Palliative Care Commons^™

Physician Orders For Life-Sustaining Treatment (Polst) Utilization In A Skilled Nursing Facility: An Educational Quality Initiative, Ryan Hazley Bsn, Rn, Dnp Student, Karl Steinberg Md, Cmd, Joseph Burkard Dnsc, Crna

Doctor of Nursing Practice Final Manuscripts

According to expert reports and recent research, frequent clinician-patient conversations about individual end-of-life preferences are necessary to avoid unwanted treatment and to ensure that desired treatments are received. The ongoing diffusion of Physician Orders for Life-Sustaining Treatment (POLST) educational initiatives in skilled nursing facilities (SNFs) are vital to success of California’s POLST program, which is now recognized as only 1 of 3 mature POLST programs in the country. The purpose of this evidence-based practice project was to answer the question: Among staff in a skilled nursing facility, does implementing a formal POLST education program compared to current practice improve staff …

Pain And Pharmacologic Pain Management In Long-Stay Nursing Home Residents, Jacob N. Hunnicutt, Christine M. Ulbricht, Jennifer Tjia, Kate L. Lapane

Jennifer Tjia

Prior studies estimate that >40% of long-stay nursing home (NH) residents experience persistent pain, with 20% of residents in pain receiving no analgesics. Strengthened NH surveyor guidance and improved pain measures on the Minimum Data Set (MDS) 3.0 were introduced in March 2009 and October 2010, respectively. This study aimed to provide estimates after these important initiatives of: 1) prevalence and correlates of persistent pain; and 2) prevalence and correlates of untreated or undertreated persistent pain. We identified 1,387,405 long-stay residents in United States NHs between 2011-2012 with 2 MDS assessments 90 days apart. Pain was categorized as persistent (pain …

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

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

Palliative Care Institute

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

Please Note: Look below at Additional Files to find an updated, 2019, version of the Northwest Life Passages Blueprint.

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

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.

Charter: Northwest Life Passages Coalition, Northwest Life Passages Coalition

Northwest Life Passages Coalition Documents

The purpose of the Northwest Life Passages Coalition is to further the community vision articulated in the Blueprint for Community Excellence at End of Life. A primary means of doing this will be to align and advance the Blueprint recommendations.

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.

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. Eight …

Blueprint For Creating A Community Of Care And Support For People With Serious Illness, Mary Carlson, Marie Eaton, Heather Flaherty, Carol Gipson, Margaret Jacobson, Bree Johnston, Brenda-Lee Karasik, Dan Murphy, Mary Percy, Chris Phillips, Berdi Safford, Sue Sharpe, Bobbi Virta

Northwest Life Passages Coalition Documents

There is growing awareness nationwide about the importance of care during serious illness and at endof-life.2 The Institute of Medicine (IOM) Report, Dying in America, released in 2014, recommends a person-centered, family-oriented approach that honors individual preferences and promotes quality of life. The IOM Report emphasizes that implementing this vision is a matter of national priority and urgency.

In Whatcom County, there is a rising tide of initiatives, interest, and excitement about the idea of creating a community of excellence for people with serious illness. Whatcom County has supported a successful Hospice and inpatient palliative care service for a number …

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

Williams Honors College, 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 …

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 …

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

Family Medicine 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.

More Than Medication: Perinatal Palliative Care., Brian S. Carter

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

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

Palliative Care Institute

No abstract provided.

Dying Among Older Adults In Switzerland: Who Dies In Hospital, Who Dies In A Nursing Home?, Xhyljeta Luta, Radoslaw Panczak, Maud Maessen, Matthias Egger, David Goodman

Dartmouth Scholarship

Background: Institutional deaths (hospitals and nursing homes) are an important issue because they are often at odds with patient preference and associated with high healthcare costs. The aim of this study was to examine deaths in institutions and the role of individual, regional, and healthcare supply characteristics in explaining variation across Swiss Hospital Service Areas (HSAs).

Methods: Retrospective study of individuals ≥66 years old who died in a Swiss institution (hospital or nursing homes) in 2010. Using a two-level logistic regression analysis we examined the amount of variation across HSAs adjusting for individual, regional and healthcare supply measures. The outcome …

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 and …

Adding Music Therapy To The Care Plan, Amy Clements-Cortés

Music Faculty Publications

I have chosen to write a short editorial on a topic not often included at the forefront of palliative care; music therapy. At the launch of an important journal that encourages articles addressing quality of life, while offering an educational forum for healthcare professionals to maintain relevance, it seems fitting to raise a topic that does not receive adequate attention in many palliative care settings.

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

Honors Theses

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 Care …