Journal of pain and symptom management
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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
Psycho-existential Symptom Assessment Scale (PeSAS) Screening in Palliative Care.
Psycho-existential symptoms are common yet often missed or neglected in palliative care. Screening can be an effective way to recognize and respond to this need. ⋯ Clinicians can be trained to screen with the Psycho-existential Symptom Assessment Scale, which serves as a valuable measure to better recognize symptoms of psycho-existential distress among palliative care patients. Implementation barriers included the prior ethos of the service, confidence in talking about these themes, electronic data entry, and perceived time pressures.
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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
"I Don't Do Religion": Using Nature Photographs to Engage Patients in Spiritual Reflection.
When caring for healthcare patients, professional chaplains may find an increasing proportion of individuals in the U. S. who do not identify as religious and who may benefit from creative approaches to discussing their spiritual and existential concerns. One approach to engaging patients is using a "third voice," as shared in a personal narrative in which a chaplain uses landscape photographs to engage a patient for discussion of spiritual and existential concerns. The content of the conversation may inform decisions about treatment, quality of life, and person-centered care.