Journal of palliative medicine
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Palliative medication kits for home use were developed in order to extend the period of time terminally ill patients might be cared for in their homes. ⋯ Palliative medication kits are a simple and effective way of anticipating and addressing comfort and symptom control for dying patients being cared for in the community. These kits can avert institutional crisis admissions, extend the period of time patients can be cared for in their homes and may increase the likelihood of a home death.
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To test whether the presence of an informal or formal care network in the home leads to different hospice utilization patterns near death. To examine how the informal care relationship affects hospice use patterns. ⋯ Because formal care is associated with increased use of hospice, future work should examine whether patients without an in-home network faced access barriers. Caregiver relationships had large effects on length of hospice stays, yet we do not know whether changes moved a patient closer to or further away from their optimum use of the benefit.
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We evaluated the factors associated with life-supportive therapy withdrawal (LSTW) and length-of-stay (LOS) of adult patients with cancer who died while in the intensive care unit (ICU). We performed chart review of adult patients with cancer who died in a 53-bed ICU of a comprehensive cancer center and evaluated the relative impact of demographic and clinical factors by using logistic regression and linear regression. A total of 267 patients were included in the study. ⋯ Having a hematologic cancer, LSTW, or admission into the surgical oncologic ICU independently predicted increased LOS for those who died in the ICU (p < 0.001 p = 0.001, and p < 0.001, respectively). Cultural differences in dealing with the end-of-life process rooted in religious beliefs or language barriers and reflected in the utilization rates of LSTW by non-whites and whites may partially explain our findings. The difficult transition from curative to palliative care in the ICU is reflected by the increased LOS of patients who received LSTW, were diagnosed with hematologic cancers, or were admitted into the surgical unit.