Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2022
Randomized Controlled TrialVulnerability and Resilience: Phenomenological Analysis of Cancer Patients Value Directives.
Personal values are individual conceptions of the desirable appraisals and actions that guide our attitudes and behaviour. Advance care planning (ACP) now emphasises the consideration of personal life goals and values expressed as a Values Directive (VD) to guide discussions concerning medical treatment. ⋯ Cancer patients seek to make meaning of their experiences, concurrently posturing vulnerability and resilience, despite conflicting emotions and experiences. Given that the choices people make as they approach dying relate to their most deeply held values, ACP conversations should explore how patients draw from their values and life goals to optimise their adaptations to illness.
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J Pain Symptom Manage · Nov 2022
Utilization of palliative care in veterans admitted with heart failure experiencing homelessness.
Patients experiencing housing insecurity have numerous barriers affecting their utilization of medical care. ⋯ Housing stability may be a factor in Veterans receiving PC during hospitalization for heart failure. While the logistical challenges of delivering PC and hospice to people experiencing homelessness are daunting, advocating for these services shows commitment to reducing suffering in life-limiting Illness.
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J Pain Symptom Manage · Nov 2022
End-of-life costs of cancer patients with Alzheimer's Disease and Related Dementias in the U.S.
End-of-Life (EOL) care consumes a substantial amount of healthcare resources, especially among older persons with cancer. Having Alzheimer's Disease and Related Dementias (ADRD) brings additional complexities to these patients' EOL care. ⋯ Medicare spending at the EOL per beneficiary was not statistically different between cohorts. However, specific types of service (i.e., inpatient, SNF, home health, and hospice) were significantly higher in the ADRD group compared to their non-ADRD counterparts. This study underscored the potential financial burden and informed Medicare about allocation of resources at the EOL.
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J Pain Symptom Manage · Nov 2022
Care Intensity and Palliative Care in Chronically Critically Ill Infants.
Increasingly, chronically critically ill (CCI) infants survive to discharge from Neonatal Intensive Care Units (NICUs). Little is known about their care intensity and the primary and specialty palliative care families receive at and following discharge. ⋯ CCI infants receive intensive medical care including multiple medical technologies, medications, and specialty follow up at discharge and remain complex at one year of life. Most receive primary interprofessional palliative care in the NICU, however these infants and their families may have limited access to specialty palliative care in the short- and long-term.
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J Pain Symptom Manage · Nov 2022
Observational StudyEnd of Life Cost Savings in the Palliative Care Unit Compared to Other Services.
Hospital deaths carry a significant healthcare cost that has been confirmed to be lower when palliative care units (PCUs) are available. ⋯ Data from this study show that cost is significantly lower when the patients are treated by a PCU during their last hospital stay when they pass away.