Wishes and Needs at the End of Life: Communication Strategies, Counseling, and Administrative Aspects

Welsch, Katja; Gottschling, Sven

doi:10.3238/arztebl.m2021.0141

Cited by 3 publications

(3 citation statements)

References 44 publications

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“…Patients should thus be enabled to select a person who is able to represent them. (Welsch & Gottschling, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…Patients should thus be enabled to select a person who is able to represent them. (Welsch & Gottschling, 2021). In this study, disease treatment planning includes preparation for a sudden worsening of the underlying disease.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, professionals have a key role in identifying and reporting the wishes of the patient and family members in an effective way in the EHR. However, patients' EOL preferences are not always accessible when needed, e.g., in the emergency department (Kuusisto et al, 2022; McQuown et al, 2017; Pyles et al, 2022; Sjöberg et al, 2021; Welsch & Gottschling, 2021).…”

Section: Introductionmentioning

confidence: 99%

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Social and healthcare professionals’ experiences of end‐of‐life care planning and documentation in palliative care

et al. 2023

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AimTo explore social and healthcare professionals' experiences of end‐of‐life (EOL) care planning and documentation in palliative care.DesignA qualitative study with narrative methodology.MethodsA narrative method with interviews was used. Data were collected from purposively selected registered nurses (n = 18), practical nurses (n = 5), social workers (n = 5) and physicians (n = 5) working in palliative care unit in five hospitals in three hospital districts. Content analysis within narrative methodologies was undertaken.ResultsTwo main categories – patient‐oriented EOL care planning and multi‐professional EOL care planning documentation– were formed. Patient‐oriented EOL care planning included treatment goals planning, disease treatment planning and EOL care setting planning. Multi‐professional EOL care planning documentation included healthcare professionals' and social professionals' perspectives. Healthcare professionals' perspectives on EOL care planning documentation included benefits of structured documentation and poor support of electronic health record (EHR) for documentation. Social professionals' perspective on EOL care planning documentation included usefulness of multi‐professional documentation and externality of social professionals in multi‐professional documentation.ConclusionThe results of this interdisciplinary study demonstrated a gap between what healthcare professionals consider important in Advance Care Planning (ACP), that is, proactive, patient‐oriented and multi‐professional EOL care planning and the ability to access and document this in a useful and accessible way in the EHR.Relevance to Clinical PracticeKnowledge of the patient‐centered EOL care planning and multi‐professional documentation processes and their challenges are prerequisites for documentation to be supported by technology.Reporting MethodThe Consolidated Criteria for Reporting Qualitative Research checklist was followed.Patient or Public ContributionNo patient or public contribution.

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“…Patients should thus be enabled to select a person who is able to represent them. (Welsch & Gottschling, 2021).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Social and healthcare professionals’ experiences of end‐of‐life care planning and documentation in palliative care

et al. 2023

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Curriculum „Palliative nephrologische Betreuung“

Gerhard¹,

Pommer

2021

Nephrologe

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Palliativmedizinische Aspekte wie Dialysevorenthalt und -abbruch, Einleitung einer konservativen Therapie sowie kooperative Betreuung am Lebensende sind zunehmend Teil der nephrologischen Regelversorgung geworden. Die entsprechende Wissensvermittlung palliativmedizinischer Grundsätze fehlt bislang in Aus- und Weiterbildung. In diesem Konsensuspapier wird für das nephrologische Team eine strukturierte kurrikuläre Weiterbildung zu den Grundprinzipien einer palliativen Betreuung vorgeschlagen.

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Outpatient palliative care during the COVID-19 pandemic: a retrospective single centre analysis in Germany

et al. 2022

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Background The coronavirus disease 2019 (COVID-19) pandemic has challenged health care systems worldwide. In Germany, patients in a palliative care setting have the opportunity to receive treatment by a specialised mobile outpatient palliative care team (OPC). The given retrospective single centre analysis describes the use of OPC structures for terminally ill COVID-19 patients during the height of the pandemic in Germany and aims to characterise this exceptional OPC patient collective. Methods First, death certificates were analysed in order to collect data about the place of death of all deceased COVID-19 patients (n = 471) within our local governance district. Second, we investigated whether advance care planning structures were established in local nursing homes (n = 30) during the height of the COVID-19 pandemic in 2020. Third, we examined patient characteristics of COVID-19 negative (n = 1579) and COVID-19 positive (n = 28) patients treated by our tertiary care centre guided OPC service. Results The analysis of death certificates in our local district revealed that only 2.1% of all deceased COVID-19 patients had succumbed at their home address (n = 10/471). In contrast, 34.0% of COVID-19 patients died in nursing homes (n = 160/471), whereas 63.5% died in an inpatient hospital setting (n = 299/471). A large proportion of these hospitalised patients died on non-intensive care unit wards (38.8%). Approximately 33.0% of surveyed nursing homes had a palliative care council service and 40.0% of them offered advance care planning (ACP) structures for their nursing home residents. In our two OPC collectives we observed significant differences concerning clinical characteristics such as the Index of Eastern Cooperative Oncology Group [ECOG] (p = 0.014), oncologic comorbidity (p = 0.004), as well as referrer and primary patient location (p = 0.001, p = 0.033). Conclusions Most COVID-19 patients in our governance district died in an inpatient setting. However, the highest number of COVID-19 patients in our governance district who died in an outpatient setting passed away in nursing homes where palliative care structures should be further expanded. COVID-19 patients who died under the care of our OPC service had considerably fewer oncologic comorbidities. Finally, to relieve conventional health care structures, we propose the expansion of established OPC structures for treating terminally ill COVID-19 patients.

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Wishes and Needs at the End of Life: Communication Strategies, Counseling, and Administrative Aspects

Cited by 3 publications

References 44 publications

Social and healthcare professionals’ experiences of end‐of‐life care planning and documentation in palliative care

Social and healthcare professionals’ experiences of end‐of‐life care planning and documentation in palliative care

Curriculum „Palliative nephrologische Betreuung“

Outpatient palliative care during the COVID-19 pandemic: a retrospective single centre analysis in Germany

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