FUTURE HOSPITAL JOURNAL, 2015;2(2):87-89. Medically led, patient-centered, future care planning for patients predicted to be in their last year of life is possible on the complex care ward of an acute hospital, where patients often wait for social care placement into a nursing home. When the patient lacks the mental capacity to engage in the planning discussions themselves, meetings can take place between the multidisciplinary geriatric team and either those close to the patient or an independent mental capacity advocate. Participants ... should use any existing advance care planning information, as appropriate, to develop ‘best interests advice’ (which can be referred to at a later date when a best interests decision needs to be made for the patient). Any future medical care plan should be reviewed for applicability and validity if the person’s condition changes (improves or deteriorates), if the patient or those close to the patient request it, or 6-12 months after the initial plan is made. Education, training and support must be provided to ensure acceptance and understanding of the PEACE (PErsonalised Advisory CarE) process and general end-of-life care.
GERONTOLOGY & GERIATRIC RESEARCH | Online – 30 April 2015 – Condolence visits are an integral part of the therapeutic medical process and contribute to the comprehensive treatment of the ‘whole’ patient. This article describes the spontaneous evolvement of condolence visits by team members of a geriatric skilled nursing department and discusses the ensuing issues and questions as a result. The recurring themes of the discussion were: Do these visits invade the privacy of the families during the initial mourning period? Are the home visits really a part of the professional treatment? Are these visits confusing the professional and personal boundaries? What purposes do these visits serve? Do these visits benefit the families and/or the staff? Given that the condolence visits are beneficial to team members and probably also to the bereaved family we discuss how should such visits be conducted?
INTERNATIONAL ARCHIVES OF MEDICINE, 2015;8(126):1-5. In Brazil, cancer is the second leading cause of death among children and adolescents, forcing family members, patients and professionals to deal with the issues of human finitude. The multidisciplinary team considers the discussions at the end of life as a difficult task to be performed on pediatric patients. The family is essential to overcome the communication barriers, acting as liaison between the multidisciplinary team and the patient. Children should be invited to participate in the decision making process and their wishes should be honored at the end of life. Professionals should to be able to meet the physical, psychosocial, spiritual, social and cultural rights of patients and families.
PRIMARY HEALTH CARE, 2015;5(1). Aim of this article is to identify, how family physicians (FPs) can be supported in palliative home care in Switzerland by the availability of guidelines and advance directives, community-based palliative care structures, education and training, as well as remuneration of palliative home care services. The availability and use of guidelines as well as advance directives is rather small in general practice, and FPs care and treatment at the end of life is only marginally supported by ambulant care structures, especially in rural areas. Also the coordination of services and collaboration between specialists and generalists is poorly developed. Furthermore FPs possibilities to acquire competencies in palliative care are strongly limited, and palliative home care provided by FPs is poorly financed. The results [of this case based study] draw a rather bleak picture with respect to the support of FPs palliative home care services in Switzerland today. Though considerable steps towards implementing palliative care have been made in recent years, in general, conditions for FPs medical services have to get improved strongly. Major efforts have to be made to foster the recognition and implementation throughout Switzerland.
SAFETY IN HEALTH | Online – Accessed 17 June 2015 – Palliative care clients with complex needs are increasingly choosing to remain at home for their care. Home represents familiarity, presence of supportive family and friends, potential for normalcy and, a safe haven. The palliative care literature although robust is hardly ever linked with safety and home care. Patient safety has been focused predominantly on institutions without a corresponding level of research or safety initiatives in the home care sector. Although a growing body of research has begun to highlight the complexity and multi-dimensionality of home care safety there is a dearth of understanding of safety issues from the perspectives of clients, caregivers, and paid providers who are responsible for managing and coordinating palliative home care. More information.
Media Watch is intended as an advocacy and research tool. The weekly report, published by Barry R. Ashpole, a Canadian communications consultant and educator, monitors the literature and the lay press on issues specific to the quality of end-of-life care. It is international in scope and distribution. Each month, this section of the IAHPC Newsletter will publish an abstract or summary of an article or report of special interest noted in a recent issue of Media Watch (see below).