Palliative Medicine, 2018 32(7) p.1267-1274
Thomas, Tabitha; Clarke, Gemma; Barclay, Stephen
The aim of this study was to investigate the issues that arise when patients are transferred from hospice to care home at the end of life, from the perspective of the hospice multidisciplinary team. Difficulties identified included (1) ethical concerns (dilemmas around the decision, lack of patient autonomy and allocation of resources); (2) communication challenges; and (3) discrepancies between the ideals and realities of hospice palliative care. The authors suggest that further research is needed to understand patients' experiences concerning moving to care homes for end of life care in order that interventions can be implemented to mitigate patients' and families' distress.
A current awareness bulletin produced by the library service at Arthur Rank Hospice
Wednesday 25 July 2018
The engagement of young people in their own advance care planning process: A systematic narrative synthesis
Palliative Medicine, 2018 32(7) p.1147-1166
Hughes, Ben; O'Brien, Mary R.; Flynn, Anita; Knighting, Katherine
With an increasing number of young people living with life-limiting conditions there is a need to understand how far young people are engaged in their own advance care planning in order to shape future practice and facilitate young people's wishes. The aim of this study was to identify and assess the current evidence to determine the barriers and facilitators to the engagement of young people in their own advance care planning process.
Hughes, Ben; O'Brien, Mary R.; Flynn, Anita; Knighting, Katherine
With an increasing number of young people living with life-limiting conditions there is a need to understand how far young people are engaged in their own advance care planning in order to shape future practice and facilitate young people's wishes. The aim of this study was to identify and assess the current evidence to determine the barriers and facilitators to the engagement of young people in their own advance care planning process.
How might organisational institutionalism support the challenges of the modern hospice?
International Journal of Health Planning and Management, 2018, 28th June
E. Hodges; S. Read
The authors argue that the external environment within which UK charitable hospice care operates is changing. This paper outlines a number of environmental and influencing factors driving and impacting those changes. A model of institutional change is introduced, explored, and considered from the context of hospice.
E. Hodges; S. Read
The authors argue that the external environment within which UK charitable hospice care operates is changing. This paper outlines a number of environmental and influencing factors driving and impacting those changes. A model of institutional change is introduced, explored, and considered from the context of hospice.
Dementia: assessment, management and support for people living with dementia and their carers. (Guideline)
National Institute for Health and Care Excellence (NICE)
June 2018
This guideline covers diagnosing and managing dementia (including
Alzheimer’s disease). It aims to improve care by making recommendations on
training staff and helping carers to support people living with dementia.
Section 1.10 makes recommendations for Palliative care.
Contemporary best practice in the management of malignant pleural effusion
Therapeutic Advances in Respiratory Disease 2018, 12: 1753466618785098
Coenraad F N Koegelenberg, Jane A Shaw, Elvis M Irusen, Y C Gary Lee
Malignant pleural effusion (MPE) affects more than 1 million people
globally but there is a lack of evidence on the therapeutic approach to MPE, and, as a result, a high degree of variability in its management. This review aims to provide practicing clinicians with an overview of the current evidence
on the management of MPE and to provide guidance
on how to approach individual cases.
Fulltext available at Sage Publications
Laycarers can confidently prepare and administer subcutaneous injections for palliative care patients at home: A randomized controlled trial
Palliative Medicine, 2018 32(7) p1208-1215
Healy, Sue; Israel, Fiona; Charles, Margaret; Reymond, Liz
This Australian study explored differences in laycarers' confidence in administering subcutaneous injections depending upon whether a laycarer, registered nurse or pharmacist prepared injections for subsequent administration by laycarers. Results indicated that upskilled laycarers can confidently administer subcutaneous injections for loved ones, regardless of who prepares injections. This finding can improve patient outcomes and potentially decrease unwanted admissions to inpatient facilities.
Healy, Sue; Israel, Fiona; Charles, Margaret; Reymond, Liz
This Australian study explored differences in laycarers' confidence in administering subcutaneous injections depending upon whether a laycarer, registered nurse or pharmacist prepared injections for subsequent administration by laycarers. Results indicated that upskilled laycarers can confidently administer subcutaneous injections for loved ones, regardless of who prepares injections. This finding can improve patient outcomes and potentially decrease unwanted admissions to inpatient facilities.
A retrospective medical records review of risk factors for the development of respiratory tract secretions (death rattle) in the dying patient
Journal of Advanced Nursing, 2018 74(7) p1639-1648
Kolb, Hildegard; Snowden, Austyn; Stevens, Elaine; Atherton, Iain
The identification of risk factors for the development of death rattle would allow for targeted interventions. Two hundred consecutive medical records of mainly cancer patients who died in a hospice inpatient setting between 2009-2011 were reviewed. Fifteen potential risk factors were investigated. The authors conclude that dying patients with a requirement for a high dose of Midazolam have an increased likelihood of developing death rattle.
Kolb, Hildegard; Snowden, Austyn; Stevens, Elaine; Atherton, Iain
The identification of risk factors for the development of death rattle would allow for targeted interventions. Two hundred consecutive medical records of mainly cancer patients who died in a hospice inpatient setting between 2009-2011 were reviewed. Fifteen potential risk factors were investigated. The authors conclude that dying patients with a requirement for a high dose of Midazolam have an increased likelihood of developing death rattle.
Pressure injury progression and factors associated with different end-points in a home palliative care setting: a retrospective chart review study
Journal of Pain and Symptom Management, 2018 56(1) p23-32
Artico, Marco; D'Angelo, Daniela; Piredda, Michela; et al
The authors of this study carried out in Italy conclude that pressure injury healing is a realistic aim in home palliative care, particularly for injuries not exceeding Stage II occurring at least two weeks before death. When assessing pressure injuries, their results highlight the need to also pay attention to artificial nutrition, continuous deep sedation, and the caregiver's role and gender.
Artico, Marco; D'Angelo, Daniela; Piredda, Michela; et al
The authors of this study carried out in Italy conclude that pressure injury healing is a realistic aim in home palliative care, particularly for injuries not exceeding Stage II occurring at least two weeks before death. When assessing pressure injuries, their results highlight the need to also pay attention to artificial nutrition, continuous deep sedation, and the caregiver's role and gender.
Wednesday 11 July 2018
Palliative sedation in terminal cancer patients admitted to hospice or home care programs: does the setting matter? Results from a national multicenter observational study
Journal of Pain and Symptom Management, 2018 56(1) p33-43
Caraceni, Augusto; Speranza, Raffaella; Spoldi, Elio et al
The aim of this study was to compare palliative sedation rates in the hospice care and home care settings, patient clinical characteristics before and during palliative sedation, the decision-making process and clinical aspects of palliative sedation.
Caraceni, Augusto; Speranza, Raffaella; Spoldi, Elio et al
The aim of this study was to compare palliative sedation rates in the hospice care and home care settings, patient clinical characteristics before and during palliative sedation, the decision-making process and clinical aspects of palliative sedation.
Psychotherapy targeting depression and anxiety for use in palliative care: a meta-analysis
Journal of Palliative Medicine, 2018 21(7) p1024-1037
Fulton, Jessica J.; Ramos, Katherine; Porter, Laura S.; Newins, Amie R.
This meta-analysis examined the effect of psychotherapy on depression and anxiety among individuals with any condition appropriate for palliative care. Overall, findings suggest that psychotherapy in palliative care populations reduced depression (large effect) and anxiety (small effect) symptoms. Psychotherapy also improved quality of life (small effect). Significant moderators of intervention effects included type of intervention and provider, number and length of treatment sessions, and sample age. Cognitive-behaviorally based and other therapies (e.g., acceptance, mindfulness) showed significant effects, as did interventions delivered by mental health providers. More treatment sessions were associated with greater effect sizes; longer sessions were associated with decreased effect sizes.
Fulton, Jessica J.; Ramos, Katherine; Porter, Laura S.; Newins, Amie R.
This meta-analysis examined the effect of psychotherapy on depression and anxiety among individuals with any condition appropriate for palliative care. Overall, findings suggest that psychotherapy in palliative care populations reduced depression (large effect) and anxiety (small effect) symptoms. Psychotherapy also improved quality of life (small effect). Significant moderators of intervention effects included type of intervention and provider, number and length of treatment sessions, and sample age. Cognitive-behaviorally based and other therapies (e.g., acceptance, mindfulness) showed significant effects, as did interventions delivered by mental health providers. More treatment sessions were associated with greater effect sizes; longer sessions were associated with decreased effect sizes.
Ten tips palliative care pharmacists want the palliative care team to know when caring for patients
Journal of Palliative Medicine, 2018 21(7) p 1017-1023
Uritsky, Tanya J.; Atayee, Rabia S.; Herndon, Christopher M.; Lockman, Kashelle; McPherson, Mary Lynn; Jones, Christopher A.
Pharmacists, experts in the nuances of medication management, are valuable resources and colleagues for palliative care providers. This article will offer 10 useful clinical pharmacy tips that PC pharmacists think all PC providers should know for safe and effective symptom management.
Uritsky, Tanya J.; Atayee, Rabia S.; Herndon, Christopher M.; Lockman, Kashelle; McPherson, Mary Lynn; Jones, Christopher A.
Pharmacists, experts in the nuances of medication management, are valuable resources and colleagues for palliative care providers. This article will offer 10 useful clinical pharmacy tips that PC pharmacists think all PC providers should know for safe and effective symptom management.
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