Journal of the American Geriatrics Society
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The objective of this study was to systematically review the literature to better understand the conceptualization of satisfaction with end-of-life care and the effectiveness of palliative care interventions on this outcome. Data sources included Medline and the Database of Reviews of Effects. The review included relevant qualitative studies and intervention studies using satisfaction as an outcome from 1990 to 2005. ⋯ Evaluations used many different measures, only one of which was designed for the end of life. In conclusion, researchers have conceptualized satisfaction in palliative care, and different types of palliative care interventions can improve satisfaction, but it is often not included as an outcome. More focus on these satisfaction elements might improve the effectiveness of end-of-life interventions and their evaluation.
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Dehydration is a serious acute condition in older adults associated with significant morbidity and mortality. Hypodermoclysis (HDC; the infusion of fluids into the subcutaneous tissue) can provide an alternative to intravenous (i.v.) rehydration of older adults. This article reviews the relevant literature on the use of HDC to treat mild to moderate dehydration in older adults. ⋯ The evidence indicated that HDC is as effective as i.v. rehydration of older adults with mild to moderate dehydration. The literature cites advantages of HDC over i.v. hydration, including the same number of or fewer complications, cost savings, greater patient comfort, and less nursing time to start and maintain the infusion. It remains unclear from the literature why HDC is used infrequently in the United States.
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Dehydration is a serious acute condition in older adults associated with significant morbidity and mortality. Hypodermoclysis (HDC; the infusion of fluids into the subcutaneous tissue) can provide an alternative to intravenous (i.v.) rehydration of older adults. This article reviews the relevant literature on the use of HDC to treat mild to moderate dehydration in older adults. ⋯ The evidence indicated that HDC is as effective as i.v. rehydration of older adults with mild to moderate dehydration. The literature cites advantages of HDC over i.v. hydration, including the same number of or fewer complications, cost savings, greater patient comfort, and less nursing time to start and maintain the infusion. It remains unclear from the literature why HDC is used infrequently in the United States.