Scarborough's Palliative ‘At-Home’ Care Team (PACT): A Model for a Suburban Physician Palliative Care Team

1995 ◽  
Vol 11 (3) ◽  
pp. 43-49 ◽  
Author(s):  
J.S. Gardner-Nix ◽  
R. Brodie ◽  
E. Tjan ◽  
M. Wilton ◽  
L. Zoberman ◽  
...  
2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 170-170
Author(s):  
Carole Bouleuc

170 Background: In May 2005, the Curie Institute in Paris opened the first supportive care day hospital in France. This type of new ward is now very frequent in the French comprehensive cancer centers. Methods: Patients are managed by the palliative care team with a two-part team of a physician and a nurse in order to address their supportive care needs: advanced-care symptoms, psychosocial distress, medical questions and concerns, support need in decision making, end of life care preference and advance care plan when patients or caregivers when needed. Depending of the needs identified by the palliative care team assess, at least 2 of the following healthcare professionals will intervene: oncologist, pain physician, psycho-oncologist, dietitician, social worker, physiotherapist. Coordination with the home care team takes systematically place (with general practitioner, nurse and home palliative care team). New symptoms occurrence are explored with biological test or radiographic examination when necessary. Medical procedures are sometimes performed like venous perfusion therapy, blood transfusions, or draining effusion after ultrasonic tracking. It is possible to offer the patient hypnosis, relaxation or sophrology consultation. Eventually at the end of the in-patient stay, the patient is given a medical synthesis with therapeutic recommendations and personalized care plan. 1 Physician and two nurses are needed to manage 4 patients every day. Results: In 2016 we have admitted 350 patients and performed 948 stays in our supportive rand 55% of them have breast cancer. Median survival since the first day at supportive care day hospital is 65 days. Death at home occurred in 15% of patients and in hospice for 62%. Home death is more often when patients don’t have any dyspnea are included in a home palliative care network and when they receive the last chemotherapy more than 30 days before death. More date will be shown. Conclusions: Supportive care day hospital is really a good tool for integrated palliative care, promoting collaboration with oncologists, coordination with home care teams, and advance care planning, so that patients can longer stay at home as they often hope so.


2019 ◽  
Vol 40 (1) ◽  
pp. 15-24 ◽  
Author(s):  
Elina Mikaelsson Midlöv ◽  
Terese Lindberg

The trend shows that more people are choosing to die at home. Since at home palliative care is often provided by district nurses, their work will be affected, and the burden will increase. The aim of this study was to illuminate district nurses' experiences of providing palliative care in the home. Qualitative semi-structured interviews were conducted with 12 district nurses. The interviews were analyzed according to the qualitative content analysis methods that Graneheim and Lundman describe. Findings consist of three main categories with nine subcategories. The conclusion is that collaboration with others is essential. Providing palliative care in the home is both emotionally rewarding and demanding, and the work is additionally time and expertise consuming. District nurses want more resources and organizational changes, such as access to doctors and a palliative home care team who only work with these patients. This would be an advantage both for district nurses and the patients.


2021 ◽  
Vol 10 (2) ◽  
pp. 61-67
Author(s):  
A.V. Tsarenko ◽  
A.A. Babskiy ◽  
Yu.V. Krynychniy ◽  
Yu.Yu. Shchetko

Background. Many Ukrainian authors noted that an innovative System of Palliative and Hospice Care (PHC) and Social Services for Palliative Care (SSPC) the creation and implementation are the most important medical and social tasks of the Government and society in Ukraine today which appreciate the civilization and humanity of our state and society. PHC are a modern patient-family-oriented humanitarian approach that contributes to the preservation of the human dignity of palliative care patients (PCP) and can ensure the proper quality of life of PCP and their relatives. According to the WHO and the Council of Europe Committee of Ministers Recommendations, palliative care should be one of the priorities of the Health Care Government Policy in the European region. The purpose of the study: the "Program of palliative care in an outpatient setting in Dnipro City for 2018-2021" the implementation analysis. Materials and methods. The work used national and international legal documents and literature sources, data from medical statistics, methods of systemic and structural-functional analysis, bibliosemantic and statistical research methods. Results. The international and national legal documents and scientific literature a content analysis showed that in accordance with modern approaches and standards, PHC is provided taking into account the PCP and its family members needs, wishes and consent, depending on medical, demographic, socio-economic and cultural ethnic features of the region. A comparative analysis of the PHC state in Ukraine and Dnipro City showed some regional features, in particular, the significant need to provide PHC and SSPC to patients at home and the need and ensure a mechanism of cooperation between primary health care physicians, inpatient health care and social care institutions to develop. In 2017, the “Program of outpatient palliative care in Dnipro City for 2018–2021” (hereinafter - the Program) was developed and approved at the City Council session, which allowed the PHC and SSPC multidisciplinary and interagency approaches implementation, effective interdepartmental coordination, cooperation and the continuity of PHC and SSPC to ensure. The Multidisciplinary Mobil Specialized Palliative Care Team has been working in close contact with family doctors and social workers in the city since June 2019. As part of the Program, PCP are provided with medicines, technical and other means of care and rehabilitation free of charge or on preferential terms. In addition, the Palliative Care Team provides PCP, if indicated, oxygen concentrators and anti-decubitus mattresses. The Program creates points for renting medical care for PCP (wheelchairs, walkers, anti-decubitus mattresses, crutches, etc.), as well as providing patients with medical care at home (urine and feces, diapers, etc.). In 2020, UAH 300,000 was allocated from the Program budget for the Palliative Care Team with medical equipment, medicines and rehabilitation technical means complete set. In total, it is planned to allocate over UAH 40 million from the Dnipro City Budget for the Program implementation. Conclusions. 1. Thus, today in Dnipro City the Comprehensive Palliative Care System at home is implemented due to co-financing from the State Budget and due to the "Program of palliative care in outpatient conditions in Dnipro City for 2018-2021", approved by the Dnipro City Council the deputies. 2. An important condition for comprehensive provision of the Dnipro City population needs in PHC and SSPC is the Dnipro City Council support to create a modern accessible, high-quality and efficient PHC and SSPC service, which an effective interagency coordination, continuity and cooperation between health care providers and social care institutions provides, Multidisciplinary Mobil Specialized Palliative Care Team creation and development of in each the city district, the coordination and continuity of inpatient PHC in the city health provides. 3. There is both the Government support and municipal or regional budgets support for PHC Programs in many developed countries. The international PHC standards and experience implementation can significantly the provision of needs and the quality of life of both PCP and their families improve.


2015 ◽  
Vol 10 (2) ◽  
pp. 901-905
Author(s):  
Hiroyuki Watanabe ◽  
Miwako Eto ◽  
Keiichi Yamasaki

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