Palliative medicine
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Palliative medicine · Apr 2020
Availability of home palliative care services and dying at home in conditions needing palliative care: A population-based death certificate study.
Avoiding inappropriate care transition and enabling people with chronic diseases to die at home have become important health policy issues. Availability of palliative home care services may be related to dying at home. ⋯ Specialised home palliative care services may be suboptimal, and primary care services may serve as a key access point in providing baseline palliative care to people with conditions needing palliative care. Therefore, primary care services should aim to enhance their palliative care workforce.
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Palliative medicine · Apr 2020
Drivers of care costs and quality in the last 3 months of life among older people receiving palliative care: A multinational mortality follow-back survey across England, Ireland and the United States.
Care costs rise towards the end of life. International comparison of service use, costs and care experiences can inform quality and improve access. ⋯ Poverty and poor home care drove high costs, suggesting that improving community palliative care may improve care value, especially as palliative care expenditure was low. Major diagnostic variables were not cost drivers. Care costs in the United States were high and highly variable, suggesting that high-cost low-value care may be prevalent.
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Palliative medicine · Apr 2020
Spiritual needs and communicating about death in nonreligious theistic families in pediatric palliative care: A qualitative study.
Spiritual support should be offered to all patients and their families regardless of their affiliated status with an organized religion. ⋯ Religious support could be an element of spiritual support for nonreligious theistic parents of terminally ill children. Multiple strategies including religious supports and nonreligious supports should be rationally integrated into spiritual support of nonreligious theistic family. Patient's personal belief in death should be assessed before discussing death with them.
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Palliative medicine · Apr 2020
Components of palliative care interventions addressing the needs of people with dementia living in long-term care: A systematic review.
People with dementia requiring palliative care have multiple needs, which are amplified in long-term care settings. The European Association for Palliative Care White Paper offers recommendations for optimal palliative care in dementia integral for this population, providing useful guidance to inform interventions addressing their specific needs. ⋯ Almost all domains were addressed across all interventions currently offered for this population to various degrees, but not within a singular intervention. Future research optimally needs to be theory driven when developing dementia-specific interventions at the end of life, with the European Association for Palliative Care domains serving as a foundation to inform the best care for this population.