scholarly journals Home Based Palliative Care

2021 ◽  
Author(s):  
Sourav Goswami
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Psychosocial Support ◽  
Symptom Control ◽  
Family Members ◽  
Care Needs ◽  
Care Services ◽  
Home Based ◽  
The Family ◽  
Health Related

Palliative care aims at improving the quality of life of a patient who is suffering from a chronic serious ailment like that of advanced cancer. Nobody wants to be away from his/her own family, especially when it’s known, he has limited days to live in this world. A patient gets the best treatment when it’s given in his own home and that too by his close ones. When palliative care is provided at the patient’s home, it provides a sense of safety, privacy, confidentiality and peace of mind for the patient. Specialist home-based palliative care improves symptom control, health-related communication and psychosocial support. It helps in better preparing the patient and the family members to accept death. It is provided by a team of trained members which includes doctor, nurse, social worker, volunteers, physiotherapist etc. They pay regular visits at the home of the patient and provide necessary health care to the patient. Considering the increasing cost of treatment of chronic illnesses, it’s sometimes hard on the part of the family to continue treatment in a hospital or hospice. It’s especially true in scenarios where population are not protected financially, in countries like India. The family members also play a vital role in home-based palliative care. They get trained from the team to learn the basics of palliation. Home based palliative care needs to be integrated into regular home health care services.

scholarly journals Development of a model of Home-based Cancer Palliative Care Services in Mumbai - Analysis of Real-world Research Data over 5 Years

2021 ◽  
Vol 0 ◽  
pp. 1-31
Author(s):  
Sunil Rameshchandra Dhiliwal ◽  
Arunangshu Ghoshal ◽  
Manjiri Pushpak Dighe ◽  
Anuja Damani ◽  
Jayita Deodhar ◽  
...  
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Symptom Management ◽  
Symptom Control ◽  
Care Process ◽  
Model Of Care ◽  
Patient Assessment ◽  
Care Services ◽  
Home Based ◽  
Management Protocol

Objectives: Patients needing palliative care prefer to be cared for in the comfort of their homes. Although private home health-care services are entering the health-care ecosystem in India, for the majority it is still institution-based. Here, we describe a model of home-based palliative care developed by the Tata Memorial Hospital, a government tertiary care cancer hospital. Materials and Methods: Data on patient demographics, services provided and outcomes were collected prospectively for patients for the year November 2013 - October 2019. In the 1st year, local general physicians were trained in palliative care principles, bereavement services and out of hours telephone support were provided. In the 2nd year, data from 1st year were analysed and discussed among the study investigators to introduce changes. In the 3rd year, the updated patient assessment forms were implemented in practice. In the 4th year, the symptom management protocol was implemented. In the 5th and 6th year, updated process of patient assessment data and symptom management protocol was implemented as a complete model of care. Results: During the 6 years, 250 patients were recruited, all suffering from advanced cancer. Home care led to good symptom control, improvement of quality of life for patients and increased satisfaction of caregivers during the care process and into bereavement. Conclusion: A home-based model of care spared patients from unnecessary hospital visits and was successful in providing client centred care. A multidisciplinary team composition allowed for holistic care and can serve as a model for building palliative care capacity in low- and middle-income countries.

Nursing patients with palliative care needs

2009 ◽  
pp. 861-884
Keyword(s):  
Palliative Care ◽  
Hospice Care ◽  
Psychological Symptoms ◽  
Symptom Control ◽  
Nausea And Vomiting ◽  
Care Needs ◽  
Appetite Loss ◽  
The Family ◽  
Control Pain ◽  
Palliative Care Needs

Principles of palliative care 862 Hospice care 863 Palliative care interventions 864 The importance of the family in palliative care 868 Symptom control: overview 870 Symptom control: pain 872 Symptom control: appetite loss 875 Symptom control: nausea and vomiting 876 Symptom control: psychological symptoms 878...

Rural Palliative Care

2019 ◽  
pp. 670-681
Author(s):  
Richard A. Taylor ◽  
J. Nicholas Dionne-Odom ◽  
Erin R. Currie ◽  
Macy Stockdill ◽  
Marie A. Bakitas
Keyword(s):  
Palliative Care ◽  
Nurse Practitioners ◽  
Rural Areas ◽  
Health Workers ◽  
Symptom Control ◽  
Care Needs ◽  
Web Based ◽  
Care Services ◽  
Palliative Care Services ◽  
Care Training

Access to palliative care remains challenging to those living in rural areas across the globe. This disparity of care leaves many without critically important palliative care services across their illness trajectory, especially in its final stages. Creative strategies to meet the palliative care needs of rural patients such as telehealth, videoconferencing specialists’ consultation, and web-based resources exist. Using these strategies where available can address some palliative care disparities and access to care in rural areas that were previously absent. Developing clinical capacity of rural clinicians through enhanced education in primary palliative care in training programs, expanding services with the use of nurse practitioners, and using palliative care–trained community lay health workers are also strategies to improve access. Additionally, by developing rural hospital providers’ knowledge and skills to provide primary palliative care in tasks such as establishing care goals, communication, and basic symptom control may prevent many transfers to academic centers miles away. Through ongoing education and primary palliative care training and innovations in bringing specialty care to rural areas, “palliative care everywhere” will soon be a reality.

scholarly journals A novel care guide for personalised palliative care – a national initiative for improved quality of care

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Dröfn Birgisdóttir ◽  
Anette Duarte ◽  
Anna Dahlman ◽  
Bengt Sallerfors ◽  
Birgit H. Rasmussen ◽  
...  
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Professionals ◽  
Care Needs ◽  
Comprehensive Overview ◽  
Pilot Studies ◽  
Early Palliative Care ◽  
The Family ◽  
Palliative Care Needs

Abstract Background Even when palliative care is an integrated part of the healthcare system, the quality is still substandard for many patients and often initiated too late. There is a lack of structured guidelines for identifying and caring for patients; in particular for those with early palliative care needs. A care guide can act as a compass for best practice and support the care of patients throughout their palliative trajectory. Such a guide should both meet the needs of health care professionals and patients and families, facilitating discussion around end-of-life decision-making and enabling them to plan for the remaining time in life. The aim of this article is to describe the development and pilot testing of a novel Swedish palliative care guide. Methods The Swedish Palliative Care Guide (S-PCG) was developed according to the Medical Research Council framework and based on national and international guidelines for good palliative care. An interdisciplinary national advisory committee of over 90 health care professionals together with patient, family and public representatives were engaged in the process. The feasibility was tested in three pilot studies in different care settings. Results After extensive multi-unit and interprofessional testing and evaluation, the S-PCG contains three parts that can be used independently to identify, assess, address, follow up, and document the individual symptoms and care-needs throughout the whole palliative care trajectory. The S-PCG can provide a comprehensive overview and shared understanding of the patients’ needs and possibilities for ensuring optimal quality of life, the family included. Conclusions Based on broad professional cooperation, patients and family participation and clinical testing, the S-PCG provides unique interprofessional guidance for assessment and holistic care of patients with palliative care needs, promotes support to the family, and when properly used supports high-quality personalised palliative care throughout the palliative trajectory. Future steps for the S-PCG, entails scientific evaluation of the clinical impact and effect of S-PCG in different care settings – including implementation, patient and family outcomes, and experiences of patient, family and personnel.

scholarly journals Modified Palliation in Cancer Patients during COVID-19 Pandemic

2020 ◽  
Vol 4 (1) ◽  
pp. 8-10
Author(s):  
Bhawna Wagle ◽  
Eliza Koirala
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Services ◽  
Psychosocial Support ◽  
Virus Disease ◽  
Vulnerable Groups ◽  
Early Palliative Care ◽  
Health Delivery ◽  
Care Services ◽  
Demand For Health

Corona virus disease 2019 (COVID 19) has put huge challenge to the health delivery system all across the globe. The risk of mortality due to COVID 19 is highest on critically ill patients and those with preexisting disease. Palliative and end of life care are no exceptions to the surge in increased demand for health care services. It is now an essential part of global health care. The benefits of early palliative care are already well established. In the pandemic like this, we must not pull back the services, particularly in these vulnerable groups. It is important to determine how best to deliver palliative care during this crisis. It may include preparedness to shift the focus of resources to community level and the innovative use of telemedicine. Use of telemedicine is to ease patients and minimize caregiver distress, and to prevent hospitalizations. The fear of contracting COVID-19 and the emotional burden during diagnosis requires the need of continuous psychosocial support. These challenges should be handled by specialized and skilled interdisciplinary palliative care team.

Family experiences of oncological palliative and supportive care in children: can we do better?

2019 ◽  
Vol 25 (9) ◽  
pp. 421-430
Author(s):  
Jan Plessis ◽  
David Stones ◽  
Michelle Meiring
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
Healthcare Professionals ◽  
Psychosocial Support ◽  
Family Members ◽  
Hospital Setting ◽  
Structured Interview ◽  
Theory Approach ◽  
Children With Cancer ◽  
Care Services

Aims: Families were interviewed as a quality improvement assessment for palliative and supportive care services for children. Methods: This exploratory qualitative study of family members of children with cancer was conducted at an academic hospital in central South Africa and a grounded theory approach was used. Face-to-face interviews using a semi-structured interview guide were conducted with 16 family members of 16 children. Findings: Parents felt supported by the healthcare professionals who were caring for their child, but several shortcomings were identified. These included erratic psychosocial support, minimal financial support and poor parental access to basic needs and food provision, preventable errors in procedures and a lack of support available for siblings. It is also worth noting that healthcare professionals did not always seem sufficiently equipped to attend to palliative care patients. Conclusion: Strategies to improve supportive and palliative care are needed for children with cancer and their families in a hospital setting. The interviews identified a number of themes and current shortcomings that should be considered to improve services.

Meeting the family: Measuring effectiveness of family meetings in a specialist inpatient palliative care unit

2012 ◽  
Vol 10 (1) ◽  
pp. 43-49 ◽  
Author(s):  
Breffni Hannon ◽  
Valerie O'Reilly ◽  
Kathleen Bennett ◽  
Karen Breen ◽  
Peter G. Lawlor
Keyword(s):  
Palliative Care ◽  
Family Member ◽  
Family Members ◽  
Palliative Care Unit ◽  
World Health ◽  
Healthcare Team ◽  
Care Needs ◽  
Family Meeting ◽  
Family Meetings ◽  
The Family

AbstractObjective:The World Health Organization (WHO) definition of palliative care as “an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness …” recognizes the importance of family members in this setting. In practice, family meetings account for a significant amount of the weekly workload in a specialist inpatient palliative care unit. Despite this, there is little empirical evidence to support the benefits of family meetings from the perspective of family members.Method:A prospective study over 6 months, invited a designated family member to complete a self-report instrument (SRI) and the Family Inventory of Needs (FIN) questionnaire prior to, immediately following, and 48 hours after a planned family meeting attended by several members of the multidisciplinary team.Results:Thirty-one designated family members completed the study. The SRIs completed prior to a family meeting identified particular areas of concern and worry for family members, and also helped to generate an agenda based on the family's particular needs. The pre-meeting FIN identified areas of patient care of greatest importance to each family member, and asked them to rate whether particular care needs were presently met or unmet, in their opinion, by the healthcare team caring for the patient. Following the family meeting, repeat SRIs showed an overall reduction in concerns and increased confidence in dealing with those issues raised. Post-family meeting FIN scores confirmed a greater number of met care needs compared with pre-meeting scores, all of which were sustained over time.Significance of results:This study confirms the value of planned multidisciplinary family meetings for patients in specialist inpatient palliative care units. It identifies the often unmet needs of family members and the sustained benefits associated with formal family meetings.

When a Baby Dies: When Families Need You the Most

2010 ◽  
Vol 29 (4) ◽  
pp. 259-261 ◽  
Author(s):  
Deb Discenza
Keyword(s):  
Health Care ◽  
Special Needs ◽  
Stressful Life Event ◽  
Family Members ◽  
Stressful Life ◽  
Health Care Needs ◽  
Care Needs ◽  
Changing Environment ◽  
Life Event ◽  
The Family

A NEONATAL NURSE SEES SOME truly stressful situations in the NICU. Day in and day out, infants are brought into the NICU, others are discharged to go home, and in between there are a lot of health care needs to tend to for each patient. Add to those demands caring for each patient’s family—helping them address the reality of their child’s special needs now and going forward. Although most nurses in the NICU love their jobs and thrive on the ever-changing environment, one of the most difficult tasks is likely working with the family of an infant who is dying. It is heartbreaking to see a child die and to watch family members go through such trauma. But you can help prepare grieving families for this stressful life event and support them so that they can handle it with dignity.

scholarly journals Palliative care needs and preferences of female patients and their caregivers in Ethiopia: A rapid program evaluation in Addis Ababa and Sidama zone

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0248738
Author(s):  
Mirgissa Kaba ◽  
Marlieke de Fouw ◽  
Kalkidan Solomon Deribe ◽  
Ephrem Abathun ◽  
Alexander Arnold Willem Peters ◽  
...  
Keyword(s):  
Palliative Care ◽  
Service Provision ◽  
Addis Ababa ◽  
Primary Caregivers ◽  
Care Needs ◽  
Female Patients ◽  
Care Services ◽  
Home Based ◽  
Palliative Care Services ◽  
Palliative Care Needs

Introduction In Ethiopia there is an extensive unmet need for palliative care, while the burden of non-communicable diseases and cancer is increasing. This study aimed to explore palliative care needs and preferences of patients, their caregivers, and the perspective of stakeholders on service provision in palliative programs for women, mostly affected by cervical cancer and breast cancer. Methods A rapid program evaluation using a qualitative study approach was conducted in three home-based palliative care programs in Addis Ababa and Yirgalem town, Ethiopia. Female patients enrolled in the programs, and their primary caregivers were interviewed on palliative care needs, preferences and service provision. We explored the views of purposely selected stakeholders on the organization of palliative care and its challenges. Audio-taped data was transcribed verbatim and translated into English and an inductive thematic analysis was applied. Descriptive analyses were used to label physical signs and symptoms using palliative outcome scale score. Results A total of 77 interviews (34 patients, 12 primary caregivers, 15 voluntary caregivers, 16 stakeholders) were conducted. The main physical complaints were moderate to severe pain (70.6%), followed by anorexia (50.0%), insomnia, nausea and vomiting (41.2%). Social interaction and daily activities were hampered by the patients’ condition. Both patients and caregivers reported that programs focus most on treatment of symptoms, with limited psychosocial, emotional, spiritual and economic support. Lack of organizational structures and policy directions limit the collaboration between stakeholders and the availability of holistic home-based palliative care services. Conclusions Although female patients and caregivers appreciated the palliative care and support provided, the existing services did not cover all needs. Pain management and all other needed supports were lacking. Multi-sectorial collaboration with active involvement of community-based structures is needed to improve quality of care and access to holistic palliative care services.

The availability of and satisfaction with palliative care services among VHA-based radiation oncologists.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 55-55
Author(s):  
George A. Dawson ◽  
Alice V. Cheuk ◽  
Shruti Jolly ◽  
Ruchika Gutt ◽  
Drew Moghanaki ◽  
...  
Keyword(s):  
Palliative Care ◽  
Radiation Oncology ◽  
Psychosocial Support ◽  
Care Delivery ◽  
Symptom Control ◽  
Care Services ◽  
Radiation Oncologists ◽  
Advanced Malignancies ◽  
Palliative Care Teams ◽  
Palliative Care Services

55 Background: Palliative care services enhance quality of life in patients with advanced malignancies and are an integral component of multidisciplinary cancer care. They provide symptom control and psychosocial support for patients and family members. A survey in non-VHA cancer centers showed that despite availability of palliative care programs, there was wide variability in the use of these services (Hui et al, JAMA 2010). Palliative care services are a component of the VHA medical benefits package. We sought to determine the ease of access to palliative care services and provider satisfaction among VHA Radiation Oncologists. Methods: VHA-based Radiation Oncologists were identified using the National VHA Radiation Oncology list serve group. All practicing Radiation Oncologists were surveyed to determine the extent of Palliative Care Services available to them and to measure their level of satisfaction with these services. Eighty two surveys were electronically mailed to practitioners at the 38 active VHA Radiation Oncology sites, followed by a reminder phone call.This survey was conducted over a four week period in May of 2014. Results: Sixty four of the 82 surveys distributed over the 4 week period, or 78% were completed. They represent 89% (34/38) of VHA Radiation Oncology Services. All respondents had Palliative Care Services available to them and 98% were happy with the services rendered by the Palliative Care teams. Conclusions: All VHA-based Radiation Oncologists who responded to this survey have access to local VHA based Palliative Care Services. This represented 82% of VHA Radiation Oncology practitioners and 98% were satisfied with the services rendered. Further studies should explore the scope and extent of palliative care involvement including when these services are integrated into the management of patients with advanced malignancies, availability of outpatient palliative care services and variations in care delivery. Radiation therapy is utilized in over 50% of patients with malignancy, often in advanced disease for symptom management and standard guidelines integrating radiotherapy and palliative care should be developed.

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