Empathy Training Through Symptom Burden Simulation

2018 ◽  
Vol 36 (2) ◽  
pp. 169-171
Author(s):  
Polly Addison ◽  
Cathy Morley
Keyword(s):  
Palliative Care ◽  
Quality Care ◽  
Real Life ◽  
Disease Process ◽  
Symptom Burden ◽  
Care Staff ◽  
New Employees ◽  
Palliative Care Setting ◽  
New Employee ◽  
Hospice And Palliative Care

Background: Providing quality care to hospice and palliative care patients requires the ability to feel and demonstrate empathic behaviors. To acquire a heightened level of empathy, the learner needs to internalize a process of experiencing first-hand real-life symptom burdens common at end of life. Making this happen during new employee orientation is a challenge but with powerful outcomes. Objective: To increase empathy levels in hospice and palliative care staff within the agency. Methods: A mandatory class for all new employees and open sessions for existing employees in a hospice and palliative care setting. Subjecting participants to multiple disease process simulations. Results: All new employees participated in a symptom simulation workshop during their orientation. Conclusions: Ninety-eight percent of the new employees found their experience in the workshop to dramatically positively affect their empathy levels and consequently formulate compassionate responses to patient situations based on their experiences of feeling empathy during the training.

Palliative Care For Patients with Advanced COPD in Primary Care

Praxis ◽  
2021 ◽  
Vol 110 (15) ◽  
pp. 902-906
Author(s):  
Tanja Fusi-Schmidhauser
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
Symptom Management ◽  
Quality Care ◽  
Symptom Burden ◽  
High Quality ◽  
High Quality Care ◽  
Care And Support ◽  
Care Approach ◽  
Advance Planning

Abstract. Patients with advanced COPD have a high symptom burden that is often multidimensional. Identification of patients who might benefit from palliative care through validated identification tools, multidimensional symptom management, and timely discussion of advance planning are elements of a palliative care approach for these patients and their families. Coordination among stakeholders providing care and support to these patients is central to ensuring high-quality care and meeting all of their needs.

scholarly journals EXPERIENCE OF LGBT PATIENTS AND FAMILY WITH HOSPICE AND PALLIATIVE CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S623-S624
Author(s):  
Gary L Stein ◽  
Cathy Berkman
Keyword(s):  
Palliative Care ◽  
Staff Training ◽  
Online Survey ◽  
Research Policy ◽  
Cross Sectional Study ◽  
Care Staff ◽  
Future Research ◽  
Policy And Practice ◽  
Cross Sectional ◽  
Hospice And Palliative Care

Abstract This study examines the degree to which hospice and palliative care staff observe or perceive inadequate, disrespectful, or abusive care to LGBT patients and family members. A cross-sectional study using an online survey completed by 865 providers, including social workers, physicians, nurses, and chaplains. Among respondents, 55% reported that LGB patients were more likely to experience discrimination at their institution than non-LGB patients; 24% observed discriminatory care; 65% reported that transgender patients were more likely than non-transgender patients to experience discrimination; 20% observed discrimination to transgender patients; 14% observed the spouse/partner of LGBT patients having their treatment decisions disregarded or minimized; and 13% observed the spouse/partner being treated disrespectfully. Findings reported also include: institutional non-discrimination policy, staff training, intake procedures, and comfort in assessing LGBT status. Implications for future research, policy, and practice will be presented.

Facing uncertainty: The lived experience of palliative care

2007 ◽  
Vol 5 (4) ◽  
pp. 367-376 ◽  
Author(s):  
Roz Mckechnie ◽  
Rod Macleod ◽  
Sally Keeling
Keyword(s):  
Qualitative Research ◽  
Palliative Care ◽  
Lived Experience ◽  
Disease Process ◽  
Phenomenological Approach ◽  
Diagnostic Process ◽  
Main Theme ◽  
Original Design ◽  
Social Death ◽  
Palliative Care Setting

ABSTRACTObjective:This qualitative research study listens to the narratives of people experiencing the dying process who attended the Otago Community Hospice, Dunedin, New Zealand.Methods:Ten people, aged between 51 and 65, were approached; two declined and one died sooner than expected. All were women (although this was not part of the original design) and all had carcinoma. Data for the study was sought through qualitative research interviews, considering the development of each participant's illness in relation to her perception of her embodiment in the palliative care setting, and concluding with questions about what she wants the people who care for and about her to learn from her experience. Consistent with this phenomenological approach, the method of analysis was thematic and interpretive.Results:The main theme was the uncertainty that all participants felt throughout the diagnostic process and during treatment. Uncertainty, too, was a factor in how they managed their day, whether they would be able to sustain an outing or an activity or not and whether they would be pain free. None were afraid of dying but hoped that when they did die, they would do so comfortably. The relationship with their general practitioners varied. Where fatigue or the effects of medication were not an issue, they could think clearly, but their bodies were experienced as letting them down and limiting their activities. The ideal of “living until you die” was not able to be fulfilled. The increasing approach of social death as they withdrew from their employment and social responsibilities affected them.Significance of results:Whether one has a “good death” or not is determined not only by the progression and management of the disease process by health professionals, but also by the way in which one is perceived, by self and others. There are no guidelines for the dying role; everybody dies differently and individually.

scholarly journals Investigation and management of iron deficiency anaemia in a specialist palliative care setting and the role of intravenous iron: a descriptive analysis of hospice data

2021 ◽  
Vol 3 ◽  
pp. 6
Author(s):  
Thomas Steele ◽  
Helen Bonwick ◽  
Amara Callistus Nwosu ◽  
Laura Chapman
Keyword(s):  
Palliative Care ◽  
Iron Deficiency ◽  
Iron Status ◽  
Descriptive Analysis ◽  
Symptom Burden ◽  
Intravenous Iron ◽  
Severe Anaemia ◽  
Significant Difference ◽  
Palliative Care Setting ◽  
Clinical Records

Background: Anaemia is common in hospice populations and associated with significant symptom burden. Guidelines recommend investigating for and treating iron deficiency (ID), but there is little evidence of this practice in palliative care populations. This report describes the results of investigations for and subsequent management of ID in a UK hospice. Methods: This is a descriptive study of routine clinical data. Laboratory and clinical records were reviewed retrospectively for 12 months following the implementation, in August 2018, of routine investigation for ID amongst patients with clinically relevant anaemia in whom treatment would be considered. Absolute (AID) and functional iron deficiency (FID) were diagnosed using established definitions and treatments recorded. Results: Iron status was evaluated in 112 cases, representing 25/110 (22.7%) of those with mild, 46/76 (60.5%) moderate and 41/54 (75.9%) severe anaemia. Twenty-eight (25%) were defined as having AID, 48 (42.8%) FID and 36 (32%) no ID. There was a significant difference between groups in symptoms triggering haemoglobin check and diagnosis, with a higher proportion of patients with classic symptoms of anaemia and gastrointestinal malignancy in those with AID. Intravenous iron was given on 12 occasions in the hospice with no major adverse events. Subjective symptom benefit in 7 cases and a statistically significant increase in overall mean haemoglobin were observed. Conclusions: This report describes the outcome of investigations for iron deficiency in patients with clinically significant anaemia in a UK hospice. Results indicate iron deficiency is common and can be safely treated with intravenous iron replacement, within current guidelines, in a hospice setting. Further research should define the optimum use of this approach in palliative care patients.

scholarly journals Palliative care referral criteria and outcomes in cancer and heart failure: a systematic review of literature

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Anecita P. Fadol ◽  
Ashley Patel ◽  
Valerie Shelton ◽  
Kate J. Krause ◽  
Eduardo Bruera ◽  
...  
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Symptom Burden ◽  
Cochrane Library ◽  
Early Integration ◽  
Patients With Cancer ◽  
Ovid Medline ◽  
Referral Criteria ◽  
Patient Reported ◽  
Hospice And Palliative Care

Abstract Background Cardiotoxicity resulting in heart failure (HF) is among the most dreaded complications of cancer therapy and can significantly impact morbidity and mortality. Leading professional societies in cardiology and oncology recommend improved access to hospice and palliative care (PC) for patients with cancer and advanced HF. However, there is a paucity of published literature on the use of PC in cardio-oncology, particularly in patients with HF and a concurrent diagnosis of cancer. Aims To identify existing criteria for referral to and early integration of PC in the management of cases of patients with cancer and patients with HF, and to identify assessments of outcomes of PC intervention that overlap between patients with cancer and patients with HF. Design Systematic literature review on PC in patients with HF and in patients with cancer. Data sources Databases including Ovid Medline, Ovid Embase, Cochrane Library, and Web of Science from January 2009 to September 2020. Results Sixteen studies of PC in cancer and 14 studies of PC in HF were identified after screening of the 8647 retrieved citations. Cancer and HF share similarities in their patient-reported symptoms, quality of life, symptom burden, social support needs, readmission rates, and mortality. Conclusion The literature supports the integration of PC into oncology and cardiology practices, which has shown significant benefit to patients, caregivers, and the healthcare system alike. Incorporating PC in cardio-oncology, particularly in the management of HF in patients with cancer, as early as at diagnosis, will enable patients, family members, and healthcare professionals to make informed decisions about various treatments and end-of-life care and provide an opportunity for patients to participate in the decisions about how they will spend their final days.

scholarly journals Psychiatric liaison in palliative care

2003 ◽  
Vol 9 (4) ◽  
pp. 241-248 ◽  
Author(s):  
Simon Dein
Keyword(s):  
Palliative Care ◽  
Care Setting ◽  
Depressive Illness ◽  
Care Staff ◽  
Cognitive Behavioural ◽  
Palliative Care Setting ◽  
Total Care ◽  
Body Image Disturbances ◽  
Illness Anxiety

Palliative care is the active, total care of patients whose disease is not responsive to curative treatment. Psychological problems such as depressive illness, anxiety, delirium, problems coping and body image disturbances are common in the palliative care setting, although they are often missed. A full assessment of these patients should take into account physical, emotional and spiritual factors; therapeutic work should include the patient's family. Pharmacological (antidepressants, anxiolytics and antipsychotics) and cognitive–behavioural treatments are often effective in allaying distress in this group of patients, and can improve coping skills and quality of life. Liaison psychiatrists have a role in teaching palliative care staff to recognise psychiatric disorders. A number of case studies are presented to illustrate these points.

Homoeopathy in Cancer Pain Palliation and End of Life with Future Perspectives

2019 ◽  
Vol 32 (02) ◽  
pp. 095-104
Author(s):  
Jyoti Sachdeva ◽  
Joy Kumar Dey
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Cancer Pain ◽  
End Of Life ◽  
Disease Process ◽  
Symptom Burden ◽  
Holistic Approach ◽  
Future Perspective ◽  
Pain Palliation

AbstractPain is a common companion of people receiving palliative care in cancer and at the end of life. Cancer pain is multifactorial and complex. Its impact can be devastating, with increased morbidity and poor quality of life, if not treated adequately. Cancer pain management is a challenging task both due to disease process and due to treatment-related side effects; therefore, it requires a holistic approach which can be covered by homoeopathic remedies. The purpose of this article is to enlighten the scope and future perspective of homoeopathy in pain palliative care and at the end of life. This article summarises the need of multidimensional approach towards the cancer pain palliation and at the end of life in which homoeopathy may play a key role of supportive care. Homoeopathy may become a valuable treatment in palliative care to provide relief and comfort to the dying patient, and therefore the fear of death may reduce and the family may be better prepared for the bereavement. Homoeopathy can well integrate with standard oncologic cares to improve patient outcome including symptom burden, quality of life and end-of-life outcomes, all achieved with low associated costs.

Facing uncertainty: The lived experience of palliative care

2007 ◽  
Vol 5 (3) ◽  
pp. 255-264 ◽  
Author(s):  
Roz McKechnie ◽  
Rod MacLeod ◽  
Sally Keeling
Keyword(s):  
Qualitative Research ◽  
Palliative Care ◽  
Lived Experience ◽  
Disease Process ◽  
Phenomenological Approach ◽  
Diagnostic Process ◽  
Main Theme ◽  
Original Design ◽  
Social Death ◽  
Palliative Care Setting

Objective: This qualitative research study listens to the narratives of people experiencing the dying process who attended the Otago Community Hospice, Dunedin, New Zealand.Methods: Ten people, aged between 51 and 65 years old, were approached; two declined and one died sooner than expected. All were women (although this was not part of the original design), and all had carcinoma. Data for the study were sought through qualitative research interviews, considering the development of each participant's illness in relation to her perception of her embodiment in the palliative care setting, and concluding with questions about what she wants the people who care for and about her to learn from her experience. Consistent with this phenomenological approach, the method of analysis was thematic and interpretive.Results: The main theme was the uncertainty that all participants felt throughout the diagnostic process and during treatment. Uncertainty, too, was a factor in how they managed their day, whether they would be able to sustain an outing or an activity or not, and whether they would be pain free. None were afraid of dying but hoped that when they did die, they would do so comfortably. The relationship with their general practitioners varied. Where fatigue or the effects of medication were not an issue, they could think clearly, but their bodies were experienced as letting them down and limiting their activities. The ideal of “living until you die” was not able to be fulfilled. The increasing approach of social death as they withdrew from their employment and social responsibilities affected them.Significance of results: Whether one has a “good death” or not is determined not only by the progression and management of the disease process by health professionals, but also by the way in which one is perceived, by self and others. There are no guidelines for the dying role; everybody dies differently and individually.

Abstract 13221: Family Caregivers’ Perceptions of Illness Severity in Heart Failure Patients with Limited Life Expectancy

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Lisa Kitko ◽  
Judith Hupcey ◽  
Maureen Palese
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Quality Care ◽  
Healthcare Providers ◽  
Illness Severity ◽  
Patient Death ◽  
Disease Trajectory ◽  
Advance Care ◽  
Hospice And Palliative Care ◽  
Perceived Illness

Introduction: End-of-life (EOL) services, such as hospice and palliative care are often lacking even for the sickest heart failure (HF) patients. Use of these services have been hampered by the lack of availability, lack of referrals due to the unpredictable course in HF, and refusal of services by patients and caregivers due to a lack of understanding of the terminality of HF. The purpose of this study was to determine whether caregivers of HF patients with a predicted survival of less than 2 years, understood disease terminality prior to and after the patient’s death. Methods: As part of a longitudinal study of 100 patient-caregiver dyads, caregivers were interviewed monthly until the patient’s death and then twice post-death. Caregiver interviews immediately preceding and post-patient death were analyzed to determine caregivers’ perceptions of the terminality of heart failure. Results: There were 49 caregivers of patients who died. Patients died an average of 8 months after study enrollment. Most caregivers did not understand the severity of the patient’s disease and 51% (25/49) viewed the death as unexpected. When caregivers retrospectively reflected on the patient’s illness trajectory, they recounted downward trends in patient’s health, but were not aware of the terminality of the patient until after death occurred. Those few caregivers who perceived the illness severity prior to death came to this realization late in the disease trajectory. At the point of recognition, advanced treatments were limited or withdrawn and the short-term use of EOL services such as palliative care or hospice was instituted. Conclusions: The lack of perceived illness severity/terminality has profound implications for patients, caregivers, and healthcare providers. Patients and caregivers who do not understand the seriousness of the illness are less likely to accept EOL services, if offered. Clinicians need to understand the HF EOL trajectory and that EOL discussions and advance care planning help patients and caregivers make informed choices and receive quality care at EOL. We also need to educate all healthcare providers about having these discussions, so palliative care becomes a philosophy of care not merely a referral service immediately preceding death.

Developing a renal supportive care team from the voices of patients, families, and palliative care staff

2008 ◽  
Vol 6 (2) ◽  
pp. 133-139 ◽  
Author(s):  
Joan Berzoff ◽  
Jennifer Swantkowski ◽  
Lewis M. Cohen
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
Family Members ◽  
Disease Process ◽  
Care Team ◽  
Care Staff ◽  
Dialysis Patients ◽  
Open Communication ◽  
Stage Renal Disease ◽  
Bereaved Family

ABSTRACTObjective:Although half a million Americans suffer from end stage renal disease (ESRD), their quality of end-of-life care has been woefully inadequate. The Renal Supportive Care Team is a demonstration project that is designed to elicit and provide for the needs of dialysis patients and their families throughout the trajectory of their illnesses.Method:Six focus groups, including medical health professionals, dialysis patients, family members, and bereaved family members, discussed how to promote improved palliative care and encourage hospice referral for patients with ESRD.Results:Respondents agreed that there needed to be greater education of both patients and families regarding all aspects of the disease process, open communication, on-going support between patients, families, and the staff, continuity of care, pain control, and assistance with advance care planning.Significance of results:Palliative and supportive care issues in ESRD need greater attention.

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