‘BUSINESS AS USUAL’: IMPLEMENTATION OF ADVANCE CARE DIRECTIVES IN A RENAL DIALYSIS UNIT

The study aimed to describe views on Voluntary Assisted Dying (VAD), gleaned through qualitative analysis of participant responses to a set activity, run during the 2018 ‘Dying2Learn’ Massive Open Online Course (MOOC). Data from 508 participants, most of whom identified as health professionals, were analysed using thematic content analysis, and themes generated. A large proportion of participants discussed their personal views related to VAD, specifically around choice, control, dignity, palliative care and dying at home, medical intervention, societal factors, the impact on those left behind, laws and regulations, dying ‘naturally’, advance care directives, and being in pain. In this study, participants had many different views on the act itself, often divisive, but also with common concepts such as respecting the choices and decisions of others.

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Inadequate completion of advance care directives by individuals with dementia: national audit of health and aged care facilities

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2020-002767 ◽

2021 ◽

pp. bmjspcare-2020-002767

Author(s):

Jamie Bryant ◽

Marcus Sellars ◽

Craig Sinclair ◽

Karen Detering ◽

Kimberly Buck ◽

...

Keyword(s):

Healthcare Providers ◽

Aged Care ◽

Care Plan ◽

Residential Aged Care ◽

Multinomial Regression ◽

People With Dementia ◽

Care Facilities ◽

Aged Care Facilities ◽

Advance Care Directives ◽

Advance Care

Objectives(i) Describe the prevalence and type of advance care directives (ACDs) and other advance care planning (ACP) documentation completed by persons with dementia, healthcare providers and others on behalf of a person with dementia; (ii) identify the personal and ACP programme characteristics associated with having ACP documentation in the health record; (iii) identify the personal and ACP programme characteristics associated with having a self-completed ACD.MethodsA multicentre audit was undertaken in Australian hospitals, general practices and residential aged care facilities. Auditors extracted demographic and ACP data from the records of eligible patients. ACP programme characteristics were provided by a site representative. Logistic and multinomial regression were used respectively to examine the factors associated with completion of any ACP documentation, and self-completion of an ACD by persons with dementia.ResultsA total of 1388 people with dementia (33.2%) from 96 sites were included. Overall, 60.8% (n=844) had ACP documentation; 31.6% (n=438) had a self-completed ACD and 29.3% (n=406) had an ACP document completed by a health professional or someone else on their behalf. Older participants were more likely to have ACP documented. Multivariate analyses indicated the odds of having self-completed ACP documents, compared with no advance care plan or ACP completed by someone else, were significantly influenced by age, country of birth, setting and whether the site had ACP training, policies or guidelines.DiscussionWhile 60% of people with dementia had some form of ACP documentation, only half of the cases in which ACP was documented included an ACD completed by the person themselves.

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Lifelines and End-of-life Decision-making: An Anthropological Analysis of Advance Care Directives in Cross-cultural Contexts

Ethnos ◽

10.1080/00141844.2019.1696857 ◽

2019 ◽

pp. 1-19 ◽

Cited By ~ 1

Author(s):

Tanya Zivkovic

Keyword(s):

Decision Making ◽

End Of Life ◽

Cross Cultural ◽

Cultural Contexts ◽

Advance Care Directives ◽

Advance Care ◽

End Of Life Decision ◽

Life Decision

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Health Care for South Lebanon's Civilian Population Following the June 1982 War

Journal of the World Association for Emergency and Disaster Medicine ◽

10.1017/s1049023x00032696 ◽

1985 ◽

Vol 1 (1) ◽

pp. 50-54

Author(s):

T.H. Tulchinsky ◽

Yakov Adler

Keyword(s):

Public Health ◽

Health Care ◽

Health Services ◽

Child Nutrition ◽

Renal Dialysis ◽

Nutrition Status ◽

Local Health ◽

Dialysis Unit ◽

Medical Needs ◽

South Lebanon

AbstractFollowing the June 1982 war in South Lebanon, the Israel Ministry of Health sent a medical team to assess health conditions in the area, to assist in the restoration of local health services, and to provide additional medical assistance as needed in public health and specialized medical services. For the approximately 600,000 population of the area, public health sanitary conditions were restored by local authorities, with some external assistance. Sanitation and housing for the refugee camp populations were difficult to solve because of extensive damage in the camps; but United Nations activities, supported by international and Israeli sources, were effective. Epidemic conditions did not occur. Monitoring for specific infectious diseases showed increases not exceeding usual summer conditions. Child nutrition status was satisfactory. Medical needs for specialty services, not available in South Lebanon, were arranged through screening and referral to Israeli hospitals. Renal dialysis needs were met by establishing a dialysis unit using local personnel in a damaged and non-functioning government hospital. Private medical and hospital services, the bulk of health care in the area, functioned except for minor dislocations throughout the war and post-war period. Israeli medical aid, managed by a small multidisciplinary team, was designed to assist and, where necessary, augment rather than replace local health services.

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Advance care directives

Journal of General Internal Medicine ◽

10.1007/bf02599118 ◽

1992 ◽

Vol 7 (1) ◽

pp. 120-121

Author(s):

Dominic J. Balestra ◽

Louis L. Brunetti ◽

Stephanie Carperos

Keyword(s):

Advance Care Directives ◽

Advance Care

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P-31 Examining how advance care directives are used for individuals with dementia living in residential accommodation: A literature review

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2015-000978.161 ◽

2015 ◽

Vol 5 (Suppl 2) ◽

pp. A52.3-A53

Author(s):

Vivian Masukwedza ◽

Victoria Traynor ◽

Elizabeth Halcomb

Keyword(s):

Literature Review ◽

Advance Care Directives ◽

Advance Care

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Critical appraisal of two methods for determining aluminum in blood samples

Clinical Chemistry ◽

10.1093/clinchem/36.8.1466 ◽

1990 ◽

Vol 36 (8) ◽

pp. 1466-1469 ◽

Cited By ~ 14

Author(s):

C D Hewitt ◽

K Winborne ◽

D Margrey ◽

J R Nicholson ◽

M G Savory ◽

...

Keyword(s):

Critical Appraisal ◽

Renal Dialysis ◽

Reference Interval ◽

Linear Calibration ◽

Matrix Modifier ◽

Dialysis Unit ◽

Routine Monitoring ◽

Analytical Recovery ◽

Triton X ◽

Drug Studies

Abstract We report two methods for determining aluminum concentrations in blood. Method 1, proposed for routine monitoring of patients with chronic renal failure, includes a collection procedure that can be adopted by any renal dialysis unit, with a minimum of sample contamination. Plasma samples are diluted fourfold with HNO3/Triton X-100 matrix modifier. Method 2 is proposed for determining aluminum concentrations in patients with normal renal function, e.g., in drug studies and environmental monitoring. Samples are diluted with an equal volume of Mg(NO3)2 matrix modifier and atomized from a L'vov platform. By either method, analytical recovery of aluminum added to serum ranged between 92% and 105% throughout the linear calibration range. The reference interval (mean +/- SD) for aluminum in 22 healthy subjects by method 2 was 0.044 +/- 0.030 mumol/L.

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