Palliative Care

Care Practices for Patients With Advanced Kidney Disease Who Forgo Maintenance Dialysis – JAMA Internal Medicine (link to abstract – $ for full-text)

Commentaries: End Stage Kidney Disease: Decoding How Patients Decide to Forgo Dialysis – MedicalResearch.com (free) AND Shared Decision-Making About Dialysis Initiation Needs to Improve – Renal & Urology News (free)

“There is need for more patient-centered models of care for advanced kidney disease capable of supporting those who do not wish to start dialysis.”

 


Report: Talking About Dying

26 Oct, 2018 | 01:39h | UTC

Guideline: Early Palliative Care

2 Sep, 2018 | 02:24h | UTC

Special Issue: Roles of Physicians in Healthy Dying- AMA Journal of Ethics (free articles)

“What the roles of clinicians and patients should be in defining what constitutes a quality dying experience and good care of dying people has received less attention than issues like euthanasia and assisted death. Which parts of dying, if any, should be medicalized and why? What do patients and clinicians need to know about dying and why? The August 2018 issue of the AMA Journal of Ethics explores these and other questions.”

 


Opinion: How Do You Want to Die?

3 Aug, 2018 | 02:57h | UTC

How Do You Want to Die? – The New York Times (10 articles per month are free)

“Are we turning sudden cardiac death into a longer, winding path? Defibrillators can prevent sudden death but they also can take away the sudden-death option.” (via @RasoiniR see Tweet)

 


Breathing Tubes Fail to Save Many Older Patients – The New York Times (10 articles per month are free)

“One-third of patients over age 65 die in the hospital after they are put on ventilators. Doctors are beginning to wonder if the procedure should be used so often”.

 


Guide: Age-attuned Hospice Care

18 Jun, 2018 | 00:19h | UTC

Age-attuned Hospice care: An opportunity to better end of life care for older people – StCristopher’s (free PDF) (via @hospicedoctor see tweet)

“Despite the evidence that more people will die of frailty and multiple long-term conditions than of cancer, our services for those moving towards the end of their life remain focussed on the needs of the latter group”

 


Clinical Updates: Palliative radiotherapy – The BMJ (free)

Clinical Update for non-specialists on the benefits, practicalities, and side effects of palliative radiotherapy

 


Outcomes, experiences and palliative care in major stroke: a multicentre, mixed-method, longitudinal study – Canadian Medical Association Journal (free)

““Palliative care” had connotations of treatment withdrawal and imminent death… practicing the principles of palliative care is needed, but the term “palliative care” should be avoided or reframed”.

See related articles on this subject: Palliative care: renaming as supportive care and integration into comprehensive cancer care – CMAJ (free) AND Perceptions of palliative care among patients with advanced cancer and their caregivers (free)

 


One Day Your Mind May Fade. At Least You’ll Have a Plan – The New York Times (10 articles per month are free)

Free download: Health Directive for Dementia (free PDF) from Advanced Directive for Dementia

Source: New document allows advance planning for dementia – Univadis (free registration required)

“A Simple Way to Document the Medical Care You Would Want If You Had Dementia”

 


The Right Place at the Right Time: Medical Oncology Outpatients’ Perceptions of Location of End-of-Life Care – JNCCN (free)

Commentary: Let’s Talk About End-of-Life Care – National Comprehensive Cancer Network, via NewsWise (free)

“…majority of people with cancer would like their physicians to ask them where they would prefer to receive end-of-life care” (from NewsWise).

 


Supporting Patients Through Serious Illness and the End of Life: Sutter Health’s AIM Model – The Commonwealth Fund (free)

“By proactively managing care for the terminally ill, the Advanced Illness Management program has produced savings of $8,000–$9,000 per patient” (via @commonwealthfnd see Tweet)

 


Review: Palliative Care in Neurology

7 Oct, 2017 | 22:09h | UTC

Development and validation of QMortality risk prediction algorithm to estimate short term risk of death and assess frailty: cohort study – The BMJ (free)

Editorial: Identifying frailty in primary care (free)

Commentary: Frailty calculator to support GPs in targeting patients for better care – MyScience (free)

See calculators: QMortality®-2017 risk calculator (free) AND QFrailty®-2017 risk calculator (free)

“the tool can reliably estimate risk of dying within 12 months and risk of unplanned admissions among patients aged between 65 and 100 years old” (from MyScience).

 


RCT: Palliative Care in Heart Failure

10 Sep, 2017 | 02:00h | UTC

NCCN Guideline: Palliative Care

21 Aug, 2017 | 01:32h | UTC

An order not to hospitalize

16 Aug, 2017 | 15:17h | UTC

RCT: Palliative Care in Heart Failure

11 Jul, 2017 | 17:07h | UTC

Effect of specialist palliative care services on quality of life in adults with advanced incurable illness in hospital, hospice, or community settings: systematic review and meta-analysis – The BMJ (free)

The meta-analysis showed a small effect on quality of life with specialist palliative care. The effect was most pronounced for patients with cancer and for those who received specialized care early.

 


Who Should Assess the Needs of and Care for a Dementia Patient’s Caregiver? – AMA Journal of Ethics (free)

“Physicians have an obligation to check in on dementia patients’ caregivers, and provide support if necessary” (RT @JournalofEthics see Tweet)

 


A better way to care for the dying

28 Apr, 2017 | 16:39h | UTC

A better way to care for the dying – The Economist (a few articles per month are free) (RT @EricTopol see Tweet)

“How the medical profession is starting to move beyond fighting death to easing it”.

 


Prospective, before-after cohort study: Standardized Criteria for Palliative Care Consultation on a Solid Tumor Oncology Service Reduces Downstream Health Care Use – Journal of Oncology Practice (free)

Editorial: Making the Right Thing Easier to Do: Standardized Integration of Oncology and Palliative Care – Journal of Oncology Practice (free)

Related Guideline: Integration of Palliative Care Into Standard Oncology Care: American Society of Clinical Oncology Clinical Practice Guideline Update (free)

Commentaries on the study: Standardized Palliative Care Consults Cut Cancer Readmissions – Also, less chemotherapy after discharge – MedPage Today (free registration required) AND Standardized Cancer Palliative Care Consults Linked to Stronger Home-Based Support – AJMC (free)

Patients with at least one of the following 4 criteria: 1) advanced solid tumor; 2) prior hospitalization within 30 days; 3) hospitalization > 7 days; or 4) active symptoms – received automatic palliative care consultation. The rates of 30-day readmissions dropped from 35% to 18% and chemotherapy after discharge dropped from 44% to 18%.

 


The Patients Were Saved. That’s Why the Families Are Suing – The New York Times (free)

“Historically, the practice has been “if in doubt, err on the side of aggressive, life-sustaining treatment,””. That might be changing.

 


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