Articles: palliative-care.
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Care management benefits community-dwelling patients with dementia, but studies include few patients with moderate to severe dementia or from racial and ethnic minority populations, lack palliative care, and seldom reduce health care utilization. ⋯ Among community-dwelling patients with moderate to severe dementia and their caregivers, dementia palliative care, compared with usual care, did not significantly improve patients' neuropsychiatric symptoms through 24 months.
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Background: Medical aid in dying is legal in 10 states plus Washington DC, covering 22% of the U. S. population. Much has been written about the ethics of aid in dying, but little about evidence-based care, especially the medications used. ⋯ Two of the sedative/cardiotoxin combinations yielded median times to death of 0.8 hours. But from 2018 to 2023, as the medication combinations shifted, the mean time to death declined while the median remained relatively steady-confirming that these combinations reduced the incidence of longer deaths (especially extreme outliers). Conclusion: This first-time analysis of aid-in-dying medication protocols showed that while a sedative alone had the best median time to death, the most recent sedative/cardiotoxin protocol had an acceptable median time to death of 0.8 hours, but with fewer prolonged-death outliers.
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Systemic autoimmune rheumatic diseases (SARDs) consist of a broad range of immune-mediated multisystem diseases. They are chronic, incurable illnesses that often present in early to mid-life and can be associated with a high symptom burden, disability, and early mortality. ⋯ Integration of PC into rheumatology offers an opportunity to improve quality of life and deliver better goal-concordant care for people with severe rheumatic disease. This article provides 10 tips to guide PC clinicians when caring for people with rheumatic diseases.