Fostering Trust With a Young Man Experiencing Homelessness and Advanced Cancer

2021 ◽  
pp. 082585972110139
Author(s):  
William E. Rosa ◽  
Laurie J. Andersen ◽  
Ethel Frierson ◽  
Carolyn Fulton ◽  
Natalie Moryl
Keyword(s):  
New York ◽  
Palliative Care ◽  
Care Plan ◽  
Team Members ◽  
Safe Place ◽  
Somatic Pain ◽  
Care Services ◽  
Palliative Care Services ◽  
History Of ◽  
Lung Lymph

Persons experiencing homelessness (PEH) face countless barriers to equitable health, social, and palliative care across all settings. Brandon was a 23-year-old male, well-spoken, groomed, and polite despite difficult circumstances. He was severely abused then abandoned as a child, living in multiple foster homes until 18. With no consistent caring adult figure, he predictably fell into a chaotic lifestyle, had 3 children by different mothers, and became homeless in New York City. He presented with newly diagnosed renal cell carcinoma metastatic to lung, lymph nodes, and bone. Spine and pelvic metastases caused paralyzing somatic pain that interfered with walking and sitting and prevented Brandon from performing the activities of daily living essential for his survival on the streets and safekeeping of opioids. Lack of basic social support and a history of multiple abandonments made a care plan for this young, homeless, and truly isolated man very challenging. The inpatient and outpatient interdisciplinary team members partnering with Brandon each earned his trust with time. A “safe place” opened hearts on all sides of the therapeutic relationship and led to a plan that was acceptable for both the patient and the palliative care team. Clinicians are often challenged to provide sustained and pragmatic palliative care services for PEH due to complex barriers. Continued advocacy for equitable and tailored services that ensure high-quality palliative care for PEH is critical at individual, institutional, and system levels to promote health equity and dignified care.

Volunteering in hospice and palliative care in the United Kingdom

2018 ◽  
Author(s):  
Ros Scott
Keyword(s):  
Palliative Care ◽  
United Kingdom ◽  
Care Services ◽  
The United Kingdom ◽  
Strategic Direction ◽  
Palliative Care Services ◽  
History Of ◽  
The Uk ◽  
Hospice And Palliative Care ◽  
Changing Role

This chapter explores the history of volunteers in the founding and development of United Kingdom (UK) hospice services. It considers the changing role and influences of volunteering on services at different stages of development. Evidence suggests that voluntary sector hospice and palliative care services are dependent on volunteers for the range and quality of services delivered. Within such services, volunteer trustees carry significant responsibility for the strategic direction of the organiszation. Others are engaged in diverse roles ranging from the direct support of patient and families to public education and fundraising. The scope of these different roles is explored before considering the range of management models and approaches to training. This chapter also considers the direct and indirect impact on volunteering of changing palliative care, societal, political, and legislative contexts. It concludes by exploring how and why the sector is changing in the UK and considering the growing autonomy of volunteers within the sector.

scholarly journals How to implement quality indicators successfully in palliative care services: perceptions of team members about facilitators of and barriers to implementation

2015 ◽  
Vol 23 (12) ◽  
pp. 3503-3511 ◽  
Author(s):  
Kathleen Leemans ◽  
Lieve Van den Block ◽  
Robert Vander Stichele ◽  
Anneke L. Francke ◽  
Luc Deliens ◽  
...  
Keyword(s):  
Palliative Care ◽  
Quality Indicators ◽  
Team Members ◽  
Care Services ◽  
Palliative Care Services ◽  
Barriers To Implementation

scholarly journals An Australian Neuro-Palliative perspective on Huntington's disease: a case report

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Rajvi Shah ◽  
Sarah CM Lee ◽  
Rupert B Strasser ◽  
Christopher Grossman
Keyword(s):  
Palliative Care ◽  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Late Stage ◽  
Care Service ◽  
Palliative Care Service ◽  
Care Services ◽  
Stage Disease ◽  
Palliative Care Services ◽  
History Of

Abstract Background Huntington’s Disease (HD) is an incurable, progressive neuro-degenerative disease. For patients with HD access to palliative care services is limited, with dedicated Neuro-Palliative Care Services rare in Australia. We discuss the experiences of and benefits to a patient with late-stage HD admitted to our Neuro-Palliative Care service. Case presentation We present the case of a patient with a 16-year history of HD from time of initial genetic testing to admission to our Neuro-Palliative Care service with late-stage disease. Conclusions Given the prolonged, fluctuating and heterogenous HD trajectory, measures need to be implemented to improve earlier access to multi-specialty integrative palliative care services. Given the good outcomes of our case, we strongly advocate for the role of specialised Neuro-Palliative Care services to bridge the gap between clinical need and accessibility.

The Changing Face of Volunteering in Hospice and Palliative Care

2018 ◽  
Keyword(s):  
Palliative Care ◽  
International Perspective ◽  
Vital Role ◽  
Policy Makers ◽  
Care Services ◽  
Palliative Care Services ◽  
History Of ◽  
The Many ◽  
Hospice And Palliative Care ◽  
Different Cultures

Volunteers have a long history of supporting the development and delivery of hospice and palliative care in most countries throughout the world. As hospice and palliative care services anticipate significant increasing and changing demands, it is recognised that volunteers have a vital role to play in supporting the future delivery of services. However, as society changes so too does volunteering. This multi-author text explores the complex phenomenon of hospice and palliative care volunteering from an international perspective and considers the influence on volunteering of different cultures and constructs. The book also explores the likely impact of changes in hospice and palliative care on volunteers and considers how and why volunteering itself is changing and the subsequent implications for managers, organizations, and policy makers. This book does not attempt to offer solutions to the many challenges ahead, but rather poses questions that may help to reflect on new possibilities and opportunities.

Dying with dignity: the challenges of end-of-life care in patients with substance use disorders

2021 ◽  
Vol 14 (11) ◽  
pp. e240945
Author(s):  
Prasun Datta ◽  
Jeffrey S Kruk ◽  
Kylie Jordan ◽  
Karen A Fisher
Keyword(s):  
Palliative Care ◽  
Substance Use ◽  
End Of Life ◽  
Addiction Medicine ◽  
Opioid Agonist ◽  
Care Services ◽  
Dying With Dignity ◽  
Palliative Care Teams ◽  
Palliative Care Services ◽  
History Of

Substance use disorder is a chronic disease carrying a high risk of morbidity and mortality. We report a case of a patient on long-term opioid agonist treatment who was diagnosed with metastatic cholangiocarcinoma and was referred to palliative care services almost contemporaneously with this diagnosis. In this report, we explore the challenges posed in offering holistic care during the end of life of a patient with a history of opioid dependence. A coordinated approach by addiction medicine and palliative care teams can allow patients from this complex cohort to ultimately die with dignity.

scholarly journals Palliative care in critically ill COVID-19 patients: the early New York City experience

2020 ◽  
pp. bmjspcare-2020-002677
Author(s):  
Jacqueline Sheehan ◽  
Kam Sing Ho ◽  
Joseph Poon ◽  
Kimberly Sarosky ◽  
Jennifer Y Fung
Keyword(s):  
New York ◽  
Palliative Care ◽  
New York City ◽  
Critically Ill ◽  
York City ◽  
Care Services ◽  
Palliative Care Consultation ◽  
Telemedicine Consultation ◽  
Palliative Care Services ◽  
Care Consultation

ObjectivesThe COVID-19 pandemic in the USA has been accompanied by high rates of mortality and an unprecedented need for palliative care delivery. Little is known about the use of palliative care services in intensive care unit (ICU) settings during the COVID-19 pandemic.MethodsThis is a retrospective cohort study of critically ill COVID-19 patients requiring ICU admission, between 7 March and 14 April 2020 to two academic teaching hospitals in New York City. Palliative care consultation included a one-time telemedicine consultation or continued telemedicine consultation and follow-up with multidisciplinary team involvement. Patient information was collected from the electronic health record and analyses were conducted with Stata V.15.1 (StataCorp) statistical software.ResultsA total of 151 critically ill patients with COVID-19 pneumonia requiring ICU admission were identified, of whom 59 (39.07%) received an inpatient palliative care consultation. More than half of patients died (n=85/151, 56.29%), with 57.65% (n=49/85) of these patients receiving palliative care services during their hospitalisation. Patients who received palliative care consultation were more likely to be older, sicker and receive mechanical ventilation than their counterparts. Patients who died and did not receive palliative care were younger and required non-invasive ventilation support.ConclusionThere is a lack of utilisation of palliative care in COVID-19 patients admitted to the ICU. Further research into predictors of poor outcomes in critically ill COVID-19 patients may help identify patients that would benefit from early palliative care involvement going forward.

Diagnosis, assessment, and treatment of depression in advanced disease

2018 ◽  
Author(s):  
Matthew Hotopf
Keyword(s):  
Palliative Care ◽  
Advanced Disease ◽  
Antidepressant Treatment ◽  
Population Level ◽  
Care Staff ◽  
Care Services ◽  
Treatment Of Depression ◽  
Assessment And Treatment ◽  
Palliative Care Services ◽  
Key Issues

Depression in palliative care is common, under-recognised and has significant impacts for sufferers. There are effective treatments but often a shortage of staff to provide them. This chapter sets out a number of key issues to consider when assessing and treating individual patients and considers the way in which palliative care services can innovate to provide a population level response to depression. Palliative care staff can be trained to deliver basic depression care and follow simple protocols to initiate, monitor and adjust antidepressant treatment. These approaches have been tested in trials in cancer care but the challenge is to take these approaches from research trials conducted in centres of excellence with good resources, to other settings.

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