Final Acts: The End of Life: Hospice and Palliative Care

10.2190/fat ◽  
2013 ◽  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Hospice And Palliative Care

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.

Improving the Quality of Care across All Settings

2019 ◽  
pp. 573-605
Author(s):  
Marilyn Bookbinder ◽  
Romina Arceo ◽  
James T. McDaniel
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
The United States ◽  
Healthcare Settings ◽  
National Priority ◽  
Hospice And Palliative Care ◽  
Eol Care ◽  
Clinician Assessment ◽  
Care Path

This chapter provides perspectives on quality-based initiatives in the United States across healthcare settings and populations and describes their impact on patient, professional, and system outcomes. The authors discuss the need for quality improvement (QI) at end of life, QI principles, and the models, methods, and tools most frequently used. Also described are areas of national priority for improving end-of-life (EOL) care. A care-path for the end of life is used to illustrate a QI effort and the FOCUS_PDSA method and to encourage use of specific tools for improving EOL care, including respiratory distress, and a clinician assessment of EOL care using The Joint Commission (TJC) tracer methodology. The authors review the linkages between QI and practice changes in hospitals and hospices that ultimately lead to improved EOL care and close with examples of how nurses are providing leadership in the field of quality hospice and palliative care.

Managing Cardiac Devices Near the End of Life: A Survey of Hospice and Palliative Care Providers

2010 ◽  
Vol 27 (8) ◽  
pp. 545-551 ◽  
Author(s):  
Laura J. Morrison ◽  
Amy O. Calvin ◽  
Hope Nora ◽  
C. Porter Storey
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Care Providers ◽  
Cardiac Devices ◽  
Hospice And Palliative Care

scholarly journals Masculinity and Military Culture in VA Hospice and Palliative Care: A Narrative Review With Clinical Recommendations

2019 ◽  
Vol 35 (2) ◽  
pp. 120-126
Author(s):  
Evan Plys ◽  
Ronald Smith ◽  
M. Lindsey Jacobs
Keyword(s):  
Mental Health ◽  
Palliative Care ◽  
End Of Life ◽  
Mental Health Treatment ◽  
Military Culture ◽  
Family Roles ◽  
Clinical Recommendations ◽  
Male Veterans ◽  
Hospice And Palliative Care ◽  
The Impact

This article examines the intersection between masculinity, military culture, and hospice and palliative care (HPC). The authors conducted a narrative literature review, supplemented with clinical annotations, to identify the impact of masculinity and military culture on the following topics salient to end-of-life care with older male veterans: pain management, mental health, coping, communication, autonomy and respect, and family roles. Findings suggest that traits associated with masculinity and military culture have an influence on the end-of-life process and HPC for older male veterans. Specifically, results suggest that older male veterans may deny or minimize physical pain, decline mental health treatment, utilize maladaptive coping strategies, avoid emotional conversations, struggle to manage perceived shifts in autonomy, and experience challenges negotiating changing family roles. The authors provide clinical recommendations for providers across various disciplines to address the aforementioned concerns with older male veterans in HPC. Overall, information presented in this article may be an important contribution to the literature for building cultural competencies with older male veterans and has the potential to improve the delivery of HPC for veterans and their families.

Opportunities for improved end-of-life (EOL) care for adult patients with advanced cancer: Results of a longitudinal assessment of care provided by Quality Oncology Practice Initiative (QOPI) participants.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9537-9537
Author(s):  
David W. Dougherty ◽  
Pamela Kadlubek ◽  
Trang Pham ◽  
Craig Earle ◽  
Jennifer Malin ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Advanced Cancer ◽  
Care Quality ◽  
Adult Patients ◽  
Trend Test ◽  
Chemotherapy Administration ◽  
Hospice And Palliative Care ◽  
Eol Care ◽  
Over Time

9537 Background: End of life care of patients with advanced cancer has received recent attention because of evidence of widespread variation in utilization of aggressive therapies and interventions and possible suboptimal use of palliative care and hospice services. QOPI, the ASCO sponsored quality assessment program, has been available to all United States physician members since January 2006 and has assessed EOL care since its inception. The current analysis explores whether the increased national focus on EOL and increased availability of palliative care and hospice services has resulted in improvements in EOL care as reported by QOPI participants. Methods: Data was aggregated across all EOL care quality measures for 9 sequential semi-annual QOPI collection periods from 2008 through 2012. Trends were analyzed among rates of eligible patients related to hospice enrollment and timing of enrollment, palliative care referrals, discussions about hospice and palliative care, and chemotherapy administration at the end of life. The Cochran-Armitage trend test was performed to determine the significance of trends and differences in measure performance over time. Results: From Fall 2008 to Fall 2012, the rate of hospice enrollment for appropriate patients improved by 7.4% [51.8% to 59.2%; p<0.0001] and the rate of hospice enrollment or palliative care referral improved by 5.6% [63.3% to 68.9%; p<0.0001]. Modest improvements were seen in the rates of hospice enrollment more than 3 and 7 days before death [2.8%, 2.6%], discussion of hospice or palliative care with patients not referred for these services within the last 2 months of life [2.7% increase; 19% to 21.7%], and chemotherapy administration within the last 2 weeks of life [2.4% improvement from 13.7% to 11.3%]. Conclusions: Despite modest increases in the rate of hospice enrollment and palliative care referrals over time, EOL care for adult patients with cancer associated with QOPI practices remains suboptimal. Opportunities exist to increase more meaningful participation in hospice and palliative care and to reduce exposure to chemotherapy near death.

Cicely Saunders

2018 ◽  
Author(s):  
David Clark
Keyword(s):  
Twentieth Century ◽  
Palliative Care ◽  
End Of Life ◽  
Advanced Disease ◽  
Professional Life ◽  
The World ◽  
The Face ◽  
The Individual ◽  
Hospice And Palliative Care ◽  
First Time

Cicely Saunders founded St Christopher’s Hospice in London in 1967 as a centre for teaching, research, and care. Its influence quickly spread around the world. Cicely Saunders — A Life and Legacy shows how she played a crucial role in shaping a new discourse of care at the end of life. From the nihilism of ‘there is nothing more we can do’, medicine and healthcare gradually adopted a more purposeful approach to care in the face of advanced disease and at the end of life. This came to be known as palliative care. This biography links for the first time the ideas and practice of Cicely Saunders to the spreading global interest in hospice and palliative care. It explores her deep reflection on the nature of suffering at the end of life, the possibilities of a more informed approach to the medical management of pain and other symptoms, and above all the importance of remaining focussed on the personal and spiritual concerns of the individual patient as death approaches. It is a story of a remarkable personal and professional life and of a seismic shift in twentieth-century medical history.

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