (S855)

2019 ◽  
Vol 57 (2) ◽  
pp. 510-511
Author(s):  
Sandhya Mudumbi ◽  
Macy Stockdill ◽  
Nicholas Hoppmann ◽  
James Dionne-Odom ◽  
Brendan McGuire ◽  
...  
Keyword(s):  
Palliative Care ◽  
Liver Disease ◽  
Qualitative Study ◽  
Family Caregiver ◽  
Care Needs ◽  
End Stage Liver Disease ◽  
End Stage ◽  
Palliative Care Needs

Mortality among referrals to a community-based intermediate care team

2017 ◽  
Vol 9 (3) ◽  
pp. 263-266
Author(s):  
Bharath Lakkappa ◽  
Sanjay Shah ◽  
Stephen Rogers ◽  
Leanne Helen Holman
Keyword(s):  
Palliative Care ◽  
Care Team ◽  
Intermediate Care ◽  
Care Needs ◽  
Community Based ◽  
Care Services ◽  
Palliative Care Teams ◽  
Care Models ◽  
End Stage ◽  
Palliative Care Needs

ObjectivesIntermediate care services have been introduced to help mitigate unnecessary hospital demand and premature placement in long-term residential care. Many patients are elderly and/or with complex comorbidities, but little consideration has been given to the palliative care needs of patients referred to intermediate care services. The objective of this study is to determine the proportion of patients referred to a community-based intermediate care team who died during care and up to 24 months after discharge and so to help inform the development of supportive and palliative care in this setting.MethodsA retrospective cohort study of all 4770 adult patients referred to Northamptonshire Intermediate Care Team (ICT) between 11 April 2010 and 10 April 2011.ResultsOf 4770 patients referred, 60% were 75 years or older and 32% were 85 years of age or older. 4.0% of patients died during their ICT stay and 11% within 30 days of discharge. At the end of 12 months, 25% of the patients had died, increasing to 32% before the end of the second year. About 34% of all deaths occurred during the ICT stay or within 30 days of discharge, and a further 46% by the end of the first year. Male gender and higher age were associated with greater likelihood of death.ConclusionsIt is important for ICT clinicians to consider immediate and longer-term palliative care needs among patients referred to ICTs. Care models involving ICTs and palliative care teams working together could enable more people with end-stage non-cancer illnesses to die at home.

Caregiver Burden among the Caregivers of Older Adults with Palliative Care Needs

2020 ◽  
Vol 16 (2) ◽  
Author(s):  
Khojji Humera ◽  
Sathiq Ali ◽  
Shruthi Bhat ◽  
Prabha Adhikari
Keyword(s):  
Palliative Care ◽  
Caregiver Burden ◽  
End Stage Renal Disease ◽  
Geriatric Patients ◽  
Design Method ◽  
Objective Measures ◽  
Care Needs ◽  
Stage Renal Disease ◽  
End Stage ◽  
Palliative Care Needs

Objective: To examine caregiver burden among caregivers of hospitalised geriatric patients with palliative care design. Method: Caregivers of 330 geriatric patients with various chronic end-stage diseases were assessed using BSFC-s questionnaire. Results: Majority of caregivers were spouses (26%). The caregiver burden across the categories was more than 60% across all the questions asked in the BSFC-s questionnaire. Maximum in the caregiver with end-stage renal disease (60.3%) and a minimum of frail elderly (50.2%). Conclusion: Caregiver burden was common in caregivers of geriatric patients with end-stage chronic diseases. The burden was associated with the caregiver’s report of need for greater help with daily tasks but not with objective measures of the patient’s need for assistance, such as symptoms or functional status, suggesting that burden may be a measure of the caregiver’s ability to adapt to the caregiving role.

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