scholarly journals Caregivers burden in people in palliative care: an integrative literature review

2016 ◽  
Vol 49 (4) ◽  
pp. 344 ◽  
Author(s):  
Gabriela Rezende ◽  
Cristiane A. Gomes ◽  
Fernanda C. Rugno ◽  
Renata C. Carvalho ◽  
Marysia M. R. P. De Carlo
Keyword(s):  
Palliative Care ◽  
Literature Review ◽  
Supportive Care ◽  
Terminal Care ◽  
Hospice Care

Modelo do estudo: Revisão Integrativa da Literatura. Objetivo: sintetizar os principais resultados de pesquisas e analisar criticamente as evidências científicas relativas ao tema da sobrecarga de cuidadores de pessoas em Cuidados Paliativos. Método: Busca bibliográfica nas bases de dados MEDLINE, LILACS, CINAHL e na biblioteca virtual SciELO, com os cruzamentos entre os descritores: “Caregivers”, “Palliative Care”, “Terminal Care”, “Hospice Care”, e as palavras-chave “Burden”, “Supportive Care”. Resultados: Foram selecionados 23 artigos publicados em periódicos internacionais, no período de janeiro de 2004 a junho de 2014. Foram categorizados em três unidades de análise: a tarefa de cuidar e as consequências para a vida do cuidador (N=7); a sobrecarga do cuidador diante da proximidade da morte (N=8); programas e serviços de apoio aos cuidadores (N=8). Os artigos indicaram que a sobrecarga do cuidador varia de acordo com sua vivência da tarefa de cuidar e a evolução da doença da pessoa cuidada; o cuidador necessita ser acolhido em suas necessidades e ter acesso a recursos da comunidade e serviços de saúde para diminuir a sobrecarga e melhorar tanto sua qualidade de vida, quanto da pessoa cuidada. Porém, as evidências científicas são consideradas fracas, com níveis 4 (65,2%) e 5 (21,8%) e apenas 13% dos estudos apresentam evidências consideradas fortes. Conclusão: O tema da sobrecarga de cuidadores de pessoas em Cuidados Paliativos é relevante para a pesquisa e para a prática clínica, mas há necessidade de estudos com melhor qualidade metodológica e evidências científicas que alicercem o cuidado a essa população

Subcutaneous levetiracetam for the management of seizures at the end of life

2017 ◽  
Vol 8 (2) ◽  
pp. 129-135 ◽  
Author(s):  
Anna Elizabeth Sutherland ◽  
John Curtin ◽  
Victoria Bradley ◽  
Olivia Bush ◽  
Maggie Presswood ◽  
...  
Keyword(s):  
Palliative Care ◽  
Literature Review ◽  
End Of Life ◽  
Terminal Care ◽  
Seizure Control ◽  
Case Reports ◽  
Subcutaneous Administration ◽  
Case Series ◽  
Comprehensive Literature Review ◽  
Randomised Controlled

ObjectivesTo report the results of a combined case series analysis of subcutaneous levetiracetam (Keppra) for the management of seizures in palliative care patients.MethodsA comprehensive literature review on the use of subcutaneous levetiracetam was performed, and these data were combined with a prospective observational audit of its use in terminal care undertaken in a regional palliative care network.Results7 papers were identified from the literature review-four case reports and three observational case series-reporting on a total of 53 cases where subcutaneous levetiracetam was administered.We report 20 further cases of subcutaneous levetiracetam administration from a prospective observational audit. Doses ranged from 250mg to 4000 mg daily. Oral to subcutaneous conversion ratios where stated were 1:1. Levetiracetam was reported as the sole administered antiepileptic drug (AED) in eight cases, and no seizures were reported until death in five cases. Five were switched back to enteral levetiracetam. In seven cases, levetiracetam was combined with AEDs to provide seizure control at the end of life. There was one report of a sterile abscess after 25 days of continuous subcutaneous administration.ConclusionsCombined analysis of 73 reported cases of subcutaneous levetiracetam suggests this treatment may have a role in the management of seizures at the end of life. However, randomised controlled trials are urgently needed to establish the efficacy and tolerability of subcutaneous levetiracetam administration. If proven to be safe and effective, subcutaneous levetiracetam offers the potential to prevent and treat seizures without causing unnecessary sedation at the end of life.

Development of tools to facilitate palliative and supportive care referral for patients with idiopathic pulmonary fibrosis

2017 ◽  
Vol 8 (3) ◽  
pp. 340-346 ◽  
Author(s):  
Charles Sharp ◽  
Heather Lamb ◽  
Nikki Jordan ◽  
Adrienne Edwards ◽  
Rachel Gunary ◽  
...  
Keyword(s):  
Palliative Care ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Supportive Care ◽  
Decision Aid ◽  
Hospice Care ◽  
Supportive Care Needs ◽  
Care Needs ◽  
The Impact ◽  
Care Decision

ObjectivesPalliative care is underused in non-malignant respiratory diseases, including interstitial lung diseases (ILDs). We investigated current practices around palliative and supportive care and explored the impact of a supportive care decision aid tool.MethodsThis was a single centre study in a UK ILD centre. Retrospective analysis of hospice referrals and patients with idiopathic pulmonary fibrosis (IPF) under the Bristol ILD (BILD) service were used to identify unmet palliative and supportive care needs. Using quality improvement methodology, we explored the impact of a supportive care decision aid on clinician behaviours for patients with ILD.Results108 patients with ILD were referred for hospice care between 2010 and 2015, representing 0.15% of all referrals, compared with a population prevalence of IPF of 0.9%. The median interval between referral and death was 124 days.Records were reviewed for 64 deceased and 89 living patients with IPF seen on July–December 2014. The decision aid was prospectively assessed with 73 patients. The deceased patients had greater markers of severity. There were no other differences between the groups.After introduction, the decision aid tool was completed for 49.3% of patients and resulted in significant increases in documented discussion of referral to palliative care (11.2%vs53.6%, p<0.01) and end-of-life discussions (15.7%vs91.8%, p<0.01). Tool completion led to an increase in referral for palliative care (2.7%vs16.7%, p<0.01).ConclusionPalliative care services are underused in ILD and a supportive care decision aid can prompt consideration of palliative and supportive care needs.

Principles of Hospice and Palliative Medicine and Supportive Care

2018 ◽  
Author(s):  
Sriram Yennurajalingam
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
Hospice Care ◽  
World Health ◽  
Skill Sets ◽  
Life Threatening Illness ◽  
Assessment And Treatment ◽  
Relief Of Suffering ◽  
Life Threatening ◽  
Health Organization

The World Health Organization defines palliative care as “an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.” Hospice care, palliative care, and supportive care are the common terms used to describe the delivery of palliative care. They essentially require the same skill sets and are often delivered by the same group of health professionals. This chapter reviews the definition and core principles of hospice and palliative care.

scholarly journals Concepts and definitions for “supportive care,” “best supportive care,” “palliative care,” and “hospice care” in the published literature, dictionaries, and textbooks

2012 ◽  
Vol 21 (3) ◽  
pp. 659-685 ◽  
Author(s):  
David Hui ◽  
Maxine De La Cruz ◽  
Masanori Mori ◽  
Henrique A. Parsons ◽  
Jung Hye Kwon ◽  
...  
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
Hospice Care ◽  
Best Supportive Care

scholarly journals CUIDADOS ODONTOLÓGICOS PALIATIVOS EM PACIENTES TERMINAIS

2021 ◽  
Vol 4 (7) ◽  
pp. 1-6
Author(s):  
Renan Lemos da SILVA ◽  
Natiane Pires da SILVA ◽  
Luciana Estevam SIMONATO
Keyword(s):  
Palliative Care ◽  
Literature Review ◽  
Dental Care ◽  
Therapeutic Approach ◽  
Hospice Care ◽  
Palliative Therapy ◽  
Google Scholar ◽  
Care Hospital ◽  
Comfort Care ◽  
Life Threatening

Cuidados paliativos são abordagens terapêuticas com o objetivo de aliviar o sofrimento, diante de doenças que ameaçam a vida dos pacientes. Essa conduta terapêutica além de garantir uma melhor qualidade de vida ao paciente e aos familiares que enfrentam alguma patologia apoia- se em uma visão de que a morte deve seguir seu curso natural, proporcionando assim uma maior dignidade ao paciente afetado e promovendo uma sensação de bem-estar. O presente trabalho tem como objetivo apresentar uma revisão de literatura sobre cuidados odontológicos paliativos em pacientes terminais. Foi realizada uma revisão de literatura nas seguintes bases de dados: PubMed, SciELO e Google Scholar. As palavras-chave utilizadas para a procura estudos foram “Cuidados paliativos”, “Equipe Hospitalar de odontologia”, “Cuidados de conforto”.  A Odontologia, nos cuidados paliativos, visa diminuir o número de infecções e também evitar a porta de entrada de diversos microrganismos. Esse serviço proporciona um atendimento humanizado ao paciente impossibilitado de ir a um consultório odontológico, e assim fazendo com que o profissional se desloque até o paciente por meio de visitas domiciliares. Os cuidados odontológicos paliativos em pacientes terminais são de grande importância, fornecendo conforto e amparo para o paciente e para família. É importante que hospitais incluam em suas equipes multidisciplinares cirurgiões dentistas capacitados para odontologia hospitalar, assim, tornando a terapia paliativa humanizada para os enfermos.   THE PALLIATIVE DENTAL CARE IN TERMINAL PATIENTS   ABSTRACT Palliative care is a therapeutic approach with the intention of relieving suffering when facing life-threatening illnesses. This therapeutic approach, besides guaranteeing a better quality of life for the patient and family members who face some pathology, is based on a perspective that death may follow its natural process, thus providing more dignity to the affected patient and promoting a wellbeing feeling. The present paper aims to present a literature review on palliative dental care in terminally ill patients. A literature review was conducted in the following databases: PubMed, SciELO and Google Scholar. The keywords used to research the articles were "Palliative Care", "Hospital Dentistry Team", "Comfort Care".  Dentistry, in palliative care, aims to decrease the number of infections and to avoid the entry gate for a range of microorganisms. This is a service that provides humanized care to patients who are unable to go to a dental office, and thus by heaving the professional to visit the patient through home care routine visits. Palliative dental care in terminal patients is of paramount importance since it provides comfort and support to the patient and family. It is worthwhile that hospitals include in their multidisciplinary team dental surgeons trained in hospital dentistry, and thereby enabling the palliative therapy to be humanized for the infirm.   Keywords: Palliative Care; Hospital Dentistry Team, Hospice Care.

Early Integration of Palliative and Supportive Care in the Cancer Continuum: Challenges and Opportunities

2013 ◽  
pp. 144-150 ◽  
Author(s):  
Mellar P. Davis ◽  
Eduardo Bruera ◽  
Daniel Morganstern
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
Cancer Treatment ◽  
End Of Life ◽  
Advanced Cancer ◽  
Hospice Care ◽  
Early Integration ◽  
Challenges And Opportunities ◽  
Policy Barriers ◽  
Complicated Bereavement

Palliative care has become synonymously associated with hospice care in the minds of patients and physicians. Supportive care is a more acceptable term and leads to earlier referral. Miscommunication and a “collusion of hope” centered on cancer treatment is detrimental to care at the end of life and results in complicated bereavement. Patients, despite being told prognosis, may not comprehend the news even if delivered in an empathetic manner. There are resource and policy barriers to palliative care. However, integration of palliative care early in the management of advanced cancer has demonstrated multiple benefits without reducing survival.

scholarly journals Palliative Care in Advanced Dementia: Comparison of Strategies in Three Countries

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
Keyword(s):  
Palliative Care ◽  
The Netherlands ◽  
Hospice Care ◽  
The United States ◽  
Artificial Nutrition ◽  
Advanced Dementia ◽  
Case Scenario ◽  
Artificial Nutrition And Hydration ◽  
Positive Elements ◽  
The Us

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.

Cannabis and End-of-Life Care: A Snapshot of Hospice Planning and Experiences Among Illinois Medical Cannabis Patients With A Terminal Diagnosis

2021 ◽  
pp. 104990912110186
Author(s):  
James Alton Croker ◽  
Julie Bobitt ◽  
Sara Sanders ◽  
Kanika Arora ◽  
Keith Mueller ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Fast Track ◽  
Hospice Care ◽  
Cannabis Use ◽  
Care Plan ◽  
Medical Cannabis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Eol Care

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.

scholarly journals 523. COVID-19 Preparedness in Hospice and Palliative Care

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S328-S328
Author(s):  
Monika Pogorzelska-Maziarz ◽  
Jeannette Kates ◽  
Jingjing Shang ◽  
Angela M Gerolamo
Keyword(s):  
Palliative Care ◽  
Hospice Care ◽  
Group Discussion ◽  
Discussion Board ◽  
Community Group ◽  
Care Community ◽  
Care Services ◽  
Do It Yourself ◽  
Hospice And Palliative Care ◽  
The Impact

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

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