scholarly journals What Proportion of Terminally Ill and Dying People Require Specialist Palliative Care Services?

2014 ◽  
Vol 2014 ◽  
pp. 1-7
Author(s):  
Donna M. Wilson ◽  
Boris Woytowich
Keyword(s):  
Palliative Care ◽  
Population Aging ◽  
Terminally Ill ◽  
Current Evidence ◽  
Specialist Palliative Care ◽  
Care Needs ◽  
Services Utilization ◽  
Care Services ◽  
Specialist Services ◽  
Palliative Care Services

Currently, around 55 million people die each year worldwide. That number is expected to increase rapidly with accelerating population aging. Despite growth in the number of palliative care specialists and specialist services in most countries, the prospect of an increasing number of terminally ill and dying persons is daunting. This paper attempts to answer the question: what proportion of terminally ill and dying persons require specialist palliative care services? To address this question and highlight which persons require specialist palliative care, the current state of access to specialist palliative care services and specialists in Canada and other countries is highlighted, along with available evidence-based information on specialist services utilization and the care needs of terminally ill and dying persons. Current evidence and information gaps reveal that this question cannot be answered now, but it should be answered in advance of a crisis of unmet end-of-life care needs with the rising death toll.

scholarly journals Specialist palliative care services for older people in primary care: A systematic review using narrative synthesis

2019 ◽  
Vol 34 (1) ◽  
pp. 32-48 ◽  
Author(s):  
Kim de Nooijer ◽  
Yolanda WH Penders ◽  
Lara Pivodic ◽  
Nele J Van Den Noortgate ◽  
Peter Pype ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Palliative Care ◽  
Older People ◽  
Narrative Synthesis ◽  
Specialist Palliative Care ◽  
Family Carers ◽  
Care Services ◽  
Specialist Services ◽  
Palliative Care Services

Background: There is recognition that older people with incurable conditions should have access to specialist palliative care services. However, it remains unclear which activities and outcomes these services entail for older people in primary care and to which patients they are provided. Aim: The aim of this review was to identify the criteria for referral to specialist services; who provides specialist palliative care; through which activities and with which frequency; which outcomes are reported; and which suggestions are made to improve services. Design: Systematic review of the literature and narrative synthesis. Quality appraisal and selection of studies were performed independently by two researchers. Participant characteristics, intervention features, outcome data and suggestions for improvement were retrieved. Data sources: Embase, Medline, Web of Science, Cochrane, Google Scholar, PsycINFO and CINAHL EBSCO databases (until June 2019). Results: Ten eligible articles, three qualitative, three quantitative, three mixed-method and one narrative review, were identified. Referral criteria were mainly based on patient characteristics such as diagnosis. The specialist services involved a variety of activities and outcomes and descriptions were often lacking. Services could be improved regarding the information flow between healthcare professionals, greater in-depth palliative care knowledge for case managers and social workers, identification of a key worker and support for family carers. Conclusion: The limited evidence available shows areas for improvement of the quality of and access to specialist services for older people, such as support for family carers. In addition, this review underscores the need for comprehensive reporting of interventions and the use of consensus-based outcome measures.

scholarly journals Commissioning of specialist palliative care services in England

2017 ◽  
Vol 8 (1) ◽  
pp. 93-101 ◽  
Author(s):  
Harriet Lancaster ◽  
Ilora Finlay ◽  
Maxwell Downman ◽  
James Dumas
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Working Hours ◽  
Life Care ◽  
Specialist Palliative Care ◽  
Care Needs ◽  
Care Services ◽  
Number Of Patients ◽  
Palliative Care Services

ObjectivesSome failures in end-of-life care have been attributed to inconsistent provision of palliative care across England. We aimed to explore the variation in commissioning of services by Clinical Commissioning Groups (CCGs) using a data collection exercise.MethodsWe sent a Freedom of Information request in the form of an open questionnaire to all 209 CCGs in England to assess their commissioning of palliative and end-of-life care services, mainly focused on the provision of specialist palliative care services.Results29 CCGs provided information about the number of patients with some form of palliative care needs in their population. For specialist palliative care services, CCGs allocated budgets ranging from £51.83 to £2329.19 per patient per annum. 163 CCGs (77.90%) currently commission 7-day admission to their specialist palliative care beds. 82.84% of CCGs commission 7-day specialist palliative care services in patients' own homes and out-of-hours services rely heavily on hospice provision. 64 CCGs (31.37%) commission pain control teams, the majority of whom only operate in regular working hours. 68.14% of CCGs reported commissioning palliative care education of any sort for healthcare professionals and 44.85% of CCGs had no plans to update or review their palliative care services.ConclusionsThe most important finding from this exercise is that the information CCGs hold about their population and services is not standardised. However, information based on data that are more objective, for example, population and total budget for palliative care, demonstrate wide variations in commissioning.

scholarly journals Identifying Palliative Care Needs in Assisted Living

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 788-788
Author(s):  
Daniel David ◽  
Abraham Brody ◽  
Tina Sadarangani ◽  
Bei Wu ◽  
Tara Cortez
Keyword(s):  
Palliative Care ◽  
Assisted Living ◽  
Unmet Needs ◽  
Care Needs ◽  
Code Status ◽  
Care Services ◽  
Palliative Care Services ◽  
Advance Care ◽  
Palliative Care Needs

Abstract Many residents of Assisted Living (AL) confront serious illness and therefore might benefit from greater access to Palliative Care Services to improve quality of life. We surveyed resident records and AL nursing staff to identify patients in need of Palliative Care. Preliminary findings showed that nurses predicted 23% would not be alive and 49% would no longer live in AL. A majority of residents were over the age of 90, yet 30% did not have a reported code status. These findings suggest that a substantial portion of AL residents may have unmet needs with respect to palliative care. Future interventions are needed to support advance care planning conversations and make palliative care more accessible to this population.

Rural Palliative Care

2019 ◽  
pp. 670-681
Author(s):  
Richard A. Taylor ◽  
J. Nicholas Dionne-Odom ◽  
Erin R. Currie ◽  
Macy Stockdill ◽  
Marie A. Bakitas
Keyword(s):  
Palliative Care ◽  
Nurse Practitioners ◽  
Rural Areas ◽  
Health Workers ◽  
Symptom Control ◽  
Care Needs ◽  
Web Based ◽  
Care Services ◽  
Palliative Care Services ◽  
Care Training

Access to palliative care remains challenging to those living in rural areas across the globe. This disparity of care leaves many without critically important palliative care services across their illness trajectory, especially in its final stages. Creative strategies to meet the palliative care needs of rural patients such as telehealth, videoconferencing specialists’ consultation, and web-based resources exist. Using these strategies where available can address some palliative care disparities and access to care in rural areas that were previously absent. Developing clinical capacity of rural clinicians through enhanced education in primary palliative care in training programs, expanding services with the use of nurse practitioners, and using palliative care–trained community lay health workers are also strategies to improve access. Additionally, by developing rural hospital providers’ knowledge and skills to provide primary palliative care in tasks such as establishing care goals, communication, and basic symptom control may prevent many transfers to academic centers miles away. Through ongoing education and primary palliative care training and innovations in bringing specialty care to rural areas, “palliative care everywhere” will soon be a reality.

Mind the gap: do tertiary cancer centres need 24 hour access to specialist palliative care services?

2012 ◽  
Vol 2 (Suppl 1) ◽  
pp. A78.1-A78
Author(s):  
Owen Pooley ◽  
Alison Coackley ◽  
Agnes Noble ◽  
Ann Griffiths ◽  
Donna Arundell
Keyword(s):  
Palliative Care ◽  
Specialist Palliative Care ◽  
Care Services ◽  
Palliative Care Services

Issues for General Practitioners Caring for Dying Patients in the Home

1999 ◽  
Vol 5 (2) ◽  
pp. 9 ◽  
Author(s):  
Annette Street ◽  
Jeanine Blackford ◽  
Anne Turley ◽  
Judy Kelso
Keyword(s):  
Palliative Care ◽  
General Practitioners ◽  
Terminally Ill ◽  
Team Approach ◽  
Fee For Service ◽  
Quality Health Care ◽  
Care Services ◽  
Dying Patients ◽  
Palliative Care Services ◽  
Counselling Program

General practitioners have a central role in the provision of quality health care to the terminally ill patient and family in their own homes. Staff from the Department of Human Services were concerned that GPs were experiencing stress through their increasing role in the provision of palliative care and that there was a need for a fee-for-service stress counselling program for them. A small qualitative study was conducted to verify this perceived need. Semi-structured telephone interviews were conducted with 50 GPs selected from a sample of metropolitan attendees at postgraduate educational activities or doctors known to palliative care services. GPs faced a number of issues in their care for terminally ill people in the community but a fee-for-service counselling program was deemed unnecessary. Evidence from the study confirmed that effective communication strategies between GPs, palliative care services and acute hospitals, an interdisciplinary team approach, and improved understanding between health professionals would enhance the quality of care for dying people and their caregivers.

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