Search results for ‘Subject term:"palliative care"’ Sort:
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A national survey of home-based care kits for palliative HIV/AIDS care in South Africa
- Authors:
- MADUDE Z. A., et al
- Journal article citation:
- AIDS Care, 20(8), September 2008, pp.931-937.
- Publisher:
- Taylor and Francis
The objective of this study was to assess home-based care (HBC) kits and programs in South Africa to evaluate the feasibility of scaling up kit production and distribution. South African HBC organizations received structured questionnaires; key informant interviews and a literature review were completed to assess systems for production, distribution and supply of HBC kits. Meetings with stakeholders were held in two Provinces to share and analyze the study findings. The study team distributed questionnaires to 466 organizations and conducted interviews with representatives from 45 organizations, the Provincial Department of Health (DoH) and manufacturers of kits. All identifiable HBC organizations in South Africa were included in the survey. As a result 215 HBC organizations returned questionnaires; including non-governmental organizations (56%), community-based organizations (32%) and organizations affiliated with government health departments. Two types of kits were available: a home kit and a professional kit. The demand for HBC kits exceeded availability, kit contents and availability varied considerably and the supply chain was irregular. Kit production and distribution systems were fragmented. Replenishment of kit items was problematic. End-users are mostly caregivers who have not received adequate training on their use. The study shows that substantial work has been done by HBC organizations in South Africa to respond to the need for palliative care supplies within resource constraints. The growing demand for kits exceeds the supply. There is a need to improve the supply chain management of HBC kits, strengthen referral systems and links between community-based organizations and government departments, expand training opportunities for care givers, and develop monitoring and evaluation systems.
Barriers to access to medical cannabis for Canadians living with HIV/AIDS
- Authors:
- BELLE-ISLE L., HATHAWAY A.
- Journal article citation:
- AIDS Care, 19(4), April 2007, pp.500-506.
- Publisher:
- Taylor and Francis
North American studies suggest that as many as one-third of people living with HIV/AIDS self-medicate with cannabis for relief of physical and stress-related symptoms. Although cannabis remains a controlled substance in Canada, legal access has been granted to people with HIV/AIDS and other serious illness under the Marihuana Medical Access Regulations (MMAR) since 2001. Several years into the programme, however, few Canadians (∼1400) have obtained MMAR approval, suggesting that substantial obstacles remain. This paper reports findings from a 2005 survey (n=197) and focus groups conducted to identify barriers to access to medical cannabis among people living with HIV/AIDS. Most (86%) respondents who reported using cannabis as medicine continue to rely on illegal sources for their supply. They cited lack of information, product quality concerns, and an onerous, confusing application process among other problems mentioned with the MMAR. The findings are discussed in terms of policy suggestions for facilitating access to a legal source of cannabis for medical users.
Cancer pain relief: with a guide to opioid availability
- Author:
- WORLD HEALTH ORGANIZATION
- Publisher:
- World Health Organization
- Publication year:
- 1996
- Pagination:
- 69p.,bibliog.
- Place of publication:
- Geneva
The first edition of this book proposed a method for relief of cancer pain, based on a small number of relatively inexpensive drugs, including morphine. Field testing in a number of countries demonstrated the efficacy of the method in most cancer patients. The second edition takes into account may of the advances in understanding and practice that have occurred since the mid-1980s. Stresses throughout the importance of undertaking pain relief as part of comprehensive palliative care.
Barriers in the decision making about and performance of continuous sedation until death in nursing homes
- Authors:
- ROBIJN Lenzo, et al
- Journal article citation:
- Gerontologist, 60(5), 2020, pp.916-925.
- Publisher:
- Oxford University Press
Background and Objectives: While decision making about and performance of continuous sedation involve many challenges, they appear to be particularly pervasive in nursing homes. This study aims to identify barriers to the decision making and performance of continuous sedation until death in Flemish nursing homes as experienced by the health care professionals involved. Research Design and Methods: Ten focus groups were held with 71 health care professionals including 16 palliative care physicians, 42 general practitioners, and 13 nursing home staff. Discussions were transcribed verbatim and analyzed using a constant comparative approach.Results: Perceived barriers concerned factors prior to and during sedation and were classified according to three types: (a) personal barriers related to knowledge and skills including the lack of clarity on what continuous sedation should be used for (linguistic ambiguity) and when and how it should be used (practical ambiguity); (b) relational barriers concerning communication and collaboration both between health care professionals and with family; (c) organizational barriers related to the organization of care in nursing homes where, for example, there is no on-site physician, or where the recommended medication is not always available. Discussion and Implications: The findings suggest there are considerable challenges for sound decision making about and performance of continuous sedation until death in nursing homes. There is a need for multicomponent initiatives that provide guidance in the context of the complexity of a resident’s medical situation, the family, and the specific organization of care, which would have the potential to facilitate and improve the decision-making process and performance of continuous sedation in nursing homes. (Publisher abstract)
Understanding learning disability and dementia: developing effective interventions
- Author:
- KERR Diana
- Publisher:
- Jessica Kingsley
- Publication year:
- 2007
- Pagination:
- 198p., bibliog.
- Place of publication:
- London
The increased longevity of the population at large also means that the number of people with a learning disability is living longer, and the numbers of these people developing dementia will continue to increase. Service providers, planners, doctors, social workers, carers and direct support staff need to be equipped with relevant knowledge prior to the onset of the condition, so they can devise appropriate therapeutic interventions and coping strategies for managing the effects of dementia, including health and medication management and palliative care. This book will provide essential knowledge for anyone involved in the provision of services, assessment of need and direct care and support for dementia sufferers who also have a learning disability.
Ethical foundations of palliative care for Alzheimer Disease
- Editors:
- PURTILO Ruth B., HAVE Henk A.M.J. ten, (eds.)
- Publisher:
- Johns Hopkins University Press
- Publication year:
- 2004
- Pagination:
- 368p.
- Place of publication:
- Baltimore, MD
Alzheimer disease afflicts more than twelve million people worldwide, and its incidence is increasing at a staggering rate. People with the disorder are living longer than have those in previous generations, and they require interventions for quality-of-life issues associated with palliative care. However, the symptoms of Alzheimer disease often fail to place such persons into settings where palliative care resources are available to them. Indeed, clinicians and other caregivers may be unsure about what constitutes effective palliation in these cases. At the same time, the ethical issues involved in providing end-of-life care to persons with Alzheimer disease remain on the margins of mainstream bioethics. In Ethical Foundations of Palliative Care for Alzheimer Disease, leading ethicists and clinicians from the United States and Europe explore ethical and scientific concerns about the diagnosis and prognosis of Alzheimer disease, challenges arising from applying palliative procedures to its symptoms, key philosophical and theological concepts central to our understanding of the disease and to end-of-life decisions, and the changing patterns of relevant medical, social, and economic policies. Cross-cultural, multidisciplinary, and state-of-the-art, this volume is a resource for bioethicists, clinicians, and policy makers everywhere.
Changing gear: guidelines for managing the last days of life in adults: 2006 update
- Author:
- NATIONAL COUNCIL FOR PALLIATIVE CARE
- Publisher:
- National Council for Palliative Care
- Publication year:
- 2006
- Pagination:
- 32p., bibliog.
- Place of publication:
- London
- Edition:
- Rev. ed.
Guidelines designed for the use of health care professionals who are caring for dying patients in all settings including primary care, care homes as well as in hospices. The guidelines include a section on the use of drugs in the last days of life.
Relieving suffering at the end of life: practitioners' perspectives on palliative sedation from three European countries
- Authors:
- SEYMOUR Jane E., JASSENS Rien, BROECKAERT Bert
- Journal article citation:
- Social Science and Medicine, 64(8), April 2007, pp.1679-1691.
- Publisher:
- Elsevier
This paper reports findings from visits to palliative care settings and research units in the UK, Belgium and the Netherlands. The aim was to learn about clinicians’ (both nurses and doctors) and academic researchers’ understandings and experiences of palliative sedation for managing suffering at the end of life, and their views regarding its clinical, ethical and social implications. The project was linked to two larger studies of technologies used in palliative care. Eleven doctors, 14 nurses and 10 researchers took part in informal interviews. Relevant reports and papers from the academic, clinical and popular press were also collected from the three countries. The study took place in a context in which attention has been drawn towards palliative sedation by the legalisation of euthanasia in the Netherlands and Belgium, and by the re-examination of the legal position on assisted dying in the UK. In this context, palliative sedation has been posited by some as an alternative path of action. The authors report respondents’ views under four headings: understanding and responding to suffering; the relationship between palliative sedation and euthanasia; palliative sedation and artificial hydration; and risks and uncertainties in the clinician-patient/family relationship. They conclude that the three countries can learn from one another about the difficult issues involved in giving compassionate care to those who are suffering immediately before death.
Professional advice: the safe management of controlled drugs in care homes
- Author:
- COMMISSION FOR SOCIAL CARE INSPECTION
- Publisher:
- Commission for Social Care Inspection
- Publication year:
- 2006
- Pagination:
- 11p.
- Place of publication:
- London
Inspectors are confident about the special arrangements that care providers should make when controlled drugs are prescribed for people in care homes. Inspectors have a clear understanding: why some medicines are ‘controlled drugs’; what the regulations and national minimum standards say; particular issues when residents look after and take their own controlled drugs; the safeguards that must be in place when care workers give controlled drugs to residents ; whether care homes can buy a stock of controlled drugs; and what changes will occur as a result of the Shipman Inquiry .
How can patients with COVID-19 and their family or unpaid carers be enabled and supported to manage palliative care treatment safely and effectively at home?
- Authors:
- FRANCE Rachel, et al
- Publisher:
- University of Oxford, Centre for Evidence-Based Medicine
- Publication year:
- 2020
- Place of publication:
- Oxford
A review of the evidence to determine how people with COVID-19 and unpaid carers could be enabled and supported by healthcare professionals to manage palliative care treatment safely and effectively at home. There is a need for prompt, responsive and anticipatory support for carers at home who may be feeling unsure about their role in providing end-of-life care and where to turn to for support and treatment for their relative. Key messages emerging from the literature include: healthcare systems have had to adapt rapidly to respond to the COVID-19 pandemic – as a result, some family and unpaid carers may take on additional responsibilities in providing palliative care treatment for patients who have opted to die at home but carers may feel unsure about their role in providing end-of-life care and where to turn for support and treatment for their relative; no empirical research was found that has been conducted during the current COVID-19 pandemic to inform how to support carers of people receiving palliative care at home or to clarify whether this approach is safe for all involved; research assessing the needs of home carers in other palliative care contexts suggests carers may be enabled to manage medication at home, provided that appropriate support and education is given, and that carers have the required capabilities; the use of digital technology can help, but healthcare professionals should be aware that not all carers have access to suitable equipment; providing education for carers, relevant to their caring role, as well as supporting their general wellbeing, can be of benefit – however, providing formal, structured interventions presents considerable challenges during the pandemic. (Edited publisher abstract)