Hospitalization Patterns and Palliation in the Last Year of Life Among Residents in Long-Term Care

Travis, Shirley S.; Loving, Gary; McClanahan, Lue; Bernard, Marie A.

doi:10.1093/geront/41.2.153

Cited by 93 publications

(77 citation statements)

References 18 publications

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“…[81]. These studies support previous research that indicates that the majority of older adults prefer treatments that facilitate comfort over those that prolong life [82]. Symptom relief is clearly a highly valued treatment outcome for elderly patients [83].…”

Section: Life Prolongation and Symptom Reliefsupporting

confidence: 79%

Too Old to Care?

2004

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Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH (http://www.theschwarzcenter.org/rounds.asp). The Schwartz Center is a nonprofit organization dedicated to supporting and advancing compassionate health care delivery, which provides hope to the patient and support to caregivers, and encourages the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members.Ageism is a pervasive problem throughout society. It is rooted in language, attitudes, beliefs, behaviors, and policies. Aging profoundly influences physiology, challenging the medical community to accommodate but not discriminate. The elderly are at an increased risk of disease and disability. Sixty percent of cancer occurs in people aged 65 and older, and the population is aging. The treatment of cancer in the elderly is complicated by comorbidities and other physiological factors, particularly renal, bone marrow, and metabolic reserve. Caregivers have to treat patients in a manner that optimizes treatment and avoids anticipated harm. However, the caregiver is often faced with situations where they must balance their personal beliefs, professional values, and knowledge of medicine with their patients' preferences and needs. Discussion in the Rounds focused on age bias, drug toxicity, life prolongation, and symptom relief, with the role of the caregiver, and the relationship to the patient, being pivotal. The Oncologist 2004;9:343-352 LEARNING OBJECTIVESAfter completing this course, the reader will be able to:1. Discuss the competing issues in the use of cytotoxic chemotherapy in older patients.2. Identify the intrinsic biases in evaluating the elderly.3. Explain how to inform patients in the face of uncertainty.Access and take the CME test online and receive 1 hour of AMA PRA category 1 credit at CME.TheOncologist.com CME CME CASE PRESENTATIONMrs. L, an 84-year-old woman, was undergoing rehabilitation after hip and wrist surgery when a mass in her lung was detected on a hospital admission chest x-ray. Evaluation of the mass revealed that it was small cell lung carcinoma. She had a cough, occasional hemoptysis, chest This material is protected by U.S.

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Section: Life Prolongation and Symptom Reliefsupporting

confidence: 79%

Too Old to Care?

2004

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“…The inclusion and exclusion criteria were applied to each title and abstract, which resulted in 16 articles identified for the evaluation (see Figure 1). However, it was clear that Chen et al [28] and Lamberg et al [29]; Hickman et al [30] and Hickman et al [31]; and Travis et al [32] and Travis et al [33] produced separate articles derived from the same retrospective chart review data collection processes. Therefore, a total of 13 unique retrospective chart review processes from 16 articles were identified for the evaluation.…”

Section: Search Resultsmentioning

confidence: 99%

“…With one exception [39], all of the authors tended to list variables that were more objective in nature, such as resident demographic characteristics, medications, and presence or absence of clinical symptoms. However, three studies clearly defined the variables that directly related to their research questions [28,29,32,33,36]. In addition, DiGiulio et al [34] provided an explanation of the functional assessment staging tool (FAST) used in Alzheimer's disease diagnosis and prognostication.…”

Section: Important Variables Definedmentioning

confidence: 99%

Revisiting Retrospective Chart Review: An Evaluation of Nursing Home Palliative and End-of-Life Care Research

Wickson-Griffiths¹,

Kaasalainen

Ploeg³

et al. 2014

PMCOA

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“…Det kan vaere vanskelig å akseptere at døden er en naturlig utgang ved det å flytte inn på sykehjem (28). Selv når pårørende er innforstått med at deres naere er i livets siste fase, kan akutte endringer føre til ønske om endring i behandlingsregime og sykehusinnleggelse (27). Sykehus har behandlingsmuligheter som sykehjem ikke innehar.…”

Section: Intervju N=50unclassified

Er sykehjemmet et verdig sted å dø?

Steindal

Sørbye

2010

Sykepleien

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Studiens bakgrunn: Et sentralt mål for palliativ omsorg er å unngå overflytting av pasienter i palliativ fase fra sykehjem til sykehus. Likevel skjer dette relativt ofte. Få studier har utforsket faktorer som bidrar til sykehusinnleggelse. Artikkelen omhandler pårørendes vurdering av sin naeres siste levedager Hensikt: Å belyse overflytting fra sykehjem til sykehus ved livets slutt og drøfte faktorer som kan bidra til at de pårørende opplever at deres naere får en verdig død ved sykehjem.Metode: Semistrukturerte intervjuer av naermeste pårørende til pasienter som døde ved et sykehus. Det ble gjort en deskriptiv innholdsanalyse av to åpne spørsmål fra intervjuskjema.Resultater: Pårørende etter 50 (43 prosent) dødsfall deltok i undersø-kelsen. Tjue pårørende (40 prosent) trakk frem erfaringer og holdninger til sykehjem. Tre hovedtema gikk igjen i datamaterialet: Forventninger og tillit til personalet, pårørende som den gamles advokat og sykehuset som symbol på en verdig død. Konklusjon: En verdig død ved syke-hjem fordrer mer personell med tilstrekkelig kompetanse innen palliasjon. Det er behov for språkopp-laering blant de ansatte slik at alle snakker tilstrekkelig godt norsk. God kommunikasjon mellom pårø-rende og ansatte er essensielt. Hva tilfører denne artikkelen?Funnene i undersøkelsen tyder på at pårørende ser behov for mer faglaert personell, bedre norskkunnskaper og økt kompetanse innen palliasjon blant de ansatte ved norske sykehjem. 2010; 5: 138-145 138ORIGINALARTIKKEL > Er sykehjemmet et verdig sted å dø? nr 2,

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Hospitalization Patterns and Palliation in the Last Year of Life Among Residents in Long-Term Care

Abstract: Transitions from active curative care to palliative care are important for residents in permanent long-term care placements. Improved end-of-life care requires more attention to these transitions and to the decisions that residents, their families, and care teams are called upon to make.

Cited by 93 publications

References 18 publications

Too Old to Care?

Too Old to Care?

Revisiting Retrospective Chart Review: An Evaluation of Nursing Home Palliative and End-of-Life Care Research

Er sykehjemmet et verdig sted å dø?

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