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