Journal of pain and symptom management
-
J Pain Symptom Manage · May 2021
Workforce Planning for Community-based Palliative Care Specialist Teams using Operations Research.
Many countries have aging populations. Thus, the need for palliative care will increase. However, the methods to estimate optimal staffing for specialist palliative care teams are rudimentary as yet. ⋯ Historical, current, and projected data can be used with operations research to forecast staffing levels for specialist palliative care teams under various scenarios. The forecast can be updated as new data emerge, applied to other populations, and used to test alternative delivery models.
-
J Pain Symptom Manage · May 2021
Goals of care conversations don't fit in a box': Hospice Staff Experiences and Perceptions of Advance Care Planning Quality Measurement.
With rising concerns about quality of care in hospice, federal agencies recently began mandating quality measurement in hospice, including measures of advance care planning (ACP). ⋯ Hospice staff take ACP quality measurement seriously, but insufficient organizational resources and regulatory bureaucracy create challenges. Efforts to enhance ACP quality measure nuance and assess outcomes are needed to improve care.
-
J Pain Symptom Manage · May 2021
Is pain assessment of community-dwelling persons with advanced dementia by family and paid care workers feasible?
The experience of pain is aggravated among older persons with advanced dementia (OPAD). It is often undetected and therefore untreated because of their limited capacity to identify and report their symptoms. Therefore, it is crucial to improve the pain identification skills of those who know and live with them. ⋯ This study shows that it is feasible to improve the assessment and identification of pain among OPAD, through the use of validated tools by family members and paid care workers, suggesting the potential to improve quality of care and quality of life of OPAD.
-
J Pain Symptom Manage · May 2021
Providing End-of-Life Care for Patients With Left Ventricular Assist Devices: Experience of a Hospice Agency.
Patients with left ventricular assist devices (LVADs) need expert palliative care at the end of life. In the U.S., hospice may provide this care, but few patients enroll, and information about hospice experience with LVAD-implanted patients is limited. ⋯ To provide specialist palliative care to LVAD-implanted patients, hospices must be prepared to manage complex and highly varied needs. To do this, hospices must have adequate staff support and access to acute care.