Does respite care address the needs of palliative care service users and carers? Their perspectives and experiences

International Journal of Palliative Nursing; Apr 2017; vol. 23 (4) p 174-185
Wolkowski, Anna; Carr, Susan M

This research revealed that although there is a need for respite care and that it's valued by service users and carers, there are some fundamental tensions in service models which limit its potential. The authors conclude that reframing respite care as an empathic response within a new palliative care approach is needed. 

Available in print in Arthur Rank Hospice Library, Cambridge

Towards a model of loss navigation in adolescence

Death Studies; May 2017; vol. 41 (5) p 291-302
Lytje, Martin

The Model of Loss Navigation in Adolescence was developed from a focus group study with 39 Danish adolescents (aged 9-17). Centered on the three factors--Being Different, Being in Control, and Being in Grief--the model highlights the social conventions children have to navigate and how these influence both their day-to-day lives and their road to recovery.

Withdrawal of ventilation at the patient's request in MND: a retrospective exploration of the ethical and legal issues that have arisen for doctors in the UK

BMJ Supportive and Palliative Care, 2017 June 7(2) pp 189-196
Kay Phelps; Emma Regen; David Oliver; Chris McDermott

Although clinicians were clear about the legality of withdrawal of treatment in theory, the practice led to ethical and moral uncertainty and mixed feelings, with many respondents experiencing negative reactions from other healthcare professionals. The authors conclude that more guidance, open discussion about the ethical issues and education to support professionals is needed.

Fulltext available in BMJ Supportive and Palliative Care
Available in print in Arthur Rank Hospice Library, Cambridge

Addressing palliative care clinician burnout in organizations: a workforce necessity, an ethical imperative

Journal of Pain and Symptom Management; Jun 2017; vol. 53 (no. 6); pp 1091-1096
Harrison, Krista L; Dzeng, Elizabeth; Ritchie, Christine S; Shanafelt, Tait D; Kamal, Arif H; Bull, Janet H; Tilburt, Jon C; Swetz, Keith M

In this article the authors consider the ethical responsibility for the management and prevention of burnout at an organisational level.

Palliative care professionals' care and compassion for self and others: a narrative review

International Journal of Palliative Nursing; May 2017; vol. 23 (no. 5) pp 219-229
Mills, Jason; Wand, Timothy; Fraser, Jennifer A

From their review of the literature, the authors identified four themes: (1) importance of self-care; (2) awareness, expression, and planning; (3) dimensions of self-care; and (4) balanced compassion. It highlights both the importance and multifaceted nature of palliative care professionals' self-care, in relation to self-compassion and compassion for others. 

Available in print in Arthur Rank Hospice Library, Cambridge

HOPES for palliative wounds

International Journal of Palliative Nursing; Jun 2017; vol. 23 (no. 6) pp 264-268
Woo, Kevin

Kevin Woo looks at the clinical assessment of key symptoms which he says should include (H)aemorrhage, (O)dour control, (P)ain, (P)ruritis, (E)xudate and (S)uperficial bioburden, as recommended by the European Oncology Nursing Society.

Ketamine for cancer pain: what is the evidence?

Jonkman, Kelly; van de Donk, Tine; Dahan, Albert
Current Opinion in Supportive and Palliative Care; Jun 2017; vol. 11 (no. 2) pp 88-92

This review found four randomized controlled trials that examined the benefit of oral, subcutaneous or intravenous ketamine in opioid refractory cancer pain but none showed clinically relevant benefit in relieving pain or reducing opioid consumption. These findings contrast the benefit from ketamine observed in a large number of open-label studies and (retrospective) case series. The authors relate the opposite outcomes to methodological issues. They conclude that there is still insufficient evidence to state with certainty that ketamine is not effective in cancer pain.

Doll therapy for dementia sufferers: A systematic review

Complementary Therapies in Clinical Practice; Feb 2017; vol. 26 pp 42-46
Ng, Qin Xiang; Ho, Collin Yih Xian; Koh, Shawn Shao Hong; Tan, Wei Chuan; Chan, Hwei Wuen

The authors of this systematic review suggest that despite some ethical concerns and the lack of empirical data, there is evidence that doll therapy is effective for dementia care, is well-aligned with the ethos of person-centred care and could be useful in the management of dementia patients.

Building community capacity in bereavement support: lessons learnt from bereaved caregivers

American Journal of Hospice and Palliative Medicine; Apr 2017; vol. 34 (no. 3) pp 275-281
Breen, Lauren J.; Aoun, Samar M.; Rumbold, Bruce; McNamara, Beverley; Howting, Denise A.; Mancini, Vincent

The study's purpose was to inform bereavement support by determining the advice people bereaved through expected deaths in palliative care have for others in that situation.   The authors suggest their responses could be incorporated into information brochures, posters, and other community education avenues in order to upskill palliative care bereavement volunteers and the wider community so that bereaved family caregivers are best supported.

The use of ultrasound in palliative care and hospice

American Journal of Hospice and Palliative Medicine; May 2017; vol. 34 (no. 4) pp 385-391
Chernack, Betty; Knowlton, Sasha E.; Kohler, Minna J.

This was a literature review into the use of ultrasound as a diagnostic tool, a therapeutic modality and a tool to accurately guide palliative procedures in hospice and palliative care.

Do blood transfusions make a difference when you are dying?

Progress in Palliative Care; Jun 2017; vol. 25 (no. 3) pp 126-131

Woodwark, Catherine; Dean, Antonia

This was a retrospective review of patient records over a 54 month period.  The researchers documented the reasons for transfusion and their impact in light of NICE guidelines and studies that question the benefits and costs of red cell transfusions. As a result of this study the hospice has developed an algorithm for the diagnosis and management of fatigue with an emphasis on assessment and re-evaluation after each intervention.

Fulltext available in Progress in Palliative Care

Available in print in Arthur Rank Hospice Library, Cambridge

'Dignity therapy', a promising intervention in palliative care: A comprehensive systematic literature review

Palliative Medicine; June 2017; vol. 31 (no. 6) pp492-509
Martínez, Marina; Arantzamendi, María; Belar, Alazne; Carrasco, José Miguel; Carvajal, Ana; Rullán, María; Centeno, Carlos

The authors report that the available evidence suggests that DT is beneficial, with patients and families evaluating it positively. The results suggest that patients with the highest distress levels can benefit the most from therapy, but more studies are needed to confirm DT’s outcomes.

Fulltext available in Palliative Medicine

Available in print in Arthur Rank Hospice Library, Cambridge

Opioids combined with antidepressants or antiepileptic drugs for cancer pain: Systematic review and meta-analysis

Palliative Medicine; June 2017
Kane, Chris M; Mulvey, Matthew R; Wright, Sophie; Craigs, Cheryl; Wright, Judy M; Bennett, Michael I

The aim of this study was to determine if there is additional benefit when opioids are combined with antidepressant or antiepileptic drugs for cancer pain. The authors conclude that combination therapy did not significantly improve pain relief in patients with tumour-related cancer pain compared with opioid monotherapy but due to the heterogeneity of patient samples, benefit in patients with definite neuropathic cancer pain cannot be excluded.

Fulltext is available in Palliative Medicine

Available in print in Arthur Rank Hospice Library, Cambridge

Palliative care for Parkinson's disease: Patient and carer's perspectives explored through qualitative interview

Palliative Medicine; Jul 2017; vol. 31 (no. 7); p. 634-641
Fox, Siobhan; Cashell, Alison; Kernohan, W George; Lynch, Marie; McGlade, Ciara; O'Brien, Tony; O'Sullivan, Sean S; Foley, Mary J; Timmons, Suzanne

The aim of this study was to explore the palliative care and related issues most affecting people with Parkinson's disease and their families and to examine their perceptions about and understanding of palliative care. Crises requiring Specialist Palliative Care involvement may occur at diagnosis and with advancing illness.  The authors suggest that an holistic palliative care approach could address the complex physical and psychosocial symptoms experienced by people with Parkinson's disease and their carers.

Fulltext available in Palliative Medicine

Available in print in Arthur Rank Hospice Library, Cambridge

Palliative care and its emerging role in Multiple System Atrophy and Progressive Supranuclear Palsy

Parkinsonism and Related Disorders 2017, 34: 7-14

Louise Wiblin, Mark Lee, David Burn

This review aims to discuss the trajectory of disease in MSA and PSP, explore significant symptoms and summarize some evidence which exists for palliative care need and quality of life in these conditions. 

Palliative care clinicians' knowledge of the law regarding the use of the Deprivation of Liberty Safeguards (DoLS).

BMJ Supportive & Palliative Care 2017 April 24

Caroline Barry, Anna Spathis, Sarah Treaddell, Sally Carding, Stephen Barclay

The aim of the study was to examine palliative care clinicians' level of knowledge of the law regarding the use of the Deprivation of Liberty Safeguards (DoLS).  The authors found that clinicians working in palliative care have good levels of knowledge of the DoLS but raised concerns about the difficulty of using them in practice, the relevance of the Safeguards to palliative care and delays in assessments. 

Fulltext available in BMJ Supportive and Palliative Care

Available in print in Arthur Rank Hospice Library, Cambridge

Consensus statement of the International Summit on Intellectual Disability and Dementia related to end-of-life care in advanced dementia.

Journal of Applied Research in Intellectual Disabilities: JARID 2017 May 9

Philip McCallion, Mary Hogan, Flavia H Santos, Mary McCarron, Kathryn Service, Sandy Stemp, Seth Keller, Juan Fortea, Kathleen Bishop, Karen Watchman, Matthew P Janicki

This report on end of life care in advanced dementia makes recommendations that will ensure greater and more appropriate support at the end of life for persons with intellectual disabilities and advanced dementia.

The Patient Dignity Inventory: just another evaluation tool? Experiences with advanced cancer patients

Palliative & Supportive Care 2017 June 21, pp1-7

María Rullán, María Arantzamendi, Ana Carvajal, Marina Martínez, Amaia Saenz de Ormijana, Carlos Centeno

The aim of the present work was to generate a better understanding of the experiences of healthcare staff when using the PDI. The authors conclude that as well as its intrinsic therapeutic value, it often led to a meaningful conversation with the patients on the meaning of life, dignity and other sensitive issues related to the process of advanced illness.

Fulltext available in Palliative and Supportive Care

Recommendations to reduce inequalities for LGBT people facing advanced illness: ACCESSCare national qualitative interview study

Palliative Medicine 2017 April 1
Katherine Bristowe, Matthew Hodson, Bee Wee, Kathryn Almack, Katherine Johnson, Barbara A Daveson, Jonathan Koffman, Linda McEnhill, Richard Harding

Despite recent legislative change, experiences of discrimination and exclusion in health care persist for LGBT people. Ten recommendations, for health-care professionals and services/institutions, are made from the data which are simple, low cost and offer potential gains in access to, and outcomes of, care for LGBT people.

Full text available in Palliative Medicine

“Unexpected and distressing": understanding and improving the experience of transferring palliative care inpatients to residential care.

Journal of Social Work in End-of-life & Palliative Care 2017, June 1, pp1-12

Voula Kallianis, Lynette Joubert, Sue Gorman, Sonia Posenelli, Carolyn Lethborg

The authors researched the effects on patients, families and the multidisciplinary healthcare team of transition from a specialist palliative care facility to residential care, identified the barriers relating to the move and highlighted opportunities to improve clinical practice in this area.