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Expanding The Concept Of ‘Care’: A Narrative Study Exploring Lessons From End-Of-Life Patients To Inform ‘Medical Assistance In Dying’ Curriculum In Canada, Jill Dombroski 2017 The University of Western Ontario

Expanding The Concept Of ‘Care’: A Narrative Study Exploring Lessons From End-Of-Life Patients To Inform ‘Medical Assistance In Dying’ Curriculum In Canada, Jill Dombroski

Electronic Thesis and Dissertation Repository

This research primarily investigates what we can learn from patient experiences that can help inform the expected curricula that will be developed in response to the new Canadian legislation regarding Medical Assistance in Dying (MAID). This is a compelling area of research because of the rapidly evolving attitudes in the general population — largely driven by terminally ill patients asserting their legal rights over their bodies and the decision to put an end to their lives as a consequence of the illness they face. The issue of medical assistance in dying has been patient initiated and patient driven. Through the lens ...


Palliative Players: Project Development And Initial Implementation, Eliza Eager 2017 University of Southern Maine

Palliative Players: Project Development And Initial Implementation, Eliza Eager

Muskie School Capstones

The Palliative Players are screened and trained hospice volunteers who provide a low-cost, sustainable, role-playing resource for use teaching communication skills to healthcare workers who discuss serious illness with patients and their families. The Palliative Players project was conceived and developed in early 2017 by Dr. Lauren Michalakes, Medical Director of Palliative Care at Coastal Healthcare Alliance (CHA); Sarah Dwelley, RN; Flic Shooter, Director of Hospice Volunteers of Waldo County (HVOWC); and Eliza Eager, Project Coordinator; to provide believable, emotive simulated patients (SPs) for role-play in workshops teaching healthcare workers communication tools and skills for use in conversations with patients ...


Patients' And Caregivers' Needs, Experiences, Preferences And Research Priorities In Spiritual Care: A Focus Group Study Across Nine Countries., Lucy Ellen Selman, Lisa Jane Brighton, Shane Sinclair, Ikali Karvinen, Richard Egan, Peter Speck, Richard A Powell, Ewa Deskur-Smielecka, Myra Glajchen, Shelly Adler, Christina Puchalski, Joy Hunter, Nancy Gikaara, Jonathon Hope 2017 George Washington University

Patients' And Caregivers' Needs, Experiences, Preferences And Research Priorities In Spiritual Care: A Focus Group Study Across Nine Countries., Lucy Ellen Selman, Lisa Jane Brighton, Shane Sinclair, Ikali Karvinen, Richard Egan, Peter Speck, Richard A Powell, Ewa Deskur-Smielecka, Myra Glajchen, Shelly Adler, Christina Puchalski, Joy Hunter, Nancy Gikaara, Jonathon Hope

Medicine Faculty Publications

Background:

Spiritual distress is prevalent in advanced disease, but often neglected, resulting in unnecessary suffering. Evidence to inform spiritual care practices in palliative care is limited.

Aim:

To explore spiritual care needs, experiences, preferences and research priorities in an international sample of patients with life-limiting disease and family caregivers.

Design:

Focus group study.

Setting/participants:

Separate patient and caregiver focus groups were conducted at 11 sites in South Africa, Kenya, South Korea, the United States, Canada, the United Kingdom, Belgium, Finland and Poland. Discussions were transcribed, translated into English and analysed thematically.

Results:

A total of 74 patients participated: median ...


Barriers To Advance Directives, Anna Malia Connor Ticknor 2017 DePaul University

Barriers To Advance Directives, Anna Malia Connor Ticknor

Grace Peterson Nursing Research Colloquium

Abstract

Background: Advanced directives (ADs) are legal documents that allows an individual to document their specific wishes for medical care should they be unable to speak for themselves. The use of advanced directives has implications directing the course of end-of-life care affecting both the cost and direction of care. Advance directives can clarify confusion and provide guidance, but their implementation is not clearly defined within the healthcare system. Despite their implications, multiple surveys indicate these documents have limited use within the United States for reasons that are not easily isolated including lack of knowledge of advanced directives and lack of ...


Palliative Care In India, Gracen Bookmyer 2017 Western Washington University

Palliative Care In India, Gracen Bookmyer

Palliative Care Institute

This essay addresses the cultural, ethical and political barriers throughout the historical and contemporary context of Palliative Care implementation, prioritization and progress in India. It touches upon the conflicting forces that arise between Western models of Palliative Care and the cultural perspectives on end of life care in India. It poses solutions and methods for navigating these challenges and discusses the communities who are most impacted by the lack of Palliative Care (PC) programs in India.


Black-White Disparities In Pain Management Among Nursing Home Residents With Cancer, Deborah Mack, Jacob N. Hunnicutt, William M. Jesdale, Christine M. Ulbricht, Kate L. Lapane 2017 University of Massachusetts Medical School

Black-White Disparities In Pain Management Among Nursing Home Residents With Cancer, Deborah Mack, Jacob N. Hunnicutt, William M. Jesdale, Christine M. Ulbricht, Kate L. Lapane

UMass Center for Clinical and Translational Science Research Retreat

Background: Racial disparities in pain management persist across healthcare settings and likely extend into nursing homes. No studies to-date have thoroughly evaluated racial disparities in cancer pain management in this setting.

Methods: Using a cross-sectional study design, we compared reported pain and pharmacological pain management between non-Hispanic White and Black newly admitted nursing home residents with cancer (n=113,765) using the Minimum Data Set version 3.0. Pain management strategies considered included: use of scheduled analgesics, pro re nata analgesics, and non-pharmacological methods. Presence of pain was based on self-report when residents were able to, or by staff. Logistic ...


Program - Palliative Care Institute 2017 Conference: Helping 'Til It Hurts, Palliative Care Institute 2017 Western Washington University

Program - Palliative Care Institute 2017 Conference: Helping 'Til It Hurts, Palliative Care Institute

Palliative Care Institute

No abstract provided.


Peacehealth Advance Directives & Palliative Care, Scott Foster MD, MPH 2017 PeaceHealth Medical Group

Peacehealth Advance Directives & Palliative Care, Scott Foster Md, Mph

Palliative Care Institute

Dr. Scott Foster, MD., MPH., Chief Medical Executive for PeaceHealth Medical Group, presented at the Your Voice-Your Choice: Let's Talk About It event on March 22, 2017 at St. Luke's Health Education Center.

Dr. Foster highlighted PeaceHealth's commitment to a comprehensive system for understanding, documenting and honoring patient values and goals for care at the end of life in all healthcare settings, including Advance Directives.


Northwest Life Passages Blueprint: Creating A Healing And Caring Community Of Excellence, Marie Eaton 2017 Fairhaven College, Western Washington University

Northwest Life Passages Blueprint: Creating A Healing And Caring Community Of Excellence, Marie Eaton

Palliative Care Institute

Presentation to the Elder Service Providers Network about the Northwest Life Passages Blueprint on March 22, 2017.


It Always Seems Too Early, Until It’S Too Late, Marie Eaton 2017 Western Washington University

It Always Seems Too Early, Until It’S Too Late, Marie Eaton

Palliative Care Institute

What is Palliative Care?

  • Specialized care for people living with chronic and serious illness.
  • Goal is to improve quality of life for both the patient and the family when cure is not possible.
  • Focuses on providing relief from the symptoms and stress of a serious illness
  • Provided by an interdisciplinary team of palliative care doctors, nurses, social workers, chaplains, family members and others who work together to provide an extra layer of support.
  • Appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment


Aging And End-Of-Life Care In China: Cultural Traditions And Modern Practices, Baozhen Luo, Li Xu 2017 Western Washington University

Aging And End-Of-Life Care In China: Cultural Traditions And Modern Practices, Baozhen Luo, Li Xu

Palliative Care Institute

For over 2000 years, Confucianism, Daoism, and Buddhism, three pillars of Chinese traditional culture, have guided Chinese people as they approach questions of how to age and how to die. Although these traditions are still woven in the fabric of everyday life, massive economic and political transformations in recent decades have drastically reshaped Chinese people’s beliefs and practices toward aging and end-of-life care.

In this presentation, Dr. Xu Li and Dr. Baozhen Luo will share insights and stories about cultural practices in the care of the elders in China from the past to the present.


Assessing Depression In Cancer Patients : A Longitudinal Comparison Of Three Questionnaires., Patrick Possel, Kerstin Knopf 2017 University of Louisville

Assessing Depression In Cancer Patients : A Longitudinal Comparison Of Three Questionnaires., Patrick Possel, Kerstin Knopf

Patrick Pössel

The article by Johns et al. (1) compares the Hopkins Symptom Checklist 20-item depression scale (HSCL-20) (2), the Short-Form 36 Mental Health Inventory five-item distress scale (MHI-5) (3), and the Patient Health Questionnaire nine-item depression scale (PHQ-9) (4) in 309 adults with cancer in a longitudinal study.


A Systematic Review - The Effect Of Hospice And Palliative Care, Justin M. Brown, David J. Havener, Jeffrey T. Byrne 2017 The University of Akron

A Systematic Review - The Effect Of Hospice And Palliative Care, Justin M. Brown, David J. Havener, Jeffrey T. Byrne

Honors Research Projects

Many older adults nearing death experience unnecessarily invasive and costly healthcare treatments, often causing more harm than good. Hospice and palliative care interventions offer a possible solution to this problem by prioritizing high-quality and cost-effective care with a strong focus on comfort and satisfaction. The authors of this paper seek to answer the following question: Do hospice and palliative care interventions directed toward older adults at the end of life improve quality of life, cost of care, and satisfaction? This paper thoroughly reviews and critically appraises existing research related to the effect of hospice and palliative care directed toward older ...


Increasing Advance Directive Knowledge Among Healthcare Professionals, Laura K. Donnelly 2017 University of Vermont

Increasing Advance Directive Knowledge Among Healthcare Professionals, Laura K. Donnelly

Family Medicine Block Clerkship, Student Projects

Advance Directives (ADs) have been shown to be associated with increased patient satisfaction with end-of-life care, decreased in-hospital deaths, and decreased end-of-life costs in high-cost regions. Nationally, prevalence of ADs has increased over the last 20 years, but the majority of patients still have not completed an AD. A significant obstacle to completion is lack of awareness. A presentation to increase knowledge regarding ADs among primary care staff was created to address this.


Implementation Of A Screening Tool Protocol To Identify Patients With Unmet Palliative Care Needs And Improve Access To Palliative Care In The Icu, Katie Roach 2017 University of Kentucky

Implementation Of A Screening Tool Protocol To Identify Patients With Unmet Palliative Care Needs And Improve Access To Palliative Care In The Icu, Katie Roach

DNP Projects

PURPOSE: The purpose of this study is to evaluate the use of a screening protocol for identifying patients with unmet palliative care needs, and improve access to these services in the intensive care units at Norton Hospital.

METHODS: This study was a single-site retrospective report of the impact of a palliative care screening protocol on palliative care use and quality metrics that correlated to access to palliative care services in the intensive care units at Norton Hospital. The sample consisted of 135 medical records of patients admitted during the study period, which spanned the timeframe between January 1, 2017 and ...


End-Of-Life Preparations Among Lesbian, Gay, Bisexual, And Transgender People: Integrative Review Of Prevalent Behaviors, Luisa Kcomt, Kevin M. Gorey 2017 University of Windsor

End-Of-Life Preparations Among Lesbian, Gay, Bisexual, And Transgender People: Integrative Review Of Prevalent Behaviors, Luisa Kcomt, Kevin M. Gorey

Social Work Publications

Proactively making end-of-life (EOL) preparations is important to ensure high quality EOL care. Critical to preparation is the discussion of preferences with one’s primary health care providers. Lesbian, gay, bisexual, and transgender (LGBT) people often experience discrimination from health care providers that will detrimentally affect their ability to communicate their care preferences. Structural barriers, such as those based on sexual orientation and gender identity, may impede timely and quality care when one is most in need. The aim of this study was to examine the prevalence of EOL preparatory behaviors among LGBT people, with particular focus on transgender individuals ...


Program - Palliative Care Institute: Death Happens: Let's Talk About Your Choices, Palliative Care Institute 2016 Western Washington University

Program - Palliative Care Institute: Death Happens: Let's Talk About Your Choices, Palliative Care Institute

Palliative Care Institute

No abstract provided.


Avoiding Overtreatment At The End Of Life: Physician-Patient Communication And Truly Informed Consent, Barbara A. Noah, Neal R. Feigenson 2016 Western New England University School of Law

Avoiding Overtreatment At The End Of Life: Physician-Patient Communication And Truly Informed Consent, Barbara A. Noah, Neal R. Feigenson

Pace Law Review

This paper’s primary focus will be on considering how best to ensure that patients have the tools to make both informed and authentic choices about their care at the end of life. We will argue that truly informed decision making can help to reduce excessive end-of-life care by any measure. Most importantly for dying patients, better informed decisions can help reduce unnecessary suffering and result in care that aligns with their well-considered values and preferences.

In the first part of this paper, we will explain that, by any of these measures, many dying patients are receiving too much therapy ...


Evaluating The Effectiveness Of Care Choices A Home-Based Palliative Care Program, Katherine Pouliot 2016 Union College - Schenectady, NY

Evaluating The Effectiveness Of Care Choices A Home-Based Palliative Care Program, Katherine Pouliot

Honors Theses and Student Projects

Background: There is a growing need for home-based palliative care services, especially for seriously ill individuals who want to avoid unnecessary hospitalizations and remain with their regular outside care providers. Objective: To evaluate the effectiveness of Care Choices, a new in-home palliative care program provided by the Visiting Nurse Services of Northeastern New York and Ellis Medicine, a community healthcare system serving New York’s Capital District. Design: A prospective cohort study tracking patient outcomes over the course of one year. Subjects and setting: One hundred twenty-three patients (49 men, 74 women) with serious illnesses who were new enrollees in ...


Evaluation Of An In-Home Palliative Care Program's Management Of Pain, Mackenzie LaPorte 2016 Union College - Schenectady, NY

Evaluation Of An In-Home Palliative Care Program's Management Of Pain, Mackenzie Laporte

Honors Theses and Student Projects

With the growing population of chronically ill patients wishing to receive care at home, care providers face unique challenges managing the pain of patients with quickly changing illness trajectories. Treating patients outside of institutionalized settings, where regular monitoring is standard, requires careful symptom management. This project was a retrospective review examining nurses’ documentation of pain for patients enrolled in Care Choices, a new home-based palliative care program coordinated through a visiting nurse service and community hospital. The extent to which nurses documented patients' pain score, site, type and pain goal as well as nursing interventions and plan of care in ...


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