Palliative medicine
-
Palliative medicine · Apr 2015
Multicenter StudyAdmission of the very elderly to the intensive care unit: family members' perspectives on clinical decision-making from a multicenter cohort study.
Little is known about the perspectives and experiences of family members of very elderly patients who are admitted to the intensive care unit. ⋯ There is incongruity between family values and preferences for end-of-life care and actual care received for very elderly patients who are admitted to the intensive care unit. Deficiencies in communication and decision-making may be associated with prolonged use of life-sustaining treatments in very elderly critically ill patients, many of whom ultimately die.
-
Palliative medicine · Apr 2015
Multicenter StudyHospital rapid response team and patients with life-limiting illness: a multicentre retrospective cohort study.
Approximately one-third of rapid response team consultations involve issues of end-of-life care. We postulate a greater occurrence in patients with a life-limiting illness, in whom the opportunity for advance care planning and palliative care involvement should be offered. ⋯ Patients with a life-limiting illness had worse outcomes post-rapid response team consultation. Our findings suggest that a routine clarification of goals of care for this cohort, within 3 days of hospital admission, may be advantageous. These discussions may provide clarity of purpose to treating teams, reduce the burden of unnecessary interventions and promote patient-centred care agreed upon in advance of any deterioration.