Why do Palliative Care Patients Present to the Emergency Department? Avoidable or Unavoidable?

Wallace, Elaine M.; Cooney, Mary; Walsh, Jackie; Conroy, Marian; Twomey, Feargal

doi:10.1177/1049909112447285

Cited by 88 publications

(98 citation statements)

References 8 publications

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“…Although cancer is a chronic disease, patients with cancer often visit to ED because lifethreatening emergencies and unexpected side effects associated with cancer or treatment. Previous studies reported that lung cancer and advanced disease were most common causes of ED admissions of cancer (Rosenwax et al, 2011;Kraft-Rovere et al, 2012;Wallace et al, 2012;Gorham et al, 2013). Our study also showed similar results with previously studies.…”

Section: Discussionsupporting

confidence: 92%

Single Center Experience on Causes of Cancer Patients Visiting the Emergency Department in Southwest Turkey

Tanrıverdi

Beydilli²,

Yıldırım³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Emergency departments are visited by cancer patients for palliation of cancer-related symptoms, management of treatment-related side effects, oncologic emergencies, co-morbidities, and/or end of life care. In this study, we aimed to identify the characteristics of cancer patients admitted to an emergency medicine department in Southwest Turkey. Materials and Methods: In this retrospective descriptive study, a total of 304 emergency department admissions of 102 patients with cancer due to medical conditions were evaluated. Descriptive statistical methods, statistical analysis for correlation, Student's t-test, chi-square tests and logistic regression test were used. Results: The majority of patients visiting to emergency departments were male (n=66, 65%) and over 65 years of age (53, 52%). Some 30% (n=31) had a lung cancer diagnosis, 32% (n=33) presentation with dyspnea, 53% (n=55) with metastasis, 30% (n=16) with multiple metastatic lesions in lung, and 68% (n=70) had a poor ECOG performance status (score 3 to 4). Conclusions: Emergency departments have valuable roles in managing and caring for patients with malignancies.

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Section: Discussionsupporting

confidence: 92%

Single Center Experience on Causes of Cancer Patients Visiting the Emergency Department in Southwest Turkey

Tanrıverdi

Beydilli²,

Yıldırım³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…13,14 Informal caregivers may often feel uncomfortable or ill equipped to manage patients' symptoms at home. [13][14][15][16] Given that caregiving and symptom management are likely intertwined components of quality home hospice care, hospitalization may signify the fact that certain caregivers require more support. Research studying symptom management interventions in the home hospice setting is still sparse; however, interventions that incorporate new technologies or empower caregivers through education have had promising results.…”

Section: Discussionmentioning

confidence: 99%

Events Leading to Hospital-Related Disenrollment of Home Hospice Patients: A Study of Primary Caregivers' Perspectives

Phongtankuel

Paustian

Reid

et al. 2017

Journal of Palliative Medicine

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Background: Approximately 25% of hospice disenrollments in the United States occur as the result of hospitalization, which can lead to burdensome transitions and undesired care. Informal caregivers (e.g., spouses, children) play a critical role in caring for patients on home hospice. Research examining hospital-related disenrollment among these patients is limited. Objective: To understand the events surrounding the hospitalization of patients discharged from home hospice through the perspective of their informal caregivers. Design: Thirty-eight semistructured phone interviews with caregivers were conducted, and data regarding the events leading to hospitalization and hospice disenrollment were collected. Study data were analyzed by using qualitative methods. Setting/Subjects: Subjects included caregivers of 38 patients who received services from one not-for-profit home hospice organization in New York City. Participants were English speaking only. Measurements: Caregiver recordings were transcribed and analyzed by using content analysis. Results: Content analysis revealed four major themes contributing to hospitalization: (1) distressing/difficult-towitness signs and symptoms, (2) needing palliative interventions not deliverable in the home setting, (3) preference to be cared for by nonhospice physicians or at a local hospital, and (4) caregivers not comfortable with the death of their care recipient at home. Over half of all caregivers called 911 before calling hospice. Conclusions: Our study provides insight into the events leading to hospitalization of home hospice patients from the caregivers' perspective. Further research is needed to quantify the drivers of hospitalization and to develop interventions that reduce utilization, while improving care for home hospice patients and their caregivers.

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“…It would not be unusual to find patients in a hospital setting with a high symptom burden during a period of acute illness and in fact this is often what precipitates an admission to hospital. 4 In view of the fact that the hospital setting is often criticised as being poorly prepared to provide adequate symptom control at the end of life 59,60 exploring the effectiveness of symptom management may be more useful.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Hospitals are often the setting where a life limiting diagnosis is made and where patients present when symptoms develop or when they are not well managed. 4 Furthermore for people with illnesses such as chronic obstructive pulmonary disease and congestive cardiac failure, hospitals provide episodic care over many years for illness exacerbations during which death could occur. 5 In most developed countries, hospitals are also the setting in which most people will die.…”

Section: Introductionmentioning

confidence: 99%

Patient and family experiences of palliative care in hospital: What do we know? An integrative review

2013

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Why do Palliative Care Patients Present to the Emergency Department? Avoidable or Unavoidable?

Cited by 88 publications

References 8 publications

Single Center Experience on Causes of Cancer Patients Visiting the Emergency Department in Southwest Turkey

Single Center Experience on Causes of Cancer Patients Visiting the Emergency Department in Southwest Turkey

Events Leading to Hospital-Related Disenrollment of Home Hospice Patients: A Study of Primary Caregivers' Perspectives

Patient and family experiences of palliative care in hospital: What do we know? An integrative review

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