Facing Dementia: Integrating Palliation Into All Aspects of Care

2013 ◽  
Vol 19 (1) ◽  
pp. 12-15
Author(s):  
Allison S. Kostrzewa

Dementia is fast becoming a serious public health concern. The lack of understanding of the terminal nature of dementia frequently results in overly aggressive treatment during the end stage of the disease. Nurses need to recognize and encourage a paradigm shift in the way dementia is perceived and treated, including promoting early initiation of palliative care services.

2017 ◽  
Vol 152 (5) ◽  
pp. S1192
Author(s):  
James Philip Esteban ◽  
Lisa Rein ◽  
Aniko Szabo ◽  
Kia Saeian ◽  
Sean Marks

2005 ◽  
Vol 3 (1) ◽  
pp. 5-14 ◽  
Author(s):  
CAROL GRBICH ◽  
IAN MADDOCKS ◽  
DEBORAH PARKER ◽  
MARGARET BROWN ◽  
EILEEN WILLIS ◽  
...  

Objective: To identify criteria for measuring the eligibility of patients with end-stage noncancer diseases for palliative care services in Australian residential aged care facilities.Methods: No validated set if guidelines were available so five instruments were used: an adaptation of the American National Hospice Association Guidelines; a recent adaptation of the Karnofsky Performance Scale; the Modified Barthel Index; the Abbey Pain Score for assessment of people who are nonverbal and a Verbal Descriptor Scale, also for pain measurement. In addition, nutritional status and the presence of other problematic symptoms and their severity were also sought.Results: The adapted American National Hospice Association Guidelines provided an initial indicative framework and the other instruments were useful in providing confirmatory data for service eligibility and delivery.


2013 ◽  
Vol 2 (2) ◽  
pp. 5-15
Author(s):  
Riawati Jahja

Trials have demonstrated improvement in patients’ quality of life through palliative care services (PCS). However, many of these trials are limited by their research methodologies. PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched to conduct a systematic review of review articles related to PCS from January 2001 to December 2011. The paper examined evidence from studies on PCS that aimed to improve elderly patients’ end-of-life outcomes by i) systematically reviewing literature on models of palliative care (PC) delivery patients received; ii) exploring methodological issues surrounding recruitment of the patients, implementation of the studies and comparison of health care services; and iii) addressing the costs of care with/without a palliative program. Seventeen trials and three observational studies were selected from nine systematic review articles. Overall, early introduction of PC to patients following identification of their life-limiting conditions and needs re-quires an organized and coordinated care approach to ensure accessibility of these services. The ideal system that offers the potential of improving patients’ quality of life is one that is integrated, interdisciplinary and holistic. Dying is commonly institutionalized; however, providing outreach programs that allow patients to die at their place of wish, such as domiciliary care, offers the potential of addressing the issue of ever-increasing health-care expenditure for the aged. However, further investigation is needed to evaluate the cost effectiveness of these programs. Methodological problems and ethical issues surrounding the study of terminally-ill patients necessitate that researchers use a combination of observational studies and surveillance system over time. DOI: http://dx.doi.org/10.3329/seajph.v2i2.15937 South East Asia J Public Health | Jul-Dec 2012 | Vol 2 Issue 2 | 5-15


2012 ◽  
Vol 23 (2) ◽  
pp. 147-155 ◽  
Author(s):  
Allison Kabel

The popularity of British hospice day care signals the expanding boundaries of palliative care beyond end-stage illness. In this article, I examine the ways hospice philosophy was interpreted and implemented in an outpatient day therapy setting run by a multidisciplinary team of health professionals. Findings suggest that hospice day care staff members used several strategies to help patients cope and retain a sense of personhood while facing numerous emotional and physical challenges associated with life-threatening illness. Health professionals in the United States will need to prepare for patients accessing hospice and palliative care services earlier in the illness trajectory to take advantage of these opportunities for patient support and advocacy.


This chapter describes the issues associated with providing palliative care to patients with renal failure, and covers initiation of renal replacement therapy, conservative treatment, symptom management for patients with advanced renal disease, and issues surrounding stopping renal replacement therapy. As obesity and diabetes increase, so does the incidence of chronic renal disease and end-stage renal failure. Determining the exact number of patients dying of renal failure is challenging. Often the cause of death will be ascribed to an associated contributing factor, e.g. diabetes mellitus, or the final acute event resulting in death, e.g. myocardial infarction. However, we know that renal failure is an independent risk factor for cardiovascular disease and is associated with a high all-cause mortality.1 In addition, patients with end-stage renal failure have a significant symptom burden and therefore it is important that patients have access to palliative care services to assist with symptom management, advanced care planning, and, where appropriate, decisions around dialysis and transplantation.


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