scholarly journals The Role of Spiritual Care with the Introduction of an End of Life Order Set

2019 ◽  
Vol 73 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Kalli Stilos ◽  
Bill Ford ◽  
Tammy Lilien ◽  
Jennifer Moore
Keyword(s):  
End Of Life ◽  
Spiritual Care ◽  
Retrospective Chart Review ◽  
Physical Symptoms ◽  
Care Team ◽  
Spiritual Support ◽  
Dying Patients ◽  
Psychosocial Concerns ◽  
One Step

Delivering comprehensive end-of-life care to dying patients must involve addressing physical symptoms and psychosocial concerns. Care pathways have been introduced to support health care teams in delivering this care. This retrospective chart review explores the contributions of the Spiritual Care Team in the care of dying patients. They offer a range of interventions which include supportive care, religious and spiritual support. This study was one step towards appreciating the contributions of the Spiritual Care Team.

When a Little May Be Just Enough? Caring for People With Swallowing Difficulties at the End of Life, and Their Caregivers

2016 ◽  
Vol 1 (13) ◽  
pp. 89-93 ◽  
Author(s):  
Justin Roe ◽  
Rob George
Keyword(s):  
End Of Life ◽  
Specialist Palliative Care ◽  
Loved One ◽  
Dying Patients ◽  
Present Information ◽  
Swallowing Difficulties ◽  
Nutritional Needs ◽  
Nutrition And Hydration ◽  
Meaningful Role

Nutrition and hydration are emotive topics in many fields of health care. This can present particular challenges towards the end of life where reduced hydration and nutritional needs are a natural part of dying. Speech-language pathologists (SLPs) are increasingly involved in the care of dying patients. It is essential that they work as part of a dedicated, multidisciplinary team delivering a comprehensive package of specialist palliative care. In this paper, we will review the role of the SLP at the end of life and present information that will support the SLP to recognise and understand dying, and how medical and SLP interventions may compound rather than relieve symptoms. It is paramount that interventions are ethically sound and decision making is shared, respecting the autonomy of patients. In the event patients lack capacity, any advance directives/decisions and statements should be considered in consultation with caregivers. At the end of life, the focus of our intervention may shift from the patient to the caregiver, ensuring that they have a meaningful role in the care of their loved one in the final stages of dying.

scholarly journals Ambulance staff and end-of-life hospital admissions: A qualitative interview study

2018 ◽  
Vol 32 (9) ◽  
pp. 1465-1473 ◽  
Author(s):  
Sarah Hoare ◽  
Michael P Kelly ◽  
Larissa Prothero ◽  
Stephen Barclay
Keyword(s):  
End Of Life ◽  
Hospital Admissions ◽  
Qualitative Interviews ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Policy Problem ◽  
Dying Patients ◽  
Qualitative Interview Study ◽  
At Home

Background: Hospital admissions for end-of-life patients, particularly those who die shortly after being admitted, are recognised to be an international policy problem. How patients come to be transferred to hospital for care, and the central role of decisions made by ambulance staff in facilitating transfer, are under-explored. Aim: To understand the role of ambulance staff in the admission to hospital of patients close to the end of life. Design: Qualitative interviews, using particular patient cases as a basis for discussion, analysed thematically. Participants/setting: Ambulance staff ( n = 6) and other healthcare staff (total staff n = 30), involved in the transfer of patients (the case-patients) aged more than 65 years to a large English hospital who died within 3 days of admission with either cancer, chronic obstructive pulmonary disease or dementia. Results: Ambulance interviewees were broadly positive about enabling people to die at home, provided they could be sure that they would not benefit from treatment available in hospital. Barriers for non-conveyance included difficulties arranging care particularly out-of-hours, limited available patient information and service emphasis on emergency care. Conclusion: Ambulance interviewees fulfilled an important role in the admission of end-of-life patients to hospital, frequently having to decide whether to leave a patient at home or to instigate transfer to hospital. Their difficulty in facilitating non-hospital care at the end of life challenges the negative view of near end-of-life hospital admissions as failures. Hospital provision was sought for dying patients in need of care which was inaccessible in the community.

Understanding the Role of the Otolaryngology Hospitalist: Tracheostomies and Tracheostomy Care

2021 ◽  
pp. 000348942110457
Author(s):  
Mohamad Issa ◽  
Nadeem El-Kouri ◽  
Sara Mater ◽  
Jonathan Y. Lee ◽  
Carl Snyderman ◽  
...  
Keyword(s):  
Medical Center ◽  
Tertiary Care ◽  
Care Facility ◽  
Retrospective Chart Review ◽  
Wait Time ◽  
High Volume ◽  
Care Team ◽  
Consulting Services ◽  
Tertiary Care Facility

Introduction: The concept of a hospitalist has been well established. This model has been associated with reduced length of stay contributing to reduction in healthcare costs. Minimal literature is available assessing the effects of an otolaryngology (ENT) hospitalist at a tertiary medical center. The aim of this study is to assess the role of an ENT hospitalist on (1) performing tracheostomies and (2) providing care as part of the tracheostomy care team (TCT). Methods: Retrospective chart review of all tracheostomies performed by the ENT service over 2 years (July 2015-June 2017), and prospective data collection of all tracheostomy care consults over 1 year (July 2016-June 2017). In year 1 (from July 2015 to June 2016), no ENT hospitalist was employed, and in year 2 (from July 2016 to June 2017), an ENT hospitalist was employed. Results: Compared to other Ear, Nose, and Throat (ENT) surgeons, the ENT hospitalist performed tracheostomies with shorter patient wait times, and performed a greater proportion of percutaneous tracheostomies at the bedside versus open tracheostomies in the operating room. The tracheostomy care team (TCT) received 91 consults over the course of 1 year with an average of 1.1 billable procedures generated per consult. Conclusion: In this study, an ENT hospitalist was decreased patient wait time to tracheostomy and increased bedside percutaneous tracheostomies, which has positive implications for resource utilization and healthcare cost. The average wait time to receive a tracheostomy was reduced when calculated across the entire department due to the availability of the ENT hospitalist to see and perform tracheostomies. The TCT generated many billable bedside procedures in addition to encouraged decannulation of patients. This study highlights the fact that the ENT hospitalist contributes to providing expedient tracheostomies and provides valuable consulting services as part of a TCT at a high-volume tertiary care facility.

scholarly journals Facilators and Barriers to Advance Care Planning Engagement among Chronic Kidney Patients in Taiwan

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 777-777
Author(s):  
YuHsuan (Olivia) Wang ◽  
Susan Enguidanos
Keyword(s):  
Kidney Disease ◽  
End Of Life ◽  
Advance Care Planning ◽  
Critical Role ◽  
Care Team ◽  
Care Planning ◽  
Theory Approach ◽  
Structured Interviews ◽  
Advance Care

Abstract End-Stage Renal Disease (ESRD) patients experience high rates of cognitive impairment and lower quality of life at end of life. Having an advance care planning (ACP) conversation is associated with better care at end of life and improved care consistency with patient preferences. Taiwan ranks highest in ESRD and dialysis incidence worldwide, highlighting the importance of ACP among this population. Since 2019, the Patient Autonomy Act entitled Taiwanese to engage in ACP, but strategies to promote its uptake and the role of healthcare providers and caregivers in ACP conversations remains unclear. This study aimed to investigate facilitators and barriers to ACP engagment among Taiwanese with kidney disease and their caregivers. In 2020, we recruited 18 adults with stage 3—5 kidney disease and their caregivers. We conducted semi-structured interviews to elicit knowledges and perspectives on ACP. A grounded theory approach was used to guide the analysis of primary themes. Two researchers independently coded the transcripts and met to reconcile codes. The primary barrier to ACP was the misconception that it equated to funeral arrangements. Themes related to ACP facilitators included: trust in the nephrology care team (especially in case managers); straighforward communication; and in-person consultations. Additionally, transplant patients were more likely to have ACP discussions with their loved ones. While kidney disease patients preferred straightforward communication, caregivers preferred indirect communications. These findings emphasize the critical role of the nephrological care team members. Improving knowledge of ACP and facilitating communication between caregivers and kidney disease patients in Taiwan is needed.

General Processes

2021 ◽  
pp. 1-18
Keyword(s):  
End Of Life ◽  
Hospice Care ◽  
Teaching Tool ◽  
Life Care ◽  
Patient Centered ◽  
Efficient Manner ◽  
Dying Patients ◽  
Centered Care ◽  
Role Definitions

This section discusses the general processes of hospice care. The role of hospice is to deliver the most effective end-of-life care in the most efficient manner possible to all dying patients. This section defines the essential steps that need to be followed, or at least considered, in the process of caring for patients at the end of life. These steps serve as a teaching tool and reminder of the fundamental goals of patient-centered care within a larger system of health care. While there are many elements that contribute to an exceptional hospice, the interdisciplinary team is at its core. The interdisciplinary group may be composed of identical professional members as the multidisciplinary paradigm, but the role definitions are purposefully blurred and the boundaries are widely overlapping. Authority is shared, as is decision making, and innovation is encouraged wherever necessitated by patient need and circumstance. The section then outlines the clinical documentation process, which serves several important functions.

scholarly journals Receiving Spiritual Care: Experiences of Dying and Grieving Individuals

2017 ◽  
Vol 76 (4) ◽  
pp. 373-394 ◽  
Author(s):  
Anthony Bonavita ◽  
Oksana Yakushko ◽  
Melissa L. Morgan Consoli ◽  
Steve Jacobsen ◽  
Rev. Laura L. Mancuso
Keyword(s):  
End Of Life ◽  
Spiritual Care ◽  
Qualitative Methodology ◽  
Hospice Care ◽  
Death And Dying ◽  
Vital Role ◽  
Spiritual Needs ◽  
Individual Perceptions ◽  
Hospice And Palliative Care

The study examines the perceptions of interfaith spiritual care, received through a volunteer hospice organization, by 10 individuals facing death and dying. Qualitative methodology based on the Interpretive Phenomenological Analysis was used to collect and analyze the data. Four superordinate themes reflected meanings ascribed to spirituality and spiritual care in facing end of life: Vital Role of Spirituality in the End-of-Life Care, Definitions and Parameters of Spirituality and Interfaith Spiritual Care, Distinct Aspects of Interfaith Spiritual Care, and Unmet Spiritual Needs. The results expand an understanding of the role of spirituality and spiritual care as part of the hospice and palliative care through attention to individual perceptions and experiences, as well as to ways to expand attention to spirituality within the hospice care.

The Role of the Social Worker at the End of Life: Paving the Way in an Academic Hospital Quality Improvement Initiative

2020 ◽  
Author(s):  
Kalliopi (Kalli) Stilos ◽  
Danielle Takahashi ◽  
Amy Eleanor Nolen
Keyword(s):  
Quality Improvement ◽  
Social Work ◽  
End Of Life ◽  
Acute Care ◽  
Social Worker ◽  
Physical Symptoms ◽  
Quality Improvement Initiative ◽  
Dying Patients ◽  
The Social ◽  
Social Work Interventions

Abstract The end-of-life (EOL) experience of patients dying in acute care has been highlighted as an area for quality improvement. Delivering comprehensive care to these patients involves addressing physical symptoms and psychosocial concerns. The social work role offers a range of interventions to address the common domains of EOL care. We report on results of an EOL survey evaluating satisfaction with social work interventions for imminently dying patients in acute care. This article is the first phase towards gaining an understanding of the contributions of the social worker in supporting dying patients and their families within our organisation.

Chaplaincy Care in the MICU: Describing the Spiritual Care Provided to MICU Patients and Families at the End of Life

2020 ◽  
Vol 37 (12) ◽  
pp. 1037-1044
Author(s):  
Dirk Labuschagne ◽  
Alexia Torke ◽  
Daniel Grossoehme ◽  
Katie Rimer ◽  
Martha Rucker ◽  
...  
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Spiritual Care ◽  
Medical Decision ◽  
Spiritual Support ◽  
Goals Of Care ◽  
Medical Icus ◽  
Part Time ◽  
Care Information ◽  
Information Number

Background: Gravely ill patients admitted to the intensive care unit (ICU), and their families experience acute spiritual and existential needs and often require complex decisions about their care. Little is known about what constitutes chaplaincy care for patients or families in ICUs. Chaplains report that participation in medical decision-making is part of their role. Objective: To describe the spiritual care provided to patients and their families in the ICU. Methods: This was a retrospective observational study of spiritual care for patients and families in the medical ICUs (MICUs) at 4 medical centers over a 3-month period. Inclusion criteria were death in the MICU or discharge to palliative care or hospice. Measures included medical, treatment, and spiritual care information (number of visits, length of visit, chaplain categories, and type of spiritual care provided). Results: Of the 254 patients, 197 (78%) received a total of 485 spiritual care visits. Seventy-seven percent of visits included provision of emotional/spiritual support; only 15% included decision-making support such as family meetings or goals-of-care conversations. The proportion receiving spiritual care increased as patients neared death or discharge. Staff chaplains were involved in goals-of-care conversations to a greater extent than student or part-time chaplains ( P < .05). Conclusion: Spiritual care was provided to most patients and/or families at the end of life. Low chaplain involvement in decision-making in the MICU suggests opportunities to improve chaplains’ contributions to ICU care.

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