Articles: caregivers.
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Sleep disturbance (SD) is common among people living with dementia (PLwD) or mild cognitive impairment (MCI). It has a significant impact on the wellbeing of PLwD and caregivers, and makes care at home more difficult. Within primary care, assessment and management of SD for this population is complex and challenging. ⋯ Increasing awareness, knowledge, and confidence in diagnosis and assessment of SD is needed. Primary care-specific assessment tools may help. Long-term medication use is the default option in absence of pragmatic and effective non-pharmacological interventions that can be easily incorporated into routine general practice.
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Critical illness results in subjective financial distress for families, but little is known about objective caregiver finances after a child's pediatric intensive care unit (PICU) hospitalization. Using statewide commercial insurance claims linked to cross-sectional commercial credit data, we identified caregivers of children with PICU hospitalizations in January-June 2020 and January-June 2021. Credit data included delinquent debt, debt in collections (medical and non-medical), low credit score (< 660), and a composite of any debt or poor credit and were measured in January 2021 for all caregivers. ⋯ Overall, 39.5% and 36.5% of post-PICU and comparator caregivers, respectively, had delinquent debt, debt in collections or poor credit. Many caregivers of critically ill children have financial debt or poor credit during hospitalization and post-discharge. However, caregivers may be at higher risk for poor financial status following their child's critical illness.
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J Pain Symptom Manage · Jun 2023
ReviewCommunity informed recruitment: a promising method to enhance clinical trial participation.
Low recruitment rates in palliative care clinical trials amongst Black and rural individuals have been attributed to lack of trust and procedural barriers. Community engagement strategies have increased clinical trial participation of under-represented populations. ⋯ A novel community-enhanced recruitment strategy demonstrated the potential to increase clinical trial participation from historically under-represented populations.
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J Pain Symptom Manage · Jun 2023
Randomized Controlled TrialThe Value of Advance Care Planning for Spokespersons of Patients with Advanced Illness.
Advance Care Planning (ACP) has fallen under scrutiny primarily because research has not consistently demonstrated patient-focused benefits. ⋯ Considering the recent debate about the utility of ACP and ADs, this analysis highlights the value of ACP for spokespersons involved in surrogate decision-making. Reframing the goals of ACP in terms of their benefit for spokespersons (and identifying appropriate outcome measures) may provide additional perspective on the utility of ACP.