Journal of palliative medicine
-
To understand how oncologists provide care at the end of life, the emotions they experience in the provision of this care, and how caring for dying patients may impact job satisfaction and burnout. ⋯ Physicians' who viewed EOL care as an important role described communicating with dying patients as a process and reported increased job satisfaction. Further research is necessary to determine if educational interventions to improve physician EOL communication skills could improve physician job satisfaction and decrease burnout.
-
Health and function vary by marital status across the life-course, but little is known about older adults approaching spousal loss (pre-widowed). ⋯ Health deficits associated with spousal bereavement may be evident earlier in the marital transition than previously thought, warranting attention to the health of elderly persons whose spouses have chronic/life-limiting conditions.
-
In geriatrics, most risk factors associated with falls have been identified and management strategies developed accordingly. This is not the case in palliative care. The incidence rate of falls, the consequences related to falls, and other related factors were determined in elderly cancer patients hospitalized for palliative care in an exploratory study. ⋯ Characteristics of falls in palliative care appear different from those evidenced in geriatric wards. To prevent delirium while prescribing neuroleptic drugs with the greatest caution should help decrease the number of falls in this highly vulnerable group of patients.
-
Methadone is generally believed to be devoid of neuroexcitatory properties, and its use is increasing. This paper reports two cases of myoclonus with high-dose parenteral methadone in patients with cancer under hospice care. ⋯ Possible mechanisms for methadone causing myoclonus include a redistribution of receptor saturation in the N-methyl-D-aspartate (NMDA) and delta receptors. Ketamine may be an option for patients with intractable pain who develop methadone-induced myoclonus.
-
The degree to which nursing homes have internal programs for hospice and palliative care is unknown. We used self-reported data from the 2004 National Nursing Home Survey (NNHS) to estimate the prevalence of special programs and (specially) trained staff (SPTS) for hospice or palliative/end-of-life care in U.S. nursing homes. Factors associated with the presence of SPTS for hospice or palliative/end-of-life care were identified. ⋯ The presence of internal SPTS for hospice or palliative/end-of-life care is prevalent in U.S. nursing homes, and may be preceded by hospice contracting and/or the implementation of specialty programs that assist nursing homes in developing the expertise needed to establish their own palliative care programs.