Articles: palliative-care.
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Palliative medicine · Feb 2022
Meta AnalysisRisk factors for delirium in adult patients receiving specialist palliative care: A systematic review and meta-analysis.
Delirium is common and distressing for patients receiving palliative care. Interventions targetting modifiable risk factors in other settings have been shown to prevent delirium. Research on delirium risk factors in palliative care can inform context-specific risk-reduction interventions. ⋯ Findings may usefully inform interventions to reduce delirium risk but more high quality prospective cohort studies are required to enable greater certainty about associations of different risk factors with delirium during specialist palliative care.
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J Pain Symptom Manage · Feb 2022
Observational StudyIdentification of Palliative Care needs in cancer patients in a Surgical Emergency Centre.
Advanced cancer is associated with a significant symptom burden, and timely identification of palliative care (PC) needs, and provision of appropriate PC can improve treatment outcomes, reduce healthcare cost, and enhance patient and family satisfaction with care. Several tools have been used to identify PC needs in different clinical settings and patient groups. ⋯ Patients with PC needs comprise a significant proportion of SEC cancer admissions. This study shows the clear need for investment in staff and infrastructure to provide integrated palliative and end-of-life care as part of surgical services. The SPICTTM and SQ were shown to predict for early death in this cohort. Further validation of PC needs assessment tools is needed to guide the cost-effective implementation of PC services in low resource settings.
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Palliative medicine · Feb 2022
Interventions to support family caregivers of people with advanced dementia at the end of life in nursing homes: A mixed-methods systematic review.
Most people with dementia transition into nursing homes as their disease progresses. Their family caregivers often continue to be involved in their relative's care and experience high level of strain at the end of life. ⋯ The findings provide useful information on which interventions may benefit family caregivers of people with advanced dementia at the end of life and where, when, and how they should be provided.
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Surviving Long Enough to Die? An Analysis of Incomplete Assessments for Medical Assistance in Dying.
Background: Medical assistance in dying (MAiD) was legalized in Canada on June 17, 2016, yet many who request MAiD do not complete the assessment process and instead experience a natural death. This analysis of patients who made a formal request for MAiD aims to clarify timelines and factors associated with completion of the MAiD assessment process, and factors associated with completion or noncompletion of MAiD once eligible. Materials and Methods: This retrospective cohort study included all patients in Nova Scotia who requested MAiD between January 1, 2018 and December 31, 2018, were deceased at the time of analysis, did not withdraw their request, and were not formally deemed ineligible for the procedure (n = 218). ⋯ Those with an incomplete assessment had a median survival from request to death of 8.0 days (interquartile range [IQR] = 11.5), whereas for those deemed eligible, median survival from request to determination of MAiD eligibility was also 8.0 days (IQR = 16.0). Interpretation: Proximity to natural death and poor performance status at the time of MAiD request may drive incomplete MAiD assessments. The majority of patients deemed eligible for MAiD complete the procedure, and as such, patients who did not complete the MAiD assessment process may not have experienced their preferred mode of death.
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Palliative medicine · Feb 2022
ReviewThe experiences, perceptions, and support needs among family caregivers of patients with advanced cancer and eating problems: An integrative review.
Advanced cancer patients often present with numerous eating problems, posing a significant challenge for family caregivers during the provision of nutritional care. ⋯ Research on the studied topic was descriptive and predominantly qualitative in nature. Quantitative research examining the impact of caregiving experiences in relation to food and eating in the context of advanced cancer patients is the first important step moving this research area forward.