Search results for ‘Subject term:"end of life care"’ Sort:
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Good decision making: what you need to know about the Mental Capacity Act and end of life care
- Authors:
- NATIONAL COUNCIL FOR PALLIATIVE CARE, DYING MATTERS COALITION
- Publishers:
- National Council for Palliative Care, Dying Matters Coalition
- Publication year:
- 2017
- Pagination:
- 20
- Place of publication:
- London
- Edition:
- 2nd ed.
This booklet provides information to help people approaching the end of life, their families and carers, and health and social care staff to understand the Mental Capacity Act (MCA) and how it affects decision-making at the end of life. It explains how people can use the MCA to express and protect their wishes about their future care and what it means for carers. It includes information on assessing a person’s capacity to make a decisions, making a best interests decisions, Independent Mental Capacity Advocates, and Deprivation of Liberty Safeguards (DOLS). (Edited publisher abstract)
The will-to-live scale: development, validation, and significance for elderly people
- Author:
- CARMEL Sara
- Journal article citation:
- Aging and Mental Health, 21(3), 2017, pp.289-296.
- Publisher:
- Taylor and Francis
Objectives: In old age, the will-to-live (WTL) is one of the most important indicators of subjective well-being (SWB). However, few studies to date have focused on WTL. In these studies, WTL has mainly been evaluated via indirect questions concerning factors that may influence peoples’ WTL, or by measures directed to patients with specific diseases. The current study describes the development and psychometric properties of a new WTL scale. Method: The five-item WTL scale was developed on the basis of previous qualitative and quantitative research, and was evaluated in a longitudinal study of a random sample of 868 adults, aged 75+. Results: Confirmatory factor analytic (CFA) models were computed showing that each of the five items contributed significantly to measurement of a single WTL latent factor. Goodness-of-fit statistics were in ideal parameters for these CFA models at each point of data collection. Moreover, temporal analyses indicated that the relative contribution to measurement for each item was equivalent across time, attesting to reliability of measurement and the construct validity of WTL measurement. Concurrent validity was supported by significant positive correlations between WTL and life satisfaction, happiness, self-rated health, morale, self-rated aging, and, as expected, by inverse associations of WTL with depression and loneliness. Conclusion: The results of these analyses indicate that the WTL scale is a valid and reliable instrument. Considering the importance of the WTL concept in late life, and the psychometric properties of the WTL scale, the authors recommend it for use in research and practice related to older adults’ SWB and end-of-life care. (Edited publisher abstract)
Rules of thumb for end of life care for people with dementia
- Authors:
- DAVIES Nathan, ILIFFE Steve
- Publisher:
- University College London
- Publication year:
- 2016
- Pagination:
- 20
- Place of publication:
- London
This paper provides four ‘rules of thumb’ which offer a framework for practitioners providing end of life care for someone with dementia. The rules cover: eating and swallowing difficulties; agitation and restlessness; reviewing treatment and interventions at the end of life; and providing routine care at the end of life. Each ‘rule of thumb’ consists of a flow chart, taking the practitioner through the decision making process, and a list of points to consider. The rules of thumb are one of the outputs from the After the Liverpool Care Pathway Study and have been produced through a development study with the help of family carers and practitioners. They have also been tested across five different sites: 2 palliative care teams, a community nursing team, a general practice, and a hospital ward. For the purposes of the study, end of life care was taken to be period when the person, their family or practitioners recognise that they might be dying. (Edited publisher abstract)
Consultation report: feedback on the quality of end of life care
- Author:
- NHS ENGLAND
- Publisher:
- NHS England
- Publication year:
- 2016
- Pagination:
- 26
- Place of publication:
- London
This is NHS England’s report of a public consultation undertaken on the collection of feedback relating to the quality of end of life care through the VOICES-SF survey (Views Of Informal Carers’ Evaluation of Service – Short Form). The survey measures of end of life care provision, using a sample extracted from the database held by The Office of National Statistics by selecting from adult deaths registered in the months January to April. This document sets out the findings of the consultation and how they are likely to contribute to any potential changes to the format and structure of the survey in the future. Specifically, the consultation looked at: how the survey findings are reported; how the survey is currently used; who takes part in the survey; how frequently the survey is carried out; and how quickly the survey data is published. Respondents indicated that VOICES-SF survey findings would be more helpful if the sample size were made large enough to report at a local level; asking for the views of a range of people, and not just the bereaved, would provide different perspectives and give richer sources of insight; and shortening the time lapse between the point of care and the publication of results would enable them to confidently make decisions based on up-to-date and relevant data. (Edited publisher abstract)
Better endings: a review of end-of-life services
- Authors:
- LAMONT T., RICHARDSON A.
- Journal article citation:
- Nursing Times, 112(12/13), 2016, pp.16-18.
- Publisher:
- Nursing Times
The NHS has undertaken research on the organisation and quality of end-of-life services, which provides valuable insights for those planning and delivering care for people approaching the end-of-life, and their families. The review of the findings, structured around the right care in the right place at the right time highlights what is already known, and how research that is currently under way will address key gaps and uncertainties for frontline staff and clinical leaders. This article summaries the findings outlined in the review. (Publisher abstract)
Using volunteers to support end-of-life care
- Authors:
- BIRD Sharon, et al
- Journal article citation:
- Nursing Times, 112(14), 2016, pp.12-13.
- Publisher:
- Nursing Times
This article reports on an innovative model of care using trained volunteers to provide support and comfort for patients who were dying, their families and friends. The programme was introduced at a Liverpool Trust in 2012. Volunteers completed a training programme and also received support with regular supervision as well as psychological and peer support. The service found that volunteers can make a substantial contribution to meet the needs of people people who are dying and their families. (Edited publisher abstract)
From research to policy and practice: Marie Curie annual research impact report 2014/15
- Author:
- MARIE CURIE
- Publisher:
- Marie Curie
- Publication year:
- 2016
- Pagination:
- 50
- Place of publication:
- London
This report outlines the research output of Marie Curie and describes how it uses evidence to inform clinical practice and improve care for people living with terminal illness throughout the UK. It sets out the research funding landscape, assesses the impact of research output, and examines the capacity building and research engagement activities carried out in 2014/15. (Edited publisher abstract)
Comparing end-of-life practices in different policy contexts: a scoping review
- Authors:
- BOIVIN Antoine, et al
- Journal article citation:
- Journal of Health Services Research and Policy, 20(2), 2015, pp.115-123.
- Publisher:
- Sage
- Place of publication:
- London
Objectives: End-of-life policy reforms are being debated in many countries. Research evidence is used to support different assumptions about the effects of public policies on end-of-life practices. It is however unclear whether reliable international practice comparisons can be conducted between different policy contexts. The authors aim was to assess the feasibility of comparing similar end-of-life practices in different policy contexts. Methods: This is a scoping review of empirical studies on medical end-of-life practices. A descriptive classification of end-of-life practices that distinguishes practices according to their legal status was examined. The authors focused on the intentional use of lethal drugs by physicians because of international variations in the legal status of this practice. Bibliographic database searches were supplemented by expert consultation and hand searching of reference lists. The sensitivity of the search strategy was tested using a set of 77 articles meeting the inclusion criteria. Two researchers extracted end-of-life practice definitions, study methods and available comparisons across policy contexts. Canadian decision-makers were involved to increase the policy relevance of the review. Results: In sum, 329 empirical studies on the intentional use of lethal drugs by doctors were identified, including studies from 19 countries. The bibliographic search captured 98.7% of studies initially identified as meeting the inclusion criteria. Studies on the intentional use of lethal drugs were conducted in jurisdictions with permissive (62%) and restrictive policies (43%). The most common study objectives related to the frequency of end-of-life practices, determinants of practices, and doctors’ adherence to regulatory standards. Large variations in definitions and research methods were noted across studies. The use of a descriptive classification was useful to translate end-of-life practice definitions across countries. A few studies compared end-of-life practice in countries with different policies, using consistent research methods. The authors identified no comprehensive review of end-of-life practices across different policy contexts. Conclusions: It is feasible to compare end-of-life practices in different policy contexts. A systematic review of international evidence is needed to inform public deliberations on end-of-life policies and practice. (Edited publisher abstract)
The economic evidence for advance care planning: systematic review of evidence
- Authors:
- DIXON Josie, MATOSEVIC Tihana, KNAPP Martin
- Journal article citation:
- Palliative Medicine, 29(10), 2015, pp.869-884.
- Publisher:
- Hodder Arnold
Background: Advance care planning is a process of discussion and review concerning future care in the event of losing capacity. Aimed at improving the appropriateness and quality of care, it is also often considered a means of making better use of healthcare resources at the end of life. Aim: This systematic review of the academic literature aimed to summarise economic evidence on advance care planning. Data sources: Searches were conducted for English language, peer-reviewed journal articles, between 1990-2014, using relevant research databases: PubMed, ProQuest, CINAHL Plus with Full Text; EconLit, PsycINFO, SocINDEX with Full Text and International Bibliography of the Social Sciences. Empirical studies using statistical methods in which advance care planning and costs are variables were included. Results: There are no published cost-effectiveness studies. Included studies focus on healthcare savings, usually associated with reduced demand for hospital care. Advance care planning appears to be associated with healthcare savings for some people in some circumstances, such as people living with dementia in the community, people in nursing homes or in areas with high end-of-life care spending. There is no evidence that advance care planning is likely to be more expensive. Conclusion: There is need for clearer articulation of the likely mechanisms by which advance care planning can lead to reduced care costs or improved cost-effectiveness, particularly for people who retain capacity. There is also a need to consider wider costs, including the costs of advance care planning facilitation or interventions and the costs of substitute health, social and informal care. Economic outcomes need to be considered in the context of quality benefits. (Edited publisher abstract)
Supporting carers in end of life care: an introductory programme
- Author:
- UNIVERSITY OF NOTTINGHAM
- Publisher:
- University of Nottingham
- Publication year:
- 2015
- Place of publication:
- Nottingham
This training programme and resource pack, produced by the University of Nottingham and funded by Marie Curie and Dimbleby Cancer Care, are intended to offer basic knowledge and skills for those who provide support for informal carers (usually family members or friends) who are providing home-based end of life care. There are seven sessions in the programme, which can be facilitated over a one-day course; each session contains extra content and exercises that can be used to expand the programme. The sessions are: introduction and welcome; caring and being cared for; supporting in practice; being a safe supporter; the principles of supporting; boundaries and exit strategies; and ongoing learning and development. The training pack comprises: a facilitator handbook; a trainee workbook; resources selected by bereaved carers; pre-course reading; a promotional poster template; and session slides. (Edited publisher abstract)