Search results for ‘Subject term:"palliative care"’ Sort:
Results 1 - 10 of 51
Provision of palliative care education in nursing homes
- Authors:
- MATHEWS Kathryn, FINCH Jemma
- Journal article citation:
- Nursing Times, 31.01.06, 2006, pp.36-40.
- Publisher:
- Nursing Times
This study aimed to explore the provision of education to nursing home staff across Mount Vernon Cancer Network (MVCN). Data was gathered from questionnaires, face-to-face and telephone interviews, visiting palliative care teams across Mount Vernon Cancer Network and attendance at conferences, meetings and seminars. A comprehensive needs assessment for palliative care education within nursing homes was completed. The findings revealed inequality across the network with regard to education provision and uptake of palliative care services. Recruitment of overseas staff and a transient workforce were both cited as major difficulties in implementing education programmes. It was concluded that there was a real and urgent need for palliative care training in the network area and there was scope for a variety of approaches to be adopted to deliver the required training.
Delivering hospice care during the COVID-19 pandemic: meeting nursing home residents' needs
- Authors:
- MEDINA Ashleigh, HUEY-MING Tzeng
- Journal article citation:
- Journal of Hospice and Palliative Nursing, early cite 17 May 2021,
- Publisher:
- Wolters Kulwer
This discussion article highlights the challenges of providing hospice care in nursing homes since the start of the COVID-19 (coronavirus disease 2019) pandemic and illuminates practice changes needed in nursing homes. The article provides an overview of the expectations of hospice care, explains the differences in delivering hospice care during the COVID-19 pandemic, examines social isolation and emotional loneliness and the role of familial caregivers, and describes policy changes related to the COVID-19 affecting hospice care delivery in nursing homes. This article answers the following questions: (1) How did residents receiving hospice care have their needs met during the COVID-19 pandemic? (2) What areas of nursing home care need to be improved through governmental policy and restructuring? This article also summarized the lessons learned as a result of the COVID-19 pandemic and provided practical implications for nursing, specific to changes in hospice care deliveries for nursing home residents. (Edited publisher abstract)
Capacity to care: a data analysis and discussion of the capacity and function of care homes as providers of end of life care
- Author:
- TEBBIT Peter
- Publisher:
- National Council for Palliative Care
- Publication year:
- 2008
- Pagination:
- 11p.
- Place of publication:
- London
Care homes with nursing are major contributors to palliative and end of life care. The purpose of this brief paper is to offer some insights into the question as to whether the volume of current provision of care homes with nursing is sufficient to meet local needs and what the consequences may be of any inadequate levels of provision.
Offering symptom relief
- Author:
- CHEESMAN Chris
- Journal article citation:
- Caring Times, March 1998, pp.20-21.
- Publisher:
- Hawker
Palliative and respite care are expensive. Reports on how one not-for-profit home manages to meet the demand for this specialist care.
Consequences of visiting restrictions during the COVID-19 pandemic: an integrative review
- Authors:
- HUGELIUS Karin, HARADA Nahoko, MARUTANI Miki
- Journal article citation:
- International Journal of Nursing Studies, 121, 2021, p.104000.
- Publisher:
- Elsevier
Background: During the COVID-19 pandemic, visiting restrictions of different extents have been implemented. However, despite the long history of visiting restrictions in health care systems, little is known about their effects. Objectives: This review sought to explore the consequences of visitor restrictions in health care services during the COVID-19 pandemic. Methods: A systematic, integrative review was conducted in accordance with the PRISMA guidelines, based on a systematic search in PubMed, CHINAL full plus, Web of Science, PsychInfo, Scopus and the Cochrane Library. Results: A total of 17 scientific papers covering intensive care, paediatric care, general medical care, hospital care, palliative care and nursing home settings were included. Although appreciation for the technical solutions enabling remote meetings was reported, visiting restrictions had several consequences, mainly negative, for the patient's health, the health and wellbeing of family members and the provision of care. Among physical health consequences, reduced nutrition intake, decreased activities of daily living and increased physical pain and symptoms were reported. Among mental health consequences for the patient, loneliness, depressive symptoms, agitation, aggression, reduced cognitive ability and overall dissatisfaction were observed. For family members, worry, anxiety and uncertainty occurred, and they reported an increased need for information from care providers. Family members of neonatal intensive care unit patients reported less bonding with their child and family relation disturbances due to the restrictions. For care providers, visiting restrictions added the burdens of ethical dilemmas, learning new technical means to enable social interaction and an increased demand for communication with families and providing social support to both family members and patients. Conclusions: When implementing visiting restrictions in health care services, decision makers and nurses need to be aware of their potential negative effects and adapt the provision of care to compensate for such effects. Nurses in all sectors should be aware that visiting restrictions may affect patients, families, and health care services for longer than the actual pandemic. Since the level of evidence regarding effect from visiting restrictions is low, further studies is strongly needed. (Edited publisher abstract)
Separation characterized by responsibility and guilt: family caregivers’ experiences with palliative care for a close family member with severe dementia in long-term care facilities
- Authors:
- MIDTBUST May H., et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 20(2), 2021, pp.518-533.
- Publisher:
- Sage
Aim and objectives: The aim of this study was to explore family caregivers’ experiences with palliative care for a close family member with severe dementia in long-term care facilities. Background: Dementia not only affects individuals but also affects and changes the lives of close family members. An increasing number of dementia-related deaths occur in long-term care facilities; therefore, it is critical to understand how healthcare professionals support and care for residents with dementia and their families at the end of life. Design: A qualitative design with a phenomenological approach was adopted. Methods: In-depth interviews were performed with 10 family caregivers of residents in 3 Norwegian long-term care facilities. Results: The family caregivers’ experiences with palliative care for a close family member with severe dementia in long-term care facilities were characterized by responsibility and guilt. Admission to a long-term care facility became a painful relief for the family caregivers due to their experiences with the poor quality of palliative care provided. The lack of meaningful activities and unsatisfactory pain relief enhanced the feelings of responsibility and guilt among the family caregivers. Despite the feelings of insecurity regarding the treatment and care given during the early phase of the stay, the family caregivers observed that their close family member received high-quality palliative care during the terminal phase. The family caregivers wanted to be involved in the care and treatment, but some felt that it became a heavy responsibility to participate in ethical decision-making concerning life-prolonging treatment. Conclusions: The family caregivers experienced ongoing responsibility for their close family members due to painful experiences with the poor quality of the palliative care provided. When their expectations regarding the quality of care were not met, the palliative care that was offered increased their feeling of guilt in an already high-pressure situation characterized by mistrust. (Edited publisher abstract)
A systematic review of nursing home palliative care interventions: characteristics and outcomes
- Authors:
- CARPENTER Joan G, et al
- Journal article citation:
- Journal of the American Medical Directors Association, 21(5), 2020, pp.P583-596.E2.
- Publisher:
- Elsevier (for the American Medical Directors Association)
Background: Despite recommendations to integrate palliative care into nursing home care, little is known about the most effective ways to meet this goal. Objective: To examine the characteristics and effectiveness of nursing home interventions that incorporated multiple palliative care domains (eg, physical aspects of care—symptom management, and ethical aspects—advance care planning). Design: Systematic review. Methods: This study searched MEDLINE via PubMed, Embase, CINAHL, and Cochrane Library's CENTRAL from inception through January 2019. This study included all randomized and nonrandomized trials that compared palliative care to usual care and an active comparator. This study assessed the type of intervention, outcomes, and the risk of bias. Results: The researchers screened 1167 records for eligibility and included 13 articles. Most interventions focused on staff education and training strategies and on implementing a palliative care team. Many interventions integrated advance care planning initiatives into the intervention. This study found that palliative care interventions in nursing homes may enhance palliative care practices, including processes to assess and manage pain and symptoms. However, inconsistent outcomes and high or unclear risk of bias among most studies requires results to be interpreted with caution. Conclusions and Implications: Heterogeneity in methodology, findings, and study bias within the existing literature revealed limited evidence for nursing home palliative care interventions. Findings from a small group of diverse clinical trials suggest that interventions enhanced nursing home palliative care and improved symptom assessment and management processes. (Edited publisher abstract)
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)
Analysis of advance directive documentation to support palliative care activities in nursing homes
- Authors:
- GALAMBOS Colleen, et al
- Journal article citation:
- Health and Social Work, 41(4), 2016, pp.228-234.
- Publisher:
- Oxford University Press
As part of an intervention to improve health care in nursing homes with the goal of reducing potentially avoidable hospital admissions, 1,877 resident records were reviewed for advance directive (AD) documentation. At the initial phases of the intervention, 50 percent of the records contained an AD. Of the ADs in the resident records, 55 percent designated a durable power of attorney for health care, most often a child (62 percent), other relative (14 percent), or spouse (13 percent). Financial power of attorney documents were sometimes found within the AD, even though these documents focused on financial decision making rather than health care decision making. Code status was the most prevalent health preference documented in the record at 97 percent of the records reviewed. The intervention used these initial findings and the philosophical framework of respect for autonomy to develop education programs and services on advance care planning. The role of the social worker within an interdisciplinary team is discussed. (Publisher abstract)
Getting serious about prevention: enabling people to stay out of hospital at the end of life
- Author:
- GREY Andrew
- Publisher:
- National Council for Palliative Care
- Publication year:
- 2015
- Pagination:
- 19
- Place of publication:
- London
This report sets out key steps that commissioners can take in collaboration with service providers to enable people who are approaching the end of life to avoid being admitted to hospital when this is possible and appropriate, as well as enabling those who are admitted to make a transition to a community setting quickly. The report argues that as well as reducing the costs to the NHS, enabling people to stay out of hospital at the end of life can make a significant difference to the experiences of dying people and their families. The report makes a number of recommendations for commissioners, service providers and health and social care staff, including: commissioning the increased provision of 24/7 care in community settings, through care homes and hospices, and community health and social care services that can provide care in people’s homes; commissioning anticipatory prescribing of medicines for people approaching the end of life; using available funding, through System Resilience Groups, the Better Care Fund, and Integrated Personal Commissioning, to improve co-ordination between hospitals and community settings, including hospices, for people approaching the end of life; and health and social care staff identifying carers of people who are approaching the end of life and referring them for local authority assessments. (Edited publisher abstract)