Palliative medicine
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Palliative medicine · Sep 2020
The occurrence and timing of delirium in acute care hospitalizations in the last year of life: A population-based retrospective cohort study.
Delirium is a distressing neurocognitive disorder that is common among terminally ill individuals, although few studies have described its occurrence in the acute care setting among this population. ⋯ This study described the occurrence and timing of delirium in acute care hospitals in the last year of life and identified factors associated with delirium. These findings can be used to support delirium prevention and early detection in the hospital setting.
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Palliative medicine · Sep 2020
ReviewThe palliative care needs of adults with intellectual disabilities and their access to palliative care services: A systematic review.
There is evidence that people with intellectual disabilities experience healthcare inequalities, including access to specialist palliative care, but to date, there has not been a systematic review of empirical evidence. ⋯ This review highlights the specific problems in providing equitable palliative care for adults with intellectual disabilities, but there is a lack of research into strategies to improve practice. This should be prioritised using methods that include people with intellectual disabilities and families.
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Palliative medicine · Sep 2020
Meta AnalysisUnmet device reprogramming needs at the end of life among patients with implantable cardioverter defibrillator: A systematic review and meta-analysis.
Use of implantable cardioverter defibrillators is increasingly common. As patients approach the end of life, it is appropriate to deactivate the shock function. ⋯ The prevalence of implantable cardioverter defibrillator reprogramming and advance directives that explicitly mentioned the device was very low. Study data suggested reprogramming decisions were made very late, after the patient experienced multiple shocks. Patient suffering could be ameliorated if physicians and other healthcare professionals adhere to clinical guidelines for the good management of the device at the end of life and include deactivating the shock function in the discussion that leads to the advance directive.
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Palliative medicine · Sep 2020
Identification of patients with potential palliative care needs: A systematic review of screening tools in primary care.
Despite increasing evidence of the benefits of early access to palliative care, many patients do not receive palliative care in a timely manner. A systematic approach in primary care can facilitate earlier identification of patients with potential palliative care needs and prompt further assessment. ⋯ The ability of current screening tools to identify patients with advanced progressive diseases who are likely to have palliative care needs in primary care is limited. Further research is needed to identify standardised screening processes that are based not only on predicting mortality and deterioration but also on anticipating the palliative care needs and predicting the rate and course of functional decline. This would prompt a comprehensive assessment to identify and meet their needs on time.
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Palliative medicine · Sep 2020
A case series of suprascapular nerve block (with an historical comparator) for shoulder pain in motor neurone disease.
Shoulder pain is a distressing but under-reported and poorly managed symptom in people with motor neurone disease. ⋯ Suprascapular nerve block is a safe, effective therapy for patients with chronic shoulder pain.