scholarly journals Married just in time: Deathbed weddings, meaning and magic

2020 ◽  
Vol 7 (1) ◽  
pp. 5
Author(s):  
Ros Taylor
Keyword(s):  
Palliative Care ◽  
Self Esteem ◽  
Palliative Care Team ◽  
Care Team ◽  
Just In Time ◽  
Healthcare Team ◽  
Advanced Illness ◽  
Cancer Centre ◽  
The Face ◽  
The Impact

Background :Brave conversations in hospital, often facilitated by the palliative care team, lead to a discovery of what really matters if time is short.Getting married turned out to be high on the agenda for many couples where one partner is facing mortality.There has been little exploration of romance and marriage in the context of advanced illness. Method:7 deathbed weddings in a tertiary cancer centre were analysed. These had taken place over a period of 2 years. Initial conversations, subsequent arrangements, the impact on the couple, and the subsequent reactions in bereavement were explored. Demographics, illness details, reasons for the marriage and logistics of the wedding were recorded Bereaved spouses were subsequently interviewed about the meaning of the wedding. Results:6/7 weddings were identified as ‘goals’ by the palliative care team On average the time from conversation to wedding was 10 days 3/7weddings took place within 1 day of the conversation Wedding outfits ranged from pyjamas to full white wedding on a hospital ward.5/7 brides/grooms died in hospital, on average 16 days after the wedding, In terms of meaning, this ranged from legal and financial reasons, to a statement of love and connection Discussion:Momentous celebrations distracted patients, relatives and healthcare team from the daily tragedy they were immersed in. The focus became one of healing not curing. Teams were uplifted, symptoms improved.The stories reinforced the idea that self-esteem and need for connection are dominant forces even in the face of death. 

Evaluating the impact of early versus late inpatient palliative care consultation for cancer patients.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6638-6638
Author(s):  
Brian Cassel ◽  
Patrick J. Coyne ◽  
Nevena Skoro ◽  
Kathleen Kerr ◽  
Egidio Del Fabbro
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Palliative Care Team ◽  
Care Team ◽  
Care Hospital ◽  
Palliative Care Consultation ◽  
Social Security Death Index ◽  
Hospital Deaths ◽  
Care Consultation ◽  
The Impact

6638 Background: Access to specialist palliative care (hospital-based or hospice) is a recognized measure of quality in cancer care. Most cancer centers do have palliative care consult services, although the availability of a comprehensive program that includes a palliative care unit and outpatient clinic (Hui 2010) is inconsistent. A simultaneous integrated model of palliative care that facilitates earlier access to a specialized palliative care team may improve clinical outcomes. Palliative care programs should measure the access, timing and impact of their clinical service. Methods: Hospital claims data were linked to Social Security Death Index (SSDI) data from the US Department of Commerce. 3,128 adult cancer patients died between January 2009 and July 2011 and had contact with our inpatient palliative care team in their last six months of life. We determined whether IPC earlier than 1 month prior to death had an impact on hospitalizations, in-hospital mortality and referral to hospice. Results: 27.5% of cancer decedents accessed IPC, median of 22 days before death. 13.2% were discharged to hospice, median of 13 days before death. Patients with IPC earlier than 1 month until death were more likely to have hospice and fewer in-hospital deaths but there was no association between early IPC and a 30-day mortality admission. Conclusions: Palliative care services are accessed by a minority of patients and typically in the last 2-3 weeks of life. Although in-hospital deaths were reduced by earlier palliative care consultation, 30 day mortality did not improve. Hospitals may need to implement other strategies including early integration of outpatient palliative care among cancer patients, to achieve an impact on 30-day mortality admissions. [Table: see text]

The benefits of a hospital palliative care team

2019 ◽  
Vol 25 (7) ◽  
pp. 345-352
Author(s):  
Federica Sganga ◽  
Christian Barillaro ◽  
Andrea Tamburrano ◽  
Nicola Nicolotti ◽  
Andrea Cambieri ◽  
...  
Keyword(s):  
Palliative Care ◽  
Length Of Stay ◽  
Average Length ◽  
Severe Heart Failure ◽  
Palliative Care Team ◽  
Care Team ◽  
Severe Illness ◽  
Hospital Death ◽  
Hospital Outcome ◽  
The Impact

Aim: To investigate the association between a hospital palliative care unit assessment and hospital outcome. Methods: This was a prospective cohort study. Data were assessed from all patients treated and followed by the hospital palliative care team (HPCT) from November 2016 until December 2017. Results: The mean age of the 588 patients was 73.15±13.6 years. All of the patients included in the study were referred to palliative care. A large proportion of patients were affected by cancer, 69.7% (410), while 30.3% (178) were affected by an advanced chronic illness. The three most frequent cancers were: gastrointestinal (n=81, 19.8%), gynaecological (n=66, 16.1%) and lung (n=63, 15.4%); the three most frequent chronic advanced diseases were: advanced dementia (n=45, 25.3%), severe ischaemic/haemorrhagic stroke (n=36, 20.2%) and severe heart failure (n=25, 15.3%). The majority of patients were in clinical wards (n=476, 81.0%) and the average length of stay was 22.9 days. Hospital outcome trends were evaluated in terms of length of stay and number of deaths that occurred in the hospital. In particular, length of stay decreased from 25.8 days to 18.1 days, hospital death from 13 to 0 during the time that the HPCT assessed patients for an appropriate discharge. Conclusion: The HPCT is an effective means of managing patients affected by severe illness, reducing the number of deaths that occur within the hospital, long periods of hospitalisation and instances of readmission. However, further studies are required to fully assess the impact of an HPCT on hospital outcomes.

scholarly journals Palliative Radiotherapy with or without Additional Care by a Multidisciplinary Palliative Care Team: A Retrospective Comparison

ISRN Oncology ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Carsten Nieder ◽  
Kent Angelo ◽  
Astrid Dalhaug ◽  
Adam Pawinski ◽  
Gro Aandahl ◽  
...  
Keyword(s):  
Palliative Care ◽  
Performance Status ◽  
Symptom Control ◽  
Palliative Radiotherapy ◽  
Palliative Care Team ◽  
Care Team ◽  
Dose Fractionation ◽  
Poor Performance Status ◽  
Pattern Of Care ◽  
The Impact

Purpose. To analyze pattern of care and survival after palliative radiotherapy (RT) in patients managed exclusively by regular oncology staff or a multidisciplinary palliative care team (MPCT) in addition. Methods. Retrospective analysis of 522 RT courses. Comparison of Two Groups: MPCT versus none. Results. We analyzed 140 RT courses (27%) with MPCT care and 382 without it. The following statistically significant differences were observed: 33% of female patients had MPCT care versus only 23% of male patients and 37% of patients <65 years had MPCT care versus only 22% of older patients. MPCT patients were more likely to have poor performance status and liver metastases. In the MPCT group steroid and opioid use was significantly more common. Dose-fractionation regimens were similar. Median survival was significantly shorter in the MPCT group, 3.9 versus 6.9 months. In multivariate analysis, MPCT care was not associated with survival. Adjusted for confounders, MPCT care reduced the likelihood of incomplete RT by 33%, P>0.05. Conclusions. Patterns of referral and care differed, for example, regarding age and medication use. It seems possible that MPCT care reduces likelihood of incomplete RT. Therefore, the impact of MPCT care on symptom control should be investigated and objective referral criteria should be developed.

scholarly journals The imPaCT study: a randomised controlled trial to evaluate a hospital palliative care team

2002 ◽  
Vol 87 (7) ◽  
pp. 733-739 ◽  
Author(s):  
G W Hanks ◽  
M Robbins ◽  
D Sharp ◽  
K Forbes ◽  
K Done ◽  
...  
Keyword(s):  
Palliative Care ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Palliative Care Team ◽  
Care Team ◽  
Impact Study ◽  
Randomised Controlled ◽  
The Impact

scholarly journals Added Value of Early Consultation of an Inpatient Palliative Care Team in Hospitalized Older Patients With High Symptom Burden: A Prospective Comparative Study

2020 ◽  
pp. 104990912098260
Author(s):  
Myrthe W. Naaktgeboren ◽  
Fabienne J. H. Magdelijns ◽  
Daisy J. A. Janssen ◽  
Marieke H. J. van den Beuken-van Everdingen
Keyword(s):  
Palliative Care ◽  
Older Patients ◽  
Symptom Burden ◽  
Palliative Care Team ◽  
Care Team ◽  
Added Value ◽  
Symptom Improvement ◽  
Period 2 ◽  
The Impact

Background: It is estimated that in 2050 one quarter of the population in Europe will be aged 65 years and older. Although the added value of a palliative care team is emphasized in the literature, the impact of the palliative care team on the symptom burden in older non-cancer patients is not yet well established. Objectives: To structurally measure symptoms and to investigate whether proactive consultation with a palliative care team results in improvement of symptoms. Design: This study has a prospective comparative design. Setting/Participants: Older patients, admitted to a Dutch University Medical Centre for who a health care professional had a negative response to the Surprise Question, were selected. Measurements, Results: In period one, 59 patients completed the Utrecht Symptom Diary (USD) at day one of admission and after 7 days. In period 2 (n = 60), the same procedure was followed; additionally, the palliative care team was consulted for patients with high USD-scores. Significant improvement on the USD Total Distress Score (TSDS) was observed in both groups without a difference between the 2 periods. This study showed an association between consultation of the palliative care team and improvement on USD TSDS (adjusted odds ratio: 4.9; 95% confidence interval: 1.816-13.198), despite low follow-up rate of advices (approximately 50%). Conclusions: This study emphasizes the importance of creating awareness for consulting the palliative care team. Further research should focus on assessing the reason behind the low follow-up rate of the advice given and understanding the specific advices contributing to symptom improvement.

scholarly journals The impact of and response to the COVID-19 pandemic on a hospital palliative care team

2021 ◽  
Vol 8 (1) ◽  
pp. 62-64
Author(s):  
Polly M Edmonds ◽  
Katherine E Sleeman ◽  
Natasha Lovell ◽  
Rosemary Chester ◽  
Richard P Towers ◽  
...  
Keyword(s):  
Palliative Care ◽  
Palliative Care Team ◽  
Care Team ◽  
The Impact

Impact of timing of palliative care team consults in patients with advanced cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18182-e18182
Author(s):  
Thomas Bemis ◽  
Praneeth Baratam ◽  
Dawn Seiders ◽  
Kristine Marie Ward ◽  
Michael Styler
Keyword(s):  
Palliative Care ◽  
Advanced Cancer ◽  
Cancer Diagnosis ◽  
Average Cost ◽  
Cost Savings ◽  
Palliative Care Team ◽  
Care Team ◽  
For Profit ◽  
Chi Square Analysis ◽  
The Impact

e18182 Background: The 2018 ASCO palliative care guidelines recommend palliative care team (PCT) involvement within 8 weeks for patients with an advanced cancer diagnosis. However, the optimal timing of PCT consults in the inpatient setting has not been established. We investigated whether early PCT involvement for in-patients with an advanced cancer diagnosis affected discharge outcomes. Methods: We queried the Hahnemann University Hospital’s Palliative Care In-patient database between 2015 and 2018 for patients with advanced cancer and an estimated life expectancy of < 6 months. Dates of admission, initial PCT consult and discharge were examined. PCT consults within 7 days of admission were defined as early consults and those > 7 days as late consults. Chi square analysis was used to determine differences in LOS and time from PCT consult to discharge between the two groups. Cost-savings estimates were based on the Kaiser State Health Facts, which list an average cost per inpatient day in US hospitals of $2,289 in nonprofit and $1,791 in for-profit hospitals. Results: The majority of cases (69.7%) had PCT involvement < 7 days from admission and were associated with an overall shorter LOS of 12 days compared to 30 days with consults called > 7 days (p = < 0.001). Furthermore, early PCT involvement led to a 2-day shorter time to discharge (p = < 0.02) for an average cost-savings of at least $4,578 at a non-profit hospital and $3,582 at a for-profit hospital. Conclusions: Our findings show that the majority of patients at our institution with advanced cancer had early PCT involvement, which was associated with reduced hospital length of stay. These findings suggest that PCT involvement may expedite hospital discharge and by extension lead to increased cost-savings and patient quality of life. Future studies will aim to investigate the impact of early PCT involvement on hospital readmission rates and discharge to hospice care among other indicators of improved patient well-being.[Table: see text]

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