Palliative care needs of chronically ill nursing home residents in Germany: focusing on living, not dying

2011 ◽  
Vol 17 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Barbara Strohbuecker ◽  
Yvonne Eisenmann ◽  
Maren Galushko ◽  
Thomas Montag ◽  
Raymond Voltz
Keyword(s):  
Palliative Care ◽  
Nursing Home ◽  
Nursing Home Residents ◽  
Chronically Ill ◽  
Care Needs ◽  
Palliative Care Needs

scholarly journals Nurse-Physician Communication Around Identifying Palliative Care Needs in Nursing Home Residents

2021 ◽  
Author(s):  
Jenny T. van der Steen ◽  
Esmée A. Jongen ◽  
Natashe Lemos Dekker ◽  
Lotje Bagchus ◽  
H. Roeline W. Pasman ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nursing Home ◽  
Nursing Home Residents ◽  
Physician Communication ◽  
Care Needs ◽  
Palliative Care Needs

scholarly journals Palliative care needs and symptoms of nursing home residents with and without dementia: A cross-sectional study

2016 ◽  
Vol 17 (10) ◽  
pp. 1501-1507 ◽  
Author(s):  
Kirsten Hermans ◽  
Joachim Cohen ◽  
Nele Spruytte ◽  
Chantal Van Audenhove ◽  
Anja Declercq
Keyword(s):  
Palliative Care ◽  
Nursing Home ◽  
Nursing Home Residents ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Care Needs ◽  
Cross Sectional ◽  
Palliative Care Needs

scholarly journals Nurse-physician Communication around Identifying Palliative Care Needs in Nursing Home Residents

2021 ◽  
Author(s):  
Jenny T. van der Steen ◽  
Esmée Jongen ◽  
Natashe Lemos Dekker ◽  
Lotje Bagchus ◽  
H. Roeline W. Pasman ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nursing Home ◽  
Nursing Homes ◽  
The Netherlands ◽  
Nurse Practitioners ◽  
Nursing Staff ◽  
Nursing Home Residents ◽  
Care Needs ◽  
Qualitative Interview Study ◽  
Palliative Care Needs

Objective: To assess experiences of medical practitioners who are on the staff of nursing homes with communication with nursing staff about identifying emerging and changing (palliative) care needs of residents of nursing homes in the Netherlands. Design: Qualitative interview study. Setting and Participants: Fifteen physicians and two nurse practitioners employed by eight care organizations in the western urbanized region of the Netherlands. Methods: We conducted individual semi-structured interviews in 2018 informed by a topic list that was based on a qualitative dataset about facilitators to palliative care in dementia reported by elderly care physicians. The interviews were recorded, transcribed verbatim and analysed with Atlas.ti. We used both deductive and inductive coding adding refined codes related to communication. Results: All interviewees expressed appreciation for nursing staff on whom they relied to communicate palliative care needs, yet they reported a variety of communication challenges around important changes in the condition of the residents which were covered by two themes. (1) Teamwork was facilitated or impeded by team size and structure, quality of relationships and clarity in hierarchical relationships. (2) Continuity of information was affected by (in)effective routes of consultation and (lack of) detail in communicating observations. Conclusions and Implications: Also in the case of on-staff physicians, functioning of the multidisciplinary team and accurate sharing of observed changes in the condition of nursing home residents are crucial for physicians to be able to address palliative care needs. The expressions of the physicians of how they would favor nursing staff to communicate can inspire interprofessional training, such as reporting objective observations and phrasing a clear request for help while avoiding overly demanding appeals.

scholarly journals A New Approach to the Identification of Palliative Care Needs and Advanced Chronic Patients among Nursing Home Residents

2021 ◽  
Vol 18 (6) ◽  
pp. 3171
Author(s):  
Ana A. Esteban-Burgos ◽  
María José Lozano-Terrón ◽  
Daniel Puente-Fernandez ◽  
César Hueso-Montoro ◽  
Rafael Montoya-Juárez ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nursing Homes ◽  
Statistical Significance ◽  
Nursing Home Residents ◽  
Cross Sectional Study ◽  
Care Needs ◽  
Chronic Patients ◽  
Cross Sectional ◽  
Surprise Question ◽  
Palliative Care Needs

Background: Proper planning of Palliative Care in nursing homes requires advanced knowledge of the care needs that residents show. The aim of the study was to evaluate Palliative Needs and other conditions such as fragility, complexity, and prognosis and also to suggest new indicators for the establishment of the resident’s advanced chronic condition. Methods: Cross-sectional study conducted in 149 nursing homes Complex Chronic residents evaluated by trained professionals. Palliative Care Needs, assessed by the NECPAL ICO-CCOMS© tool, and fragility, case and palliative complexity and prognosis were evaluate through a comprehensive assessment. Descriptive analyses and association measures were performed setting the statistical significance at 0.05. Results: More than 50% of the residents had positive Surprise Question and other Palliative Needs and were classified as Advanced Chronic Patients. Distress and/or Severe Adaptative Disorder was the most frequent need shown by the residents and significant differences in levels of frailty and other characteristics, were found between the Positive and the Negative Surprise Question Groups. Statistically significant correlations were also found between aspects of both groups. Conclusions: Nursing homes residents show Palliative Needs regardless of the response to the Surprise Question of the NECPAL tool. Other characteristics such as presence of an intermediate level of frailty are suggested as a new perspective to identify advanced chronic patients among nursing homes residents.

Nursing Home Providers' Perception of Palliative Care Needs of Residents with Advanced Dementia

2011 ◽  
Vol 12 (3) ◽  
pp. B17-B18
Author(s):  
Amy M. Corcoran ◽  
Amy M. Corcoran ◽  
Karen Hirschman ◽  
Sarah Lena Panzer ◽  
David Casarett
Keyword(s):  
Palliative Care ◽  
Nursing Home ◽  
Advanced Dementia ◽  
Care Needs ◽  
Palliative Care Needs

scholarly journals Frailty, Complexity, and Priorities in the Use of Advanced Palliative Care Resources in Nursing Homes

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 70
Author(s):  
Emilio Mota-Romero ◽  
Beatriz Tallón-Martín ◽  
María P. García-Ruiz ◽  
Daniel Puente-Fernandez ◽  
María P. García-Caro ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nursing Home ◽  
Cognitive Impairment ◽  
Nursing Homes ◽  
Poor Prognosis ◽  
Diagnostic Instrument ◽  
Lower Percentage ◽  
Care Needs ◽  
Clinical Complexity ◽  
Palliative Care Needs

Background and objectives: This study aimed to determine the frailty, prognosis, complexity, and palliative care complexity of nursing home residents with palliative care needs and define the characteristics of the cases eligible for receiving advanced palliative care according to the resources available at each nursing home. Materials and Methods: In this multi-centre, descriptive, and cross-sectional study, trained nurses from eight nursing homes in southern Spain selected 149 residents with palliative care needs. The following instruments were used: the Frail-VIG index, the case complexity index (CCI), the Diagnostic Instrument of Complexity in Palliative Care (IDC-Pal), the palliative prognosis index, the Barthel index (dependency), Pfeiffer’s test (cognitive impairment), and the Charlson comorbidity index. A consensus was reached on the complexity criteria of the Diagnostic Instrument of Complexity in Palliative Care that could be addressed in the nursing home (no priority) and those that required a one-off (priority 2) or full (priority 1) intervention of advanced palliative care resources. Non-parametric tests were used to compare non-priority patients and patients with some kind of priority. Results: A high percentage of residents presented frailty (80.6%), clinical complexity (80.5%), and palliative care complexity (65.8%). A lower percentage of residents had a poor prognosis (10.1%) and an extremely poor prognosis (2%). Twelve priority 1 and 14 priority 2 elements were identified as not matching the palliative care complexity elements that had been previously identified. Of the studied cases, 20.1% had priority 1 status and 38.3% had priority 2 status. Residents with some kind of priority had greater levels of dependency (p < 0.001), cognitive impairment (p < 0.001), and poorer prognoses (p < 0.001). Priority 1 patients exhibited higher rates of refractory delirium (p = 0.003), skin ulcers (p = 0.041), and dyspnoea (p = 0.020). Conclusions: The results indicate that there are high levels of frailty, clinical complexity, and palliative care complexity in nursing homes. The resources available at each nursing home must be considered to determine when advanced palliative care resources are required.

scholarly journals What makes palliative care needs “complex”? A multisite sequential explanatory mixed methods study of patients referred for specialist palliative care

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Anne M. Finucane ◽  
Connie Swenson ◽  
John I. MacArtney ◽  
Rachel Perry ◽  
Hazel Lamberton ◽  
...  
Keyword(s):  
Palliative Care ◽  
Focus Groups ◽  
Healthcare Professionals ◽  
Psychological Needs ◽  
Care Providers ◽  
Specialist Palliative Care ◽  
Care Needs ◽  
Complex Needs ◽  
Sequential Explanatory ◽  
Palliative Care Needs

Abstract Background Specialist palliative care (SPC) providers tend to use the term ‘complex’ to refer to the needs of patients who require SPC. However, little is known about complex needs on first referral to a SPC service. We examined which needs are present and sought the perspectives of healthcare professionals on the complexity of need on referral to a hospice service. Methods Multi-site sequential explanatory mixed method study consisting of a case-note review and focus groups with healthcare professionals in four UK hospices. Results Documentation relating to 239 new patient referrals to hospice was reviewed; and focus groups involving 22 healthcare professionals conducted. Most patients had two or more needs documented on referral (96%); and needs were recorded across two or more domains for 62%. Physical needs were recorded for 91% of patients; psychological needs were recorded for 59%. Spiritual needs were rarely documented. Referral forms were considered limited for capturing complex needs. Referrals were perceived to be influenced by the experience and confidence of the referrer and the local resource available to meet palliative care needs directly. Conclusions Complexity was hard to detail or to objectively define on referral documentation alone. It appeared to be a term used to describe patients whom primary or secondary care providers felt needed SPC knowledge or support to meet their needs. Hospices need to provide greater clarity regarding who should be referred, when and for what purpose. Education and training in palliative care for primary care nurses and doctors and hospital clinicians could reduce the need for referral and help ensure that hospices are available to those most in need of SPC input.

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