A Report of an Investigation of End-of-Life Care Practices in Health Care Facilities and the Influences on those Practices

1997 ◽  
Vol 13 (4) ◽  
pp. 34-40 ◽  
Author(s):  
Donna Wilson
Keyword(s):  
End Of Life ◽  
Technology Use ◽  
End Of Life Care ◽  
Health Care Facilities ◽  
Patient Comfort ◽  
Continuing Care ◽  
Life Care ◽  
Medical Technologies ◽  
Care Facilities ◽  
Care Practices

In 1992, 82.2% of deaths in Alberta occurred in acute care hospitals or continuing care facilities. This paper outlines the end-of-life care of adult in patients who died that year in four such facilities (n=137). CPR was an infrequent end-of-life treatment modality (2.9%), in stark contrast to the extensive use of other medical technologies. Almost every inpatient (94.2%) died with one or more technologies in continuous operation. Although reasons were infrequently given, the desire to promote patient comfort was the most frequent influence on end-of-life technology use. The findings of this study raise issues for debate and further investigation. Chief among these issues is whether or not medical technologies promote comfort during the dying process.

Bioethical Distinctions of End-of-Life Care Practices #422

2021 ◽  
Vol 24 (9) ◽  
pp. 1400-1402
Author(s):  
Travis Rinderle ◽  
James Willett
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Care Practices

A descriptive report of end-of-life care practices occurring in two neonatal intensive care units

2016 ◽  
Vol 30 (10) ◽  
pp. 971-978 ◽  
Author(s):  
Vanessa Lam ◽  
Nicole Kain ◽  
Chloe Joynt ◽  
Michael A van Manen
Keyword(s):  
Congenital Anomaly ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Life Care ◽  
Life Sustaining Treatment ◽  
Care Practices

Background: In Canada and other developed countries, the majority of neonatal deaths occur in tertiary neonatal intensive care units. Most deaths occur following the withdrawal of life-sustaining treatments. Aim: To explore neonatal death events and end-of-life care practices in two tertiary neonatal intensive care settings. Design: A structured, retrospective, cohort study. Setting/participants: All infants who died under tertiary neonatal intensive care from January 2009 to December 2013 in a regional Canadian neonatal program. Deaths occurring outside the neonatal intensive care unit in delivery rooms, hospital wards, or family homes were not included. Overall, 227 infant deaths were identified. Results: The most common reasons for admission included prematurity (53.7%), prematurity with congenital anomaly/syndrome (20.3%), term congenital anomaly (11.5%), and hypoxic ischemic encephalopathy (12.3%). The median age at death was 7 days. Death tended to follow a decision to withdraw life-sustaining treatment with anticipated poor developmental outcome or perceived quality of life, or in the context of a moribund dying infant. Time to death after withdrawal of life-sustaining treatment was uncommonly a protracted event but did vary widely. Most dying infants were held by family members in the neonatal intensive care unit or in a parent room off cardiorespiratory monitors. Analgesic and sedative medications were variably given and not associated with a hastening of death. Conclusion: Variability exists in end-of-life care practices such as provision of analgesic and sedative medications. Other practices such as discontinuation of cardiorespiratory monitors and use of parent rooms are more uniform. More research is needed to understand variation in neonatal end-of-life care.

scholarly journals Current End-of-Life Care Needs and Care Practices in Acute Care Hospitals

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Amy J. Thurston ◽  
Donna M. Wilson ◽  
Jessica A. Hewitt
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Chart Review ◽  
Life Care ◽  
Canadian Study ◽  
Care Needs ◽  
Common Diagnosis ◽  
Impending Death ◽  
Care Practices ◽  
End Stage

A descriptive-comparative study was undertaken to examine current end-of-life care needs and practices in hospital. A chart review for all 1,018 persons who died from August 1, 2008 through July 31, 2009 in two full-service Canadian hospitals was conducted. Most decedents were elderly (73.8%) and urbanite (79.5%), and cancer was the most common diagnosis (36.2%). Only 13.8% had CPR performed at some point during this hospitalization and 8.8% had CPR immediately preceding death, with 87.5% having a DNR order and 30.8% providing an advance directive. Most (97.3%) had one or more life-sustaining technologies in use at the time of death. These figures indicate, when compared to those in a similar mid-1990s Canadian study, that impending death is more often openly recognized and addressed. Technologies continue to be routinely but controversially used. The increased rate of end-stage CPR from 2.9% to 8.8% could reflect a 1994+ shift of expected deaths out of hospital.

Factors Influencing Advance Care Planning Among Older Adults in Two Socioeconomically Diverse Living Communities

2016 ◽  
Vol 35 (1) ◽  
pp. 69-74 ◽  
Author(s):  
Jennifer L. Tripken ◽  
Cathy Elrod ◽  
Susan Bills
Keyword(s):  
Older Adults ◽  
End Of Life ◽  
Advance Care Planning ◽  
End Of Life Care ◽  
Retirement Community ◽  
Continuing Care ◽  
Care Planning ◽  
Attitudes And Beliefs ◽  
Life Care ◽  
Advance Care

Background/Objectives: Advance care planning (ACP) is an iterative, complex, and dynamic process of discussion, decision-making, and documentation about end-of-life care. The extent to which this process takes place in older adults in diverse socioeconomic settings is not well documented. The aim of this study was to assess the knowledge, attitudes, and beliefs about ACP among older adults in two socioeconomically diverse settings to identify the individual and contextual factors that influence behaviors regarding end-of-life care. Design: A cross-sectional survey design was used. Setting: An affordable independent continuing care retirement community and a high-income eligible (HIE) independent continuing care retirement community. Participants: Individuals aged 55 years and older who resided in independent living. Measurements: A 61-item survey was administered. Simple descriptive statistics were used to examine the responses, and inferential statistics were used to evaluate which items were associated with key outcomes between the 2 settings. Results: Seventy-seven older adults completed the survey. Significant differences in familiarity of terminology and knowledge of ACP, as well as significant differences in completion of advance directives and communication, were found between the 2 communities. No differences were found in attitudes and beliefs about end-of-life issues. Conclusion: Higher levels of knowledge and engagement in ACP were reported at the HIE community as compared to the affordable housing community. These findings provide insight into the influence of the contextual forces that encourage and support ACP.

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