A staggered edge: End-of-life care in patients with severe mental illness

Shalev, Daniel; Brewster, Katherine; Arbuckle, Melissa R.; Levenson, Jon A.

doi:10.1016/j.genhosppsych.2016.10.004

Cited by 27 publications

(44 citation statements)

References 26 publications

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“…Individuals with schizophrenia had a decline in interactions with psychiatrists as they reached end of life. 12 Dying individuals with schizophrenia were unlikely to be referred to palliative end-of-life care and received significantly less acute care, home care, and pain management at the end of life in comparison to end-of-life patients without schizophrenia. 13,14 Explanations for these discrepancies in care were accredited to the high prevalence of homelessness, incarceration, health-care provider bias, and under treatment of physical illness within the population of people living with schizophrenia.…”

Section: Theme 1: Stigmamentioning

confidence: 99%

“…16 When this occurs, patients were less likely to be referred to the necessary specialized medical treatment. 12,14 Theme 2: Decisional Capacity for Informed Consent Of the 32 articles, 13 discussed themes related to decisional capacity for informed consent among individuals with schizophrenia. This theme was categorized into 3 subthemes: end-oflife care decisions, ability to understand a terminal illness, and substitute decision makers (SDMs).…”

Section: Theme 1: Stigmamentioning

confidence: 99%

“…Payne et al 36 Literature review C5 Picot et al 23 Case study, N ¼ 1 B2 C2, C6 Purushotham et al 35 Literature review C3 Rice et al 22 Case study, N ¼ 1 B 1 C 3 Romm et al 19 Editorial B1 C6 Shalev et al 12 Literature review A1, A2 B1 C6 D3, D4 Terpstra et al 17 Case study, N ¼ 1 B1 C1, C2, C4, C7 D1, D4 Trachsel et al 16 Theoretical article A2 Webber 20 Case study, N ¼ 1 B1, B3 C4 D4 a A denotes stigma; A1, lower quality end-of-life care; A2, misattribution of medical symptoms to a psychiatric illness; B, decisional capacity for informed consent; B1, end-of-life care decisions; B2, ability to understand a terminal illness; B3, substitute decision makers (SDMs); C, best practices; C1, psychosocial interventions; C2, pharmacology; C3, family and team collaboration; C4, goals of care; C5, setting; C6, health-care collaboration; C7, smoking; D, barriers; D1, setting; D2, communication; D3, health-care provider education; and D4, accessing care.…”

Section: C1 C2mentioning

confidence: 99%

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On the Margins of Death: A Scoping Review on Palliative Care and Schizophrenia

et al. 2018

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Schizophrenia is a serious chronic mental illness that results in marginalization and stigma for sufferers. It is the seventh leading cause for disability worldwide. The symptoms of the illness, including hallucinations, delusions, and extremely disordered thinking and behavior, may also introduce barriers to accessing treatment, education, housing, and employment. Little is known about endof-life care for individuals with schizophrenia. To address this gap, a scoping review was conducted to enhance understanding of hospice and palliative care for patients with schizophrenia. From this scoping review, 342 unique titles and abstracts were identified through a search of 20 databases, including 11 social science databases, 6 medical databases, and 3 gray literature databases. A total of 32 articles met the inclusion criteria and the following 4 themes were identified: 1. Stigma affecting quality of care and access to care; 2. Issues related to consent and capacity for the patient's end-of-life care decisions and to appoint substitute decision makers; 3. Best practices for psychosocial interventions, pharmacology, family and health-care collaborations, goals of care, setting, and smoking; and 4. Barriers to care, including setting, communication, provider education, and access to care. The review suggests the importance of mandatory interdisciplinary training practices and policy standards outlining cooperative communication across health-care providers. It highlights gaps in evidence-based research on psychosocial interventions and collaborative frameworks to enable the provision of quality end-of-life care for individuals with schizophrenia.

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Section: Theme 1: Stigmamentioning

confidence: 99%

Section: Theme 1: Stigmamentioning

confidence: 99%

Section: C1 C2mentioning

confidence: 99%

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On the Margins of Death: A Scoping Review on Palliative Care and Schizophrenia

et al. 2018

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“…Presumptions of lack of capacity and inability to discuss challenging topics (e.g., advance care planning) may contribute to this lack of comfort. 35 Stigma against patients with SMI also contributes to misattribution of medical illness as a manifestation of mental illness. 36 In a qualitative study of palliative care and psychiatric nurses on EOL care for patients with SMI, both groups of nurses identified stigma as a barrier to providing quality EOL care.…”

Section: Health Care Factorsmentioning

confidence: 99%

“…Currently, EOL care is predicated on availability of social resources such as stable housing and social support. 35 Socioeconomically disadvantaged patients are generally underscreened for symptoms, regardless of mental illness. 37 In addition, individuals experiencing homelessness face unique barriers including worse health overall, higher mortality, higher acute care utilization, and decreased care at the EOL.…”

Section: Sociocultural Factorsmentioning

confidence: 99%

End-of-Life Care in Individuals With Serious Mental Illness

2020

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Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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Psychiater in der Palliativversorgung von Menschen mit schweren psychiatrischen Erkrankungen und einer onkologischen Komorbidität

Westermair

Schreiber²,

Dümchen

et al. 2020

Nervenarzt

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Menschen mit schweren psychiatrischen Erkrankungen und einer zusätzlichen onkologischen Erkrankungen stellen die Behandler im palliativen Setting vor große Herausforderungen. Verhaltensweisen erscheinen oft unverständlich oder befremdlich. Depressiver Rückzug oder wahnhaftes Erleben im Rahmen einer chronischen Psychose kann beängstigend wirken. Der vorliegende Artikel skizziert die epidemiologischen Daten sowie die Besonderheiten im Erleben dieser Personengruppe. Im Anschluss an ausgewählte Kasuistiken aus psychologischer Sicht werden Gedanken zu den Aufgaben des Psychiaters im palliativen Setting vorgestellt. = People with severe psychiatric illnesses and an additional oncological illness represent great challenges to therapists in the palliative setting. Behavior patterns often appear incomprehensible or disconcerting. Depressive withdrawal or delusion in the context of a chronic psychosis can be frightening. This article outlines the epidemiological data as well as the particularities in the experience of this group of people. Following selected case studies from a psychological perspective, thoughts on the tasks of the psychiatrist in the palliative setting are presented.

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A staggered edge: End-of-life care in patients with severe mental illness

Cited by 27 publications

References 26 publications

On the Margins of Death: A Scoping Review on Palliative Care and Schizophrenia

On the Margins of Death: A Scoping Review on Palliative Care and Schizophrenia

End-of-Life Care in Individuals With Serious Mental Illness

Psychiater in der Palliativversorgung von Menschen mit schweren psychiatrischen Erkrankungen und einer onkologischen Komorbidität

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