Integrated Rapid Discharge Planning for palliative patients and their families/carers when a patient expresses a wish to die in their home environment

Purpose Miniaturization of digital technologies has created new opportunities for remote health care and neuroscientific fieldwork. The current study assesses comparisons between in-home auditory brainstem response (ABR) recordings and recordings obtained in a traditional lab setting. Method Click-evoked and speech-evoked ABRs were recorded in 12 normal-hearing, young adult participants over three test sessions in (a) a shielded sound booth within a research lab, (b) a simulated home environment, and (c) the research lab once more. The same single-family house was used for all home testing. Results Analyses of ABR latencies, a common clinical metric, showed high repeatability between the home and lab environments across both the click-evoked and speech-evoked ABRs. Like ABR latencies, response consistency and signal-to-noise ratio (SNR) were robust both in the lab and in the home and did not show significant differences between locations, although variability between the home and lab was higher than latencies, with two participants influencing this lower repeatability between locations. Response consistency and SNR also patterned together, with a trend for higher SNRs to pair with more consistent responses in both the home and lab environments. Conclusions Our findings demonstrate the feasibility of obtaining high-quality ABR recordings within a simulated home environment that closely approximate those recorded in a more traditional recording environment. This line of work may open doors to greater accessibility to underserved clinical and research populations.

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Understanding Why Older People Develop a Wish to Die

Crisis ◽

10.1027/0227-5910/a000078 ◽

2011 ◽

Vol 32 (4) ◽

pp. 204-216 ◽

Cited By ~ 52

Author(s):

M. L. Rurup ◽

H. R. W. Pasman ◽

J. Goedhart ◽

D. J. H. Deeg ◽

A. J. F. M. Kerkhof ◽

...

Keyword(s):

Older People ◽

Cohort Studies ◽

Conceptual Framework ◽

Life Events ◽

Traumatic Life Events ◽

Quantitative Studies ◽

Wish To Die ◽

Open Coding ◽

Death Wishes ◽

Depth Interviews

Background: Quantitative studies in several European countries showed that 10–20% of older people have or have had a wish to die. Aims: To improve our understanding of why some older people develop a wish to die. Methods: In-depth interviews with people with a wish to die (n = 31) were carried out. Through open coding and inductive analysis, we developed a conceptual framework to describe the development of death wishes. Respondents were selected from two cohort studies. Results: The wish to die had either been triggered suddenly after traumatic life events or had developed gradually after a life full of adversity, as a consequence of aging or illness, or after recurring depression. The respondents were in a situation they considered unacceptable, yet they felt they had no control to change their situation and thus progressively “gave up” trying. Recurring themes included being widowed, feeling lonely, being a victim, being dependent, and wanting to be useful. Developing thoughts about death as a positive thing or a release from problems seemed to them like a way to reclaim control. Conclusions: People who wish to die originally develop thoughts about death as a positive solution to life events or to an adverse situation, and eventually reach a balance of the wish to live and to die.

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Fatality of Suicide Attempts in Amsterdam 1996–2005

Crisis ◽

10.1027/0227-5910.30.4.180 ◽

2009 ◽

Vol 30 (4) ◽

pp. 180-185 ◽

Cited By ~ 10

Author(s):

Evertjan Jansen ◽

Marcel C.A. Buster ◽

Annemarie L. Zuur ◽

Cees Das

Keyword(s):

Health Service ◽

Time Trends ◽

Suicide Attempts ◽

Preventive Measures ◽

Case Fatality ◽

Absolute Number ◽

Demographic Differences ◽

Demographic Groups ◽

Wish To Die ◽

Municipal Health

Background: According to recent figures, Amsterdam is the municipality with the highest absolute number of suicides and the second highest suicide rate in the Netherlands. Aims: The aim of the study was to identify time trends and demographic differences in the occurrence of nonfatal suicide attempts versus suicides. Methods: We used registrations of forensic physicians and ambulance services of the Municipal Health Service of Amsterdam to study 1,004 suicides and 6,166 nonfatal attempts occurring in Amsterdam over the period 1996–2005. Results: The number of nonfatal attempts declined from 1996 to 2005, but the number of completed suicides remained relatively stable. Although case fatality was strongly associated with method used, we also found higher case fatalities for men and older people independent of method. Conclusions: The case fatality results suggest differences in motive among different demographic groups: possibly the wish to die is stronger among men and elderly. This finding had implications for the success to be expected from different preventive measures.

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