Nutrition and artificial hydration at the end of life – useful recommandations in palliative care practice

Medic ro ◽  
2018 ◽  
Vol 6 (126) ◽  
pp. 51
Author(s):  
Anca Raluca Vrânceanu ◽  
Gema Băcăoanu ◽  
Mihaela Boancă ◽  
Laurenţiu Simion ◽  
Claudia Cristina Tărniceriu ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Care Practice

scholarly journals The public health end-of-life care movement: history, principles, and styles of practice

2018 ◽  
Author(s):  
Aliki Karapliagou ◽  
Allan Kellehear ◽  
Klaus Wegleitner
Keyword(s):  
Public Health ◽  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Psychosocial Care ◽  
Care Practice ◽  
Life Care ◽  
The Public ◽  
Civic Practice ◽  
Practice Methods

This chapter briefly outlines the history, key concepts, and main practice methods from public health approaches to end-of-life care. Although linked to psychosocial care approaches, its main methods draw not from psychology or health services inspired approaches but rather from health promotion, community development, and civic engagement. Key methods covered include community volunteering, social networking, community engagement, and compassionate communities and cities. The aim of these kinds of approaches is to embed palliative care practice as a social and civic practice in all sectors of society and to ensure that palliative care as a policy is represented in all civic policies (e.g. schools, workplaces, faith groups, and cultural activities) and not solely in health care.

scholarly journals Caregiving at the margins: An ethnographic exploration of family caregivers experiences providing care for structurally vulnerable populations at the end-of-life

2020 ◽  
Vol 34 (7) ◽  
pp. 946-953 ◽  
Author(s):  
Kelli I Stajduhar ◽  
Melissa Giesbrecht ◽  
Ashley Mollison ◽  
Naheed Dosani ◽  
Ryan McNeil
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Family Caregivers ◽  
Family Caregiving ◽  
Transitional Housing ◽  
Mental Health Stigma ◽  
Care Practice ◽  
Structural Vulnerability ◽  
Structured Interviews ◽  
Care Models

Background: People experiencing structural vulnerability (e.g. homelessness, poverty, racism, criminalization of illicit drug use and mental health stigma) face significant barriers to accessing care at the end-of-life. ‘Family’ caregivers have the potential to play critical roles in providing care to these populations, yet little is known regarding ‘who’ caregivers are in this context and what their experiences may be. Aim: To describe family caregiving in the context of structural vulnerability, to understand who these caregivers are, and the unique challenges, burdens and barriers they face. Design: Critical ethnography. Setting/participants: Twenty-five family caregivers participated. Observational fieldnotes and semi-structured interviews were conducted in home, shelter, transitional housing, clinic, hospital, palliative care unit, community-based service centre and outdoor settings. Results: Family caregivers were found to be living within the constraints of structural vulnerability themselves, with almost half being street family or friends. The type of care provided varied greatly and included tasks associated with meeting the needs of basic survival (e.g. finding food and shelter). Thematic analysis revealed three core themes regarding experiences: Caregiving in the context of (1) poverty and substance use; (2) housing instability and (3) challenging relationships. Conclusion: Findings offer novel insight into the experiences of family caregiving in the context of structural vulnerability. Engaging with family caregivers emerged as a missing and necessary palliative care practice, confirming the need to re-evaluate palliative care models and acknowledge issues of trust to create culturally relevant approaches for successful interventions. More research examining how ‘family’ is defined in this context is needed.

scholarly journals Development of Bespoke and Sustainable 2-Day Cancer, Palliative, End of Life, and Bereavement Care Educational Workshops for Health Care Professionals in Nigeria

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 173s-173s
Author(s):  
A.A.F. Simon-Hart ◽  
N.A. Adekeye ◽  
L. Atter ◽  
S. Cost ◽  
J. Siddall
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
End Of Life ◽  
Health Care Professionals ◽  
Best Practice ◽  
Care Practice ◽  
Cancer Awareness ◽  
Cancer Support ◽  
The Uk ◽  
Bereavement Care

In Nigeria there is a consensus that in-country cancer services lack strategy, focus and coordination of care. This is magnified by poverty and by cultural and religious issues, resulting in the majority of patients presenting late and deemed palliative at the time of diagnosis. The Bricon Foundation, a Nigerian nongovernmental organization joined forces with Macmillan Cancer Support, a well-known established UK cancer charity to design an interactive teaching package for Nigerian health care professionals. The aim of the workshops was to share best practice in basic cancer, palliative and end of life care including bereavement support. The project concentrated on facilitating open discussions among Nigerian health care professionals about these topics including communication challenges and how to take care of themselves. The four two-day workshops were designed to identify challenges and obstacles health care professionals faced in delivering cancer and palliative care in Nigeria. They empowered participants to realize their own potential in improving the cancer experience for the patients and themselves. The cancer sessions were adapted from Macmillan cancer awareness materials that have been well evaluated in the UK. Additionally, the team developed a palliative, end of life and bereavement care study day as day two of the workshops to give participants a basic holistic overview. A team of Macmillan Alumni volunteers traveled to Nigeria to work with The Bricon Foundation team in delivering this training, which had sponsorship from NNPC, Total EPNL and partners. After each day participants completed an evaluation form. This enabled the team to adapt subsequent presentations to the Nigerian context using the feedback. The training was delivered to 91 participants from 26 government and private facilities with all 4 workshops evaluating positively. Attendees specifically valued the group work as it facilitated an exchange of ideas ensuring their voice was heard. Most expediently we were able to identify professionals drawn from different areas of healthcare who are interested in delivering future sessions on a regular basis keeping education at the forefront of cancer, palliative care and health care practice development. With further educational sessions anticipated in the near future, evaluation is on-going.

End-of-life Care of Aboriginal Peoples in Remote Locations: Language Issues

2007 ◽  
Vol 13 (1) ◽  
pp. 18 ◽  
Author(s):  
Pam McGrath ◽  
Hamish Holewa
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Research Literature ◽  
Aboriginal Peoples ◽  
Care Practice ◽  
Life Care ◽  
Language Groups ◽  
The Impact ◽  
Published Research

To date, there is scant research literature that explores the provision of end-of-life care to Aboriginal peoples in Australia. In particular, there is a lack of published research available on issues at the interface of Aboriginal languages and English during palliative care. The complexity and importance of the issue for palliative care provision, however, is demonstrated by the fact that in Australia, Aboriginality is itself a very broad category, containing many distinct language groups and subcultures. Thus, although to date there is some mention of the problems associated with language in the literature, there is scant research on the topic of the provision of palliative care to Aboriginal peoples in remote areas. The following findings from a recent two-year National Health and Medical Research Council (NHMRC) study are provided to address this hiatus. The findings provide insights on the impact of language difference on palliative care practice for Aboriginal peoples in the Northern Territory of Australia.

scholarly journals Emergency Department Referral for Hospice and Palliative Care Differs among Patients with Different End-of-Life Trajectories: A Retrospective Cohort Study

2021 ◽  
Vol 18 (12) ◽  
pp. 6286
Author(s):  
Victor Wei-Che Shen ◽  
Che Yang ◽  
Li-Ling Lai ◽  
Ying-Ju Chen ◽  
Hsien-Hao Huang ◽  
...  
Keyword(s):  
Emergency Department ◽  
Palliative Care ◽  
Organ Failure ◽  
End Of Life ◽  
Care Practice ◽  
Care Needs ◽  
Life Trajectories ◽  
Emergency Units ◽  
Hospice And Palliative Care ◽  
Palliative Care Needs

Emergency units have been gradually recognized as important settings for palliative care initiation, but require precise palliative care assessments. Patients with different illness trajectories are found to differ in palliative care referrals outside emergency unit settings. Understanding how illness trajectories associate with patient traits in the emergency department may aid assessment of palliative care needs. This study aims to investigate the timing and acceptance of palliative referral in the emergency department among patients with different end-of-life trajectories. Participants were classified into three end-of-life trajectories (terminal, frailty, organ failure). Timing of referral was determined by the interval between the date of referral and the date of death, and acceptance of palliative care was recorded among participants eligible for palliative care. Terminal patients had the highest acceptance of palliative care (61.4%), followed by those with organ failure (53.4%) and patients with frailty (50.1%) (p = 0.003). Terminal patients were more susceptible to late and very late referrals (47.4% and 27.1%, respectively) than those with frailty (34.0%, 21.2%) and with organ failure (30.1%, 18.8%) (p < 0.001, p = 0.022). In summary, patients with different end-of-life trajectories display different palliative care referral and acceptance patterns. Acknowledgement of these characteristics may improve palliative care practice in the emergency department.

Much Ado About Fried Chicken: Abetting Aspiration or Respecting Autonomy?

2019 ◽  
Vol 28 (3) ◽  
pp. 1356-1362
Author(s):  
Laurence Tan Lean Chin ◽  
Yu Jun Lim ◽  
Wan Ling Choo
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Multidisciplinary Team ◽  
Biopsychosocial Model ◽  
Family Members ◽  
Clinical Decisions ◽  
Goals Of Care ◽  
Complex Needs ◽  
Aspiration Risk ◽  
Patient Centric

Purpose Palliative care is a philosophy of care that encompasses holistic, patient-centric care involving patients and their family members and loved ones. Palliative care patients often have complex needs. A common challenge in managing patients near their end of life is the complexity of navigating clinical decisions and finding achievable and realistic goals of care that are in line with the values and wishes of patients. This often results in differing opinions and conflicts within the multidisciplinary team. Conclusion This article describes a tool derived from the biopsychosocial model and the 4-quadrant ethical model. The authors describe the use of this tool in managing a patient who wishes to have fried chicken despite aspiration risk and how this tool was used to encourage discussions and reduce conflict and distress within the multidisciplinary team.

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