Methods of Hydration in Palliative Care Patients

1998 ◽  
Vol 14 (2) ◽  
pp. 6-13 ◽  
Author(s):  
Nathalie Steiner ◽  
Eduardo Bruera
Keyword(s):  
Palliative Care ◽  
Terminally Ill ◽  
Oral Intake ◽  
Fluid Replacement ◽  
Hydration Status ◽  
Terminal Cancer ◽  
Risks And Benefits ◽  
Intravenous Hydration ◽  
Potential Risks ◽  
Careful Assessment

A strong and often polarized debate has taken place during recent years concerning the consequences of dehydration in the terminally ill patient. When a patient has a severely restricted oral intake or is found to be dehydrated, the decision to administer fluids should be individualized and made on the basis of a careful assessment that considers problems related to dehydration, potential risks and benefits of fluid replacement, and patients’ and families’ wishes. This review discusses the assessment of hydration status in the terminal cancer patient and the options for fluid administration in the cases where evaluation of the patients’ condition has led to this indication. These include different modes of hypodermoclysis, intravenous hydration, use of the nasogastric route, and proctoclysis. Arguments for and against rehydration have been previously addressed by other authors and fall outside the scope of this review.

Distress, Stress and Solidarity in Palliative Care

1993 ◽  
Vol 27 (1) ◽  
pp. 5-15 ◽  
Author(s):  
Johanne De Montigny
Keyword(s):  
Palliative Care ◽  
Clinical Observation ◽  
Terminally Ill ◽  
The Other ◽  
Terminal Cancer ◽  
Physical Energy ◽  
Number Of Patients ◽  
The Family ◽  
Good Number

What does the stoic, silent expression of the terminal cancer patient signify? Clinical observation suggests that this emotional silence is often a physical energy-saving device, essential for survival to the very last breath. Caregivers and survivors may also experience a variety of contradictory and inexpressible emotions in silence. The role of the psychologist on the palliative care unit is to be there for the terminally-ill, as well as for the family/friends, both during the dying and bereavement, and for the caregiver team. This article focuses on the work of decoding ordinary words which for a good number of patients hide a painful past. It also stresses the necessity to remain open to the unexpected and to allow and trust the other to live what happens since there is a constant and unconscious effort to fill the void.

scholarly journals Discussing the Effect of Medical Team Method in the Hospice Palliative Care to Terminal Cancer Patient

2018 ◽  
Vol 2 (3) ◽  
Author(s):  
Chia Hsing Wu
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Terminally Ill ◽  
Care Program ◽  
Team Work ◽  
Terminal Cancer ◽  
Medical Team ◽  
Terminally Ill Cancer Patients ◽  
The Relationship ◽  
Hospice Palliative Care

One of the main purposes of the hospice-palliative care program is to provide a hospice for the terminally ill cancer patients. Weisman assumed that a hospice should consist of five aspects which include Awareness of the end of life, Acceptance, Proprietary, Timing and Comfort. Therefore, the purpose of this research is to explore firstly the condition of the terminal cancer patients in the hospice. Secondly to Investigate the effect of Medical team work method and finally to compare the relationship between the hospice score and service result [1]. Materials Go to This study involved subjects from those from the terminally ill cancer patients who passed away in the hospice palliative care unit at medical Centre during 2012-2013. There were a total of 292 patients considered for the study. Thirty patients were excluded from the study because there was data missing from their file. The remaining 262 patients information was collected on 157males (53.8%) and 105 females (36%).

Delirium

2015 ◽  
Author(s):  
Meera Agar ◽  
Yesne Alici ◽  
William S. Breitbart
Keyword(s):  
Palliative Care ◽  
Symptom Control ◽  
Terminally Ill ◽  
Symptomatic Treatment ◽  
Significant Morbidity ◽  
Pharmacological Interventions ◽  
Advanced Illness ◽  
Delirious Patient ◽  
Risks And Benefits ◽  
Impending Death

Delirium is the most common and serious neuropsychiatric complication in palliative care settings. It is a source of significant morbidity in patients, and often distresses family members and staff. Delirium is often a harbinger of impending death and can significantly interfere with pain and symptom control. Unfortunately delirium is often under-recognized or misdiagnosed in the terminally ill, and even when recognized, it frequently goes untreated or is inappropriately treated. Clinicians who care for patients with advanced illness must be able to diagnose delirium accurately, undertake appropriate assessment of aetiologies, and understand the risks and benefits of the pharmacological and non-pharmacological interventions currently available for managing delirium. Symptomatic treatment with antipsychotics or sedative medications is often necessary for the delirious patient with advanced illness to minimize distress to patients, families, and staff.

Weighing in on the risks and benefits of probiotic use in HIV-infected and immunocompromised populations

2018 ◽  
Vol 9 (2) ◽  
pp. 239-246 ◽  
Author(s):  
A.U. Happel ◽  
S.L. Barnabas ◽  
R. Froissart ◽  
J.S. Passmore
Keyword(s):  
Case Reports ◽  
Terminally Ill ◽  
The Elderly ◽  
Adjunctive Treatment ◽  
Medical Conditions ◽  
Risks And Benefits ◽  
History Of ◽  
At Risk Populations ◽  
Potential Risks ◽  
Irritable Bowel

Probiotics are used in the prophylaxis and treatment of several conditions, including irritable bowel syndrome, diarrhoea, necrotising enterocolitis (NEC) and colic in infants. Despite the long history of probiotic use in humans, there is still significant debate about their efficacy and safety, particularly in HIV-infected and immunocompromised individuals. Here, we reviewed the safety and adverse event (AE) reporting from clinical trials that have tested probiotics in at risk populations, including HIV-infected individuals, the terminally ill and elderly, and neonates. Our analysis suggests that the benefits of probiotic therapy outweigh their potential risks in HIV-infected populations, and in the treatment of colic and NEC in low birth weight or premature neonates. Most case reports of severe AEs were in the elderly and terminally ill, or in those with additional severe medical conditions. We conclude that probiotic use, as adjunctive treatment, is effective and safe in the majority of patients including HIV-infected individuals, although special care should be taken in individuals with extreme immunosuppression and severe medical conditions in all ages.

scholarly journals Using reflexive tools for coping and bringing closure in pediatric palliative care: A music therapist’s story of working with a terminally ill child.

2011 ◽  
Vol 11 (3) ◽  
Author(s):  
Maeve Rigney
Keyword(s):  
Palliative Care ◽  
Music Therapy ◽  
Coping Skills ◽  
Terminally Ill ◽  
Young Girl ◽  
Pediatric Palliative Care ◽  
Terminal Cancer ◽  
Music Therapist ◽  
Her Family ◽  
Personal Reflections

 This paper outlines the therapeutic journey of a newly qualified music therapist and a young girl with terminal cancer. As well as describing the clinical sessions with this young girl and her family, it includes personal reflections from the journal of the therapist, used as a method of self-review and clarification of thoughts and feelings following each session. The aim of this paper is to narrate the music therapy journey with Tina * from the music therapist's perspective, and to share my thoughts and feelings on coping while working with terminally ill children. In addition to outlining the significance of using reflexive tools for this type of work as a way to improve coping skills and to work more effectively when the future with your client is uncertain, I hope to encourage further others to share their work in pediatric palliative care. 

Happiness at the end of life: A qualitative study

2021 ◽  
pp. 1-7
Author(s):  
Tan Seng Beng ◽  
Wong Ka Ghee ◽  
Ng Yun Hui ◽  
Ooi Chieh Yin ◽  
Khoo Wei Shen Kelvin ◽  
...  
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
End Of Life ◽  
Terminal Illness ◽  
Terminally Ill ◽  
Social Connections ◽  
Targeted Interventions ◽  
Pain And Suffering ◽  
The University ◽  
Eudaimonic Happiness

Abstract Objective Dying is mostly seen as a dreadful event, never a happy experience. Yet, as palliative care physicians, we have seen so many patients who remained happy despite facing death. Hence, we conducted this qualitative study to explore happiness in palliative care patients at the University of Malaya Medical Centre. Method Twenty terminally ill patients were interviewed with semi-structured questions. The results were thematically analyzed. Results Eight themes were generated: the meaning of happiness, connections, mindset, pleasure, health, faith, wealth, and work. Our results showed that happiness is possible at the end of life. Happiness can coexist with pain and suffering. Social connections were the most important element of happiness at the end of life. Wealth and work were given the least emphasis. From the descriptions of our patients, we recognized a tendency for the degree of importance to shift from the hedonic happiness to eudaimonic happiness as patients experienced a terminal illness. Significance of results To increase the happiness of palliative care patients, it is crucial to assess the meaning of happiness for each patient and the degree of importance for each happiness domain to allow targeted interventions.

scholarly journals Symptom clusters and their influence on prognosis using EORTC QLQ-C15-PAL scores in terminally ill patients with cancer

2021 ◽  
Author(s):  
Nanako Koyama ◽  
Chikako Matsumura ◽  
Yuuna Tahara ◽  
Morito Sako ◽  
Hideo Kurosawa ◽  
...  
Keyword(s):  
Palliative Care ◽  
Terminally Ill ◽  
Symptom Clusters ◽  
Rank Test ◽  
Appetite Loss ◽  
Patients With Cancer ◽  
Terminally Ill Patients ◽  
Log Rank Test ◽  
Eortc Qlq ◽  
Cluster 2

Abstract Purpose The aims of the present study were to investigate the symptom clusters in terminally ill patients with cancer using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative Care (EORTC QLQ-C15-PAL), and to examine whether these symptom clusters influenced prognosis. Methods We analyzed data from 130 cancer patients hospitalized in the palliative care unit from June 2018 to December 2019 in an observational study. Principal component analysis was used to detect symptom clusters using the scored date of 14 items in the QLQ-C15-PAL, except for overall QOL, at the time of hospitalization. The influence of the existence of these symptom clusters and Palliative Performance Scale (PPS) on survival was analyzed by Cox proportional hazards regression analysis, and survival curves were compared between the groups with or without existing corresponding symptom clusters using the log-rank test. Results The following symptom clusters were identified: cluster 1 (pain, insomnia, emotional functioning), cluster 2 (dyspnea, appetite loss, fatigue, and nausea), and cluster 3 (physical functioning). Cronbach’s alpha values for the symptom clusters ranged from 0.72 to 0.82. An increased risk of death was significantly associated with the existence of cluster 2 and poor PPS (log-rank test, p = 0.016 and p < 0.001, respectively). Conclusion In terminally ill patients with cancer, three symptom clusters were detected based on QLQ-C15-PAL scores. Poor PPS and the presence of symptom cluster that includes dyspnea, appetite loss, fatigue, and nausea indicated poor prognosis.

scholarly journals Sedation During Neurocritical Care

2019 ◽  
Vol 06 (02) ◽  
pp. 056-061 ◽  
Author(s):  
Nieves Vanaclocha ◽  
Vicente Chisbert ◽  
Vicent Quilis ◽  
Federico Bilotta ◽  
Rafael Badenes
Keyword(s):  
Therapeutic Strategy ◽  
Neurocritical Care ◽  
Clinical Evidence ◽  
Deep Sedation ◽  
Clinical Prognosis ◽  
Daily Interruption ◽  
Risks And Benefits ◽  
Potential Risks ◽  
Volatile Agents ◽  
Sedative Agents

AbstractSedation is an essential therapeutic strategy in the care of neurocritical patients. Intravenous sedative agents are the most widely used, with promising alternatives (dexmedetomidine, ketamine, and volatile agents) to propofol and midazolam arising. Studies designed to evaluate superiority and avoid biases are required. A neurological awakening test is safe in most patients. Potential risks and benefits of limiting deep sedation and daily interruption of sedation in these patients remain unclear. The aim of this review was to report recent clinical evidence on sedation in this subgroup of patients, focusing on its effects on clinical prognosis.

scholarly journals The Illness Experience: Palliative Care Given the impossibility of Healing

2016 ◽  
Vol 50 (spe) ◽  
pp. 47-53 ◽  
Author(s):  
Margarida Maria Florêncio Dantas ◽  
Maria Cristina Lopes de Almeida Amazonas
Keyword(s):  
Palliative Care ◽  
Participant Observation ◽  
Descriptive Analysis ◽  
Terminally Ill ◽  
Medical Model ◽  
Structured Interview ◽  
Subject Position ◽  
The Subject ◽  
Experience Of Illness ◽  
Therapeutic Possibilities

This paper presents a reflection about being terminally ill and the various ways that the subject has at its disposal to deal with this event. The objective is to understand the experience of palliation for patients undergoing no therapeutic possibilities of cure. The methodology of this study has the instruments to semi-structured interview, the participant observation and the field diary, and the Descriptive Analysis of Foucault’s inspiration how the narratives of the subjects were perceived. The Results of paper there was the possibility of looking at the experience of illness through the eyes of a subject position assumed by the very sick. As conclusion we have than when choosing palliative care, the terminally ill opts for a way to feel more comfortable and resists the impositions of the medical model of prolonging life.

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