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Gently Into The Good Night: Toward A Compassionate Response To End-Stage Illness, George P. Smith Ii

Scholarly Articles

End-of-life decision making by health care providers must respect individual patient values. Indeed, these values must always be viewed as the baseline for developing and pursuing patient-centered palliative care for those with terminal illness. Co-ordinate with this fundamental bioethics principle is that of beneficence or, in other words, respect for conduct which benefits the dying patient by alleviating end-stage suffering — be it physical or existential. Compassion, charity, agape and/or just common sense, should be a part of setting normative standards and of legislative and judicial responses to the task of managing death. Aided by the principles of medical futility, …

Medication Cost And Utilization In Hospice Care: An Analysis Of 2007 Claims Data, Rachi Parekh

Electronic Theses and Dissertations

Objectives:

1. Describe patient-related and hospice-related characteristics such as gender, average length of hospice stay, primary diagnoses, average daily census, number of admissions per year, net operating revenues, inpatient unit (IPU) operating costs, and medication expenditures of hospices in Ohio and compare it with NHPCO data.

2. Identify and analyze therapeutic drug classes and medications with the most frequent utilization rates and largest percentage of expenditures in hospice care.

Method:

Hospice Pharmacy Benefit Managers (PBM) employ pharmacists to provide comprehensive pharmaceutical care services for patients under hospice care and one component of pharmacist provided services include comprehensive medication review. To …

A Nudge In The Right Direction With A Stick The Size Of Cms: Physician-Patient Communication At The End Of Life, Katherine B. Ledden

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Clinicians May Not Administer Life-Sustaining Treatment Without Consent: Civil, Criminal, And Disciplinary Sanctions, Thaddeus Mason Pope

Faculty Scholarship

Both medical and legal commentators contend that there is little legal risk for administering life-sustaining treatment without consent. In this Article, I argue that this perception is inaccurate. First, it is based on an outdated data set, primarily damages cases from the 1990s. More recent plaintiffs have been comparatively more successful in establishing civil liability. Second, the published assessments focus on too-limited data set. Even if the reviewed cases were not outdated, a focus limited to civil liability would still be too narrow. Legal sanctions have also included licensure discipline and other administrative sanctions. In short, the legal risks of …

I'M Still Standing: Five Strategies To Survive Going Back To School, Janice Hawkins

Ellmer School of Nursing Faculty Publications

[First paragraph] Making the decision to return to school for a PhD was difficult for me. I feared the unknown but inescapable lifestyle adjustments. I’m resistant to change. When facing life’s cold waters, I wade, rather than plunge. There’s no wading into a PhD program. In spite of my cautious nature, I took the plunge.

Assessment And Management Of Pain, Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

This guideline provides evidence-based recommendations for nurses and other members of the interprofessional team who are assessing and managing people with the presence, or risk of, any type of pain.

Department Of Family And Consumer Sciences Newsletter, Fall 2012, Illinois State University, Department Of Family And Consumer Sciences

Department of Family and Consumer Sciences Newsletter

Newsletter of the Department of Family and Consumer Sciences

Spiritual Care Interventions To Improve The Quality Of Life In Patients With Advanced Cancer Receiving Palliative Care, Maria Ballen-Sanchez

HIM 1990-2015

Title: Spiritual Care Interventions and Quality of Life in Cancer Patients Receiving Palliative Care Background: Despite the evidence supporting spiritual care in nursing and an increased quality of life among patients, patients feel that their spiritual needs are not being supported by medical professionals. Nurses agree that the role they play is significant in addressing the needs of cancer patients; however, they feel that they lack the knowledge for addressing spirituality concerns at the end of life. The purpose of this study is to identify spiritual care interventions that nurses can implement to improve quality of life (QOL) in patients …

The Effect Of Heart Failure Education On Intermediate Care Unit Nursing Staff's Knowledge Of Heart Failure, Self-Care, And Best Practice Guidelines, Carol Budgin

Evidence-Based Practice Project Reports

Heart failure (HF) is a chronic disease affecting nearly six million people in the United States with an annual cost of nearly 33 billion dollars. If nurses are inadequately prepared to care for and/or educate patients with HF, evidence-based (EB) nursing care will be suboptimal and hospital readmission rates with the subsequent increased costs for care will continue to soar. To address their higher-than-national average HF readmission rates, an EB nursing project was implemented at a local, urban community hospital to assess intermediate care unit (IMCU) nursing staff’s knowledge of HF, selfcare, and best practice guidelines. The Rossworm & Larrabee …

Two Cultures Of Caring: A Comparative Study, Lisa Armstrong, Chistina Polito

Honors Theses and Capstones

There is much that the UK and the US could and should learn from each other to understand the quality of end-of-life care, through comparison of practice, analysis of care patterns and via original research (Higginson, 2005, p.170). Although comparisons between end-of-life care in the United Kingdom and United States have demonstrated similarities and disparities in many contexts, there is little evidence of research that directly compares nursing perspectives between the two Atlantic partners. This research explores nurse’s perceptions and experiences of caring for people within a hospice context and identifies themes of commonalities and disparities in theory and practice, …

Music Therapy To Sever The Silence Of A Childhood Holocaust Survivor, Amy Clements-Cortés

Music Faculty Publications

No abstract provided.

Reiki: A Complementary, Biofield Therapy For Management Of Postoperative Pain, Robin Toms

Biennial Convention (CONV)

There is increasing interest in complementary and alternative therapies that do not rely on expensive, invasive technology, and are holistic in focus. Such therapies could improve pain management in the poorest of countries globally. Research has shown the benefits of combining conventional, Western, pain management with CAM (Olson, 2003; Gillespie, 2007; Olson, 2003; Vitale, 2006 ;). Reiki, a complementary therapy, is a form of energy therapy in which the focus of the practitioner, with or without light touch, is believed to access universal energy sources that can assist in balancing the biofield and strengthening the body's ability to heal itself …

The Role Of Race In End-Of-Life Care, Barbara A. Noah

Journal of Health Care Law and Policy

No abstract provided.

The Role Of Race In End-Of-Life Care, Barbara A. Noah

Faculty Scholarship

This essay focuses on one important aspect of racial disparities that has received comparatively little attention in the legal literature--the existence and causes of racial differences in end-of-life decision making and in the utilization of palliative and hospice care. African Americans and other racial minorities in the United States utilize palliative care and hospice less frequently than white Americans. These minority populations also tend to resist advance care planning and instead opt to receive more life-prolonging care at the end of life, even when quality of life and prognosis are poor. After a lifetime of limited access to health care …

Choosing Home For Someone Else: Guardian Residential Decision-Making, Naomi Karp, Erica Wood

Utah Law Review

Sue had lived in her own home for fifty years but recently lost it due to financial exploitation by her daughter. She wanted to live as independently as possible and to avoid living in a nursing home. The public guardianship program found her an affordable apartment in a senior residence, and arranged for in-home care, transportation, and visiting nurses when needed. Several elderly tenants in the same building used the same in-home care staff, so the hours were easier to work out. The guardianship program also sought restitution from the daughter. A fifty-three-year-old man with an intellectual disability was injured …

Palliative Care And Hospice: Opportunities To Improve Care For The Sickest Patients, Kathleen Tschantz Unroe, Diane E. Meier

Notre Dame Journal of Law, Ethics & Public Policy

The article discusses how palliative care and hospice services address the quality and cost concerns in the U.S. health care system. By focusing on symptom management, coordination among providers, and improved transitions of care, the services meet the needs of the sickest persons at lower costs. The author suggests putting in place the right leadership and resources and strengthening the workforce to successfully expand the programs.

The Mediating Effect Of Distress Caused By Constipation On Predictors Of Quality Of Life Of Hospice Patients With Cancer., Abdel Alkhalouf

USF Tampa Graduate Theses and Dissertations

Abstract

The Mediating Effect of Distress Caused by Constipation on Predictors of Quality of Life of Hospice Patients with Cancer.

Key positive outcomes for hospice patients include the prevention and alleviation of physical and psychological distress, maintenance of physical and mental functioning and all aspects of quality of life. This research used secondary analysis of previously gathered data to answer new research questions with alternative strategies to examine relationships not previously analyzed. The researchers collected data from 717 cancer patients who had been admitted to one of two private hospices. The aim of their experimental intervention was to define the …

An Examination Of The Influence Of Socioeconomic Status And Race On End-Of-Life Treatment Level Following A Palliative Intervention, Kathleen Benton

College of Graduate Studies: Theses & Dissertations

The purpose of this study was to examine differences in treatment level at the end of life according to race and socioeconomic status and the extent a palliative intervention may change the course and cost of care. The study population included patients from the Medical Center of Central Georgia (N=2,920). The data were examined as a secondary analysis retrospectively. Data from the medical record and a unique clinical database were coded into descriptive, predictor, and outcome variables to define the population, and the patient's treatment status before and after the intervention. McNemar's test of symmetry, Chi Square, and Logistic Regression …

An Educational Intervention For Hospice Volunteers, Susan Conrey

Nursing Masters

Background and Significance: The House of John is a two-bed comfort care home located in rural, upstate NY and is staffed, in part, by a pool of adult volunteers. This researcher is an active member of that volunteer group. Volunteers are required to complete an eight week training course before they can begin caring for residents and fulfilling their volunteer hours. An estimated 60% of the active volunteers participated in their initial hospice volunteer training more than 5 years ago and have had little or no continuing or ongoing education since that time. In February of 2009, the newly organized …

Nield V. Pocatello Health Services Clerk's Record V. 4 Dckt. 38823

Idaho Supreme Court Records & Briefs, All

No abstract provided.

Furman Alumni News, Furman University

Furman Magazine

No abstract provided.

2011-12 Alumni Board Of Directors, Furman University

Furman Magazine

No abstract provided.

Making Music And More On The Last Frontier, Jim Stewart

Furman Magazine

No abstract provided.

Lifeline, Fall 2011, University Of Dayton

Alumni Communications

Alumni publication produced by the Premedical Programs Office at the University of Dayton

The Content And Development Of Chinese Nursing Textbooks In Taiwan: A Bio-Psychosocial Perspective Of End-Of-Life Care, Hsiao-Ling Yang, Chia-Yi Wu, Mei Chang, Quan-Wei Chang, Wen-Yu Hu

Journal of Medical Education

Palliative care models have been developed and put into practice in Taiwan for more than 20 years. However, the progress of comprehensive training programs is still in its early stages, and most nursing training modules are lacking in related courses. Thus, it is critical to examine the appropriateness and integrity of the contents in the teaching materials relating to end-of-life care (EC) on which training for students and registered nurses is based. The purpose of this study is to review the contents and distribution of published Chinese nursing textbooks in Taiwan during 1945-2009, and the percentage of contents devoted to …

Measuring The Cultural Competence Of Hospice Social Workers Using The Multicultural Counseling Self-Efficacy Scale-Racial Diversity Form, Revised Version For Use In Hospice Settings, Jessica Moore Begans

Theses, Dissertations, and Projects

Although about 40% of American deaths occur in hospice care, and although social workers are members of nearly all hospice teams, there is scant research on the cross-cultural practices and competence of hospice social workers. Before this study, no self-report cultural competence scale was available to measure the perceived cultural competence skills of hospice social workers. To address this issue, a validated cross-cultural competence scale, the Multicultural Counseling Self-Efficacy Scale – Racial Diversity (Sheu, 2005) was modified to reflect the functions of hospice social workers. The revised scale (Begans, 2011) was completed by 33 hospice social workers in a New …

Survey On Pediatric Palliative Care Care For Healthcare Providers (Sppchp): Identifying Knowledge, Barriers, And Support Needs, Mary Elizabeth Grimley

Open Access Dissertations

Objective: A significant number of children suffer from life-limiting illnesses, with many dying each year in the U.S. Services, beyond standard medical care, aimed at increasing overall quality of life for children with life-limiting illnesses, are greatly needed within and outside of our hospitals. Palliative care is conceptualized as treatment provided to relieve symptoms and improve quality of life. Despite the empirically supported benefits of providing pediatric palliative care, only a small percentage of pediatric patients actually receive these services. Thus, there is a great need for the development and provision of these services. The first aim of the current …

Wright State University Celebration Of Research, Scholarship And Creative Activities Book Of Abstracts Friday, April 8, 2011, Wright State University Office Of Undergraduate Research And Stemm Activities

Celebration of Undergraduate & Graduate Research, Scholarship, and Creative Activities Materials

The student abstract booklet is a compilation of abstracts from students' oral and poster presentations at Wright State University's second annual Celebration of Research, Scholarship and Creative Activities on April 8, 2011.

Holistic Comfort And Bereavement Of Families Receiving Prenatal Hospice Support During The Loss Of An Unborn Child With Lethal Anomalies, Sally S. Smith

Nursing Theses and Capstone Projects

The purpose of this descriptive study was to explore the grieving process and coping mechanism of families that was faced with the impeding loss of their unborn child. Grief is a very lonely process.

The aim of this research is to examine how parents cope with the lost of an unborn child with the aid of perinatal hospices. Giving families a broader range of options in regards to continuing their pregnancy. Each family has a right to choice what option is right for them. Choices should be in the hands of the family in regards to continuing with their pregnancy …

End Of Life Care During The Last Days And Hours, Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

The purpose of this best practice guideline is to provide evidence-based recommendations for Registered Nurses and Registered Practical Nurses on best nursing practices for end-of-life care during the last days and hours of life. The guideline does not replace consultation with palliative care specialists, who can support nurses to provide quality end-of-life care. The guideline is intended to be a resource to nurses who may not be experts in this practice area. It is acknowledged that individual competencies vary between nurses and across categories of nursing professionals. The inclusion of recommendations on clinical, education, organization and policy topics makes this …