Inappropriate admissions to hospital: the views of nursing and residential homes

1999 ◽  
Vol 13 (33) ◽  
pp. 32-35 ◽  
Author(s):  
Sarah Read
Author(s):  
Natasha Palipane ◽  
Abi Ponnampalampillai ◽  
Srirupa Gupta

In view of the high morbidity and mortality associated with COVID-19, early and honest conversations with patients about goals of care are vital. Advance care planning in its traditional manner may be difficult to achieve given the unpredictability of the disease trajectory. Despite this, it is crucial that patients' care wishes are explored as this will help prevent inappropriate admissions to hospital and to critical care, improve symptom control and advocate for patient choice. This article provides practical tips on how to translate decisions around treatment escalation plans into conversations, both face-to-face and over the phone, in a sensitive and compassionate manner. Care planning conversations for patients with COVID-19 should be individualised and actively involve the patient. Focusing on goals of care rather than ceilings of treatment can help to alleviate anxiety around these conversations and will remind patients that their care will never cease. Using a framework such as the ‘SPIKES’ mnemonic can help to structure this conversation. Verbally conveying empathy will be key, particularly when wearing personal protective equipment or speaking to relatives over the phone. It is also important to make time to recognise your own emotions during and/or after these conversations.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S728-S728
Author(s):  
Chantelle Sharpe ◽  
Carol Weisse

Abstract Clinical training opportunities in end-of-life care are lacking, especially in home settings where death is expected and supported as a natural process. The Community Action, Research and Education (CARE) program provides students who are interested in healthcare a better understanding the challenges of providing end-of-life care. Over 8 weeks, undergraduate students serve as surrogate family members providing care to hospice patients in residential homes for the dying. Additionally, students engage with a formal curriculum by completing online learning modules each emphasizing different skills for providing end-of-life care. This study analyzed data from three cohorts of undergraduate students (n = 21) who participated in the CARE Program. Analyses from assessment surveys revealed that students reported improved knowledge and skills, including enhanced bedside education and training and increased ability to care for someone at the end-of-life after completion of the program. Also, 95% (n = 20) of students over the three cohorts reported that the formal coursework enhanced skills and training related to bedside care. Previous research has examined end of life training in a professional school setting, but the focus was on care in an institutional or facility setting (Billings et al., 2010; Supiano, 2013). The CARE program is a model for experiential learning in a home setting that provides a special lens to the dying experience in a holistic, patient and family centered way.


2004 ◽  
Vol 21 (4) ◽  
pp. 361-371 ◽  
Author(s):  
Rhayun Song ◽  
Kyung Ja June ◽  
Chun Gill Kim ◽  
Mi Yang Jeon

2018 ◽  
Vol 36 (2) ◽  
pp. 189-197 ◽  
Author(s):  
Claudia S. de Waard ◽  
Antonius J. Poot ◽  
Wendy P. J. den Elzen ◽  
Annet W. Wind ◽  
Monique A. A. Caljouw ◽  
...  

2021 ◽  
Vol 23 (3) ◽  
pp. 1-3
Author(s):  
Mark Greener

Venous leg ulcers are common among older people in nursing and residential homes and can cause considerable pain, distress and even psychological problems. Improved awareness of guidance, greater referral to specialist vascular services and a multidisciplinary approach to management are important to deal appropriately with this frequently underprioritised condition. Mark Greener reports.


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