Palliative Care Commons^™

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 …

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

Honors Theses

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 …

“It Makes You Feel That You Are Not Just A Thing - You Are A Person”: The Role Of Touch Therapies In Enhancing The Patient Experience, Leila Kozak Phd

Palliative Care Institute

This session will introduce participants to different types of touch therapies, describe the evidence for these non-pharmacological interventions in promoting comfort and relaxation, and discuss the role of these modalities in symptom management and quality of life. The goal of this session is to support organizations in shifting from a typical barrier-driven attitude [“this cannot be done at our organization”] into a solution-driven attitude [“how can we get this done at our organization.”] The session will emphasize family caregivers and volunteer engagement, staff training, sustainable cost models, as well as appropriateness of modalities for diverse settings.

At the end of …

Biofeedback: Applications For Palliative Care, John Jordy Lmhc

Palliative Care Institute

Clinical applications of biofeedback can assist in the management of emotional and physical health, including relaxation, stress reduction, pain management and developing acceptance and effective coping strategies for what can’t be changed.

At the end of the workshop, participants will able to:

1. Articulate how the biofeedback process works physiologically
2. Identify the benefits and limitations of biofeedback as a clinical tool to assist individuals in learning more effective ways to improve health and wellbeing
3. Explore strategies for incorporating this modality into personal or clinical practice

Acupuncture In Palliative Care: Evidence Based Medicine, Sara Bowling Md

Palliative Care Institute

At the end of the session, participants will be able to:

1. Articulate how acupuncture works physiologically
2. Identify the benefits and limitations of using acupuncture as a clinical tool in the management of pain
3. Explore strategies for incorporating this modality into personal or clinical practice.

Including Everything: Mindfulness And Transforming Suffering In Palliative Care, Andrea Thach Md

Palliative Care Institute

After over 35 years, the medical benefits of mindfulness are well documented and accepted in a wide range of clinical practice. After reviewing the better known clinical effects of mindfulness training, we will look ahead at the growing research and experience of the salvific nature of this practice.

At the end of this session, participants will be able to:

1. Discuss the concept of mindfulness
2. Identify situations in which mindfulness has been proven to be effective
3. Reflect on how suffering can be addressed by mindfulness

Cannabis In Palliative And Hospice Medicine, Leanna J. Standish Nd, Phd

Palliative Care Institute

At the end of this session, participants will be able to:

1. Identify the appropriate uses of cannabis and psychedelics in the treatment of pain and end of life symptoms
2. Define the concerns and legal challenges of integrating this complementary therapy with traditional treatments

Integrative Oncology: A Local Perspective, Jennie Crews Md, Traci Pantuso N.D.

Palliative Care Institute

Drs. Crews and Pantuso will describe their collaborations in the treatment of patients with cancer.

At the end of this session, participants will be able to:

1. Understand our patients’ preferences regarding Integrative Oncology
2. Define allopathic physicians’ concerns and support of integrating complementary therapy with traditional cancer treatment
3. Identify patient resources in our community for evidence-based integrative oncology
4. Explore the potential opportunities for increased collaboration between allopathic and naturopathic providers

Evidence-Based Integrative Approaches In Palliative Care: Challenges And Opportunities, Leila Kozak Phd

Palliative Care Institute

Palliative care providers are increasingly seeking non-pharmacological supportive interventions to increase comfort and quality of life, which has led to the integration of complementary therapies within palliative care environments. This emerging field of integrative care brings wonderful opportunities as well as challenges. Among the opportunities, the ability to actively engage family caregivers in comfort care modalities, the ability to enhance comfort regardless of the care environment, and self-care opportunities for caregivers and professional staff to decrease stress and burnout. Among the challenges, the lack of education for professional staff regarding complementary therapies may deter professionals from recommending or facilitating access …

Transformation In Service Delivery For Older Adults: Policy Strategies And The Role Of The Community, Anne Montgomery Ms

Palliative Care Institute

This session will address key developments occurring at the national level as policymakers in Congress and the executive branch work to develop and refine models of value-based care delivery for rapidly-growing numbers of Medicare beneficiaries with complex chronic conditions. Montgomery will present the conceptual design, and the evidence that supports it, for a model of integrative care that spans medical care and long-term services and supports (LTSS) for a vulnerable population of frail older adults. This model, MediCaring Communities, is well-positioned to be piloted by willing communities across the country. Montgomery also will explore the existing Medicare financing platforms that …

Common Ethical Challenges In End Of Life Care, Bree Johnston Md, Ross Fewing

Palliative Care Institute

Conflict is common in end-of-life situations. This session will be an interactive session in which we explore common conflicts that emerge between caregivers, patients, and care providers, and apply ethical principles to trying to approach these conflicts.

At the end of the session, participants will be able to:

1. Discuss an ethical framework for approaching conflict in health care
2. Discuss the ethical challenges in balancing a patient or family’s hope for a miracle with health care providers’ concerns about providing care that is likely to be non-beneficial
3. Discuss an approach to addressing families’ request not to provide pain medication to a …

Program - Palliative Care Institute 2016 Spring Conference: Heal Without Cure, Palliative Care Institute

Palliative Care Institute

No abstract provided.

Spirituality And Psychological Well-Being Among Als Caregivers: Hope And Perceived Stress As Mediators, Bridget R. Jeter

Electronic Theses and Dissertations

The empirical study of the salutary relationship between spirituality/religiousness and psychological well-being is burgeoning. However, mechanisms of this association have received less empirical attention. Theory suggests that spirituality/religiousness may lead to positive psychological characteristics such as hope, which may function as a means of coping in the context of a significant stressor or stressful situation. The perceived burden and stress associated with caring for individuals with chronic illnesses such as ALS is significant, and caregivers may be at risk for increased symptoms of depression, symptoms of anxiety, somatic symptoms, and other deleterious psychological well-being related outcomes. Within the context of …

Soothing Relaxation Journeys: Designing Evidence Based Music And Imagery Opportunities, Amy Clements-Cortés

Music Faculty Publications

This paper provides information on the creation of an original collection of music and imagery journeys based on the literature in oncology and palliative care. Background evidence is shared about music and relaxation, music relaxation in medical settings, and music and relaxation in oncology/hospice treatment. The development of the resource is illuminated with respect to principles that guided the design. The Journeys collection is a tool that can be used independently by persons experiencing a variety of issues including: anxiety, pain, stress, low self-esteem, and low mood, etcetera; as well as with groups when implemented by a healthcare professional. While …

United States Acculturation And Cancer Patients’ End-Of-Life Care, Alexi Wright, Heather Stieglitz, Yankel Kupersztoch, M. Elizabeth Paulk, Yookyung Kim, Ingrid Katz, Francisco Munoz, Rachel Jimenez, Jan Mutchler, Lorna Rivera, Anthony Back, Holly Prigerson

Lorna Rivera

Background: Culture shapes how people understand illness and death, but few studies examine whether acculturation influences patients’ end-of-life treatment preferences and medical care.

Methods and Findings: In this multi-site, prospective, longitudinal cohort study of terminally-ill cancer patients and their caregivers (n = 171 dyads), trained interviewers administered the United States Acculturation Scale (USAS). The USAS is a 19- item scale developed to assess the degree of ‘‘Americanization’’ in first generation or non-US born caregivers of terminally-ill cancer patients. We evaluated the internal consistency, concurrent, criterion, and content validity of the USAS. We also examined whether caregivers’ USAS scores predicted patients’ …

An Interprofessional End Of Life Simulation Using A Movie/Discussion Format, Mary Val Palumbo, Christina S. Melvin, Nancy P. Lemieux, Deborah A. O'Rourke, Jean Beatson, Patricia A. Prelock, Kelly A. Melekis, Mary Alice Favro, Vicki Hart

College of Nursing and Health Sciences Faculty Publications

An Interprofessional End of Life Simulation Using a Movie/Discussion Format

Sigma Theta Tau International Nursing Research Congress

Cape Town, South Africa

July 25, 2016

Mary Val Palumbo, DNP, MSN, BS, APRN, GNP-BC¹ Christina S. Melvin, MS, BS, PHCNS, BC, CHPN¹ Nancy P. LeMieux, MSN, BSEd, RN¹ Deborah A. O'Rouke, PhD, MA, MClSc, BSc, PT² Jean Beatson, EdD, MS, RN³ Patricia A. Prelock, PhD, MA, BS, CCC-SLP, BCS-CL⁴ Kelly A. Melekis, PhD, MSW, LMSW⁵ Mary Alice Favro, MA, BS, CCC-SLP⁶ Vicki Hart, PhD⁷ (1)Department of Nursing, University of Vermont, Burlington, VT (2)Dept. …