International journal of palliative nursing
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This retrospective audit assessed the referral practice for patients with end-stage renal failure from the nephrology service to the specialist palliative care team in a large teaching hospital in the north-west of England. ⋯ There was well-established referral practice between the renal and the specialist palliative care team at the hospital examined. The renal team appropriately referred for symptom control and support in the dying phase of patients. There are issues surrounding placement and increased implementation of end-of-life care tools, including the Liverpool Care Pathway, Gold Standards Framework and Preferred Place of Care documentation for renal patients, which needs to be an ongoing priority.
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This article reports on the implementation process and preliminary results of a year-long pilot project providing hospice day care to patients with non-malignant conditions in Dundee, Scotland, UK. With appropriate enthusiasm, planning, consultation, staff education, access via clinical nurse specialist screening, careful referral criteria, goal-setting, an overt discharge policy and close collaboration between clinical nurse specialists, specialist palliative care services and the primary health care team, we were able to offer care to a small number of selected patients perceived to have the greatest need. ⋯ Attendance appeared generally acceptable to patients. The project did not overwhelm the service, had negligible impact upon inpatient admissions and did not require extra funding.
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This article considers the language of spirituality in palliative care (Byrne, 2002; 2007), and focuses on the concepts of metaphor and story, demonstrated in practice by the art project and publication at The Prince & Princess of Wales Hospice (PPWH), Glasgow, UK. Metaphors have been used in everyday speech and literature throughout history. The word 'cancer' is a metaphor itself traced back to Hippocrates in the 5th century BC. ⋯ Stories often include metaphoric images and give an understanding of the uniqueness of individual fear and inner need. Cullen and Alcock describe creative expression as the process of unraveling a story (2007). The creative arts project at PPWH bears witness to this.