P-178 A taste of hospice care – giving our future clinicians an insight into palliative care

2015 ◽  
Vol 5 (Suppl 3) ◽  
pp. A64.2-A64
Author(s):  
Joan Follett ◽  
Jane Carruthers
2011 ◽  
Vol 5 (6) ◽  
pp. 1444
Author(s):  
Mara Villas Boas Carvalho ◽  
Lara Roberta Lobo Martineli

ABSTRACTObjective: to identify feelings and experiences of multidisciplinary professionals of onco-hematology in the care of out-of-hope sick children and adolescents by studying the use of a nurse’s empathetic/sensitive look. Method: the use of a qualitative exploratory/descriptive study. Data was collected through the use of a questionary answered by eight professionals of a support clinic for children and adolescents with cancer and hematological diseases in the interior of the state of Sao Paulo. The criteria for the selection of participants were: to accept to participate in the study, and to be a member of the onco-hematology multidisciplinary team. From the participant´s responses, categories were assigned to identify emerged different perspectives in the care giving processes beyond curing possibilities. The project was approved by the Ethics Committee of the School of Medical Sciences, UNICAMP, protocol 856/2010. Results: revealing the truth, human transcendence, the professional self, dealing with death, dying and a new approach of "being a nurse" feelings, were related to the transdisciplinary care giving. Conclusion: results explained the relationship between the technical and care giving facets of a professional in onco-hematology through the palliative care percepts of multidisciplinary care giving. Descriptors: hospice care; nurse’s role; medical oncology; hematology.RESUMOObjetivo: identificar vivências e experiências inerentes aos profissionais de uma equipe multidisciplinar em onco-hematologia decorrentes ao processo de fora de possibilidade de cura de crianças e adolescentes através da aplicabilidade do olhar sensível/empático do enfermeiro. Método: estudo exploratório/descritivo de abordagem qualitativa. A técnica de coleta de dados foi entrevista estruturada com a aplicação de questionário à oito profissionais de uma casa de apoio ao adolescente e à criança com câncer e hemopatias no interior do estado de São Paulo. Os critérios para seleção dos sujeitos foram: aceitação em participar do estudo e ser membro de equipe multidisciplinar em onco-hematologia. Das falas dos entrevistados emergiram categorizações que identificaram perspectiva do cuidar além do curar. O projeto foi aprovado no Comitê de Ética em Pesquisa da Faculdade de Ciências Médicas da UNICAMP, sob protocolo 856/2010. Resultados: desvelar a verdade, a transcendência humana, o “self” profissional, lidar com a morte e o morrer e uma nova abordagem do “ser enfermeiro” evidenciaram o cuidar com transdisciplinaridade. Conclusão: tais considerações permitiram o encontro do “ser profissional/cuidador” em onco-hematologia por meio de fundamentação nos preceitos dos cuidados paliativos em esfera tridimensional do cuidar multidisciplinarmente. Descritores: cuidados paliativos; papel do profissional de enfermagem; oncologia; hematologia.RESUMENObjetivo: identificar las experiencias de los profesionales de un equipo multidisciplinario en onco-hematología del proceso de incapacidad de la curación de los niños y adolescentes a través de la aplicabilidad de la sensibilidad y empatia del enfermero. Método: enfoque cualitativo, exploratorio y descriptivo. La técnica de recolección de datos fue la entrevista estructurada con un cuestionario a ocho profesionales de apoyo a las adolescentes y los niños con cáncer y enfermedades hematológicas en la provincia de Sao Paulo. Los criterios de selección fueron: aceptación a participar en el estudio y ser  miembro del equipo multidisciplinario de onco-hematología. De la perspectiva de los entrevistados identificó las categorizaciones de la atención más allá de la cura. El proyecto fue aprobado por el Comité de Ética de la Facultad de Ciencias Médicas de la UNICAMP, protocolo 856/2010. Resultados: revelando la verdad, la trascendencia humana, la formación de lo "self", tratar de la muerte y el morir y un nuevo enfoque de "ser enfermero" demuenstra el cuidado con la transdisciplinariedad. Conclusión: estas consideraciones llevaron al encuentro del "ser profesional/cuidador" en onco-hematología atraves de razones en los preceptos de los cuidados paliativos en la esfera de tres dimensiones de la atención multidisciplinaria. Descriptores: cuidados paliativos; rol de la enfermera; oncología médica; hematologia.


2021 ◽  
Vol 20 (1-2) ◽  
pp. 138-141
Author(s):  
Jennifer Currin-McCulloch

Drawing from Van Gennep and Caffee’s conceptualization of liminality, this autoethnographic narrative portrays the author’s rites of passage into academia and through the death of her father. These fundamental developmental transitions and losses emerged concomitantly within the backdrop of a pandemic, further cloaking the world in grief and disequilibrium. Incorporating the voice of the personal as professional, the author portrays her existential struggles in relinquishing her cherished role as a palliative care social worker and living through her dad’s final months during a time of restricted social interaction. Interwoven throughout the narrative appear stories of strife, hope, grief, and professional epiphanies of purpose and insider privilege. The paper embraces both personal and professional conflicts and provides insight into the ways in which the unique setting of a pandemic can provide clarity for navigating the liminal states of separation, transition, and incorporation.


Geriatrics ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 44
Author(s):  
Shelley A. Sternberg ◽  
Shiri Shinan-Altman ◽  
Ladislav Volicer ◽  
David J. Casarett ◽  
Jenny T. van der Steen

Palliative care including hospice care is appropriate for advanced dementia, but policy initiatives and implementation have lagged, while treatment may vary. We compare care for people with advanced dementia in the United States (US), the Netherlands, and Israel. We conducted a narrative literature review and expert physician consultation around a case scenario focusing on three domains in the care of people with advanced dementia: (1) place of residence, (2) access to palliative care, and (3) treatment. We found that most people with advanced dementia live in nursing homes in the US and the Netherlands, and in the community in Israel. Access to specialist palliative and hospice care is improving in the US but is limited in the Netherlands and Israel. The two data sources consistently showed that treatment varies considerably between countries with, for example, artificial nutrition and hydration differing by state in the US, strongly discouraged in the Netherlands, and widely used in Israel. We conclude that care in each country has positive elements: hospice availability in the US, the general palliative approach in the Netherlands, and home care in Israel. National Dementia Plans should include policy regarding palliative care, and public and professional awareness must be increased.


2021 ◽  
Vol 27 (1) ◽  
pp. 20-29
Author(s):  
Lisa Whiting ◽  
Mark Whiting ◽  
Julia Petty ◽  
Michele O'Grady

Background: An 8-month rotation programme was implemented for five nurses employed in two kinds of children's palliative care environments: hospital wards and hospices. This study reports the views of the nurses completing the rotation. The research drew on appreciative inquiry and involved a pre- and post-rotation interview and questionnaire. Thematic analysis of the interviews revealed seven themes: adjusting to the rotation programme; support mechanisms; being safe; new knowledge and skills; knowledge exchange; misconceptions; future plans. These were supported by the questionnaire findings. Although the nurses identified some frustration at having to undertake competency assessments relating to previously acquired skills, as well as being out of their ‘comfort zone’, all the participants highly recommended the programme. They commented very positively on the support they received and the overall learning experience as well as the new insight into different aspects of care. In addition, they were able to share their newfound knowledge and expertise with others.


Author(s):  
James Alton Croker ◽  
Julie Bobitt ◽  
Sara Sanders ◽  
Kanika Arora ◽  
Keith Mueller ◽  
...  

Introduction: Between 2013 and 2019, Illinois limited cannabis access to certified patients enrolled in the Illinois Medical Cannabis Program (IMCP). In 2016, the state instituted a fast-track pathway for terminal patients. The benefits of medicinal cannabis (MC) have clear implications for patients near end-of-life (EOL). However, little is known about how terminal patients engage medical cannabis relative to supportive care. Methods: Anonymous cross-sectional survey data were collected from 342 terminal patients who were already enrolled in ( n = 19) or planning to enroll ( n = 323) in hospice for EOL care. Logistic regression models compare patients in the sample on hospice planning vs. hospice enrollment, use of palliative care vs. hospice care, and use standard care vs non-hospice palliative care. Results: In our sample, cancer patients ( OR = 0.21 (0.11), p < .01), and those who used the fast-track application into the IMCP ( OR = 0.11 (0.06), p < .001) were less likely to be enrolled in hospice. Compared to patients in palliative care, hospice patients were less likely to report cancer as their qualifying condition ( OR = 0.16 (0.11), p < .01), or entered the IMCP via the fast-track ( OR = 0.23 (0.15), p < .05). Discussion: Given low hospice enrollment in a fairly large EOL sample, cannabis use may operate as an alternative to supportive forms of care like hospice and palliation. Clinicians should initiate conversations about cannabis use with their patients while also engaging EOL Care planning discussions as an essential part of the general care plan.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S328-S328
Author(s):  
Monika Pogorzelska-Maziarz ◽  
Jeannette Kates ◽  
Jingjing Shang ◽  
Angela M Gerolamo

Abstract Background Due to the emergence of COVID-19 and resulting pandemic, there is an increased demand for palliative care and hospice care services. However, the impact of COVID-19 on the hospice and palliative agencies is unknown. Methods An electronic survey was disseminated via the Hospice & Palliative Nurses Association newsletter, posted to the Sigma Theta Tau Hospice and Palliative Care Community Group discussion board and advertised through social media from May 7–28, 2020. Summary statistics were computed. Results We collected 36 surveys representing all U.S. regions. Most respondents (78%) reported that their agency has cared for confirmed COVID-19 patients. Only half of agencies had access to laboratory facilities for surveillance and detection of the presence of outbreaks in both patients and staff (58%) and the ability to test patients and providers for COVID-19 (55%). Due to COVID-19, participants stated that the agency added new protocols regarding aerosol-generating procedures policies (58%), use of surface barriers (61%) and PPE usage (e.g. donning and doffing) in patient homes (56%). The majority (76%) reported that their agency required field clinicians to call ahead to ascertain COVID-19 exposure/symptoms before a home visit. More than half (58%) reported that their agency lacked supplies, including N95 respirators (45%), cleaning/disinfectant product (23%), alcohol based sanitizer (18%), eye protection (18%), gowns (18%), and surgical masks (14%). Overall, participants shared that field clinicians had to reuse (76%), extend (73%) or ration (30%) PPE supplies. Respondents reported that their agency accessed supplemental PPE through state/local resources (67%), private/community donations (67%), and do-it-yourself efforts (55%). One third (31%) reported that their agency was experiencing staffing shortages due to COVID-19; of these, 60% reported that shortages were due to staff infected with/quarantined due to COVID-19. Conclusion Our findings suggest that COVID-19 has presented significant challenges for palliative care and hospice agencies as they provide care to patients and families at an unprecedented rate. Disclosures All Authors: No reported disclosures


2018 ◽  
Vol 21 (2) ◽  
pp. 62-71
Author(s):  
Henry O’Lawrence ◽  
Rohan Chowlkar

Purpose The purpose of this paper is to determine the cost effectiveness of palliative care on patients in a home health and hospice setting. Secondary data set was utilized to test the hypotheses of this study. Home health care and hospice care services have the potential to avert hospital admissions in patients requiring palliative care, which significantly affects medicare spending. With the aging population, it has become evident that demand of palliative care will increase four-fold. It was determined that current spending on end-of-life care is radically emptying medicare funds and fiscally weakening numerous families who have patients under palliative care during life-threatening illnesses. The study found that a majority of people registering for palliative and hospice care settings are above the age group of 55 years old. Design/methodology/approach Different variables like length of stay, mode of payment and disease diagnosis were used to filter the available data set. Secondary data were utilized to test the hypothesis of this study. There are very few studies on hospice and palliative care services and no study focuses on the cost associated with this care. Since a very large number of the USA, population is turning 65 and over, it is very important to analyze the cost of care for palliative and hospice care. For the purpose of this analysis, data were utilized from the National Home and Hospice Care Survey (NHHCS), which has been conducted periodically by the Centers for Disease Control and Prevention’s National Center for Health Statistics. Descriptive statistics, χ2 tests and t-tests were used to test for statistical significance at the p<0.05 level. Findings The Statistical Package for Social Sciences (SPSS) was utilized for this result. H1 predicted that patients in the age group of 65 years and up have the highest utilization of home and hospice care. This study examined various demographic variables in hospice and home health care which may help to evaluate the cost of care and the modes of payments. This section of the result presents the descriptive analysis of dependent, independent and covariate variables that provide the overall national estimates on differences in use of home and hospice care in various age groups and sex. Research limitations/implications The data set used was from the 2007 NHHCS survey, no data have been collected thereafter, and therefore, gap in data analysis may give inaccurate findings. To compensate for this gap in the data set, recent studies were reviewed which analyzed cost in palliative care in the USA. There has been a lack of evidence to prove the cost savings and improved quality of life in palliative/hospice care. There is a need for new research on the various cost factors affecting palliative care services as well as considering the quality of life. Although, it is evident that palliative care treatment is less expensive as compared to the regular care, since it eliminates the direct hospitalization cost, but there is inadequate research to prove that it improves the quality of life. A detailed research is required considering the additional cost incurred in palliative/hospice care services and a cost-benefit analysis of the same. Practical implications While various studies reporting information applicable to the expenses and effect of family caregiving toward the end-of-life were distinguished, none of the previous research discussed this issue as their central focus. Most studies addressed more extensive financial effect of palliative and end-of-life care, including expenses borne by the patients themselves, the medicinal services framework and safety net providers or beneficent/willful suppliers. This shows a significant hole in the current writing. Social implications With the aging population, it has become evident that demand of palliative/hospice care will increase four-fold. The NHHCS have stopped keeping track of the palliative care requirements after 2007, which has a negative impact on the growing needs. Cost analysis can only be performed by analyzing existing data. This review has recognized a huge niche in the evidence base with respect to the cost cares of giving care and supporting a relative inside a palliative/hospice care setting. Originality/value The study exhibited that cost diminishments in aggressive medications can take care of the expenses of palliative/hospice care services. The issue of evaluating result in such a physically measurable way is complicated by the impalpable nature of large portions of the individual components of outcome. Although physical and mental well-being can be evaluated to a certain degree, it is significantly more difficult to gauge in a quantifiable way, the social and profound measurements of care that help fundamentally to general quality of care.


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