Palliative medicine
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Palliative medicine · May 2021
Advance care planning and end-of-life care in patients with an implantable cardioverter defibrillator: The perspective of relatives.
Little is known about the last phase of life of patients with implantable cardioverter defibrillators and the practice of advance care planning in this population. ⋯ Implantable cardioverter defibrillator deactivation was discussed with a minority of patients. Device shocks were reported to be distressing to patients and relatives. Relatives of patients with a deactivated device reported a higher quality of death compared to relatives of patients with an active device.
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Palliative medicine · May 2021
A qualitative study of bereaved relatives' end of life experiences during the COVID-19 pandemic.
Meeting the needs of relatives when a family member is dying can help facilitate better psychological adjustment in their grief. However, end of life experiences for families are likely to have been deleteriously impacted by the COVID-19 crisis. Understanding how families' needs can be met during a global pandemic will have current/future relevance for clinical practice and policy. ⋯ Health and social care professionals can have an important role in mitigating the absence of relatives' visits at end of life during a pandemic. Strategies include prioritising virtual connectedness and creating alternative opportunities for relatives to 'say goodbye'.
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Palliative medicine · May 2021
Compounded trauma: A qualitative study of the challenges for refugees living with advanced cancer.
Although palliative care is now an essential health service under Universal Health Coverage, ensuring access and appropriate care for refugees is a specific challenge for this large population. ⋯ This study reveals the impact of fractured families and networks on social support in advanced cancer, and the compounding trauma of the disease for refugees. Detailed person-centred assessment and emphasis on psychosocial support is essential, and home-based care should not presume community support for patients to remain at home.
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Palliative medicine · May 2021
End-of-life cost trajectories and the trade-off between treatment costs and life-extension: Findings from the Cost and Medical Care of Patients with Advanced Serious Illness (COMPASS) cohort study.
Few studies have assessed how patient preferences influence end-of-life costs. ⋯ On average, cancer patients in Singapore can expect to spend $61,680 in the last year of life. Of broader relevance is that patient preferences and other observable factors clearly influence these costs, suggesting that policymakers and patients can better predict and budget for end-of-life costs by considering these factors.