End of Life Neuropsychological Impairments and Psychological Care of Persons With Advanced Parkinsonism

2021 ◽  
pp. 104990912110497
Author(s):  
George P. Prigatano ◽  
Naomi Salins
Keyword(s):  
End Of Life ◽  
Executive Dysfunction ◽  
Psychological Care ◽  
Advanced Parkinson’S Disease ◽  
Cognitive Predictors ◽  
Impending Death ◽  
Case Vignettes ◽  
History Of ◽  
Substantial Decline ◽  
Neuropsychological Impairments

Decline in executive functioning, before frank dementia occurs, has been reported in patients with a history of stroke and malignant brain tumors. This may also be true in patients with advanced Parkinson’s disease (PD). In this paper, we summarize the limited research on the motor and cognitive predictors of mortality in advanced PD. We then provide 2 case vignettes of patients with end of life advanced PD who demonstrated a substantial decline in working memory and speech festination. We contrast these patients’ neuropsychological features to a third patient with advanced PD who shows no signs of impending death. Monitoring neuropsychological signs of executive dysfunction, explaining the neuropsychological dysfunctions to the patient and spouse while recognizing the past and retained cognitive competencies of the person is an important component of end of life psychological care. In the context of this type of consultation, the patient may experience an opportunity to communicate their emotional concerns prior to death which further reduces the anxiety associated with death.

scholarly journals Palliative Care as Response to Suffering at End of Life

2014 ◽  
Vol 6 (2) ◽  
pp. 227-245
Author(s):  
Daniela Moşoiu
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
End Of Life ◽  
Health Care System ◽  
Spiritual Distress ◽  
History Of Development ◽  
History Of ◽  
Hospice And Palliative Care ◽  
Care System

Abstract Persons suffering from chronic and life limiting illnesses often have unrelieved symptoms such as pain, depression, fatigue, and psychosocial and spiritual distress. In Romania they are frequently left in the care of their families with little support from the health care system. It seems a paradox that those who are the sickest persons in a country find little place in the health care system. This article presents palliative care as a solution to the suffering for these patients and their families by describing the concept, models of services, its beneficiaries and benefits and presenting the history of development of hospice and palliative care worldwide and in Romania.

End-of-life decision making in critical illness: Perspectives of Asian parents

2021 ◽  
pp. 1-10
Author(s):  
Kristy Xinghan Fu ◽  
Yee Keow Chiong ◽  
Nicola Ngiam
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Tertiary Care ◽  
Asian Population ◽  
Emergency Department Visits ◽  
Case Vignette ◽  
Healthcare Team ◽  
Care Hospital ◽  
Case Vignettes ◽  
End Of Life Decision

Abstract Objective To explore parents’ perspectives regarding end-of-life (EOL) decisions, factors and possible barriers that influence the EOL decision making process, and to understand parental preferences for communication about EOL care in an Asian population. Method A prospective questionnaire cohort study conducted in a university-based tertiary care hospital. 30 parents of children who had been admitted to general pediatric wards for acute ailments and/or were being followed up in general pediatric outpatient clinics after inpatient admissions or emergency department visits completed 30 interviewer-administered questionnaires. With the first 10 completed questionnaires, we sought feedback on the design of the four case vignettes and related questions. Responses to specific questions related to each case vignette were rated on a Likert scale. Results The majority of parents were able to comprehend and identify with the issues in the case vignettes, which allowed them to respond appropriately. Parents tended to avoid active withdrawal or withholding of life-sustaining treatment. The top three priorities for parents making EOL decisions for their children were: the chance of improvement, the presence of pain or discomfort, and information provided by healthcare staff. Parents reported that they would prefer to know immediately if their child is at risk of dying; they also preferred to get as much information as possible from the healthcare team and thought that meeting with the healthcare team before making EOL decisions was pivotal. Significance of results Parents place highest priorities on their child's likelihood of improvement, perception of their child's pain, and information provided by healthcare professionals in making EOL decisions.

Facing Death in Medical Training

2017 ◽  
Vol 80 (3) ◽  
pp. 340-354 ◽  
Author(s):  
Asunción Álvarez-del Río ◽  
Ma. Luisa Marván ◽  
Julieta Gómez Avalos
Keyword(s):  
Medical Students ◽  
End Of Life ◽  
Medical Training ◽  
Terminally Ill ◽  
Medical Attention ◽  
Objective Data ◽  
Educational Activities ◽  
Terminally Ill Patients ◽  
Student Views ◽  
Impending Death

This study explores how medical students feel about caring for terminally ill patients as well as how their medical courses prepare them for addressing end-of-life (EOL) issues with patients. Four hundred and five Mexican medical students were surveyed through the Student Views on Death questionnaire. The vast majority of students (94%) felt that physicians should inform patients of their impending death. Most students said they felt comfortable talking with (61%) or examining (76%) terminally ill patients. However, only half the students actually talked with patients about death. Participants in our study were interested in learning about EOL medical attention, yet most considered themselves poorly prepared to offer this type of care to terminally ill patients. The study provides objective data on a topic that has scarcely been explored in Mexico, data that will be useful in designing educational activities to improve EOL medical training.

scholarly journals First-Dose Coronavirus 2019 Vaccination Coverage among the Residents of Long-Term Care Facilities in France

Gerontology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Joël Belmin ◽  
Pierre Lutzler ◽  
Patrick Hidoux ◽  
Olivier Drunat ◽  
Carmelo Lafuente-Lafuente ◽  
...  
Keyword(s):  
End Of Life ◽  
Vaccination Coverage ◽  
Long Term Care ◽  
Vaccination Campaign ◽  
Coverage Rate ◽  
Life Situation ◽  
Term Care ◽  
Care Facilities ◽  
History Of

<b><i>Background:</i></b> Long-term care facilities (LTCFs) experienced severe burden from the Coronavirus 2019 (COVID-19), and vaccination against SARS-CoV-2 is a major issue for their residents. <b><i>Objective:</i></b> The objective of this study was to estimate the vaccination coverage rate among the residents of French LTCFs. <b><i>Method:</i></b> Participants and settings: 53 medical coordinators surveyed 73 LTCFs during the first-dose vaccination campaign using the BNT162b2 vaccine, conducted by health authorities in January and early February 2021. Measurements: in all the residents being in the LTCF at the beginning of the campaign, investigators recorded age, sex, history of clinical or asymptomatic COVID-19, serology for SARS-CoV-2 or severe allergy, current end-of-life situation, infectious or acute disease, refusal of vaccination by the resident or by the representative person of vaccine, and the final status, vaccinated or not. <b><i>Results:</i></b> Among the 4,808 residents, the average coverage rate for COVID-19 vaccination was 69%, and 46% of the LTCFs had a coverage rate &#x3c;70%. Among unvaccinated residents, we observed more frequently a history of COVID-19 or a positive serology for SARS-CoV-2 (44.6 vs. 11.2% among vaccinated residents, <i>p</i> &#x3c; 0.001), a history of severe allergy (3.7 vs. 0.1%, <i>p</i> &#x3c; 0.001), end-of-life situation (4.9 vs. 0.3%, <i>p</i> &#x3c; 0.001), current infectious or acute illness (19.6 vs. 0.3%, <i>p</i> &#x3c; 0.001), and refusal of vaccination by residents or representative persons (38.9 vs. 0.4%, <i>p</i> &#x3c; 0.001). <b><i>Conclusions:</i></b> About 3 out of 10 residents remained unvaccinated, and half of the LTCFs had a coverage rate &#x3c;70%. This suggests that COVID-19 will remain a threat to many LTCFs after the vaccination campaigns.

scholarly journals Helena Antipoff: Science as a Passport for a Woman’s Career between Europe and Latin America

2019 ◽  
pp. 15
Author(s):  
Regina Regina Helena de Freitas Campos ◽  
Erika Lourenço
Keyword(s):  
Educational Institutions ◽  
Social Risk ◽  
Psychological Care ◽  
Scientific Training ◽  
Family Work ◽  
Scientific Approach ◽  
Education And Care ◽  
History Of ◽  
The Right ◽  
Education In Brazil

Helena Antipoff was one of the pioneers in the constitution of the fields of knowledge of educational psychology and special education in Brazil. Born in Russia, Antipoff received her education in Paris and Geneva. Researches in the history of education and of psychology have revealed the innovative character of Antipoff’s work as a researcher, as a professor and as a founder of different educational institutions in Brazil, with a focus on educational and psychological care for children with disabilities or at social risk. Her career is characterized by a sound scientific approach combined with a deep commitment to the right of children and youth to education and care. These directions can be associated with her scientific training in the sciences of education in a time of social turbulence and school reform, when many women became professionals in the field of education, trying to combine family, work and militant activity.

scholarly journals B-02 Neuropsychological Deficits Following Right Hemisphere Cerebrovascular Accidents in a Patient with Human Immunodeficiency Virus, Hepatitis C, and Polysubstance Abuse

2019 ◽  
Vol 34 (6) ◽  
pp. 945-946
Author(s):  
A Olzmann ◽  
A Inscore
Keyword(s):  
Neuropsychological Assessment ◽  
Verbal Memory ◽  
Right Hemisphere ◽  
Neuropsychological Deficits ◽  
Complex Patients ◽  
Immunodeficiency Virus ◽  
History Of ◽  
Polysubstance Abuse ◽  
Patient’S History ◽  
Neuropsychological Impairments

Abstract Objective In right hemisphere cerebrovascular accident (CVA), expected deficits might include inattention syndromes, visuospatial impairment, or neglect. This case study adds to the literature by presenting neuropsychological data from a patient with a complex medical history who experienced two right hemisphere CVAs. The aim is to demonstrate that neuropsychological deficits following CVA may not be as expected in patients with comorbidities, and to highlight the importance of neuropsychological assessment in such cases. Method The patient is a 69-year-old, right-handed, African American man who presented with reading and memory difficulties, problems recognizing faces, and vision impairment following right occipital and temporoparietal ischemic CVAs. Comprehensive neuropsychological evaluation was conducted. Formal measures were utilized, but the examiners were also required to devise appropriate bedside measures. Results The patient had difficulty recognizing his caregiver’s face. He could not identify facial expressions made by examiners, but commented on individual facial features. Design copies were distorted/fragmented, and he evidenced difficulty integrating visual components into a whole. He also demonstrated spelling and verbal memory impairment (BDAE Oral Spelling raw = 0; HVLT-R recall and recognition < 1st percentile). Full results are included in a supplemental data table. Conclusions Results were strongly suggestive of simultanagnosia, though this disorder typically results from bilateral parietal-occipital lesions. Additionally, the neuropsychological impairments noted extended beyond those typical of right hemisphere CVA, likely related to the patient’s history of multiple comorbidities (e.g., infectious disease, polysubstance abuse). This case highlights the importance of neuropsychological assessment in the care of medically complex patients, and the unique ability of neuropsychologists to conduct such evaluations.

Israel

2018 ◽  
Author(s):  
Elon Eisenberg ◽  
Silviu Brill
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Cancer Pain ◽  
End Of Life ◽  
Acute Pain ◽  
Later Life ◽  
Recent Innovation ◽  
History Of ◽  
Prevalence Of Pain ◽  
Pain Care

Israel is a member of the European Pain Federation (EFIC). The national pain society works to support the needs of patients with pain, including those with acute pain, chronic pain, cancer pain, pain in later life, and at the end of life. In this chapter of European Pain Management we describe first the geography and history of the country as it relates to the recent demographics of the population, the prevalence of pain and needs for pain management, the pain workforce and its organization, the system pain specialists work within, and specific issues that have been tackled to improve the delivery of pain care. An example of recent innovation is also described.

France

2018 ◽  
Author(s):  
Didier Bouhassira ◽  
Nadine Attal
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Cancer Pain ◽  
End Of Life ◽  
Acute Pain ◽  
Later Life ◽  
Recent Innovation ◽  
History Of ◽  
Prevalence Of Pain ◽  
Pain Care

France is a member of the European Pain Federation (EFIC). The national pain society works to support the needs of patients with pain, including those with acute pain, chronic pain, cancer pain, pain in later life, and at the end of life. In this chapter of European Pain Management we describe first the geography and history of the country as it relates to the recent demographics of the population, the prevalence of pain and needs for pain management, the pain workforce and its organization, the system pain specialists work within, and specific issues that have been tackled to improve the delivery of pain care. An example of recent innovation is also described.

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