J Palliat Care
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In hospice nursing, dying persons and their families are the unit of care and the focus of nursing interventions which are provided within the context of interdisciplinary care. The key component of hospice nursing is the interaction between the nurse, the terminally ill person, and the family. This naturalistic study was designed to describe the family caregiver's relationships between the hospice patient, the nurse, and themselves. ⋯ All were bereaved at least six months prior to being interviewed. The major finding of the study was that family caregivers perceived the hospice nurses as part of the family. The hospice nurses were characterized as respectful, kind, caring, clinical experts whose presence and interventions helped meet the needs of the family experiencing death.
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We have previously published data on our use of opioids in the last week of life. A change in our pattern of opioid use, i.e. switching opioids more frequently and using high-dose methadone suppositories, appears to have resulted in a decrease in the number of patients requiring high-dose opioids. ⋯ Results confirmed a decrease in the range of opioids used, as well as a statistically significant decrease in the daily opioid dose in the last week of life. We believe that this difference is most likely due to the use of methadone in patients showing either a poor response to other opioids or a rapid development to tolerance, as well as switching opioids more frequently to take advantage of incomplete cross-tolerance.