Palliative medicine
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Palliative medicine · Sep 2015
Multicenter StudyThe desire to hasten death: Using Grounded Theory for a better understanding "When perception of time tends to be a slippery slope".
Some patients with advanced and progressive diseases express a desire to hasten death. ⋯ The desire to hasten death may be used as an extreme coping strategy to maintain control against anticipated agony. Patients expected health professionals to listen to and respect their experiences. Emerging hypotheses included the following: (a) patients try to balance life time and anticipated agony, and the perception of time is distressing in this balancing act; (b) anticipated images of agony and suffering in the dying process occur frequently and are experienced by patients as intrusive; (c) patients expressing a desire to hasten death are in need of more information about the dying process; and (d) patients wanted their caregivers to listen to and respect their wish to hasten death, and they did not expect the caregivers to understand this as an order to actually hasten their death.
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Palliative medicine · Sep 2015
Community-based palliative care is associated with reduced emergency department use by people with dementia in their last year of life: A retrospective cohort study.
To describe patterns in the use of hospital emergency departments in the last year of life by people who died with dementia and whether this was modified by use of community-based palliative care. ⋯ Community-based palliative care of people who die with or of dementia is relatively infrequent but associated with significant reductions in hospital emergency department use in the last year of life.
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Palliative medicine · Sep 2015
Chronically homeless persons' participation in an advance directive intervention: A cohort study.
Chronically homeless individuals have high rates of hospitalization and death, and they may benefit from the completion of advance directives. ⋯ A counselor-guided intervention can achieve a high rate of advance directive completion among chronically homeless persons. Most participants expressed a preference to receive cardiopulmonary resuscitation in the event of a cardiorespiratory arrest.
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Palliative medicine · Sep 2015
Perspectives on the role of the speech and language therapist in palliative care: An international survey.
Speech and language therapists can improve the quality of life of people receiving palliative care through the management of communication and swallowing difficulties (dysphagia). However, their role in this domain is poorly defined and little is understood about the current international professional practice in this field. ⋯ Internationally, speech and language therapists believe they have a role in palliative care. The speech and language therapist respondents highlighted that this area of practice is under-resourced, under-acknowledged and poorly developed. They highlighted the need for additional research as well as specialist training and education for speech and language therapists and other multidisciplinary team members in the area of palliative care.