scholarly journals Dying From Cancer

2017 ◽  
Vol 4 (2) ◽  
pp. 69-73 ◽  
Author(s):  
Larry D Cripe ◽  
Richard M Frankel
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Symptom Burden ◽  
Emergent Property ◽  
Life Care ◽  
Shared Experiences ◽  
Medical Oncologists ◽  
Informed Preferences ◽  
Timely Fashion ◽  
The Relationship

Medical oncologists and patients with advanced cancer struggle to discuss prognosis, goals, options, and values in a timely fashion. As a consequence, many patients die receiving aggressive treatment potentially inconsistent with their fully informed preferences and experience increased symptom burden and distress. The goals of patient - oncologist communication include exchanging information, building relationship, and engaging in shared decisions. Empathy is perhaps especially essential to effective patient - oncologist communication when the end of life is approaching. We speculate that, in addition to being a skilled response to a patient’s negative emotions, empathy is an emergent property of the relationship that allows the patient and oncologist to imagine what it will be like to navigate the transition from living with to dying from cancer; and to prepare for the transition. We propose that effective empathy: 1) requires an attentive, curious and imaginative physician; 2) acknowledges the complex and shifting goals as the end of life approaches; and 3) begins with a willingness of physicians to check in and find out what she may have misunderstood or misperceived. Empathy in end of life conversations cultivates the shared experiences necessary to co-create the new goals of care that underlie excellent end of life care.

scholarly journals Last Place of Care and End-of-Life Quality of Life in the United States: Evidence From a National Representative Data Set

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 17-17
Author(s):  
Yifan Lou ◽  
Nan Jiang ◽  
Katherine Ornstein
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
End Of Life ◽  
End Of Life Care ◽  
The United States ◽  
Life Care ◽  
Person Centered Care ◽  
Centered Care ◽  
The Relationship

Abstract Background: Quality of life (QoL) during last stage of life has raised expanded interests as an important aspect of person-centered care. Last place of care (LPC), refer to the last place decedents received their formal end-of-life care (EOLC), has been identified as a key indicator of older adults’ end-of-life QoL, but the relationship was understudied. This study explores the association between LPC and end-of-life QoL among American older adults. Methods: Data used seven waves of Last Month of Life data with a total sample of 3068 Medicare decedents in NHATS. Outcome is end-of-life QoL assessed by eleven measures on four domains: pain and symptoms management (SP), quality of healthcare encounter (HE), person-centered care (PC), and overall quality of care (QC). LPC was categorized into home, hospital, nursing home, and residential hospice. Multivariate logistic regression analyses were used to examine the relationship with covariates. Results: LPC varied by most demographic characteristics, except immigration status and education. Older adults whose LPC is hospital, compared to those who had home-care, were less likely to have great experiences on HE, PC, and QC. People dying at nursing homes are more likely to receive care meeting their dyspnea and spiritual needs. Residential hospice is negatively related to respected care, clear coordination, and keeping family informed, but are more likely to provide PS and spiritual care. Discussion: Home-based end-of-life care has certain advantages but still has room to improve on SP and religious concerns. Hospitals should keep reforming their service delivery structure to improve patients’ QoL.

Countertransference and ethics: A perspective on clinical dilemmas in end-of-life decisions

2003 ◽  
Vol 1 (4) ◽  
pp. 367-375 ◽  
Author(s):  
BRIAN J. KELLY ◽  
FRANCIS T. VARGHESE ◽  
DAN PELUSI
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Assisted Suicide ◽  
Clinical Decision Making ◽  
Ethical Dilemmas ◽  
Clinical Decision ◽  
Life Care ◽  
End Of Life Decisions ◽  
The Relationship ◽  
Dying Patient

Ethical dilemmas in end-of-life care, such as the request for assisted suicide, must be understood in the context of the relationship that exists between patients and the clinicians treating them. This context includes the way health professionals respond to the tasks in caring for a dying patient. This article reviews the literature exploring the factors the influence clinical decision making at the end of life. The interplay of ethics, countertransference and transference are explained in detail.

scholarly journals “A Good Death But There Was All This Tension Around” - Perspectives of Residential Managers on the Experiences and Challenges of Delivering end of Life Care for People Living with Dementia.

2020 ◽  
Author(s):  
Jessica Borbasi ◽  
Allison Tong ◽  
Alison Ritchie ◽  
Christopher J Poulos ◽  
Josephine M Clayton
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Symptom Burden ◽  
Aged Care ◽  
Residential Aged Care ◽  
Life Care ◽  
Advanced Dementia ◽  
Structured Interviews ◽  
Optimal Care ◽  
Family Demands

Abstract Background End of life care for residents with advanced dementia in the aged care setting is complex because there is prolonged and progressive cognitive decline, uncertain disease trajectory, significant symptom burden and infrequent access to specialist palliative care. Residential aged care managers offer a unique perspective in understanding the experience of providing end of life care for residents with advanced dementia from the coalface to the broader policy context. Methods Focus groups and semi-structured interviews were conducted with 20 residential managers from 11 aged care homes in Australia. Transcripts were analysed using thematic analysis. Results Six themes were identified: laying the ground work to establish what families understand about dementia, playing the peacemaker in the face of unrealistic family demands and expectations, chipping away at denial and cultivating a path towards acceptance of death, recruiting general practitioners as allies, supporting and strengthening the front line, and dedication to optimal care is relentless but rewarding.

The privilege of a good death: An intersectional perspective on dying a good death in America

2021 ◽  
Author(s):  
Miranda Corpora
Keyword(s):  
Conceptual Framework ◽  
End Of Life ◽  
End Of Life Care ◽  
Social Identities ◽  
Case Vignette ◽  
Good Death ◽  
Diverse Population ◽  
Life Care ◽  
Intersectionality Theory ◽  
The Relationship

Abstract All individuals deserve an equitable opportunity to achieve a good death. Unfortunately, access to end-of-life care and services is largely unequal on the basis of race, gender, class, and other social identities. We need to understand how individuals with multiple marginalized identities face different access in attaining a good death and use this knowledge to bring equity to end-of- life care. The conceptual framework for this argument derives from intersectionality theory and the existing disparities in end-of-life care. This argument sheds light on the relationship between intersectionality and a good death, demonstrated by a case vignette, and suggests that the more marginalized social identities one has, the more difficult their access to a good death. Because it is particularly important to both recognize and actively combat these inequities, I offer three practical strategies for end-of-life researchers and practitioners. For the sake of our increasingly diverse population, advancements in end-of-life care must be made to facilitate a good death for all.

Depression and the Desire to Die Near the End of Life

2015 ◽  
Author(s):  
Nathan Fairman ◽  
Scott A Irwin
Keyword(s):  
Decision Making ◽  
Suicidal Ideation ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Decisional Capacity ◽  
Hastened Death ◽  
Desire To Die ◽  
Clinical Conditions ◽  
The Relationship

This chapter examines how depression may affect a patient’s ability to make life-shortening decisions within the setting of care near the end of life, as well as a clinician’s willingness to support the patient’s preferences (that is, respecting his autonomy). It considers how the suspicion of depression can make the physician pause even when the obvious choice would be to support the patient’s decision. It also describes some of the defining features of depression, including hopelessness, suicidal ideation, and desire for hastened death. The chapter first reviews depression and similar clinical conditions in the context of end-of-life care before discussing the construct of capacity and the elements of its assessment. It then considers evidence on the relationship between depression and decisional capacity before concluding with suggestions to help guide decision-making.

scholarly journals EP-1651: Radiation oncologists’ role in end-of-life care: a view from medical oncologists

2018 ◽  
Vol 127 ◽  
pp. S888-S889
Author(s):  
T. Kruser ◽  
J.M. Kruser ◽  
J.P. Gross ◽  
M.R. Moran ◽  
K. Kaiser ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Radiation Oncologists ◽  
Medical Oncologists

Radiation Oncologists' Role in End-of-Life Care: A Perspective From Medical Oncologists

2019 ◽  
Vol 9 (5) ◽  
pp. 362-370 ◽  
Author(s):  
Jeffrey P. Gross ◽  
Jacqueline M. Kruser ◽  
Margaret R. Moran ◽  
Karen Kaiser ◽  
Eytan Szmuilowicz ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Radiation Oncologists ◽  
Medical Oncologists

Can the impact of an acute hospital end-of-life care tool on care and symptom burden be measured contemporaneously?

2013 ◽  
Vol 3 (2) ◽  
pp. 161-167 ◽  
Author(s):  
Colette M Reid ◽  
Jane Gibbins ◽  
Sophia Bloor ◽  
Melanie Burcombe ◽  
Rachel McCoubrie ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Symptom Burden ◽  
Acute Hospital ◽  
Life Care ◽  
The Impact

scholarly journals Strategies for introducing palliative care in the management of relapsed or refractory aggressive lymphomas

Hematology ◽  
2020 ◽  
Vol 2020 (1) ◽  
pp. 148-153
Author(s):  
Oreofe O. Odejide
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Psychological Symptom ◽  
Symptom Burden ◽  
Health Care Use ◽  
Refractory Disease ◽  
Life Care ◽  
T Cell Therapy ◽  
Aggressive Lymphomas

Abstract Recent advances in treatment of patients with aggressive lymphomas ranging from chimeric antigen receptor T-cell therapy to combination of antibody–drug conjugates with chemotherapy have improved survival outcomes. Despite these significant advances, patients with relapsed or refractory disease experience high physical and psychological symptom burden, and a substantial proportion still die of their lymphoma. In addition, end-of-life care outcomes are suboptimal with high rates of intensive end-of-life health care use and low rates of timely hospice enrollment. Integrating palliative care concurrently with disease-directed care for this patient population has strong potential to improve their symptom burden, quality of life, and end-of-life care. Multiple factors, including heightened prognostic uncertainty in the setting of relapsed/refractory disease, pose challenges to timely provision of palliative care. This article reviews benefits of primary and specialty palliative care for patients with relapsed/refractory aggressive lymphomas and barriers to such care. It also highlights strategies for effectively integrating palliative care for patients with relapsed/refractory aggressive lymphomas.

3013 Performance of medical oncologists on end-of-life care for Taiwanese cancer decedents, 2001–2006

2009 ◽  
Vol 7 (2) ◽  
pp. 179
Author(s):  
S. Tang ◽  
T.W. Liu ◽  
J.S. Chen ◽  
H.M. Wang ◽  
S.C. Wu ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Medical Oncologists
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