Chronic severe mental illness (CSMI) is a common disorder in the United States associated with numerous adverse health effects. Health promotion educational interventions can be beneficial. The purpose of this project was to implement and evaluate a community-based educational program for adults with CSMI.Analyses of quantitative and qualitative data showed overall satisfaction with the program and achievement of some specific consumer health modifications. Three primary areas of interest and benefit included socialization and support, education and information, and motivation to change. The Wellness Education Group Intervention (WEGI) can serve as a model for wellness education with adults in similar communities.
Original Research Background. For seriously critically ill elderly patients on mechanical ventilation, prognosis for significant recovery may be minimal. These individuals, or their surrogates, may decide for ''palliative extubation.'' A common prognostic question arises: ''How long does she/he have?'' Research Objectives. This study describes demographics, mortality, time to death and sites of disposition after palliative extubation. Methods. Retrospective 7-year study in an urban community hospital with an ethnically diverse, elderly population. We reviewed patients post palliative extubation, time to death or survival to discharge. Results. 435 subjects underwent palliative extubation. Mean age: 78 years, 60% Female, ethnically diverse with 46% White and 54% others. Post extubation, 304 (70%) died in-hospital while 131 (30%) survive to be discharged. Among the patients who were discharged, 88 (72%) were discharged to in-patient hospice, 24 (20%) to home hospice, and 10 (8%) were discharged to other care settings such as shortterm rehab or nursing home with comfort care. Of those who died, the mortality rates were: 72% died within 24hours post extubation and 28% more than 24 hours. Of those who died, median time to death 8.4 hours (range 1 minutes-16.7days). Conclusion. Palliative extubation at end of life was an option selected by an ethnically diverse, elderly population. Our analysis showed that while 70% died in hospital, 30% were discharged alive. These results are helpful for counseling families and for anticipatory guidance and planning.
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