Religion should be included in the vital discussions about the care people and those close to them want to receive in the last two to three days of life, according to the National Institute for Health and Care Excellence (NICE). Login using your SSSFT NHS OpenAthens details for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you requesting.
The number of children and young people (CYP) living with life-limiting and life-threatening conditions is rising. Paediatric palliative care is a relatively new aspect of healthcare, the delivery of which is variable, with a wide range of healthcare and voluntary sector providers involved. Policy recommendations are for Specialist Paediatric Palliative Care (SPPC) services to be supported by a physician with specialist training. To read the full article, log in using your NHS OpenAthens details.
Letters. Murray and colleagues discuss early introduction of palliative care. This remains uncommon for metastatic cancer, unless poor physical performance contraindicates drug treatment. As the authors state, evidence shows that early palliative care—or best supportive care, my preferred term—benefits both quality and quantity of life, even if used alone in metastatic cancer. To read the full article, log in using your NHS OpenAthens details
To understand parents’ experiences and needs during a child's end-of-life care at home and to identify systemic factors that influence its provision. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Delivering excellent end of life care is among the biggest challenges faced by nurses today, regardless of their level of experience or place of work. Just about every nurse will be confronted with a dying patient at some stage, so it is essential they have the training and resources to cope. To read the full article, log in using your NHS OpenAthens details
Our exclusive survey with Marie Curie found that many nurses and healthcare assistants received no specific training in end of life care.
More than four out of ten nurses and healthcare assistants (HCAs) have received no training in end of life care, a survey by Nursing Standard and Marie Curie has found. To read the full article, log in using your NHS OpenAthens details
Implications for practice and research
Palliative care (PC) improves patients' quality of life and symptom burden. There is also some evidence that it increases care satisfaction and reduces healthcare usage.
The impact of PC on caregiver outcomes needs more attention in future research.
PC needs a standardised outcome measurement framework to be able to fully demonstrate its impact.
Further development of integrated PC models is needed. To read the full article, log in using your NHS OpenAthens details
Editorial. Palliative sedation is a term used to describe the use of sedative drugs in dying patients to induce a state of decreased or absent awareness (unconsciousness) in order to relieve intolerable suffering from refractory symptoms.1 ,2 Perhaps, for many of us, this conjures up an image of an agitated patient who is rendered unconscious in the last hours of life as a result of the need for repeated doses of sedative drugs.
However, in the literature, ‘palliative sedation’ is used more broadly, sometimes as an umbrella term for all levels and patterns of sedation in those close to death.3 ,4 For example, a systematic review about palliative sedation includes a report of sedatives prescribed to 68/102 patients at some point in the last week of life,5 for whom ‘sublingual lorazepam tablets and clonazepam drops were commonly used and efficacious’. (This is the source of the figure quoted elsewhere that up to 67% of dying patients may need palliative sedation.) To read the full article, log in using your NHS OpenAthens details
Views and Reviews. Doctors as well as patients should talk more openly about dying, death, and care at the end of life, says one of Janet Tracey’s daughters, Kate Masters. To read the full article, log in using your NHS OpenAthens details
Aim To explore the preferences of residents with dementia for their end of life care, and nurses’ perceptions of these preferences.
Method Residents’ preferences were compared with nurses’ perceptions of their preferences in a qualitatively designed study in which the nominal group technique was adopted for data collection. Login using your SSOTP NHS Athens for full text. SSSFT - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Careers. Janet Willoughby, the first dementia nurse to be appointed at the hospice where she works, is passionate about end of life care. Login using your SSOTP NHS Athens for full text. SSSFT - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Commentary on: Kavalieratos D, Corbelli J, Zhang D, et al. Association between palliative care and patient and caregiver outcomes: a systematic review and meta-analysis. JAMA 2016;316:2104–14.OpenUrl
Implications for practice and research
Palliative care (PC) improves patients' quality of life and symptom burden. There is also some evidence that it increases care satisfaction and reduces healthcare usage.
The impact of PC on caregiver outcomes needs more attention in future research.
PC needs a standardised outcome measurement framework to be able to fully demonstrate its impact. Further development of integrated PC models is needed. To read the full article, log in using your NHS OpenAthens details
This quality standard covers care for adults (aged 18 and over) who are approaching the end of their life. This includes people who are likely to die within 12 months, people with advanced, progressive, incurable conditions and people with life-threatening acute conditions.
Skills for Health, Health Education England and Skills for Care have today announced a new End of Life Care Core Skills Education and Training Framework, with the aim of providing tailored, high-quality care and support to patients with advanced incurable illness and their families.
Many people still associate palliative care with care in the terminal stage of cancer, and patients with cancer remain more likely to receive it than those with other illnesses. It is often delayed until the last weeks or days of life once the illness is advanced and disease focused treatments are no longer effective. However, late palliative care is a missed opportunity to do better for patients, families, and health services. In high income countries, up to 80% of people who die could benefit from palliative care much earlier in their illness. To read the full article, log in using your NHS OpenAthens details
Sadly, however, palliative and end of life care can be harder to access for those who come from black and minority ethnic communities and deprived areas; those who are homeless; those held in secure and detained settings; those who have learning disabilities; those suffering with dementia or with long term conditions. And the quality of care they receive can be poorer.
This article consider some clinical and population level approaches to advanced care of chronic conditions and end of life care. One approach aims to follow patient values and preferences about acceptable end of life (EOL) as elicited by questionnaires. The grounds for emphasising patients’ preferences and the adequacy of the questionnaires are examined. Other approaches involve additional aims such as meeting patient and family members needs, providing information, cost effectiveness and satisfying professionals' preferences for a certain type of EOL experience. Issues raised by adding these (and other) aims are examined. To read the full article, log in using your NHS OpenAthens details.
The article by Kamm identifies ‘potential pitfalls’ in current approaches to providing patient-centred advanced illness and end-of-life care (EOLC). Specifically, Kamm cautions against ‘nudging and framing effects’ in discussions to elicit patients' preferences that could produce ‘skewed or biased results’. Kamm further argues that precision and neutrality in questions designed to elicit patient preferences may help to ensure that preferences are ‘reliably elicited’ and avoid mistakes in EOLC decisions. In response, we highlight the problems with a focus on precision and neutrality in discussions about end-of-life (EOL) preferences and advocate an alternative approach that we believe is more likely to achieve patient-centred care....To read the full article, log in using your NHS OpenAthens details.
We adapted elements from the NHS Improving Quality end of life care transforming hospitals and obtained funding from the local PCT (as it was) to expand our team so we could rapidly get people out of hospital at the end of their lives and link them into a local hospice & palliative care services, district nurses , care and their GP.
The GMC has produced a interactive teaching session to increase awareness of the legal issues around the complex decision making that can occur at the end of life. This includes an interplay with the mental capacity act & safeguarding. The GMC have also produced case studies which the FY2 doctors, whom we trialled this session on, received well and worked through. We complimented this with clinical teaching around pain and safe prescribing by our team.
According to the Royal College of Paediatrics and Child Health, the UK has one of the worst child mortality rates in western Europe, with more than 2,000 children and young people dying in 2012. In addition, it is estimated that about 50,000 children and young people in the UK have a life-limiting condition that may need palliative care. Login using your SSOTP NHS Athens for full text. SSSFT - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
This document summarises the evidence-base on medicines optimisation in long-term pain. It is a key therapeutic topic which has been identified to support medicines optimisation. It is not formal NICE guidance.
Editorial. Palliative sedation is a term used to describe the use of sedative drugs in dying patients to induce a state of decreased or absent awareness (unconsciousness) in order to relieve intolerable suffering from refractory symptoms. Perhaps, for many of us, this conjures up an image of an agitated patient who is rendered unconscious in the last hours of life as a result of the need for repeated doses of sedative drugs.
However, in the literature, ‘palliative sedation’ is used more broadly, sometimes as an umbrella term for all levels and patterns of sedation in those close to death. To read the full article, log in using your NHS OpenAthens details
Samei Huda highlights a recent RCT of antipsychotics for delirium palliative care, which suggests we need non-drug alternatives for this group of patients.
understanding how best to provide palliative care for frail older people with non-malignant conditions is an international priority. We aimed to develop a community-based episodic model of short-term integrated palliative and supportive care (SIPS) based on the views of service users and other key stakeholders in the United Kingdom. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
The Cancer Vanguard will develop programmes to raise public awareness and work collaboratively with partners in education, health and social care to shift the focus towards prevention and early diagnosis, to provide a recovery package to aid those living with and beyond cancer and to greatly improve care at the end of life.
Objective To assess the efficacy of active treatment targeted at underlying disease (TTD)/potentially curative treatments versus palliative care (PC) in improving overall survival (OS) in terminally ill patients. Open Access Article
The only certainty is that every one of us will die. Nothing else in healthcare in the UK applies to 100% of our population.” So stated Baroness Professor Finlay of Llandaff when she introduced the Access to Palliative Care Bill in the House of Lords.1 This was an apt reminder of the importance of good end-of-life care for every dying person and their loved ones, no matter where they die or which healthcare professionals are caring for them at the end of their life. To read the full article, log in using your NHS OpenAthens details.
Objectives To understand how end-of-life (EoL) care for people with dementia is currently commissioned (ie, contracted) and organised, with a view to informing the development of commissioning guidance for good-quality community-based EoL care in dementia. Open Access Article
Commissioners are working on a plan to restart the process and the indicative timelines to complete both procurements. Patients will continue to be involved with the work of the programme and will work alongside commissioners as equal decision makers in meetings with bidders.
This event will look at what is known about end of life care for people with learning disabilities and what can be done to improve this. Topics to be covered include pain management for people with complex needs and the difference setting makes to end of life care outcomes.
There will be new data and research findings shared about end of life care for people with learning disabilities. Speakers include Irene Tuffrey-Wijne, who has extensive clinical and research experience in the field of learning disabilities and palliative care.
This event is aimed at clinicians from primary and secondary health care settings, palliative care services and learning disability services, commissioners and service managers, family members and paid supporters.
Families with dying children must be put at the heart of care, new guidance from NICE (The National Institute for Health and Care Excellence) says.
We advise people working in health and social care to make sure mothers and fathers, brothers and sisters, get the practical and emotional support they need to care for a family member at the end of life.
As part of Haelo’s new film series Voices from the Front Line, our first film Nurses on Death and Dying, which premiered at the Dying Inspirationally session of Haelo Hosts ’16, documents front line nurses discussing the realities of palliative care.
NHS England have launched a new Ambitions for Palliative and End of Life Care website, a one stop shop for palliative and end of life care information.
EBN Perspectives brings together key issues from the commentaries in one of our nursing topic themes.
This article is part of Evidence Based Nursing (EBN) Perspectives. In this series, commentaries from the past 2 years from a specific nursing theme are brought together and highlights are discussed. The topic for this edition is advance care planning and palliative care. From October 2014 to the October 2016 edition, 12 commentaries were published on the chosen topic. Key themes are extrapolated from these commentaries, and the implications for practice and future research are explored. To read the full article, log in using your NHS OpenAthens details
Work to improve care for dying patients and their families at Shropshire’s two acute hospitals has been enhanced with two specialist nurses starting work this month.
For patients with advanced cancer, several randomised controlled trials have shown that access to palliative care at least 6 months before death can improve symptoms, reduce unplanned hospital admissions, minimise aggressive cancer treatments and enable patients to make choices about their end-of-life care, including exercising the choice to die at home. This study determines in a UK population the duration of palliative care before death and explores influencing factors. Open Access Article