Palliative Care in a Community-Based Serious-Illness Care Program

2020 ◽  
Vol 23 (5) ◽  
pp. 692-697 ◽  
Author(s):  
Natalie C. Ernecoff ◽  
Laura C. Hanson ◽  
Alexandra L. Fox ◽  
Timothy P. Daaleman ◽  
Christine E. Kistler
Keyword(s):  
Palliative Care ◽  
Care Program ◽  
Community Based ◽  
Serious Illness

Pain Management

2019 ◽  
pp. 116-131
Author(s):  
Judith A. Paice
Keyword(s):  
Palliative Care ◽  
Pain Management ◽  
End Of Life ◽  
Family Communication ◽  
Pain Control ◽  
Care Program ◽  
Palliative Care Program ◽  
Institutional Policies ◽  
Team Members ◽  
Serious Illness

Pain is one of the most common and most feared symptoms experienced by those with serious illness. The nurse’s role begins with assessment and continues through the development of a plan of care and its implementation. During this process, the nurse provides education and counseling to the patient, family, and other team members. Nurses also are critical for developing institutional policies and monitoring outcomes that ensure good pain management for all patients within their palliative care program. To provide optimal pain control, all healthcare professionals must understand the frequency of pain at the end of life, the barriers that prevent good management, the comprehensive assessment of this syndrome, and the treatments used to provide relief. Effective pain control and alleviation of suffering is highly dependent upon the strength of clinician, patient, and family communication and relationship. These are key strengths of nursing, at all phases of palliative care.

scholarly journals How to Design, Build, and Pay for a Community-Based Palliative Care Program (P16)

2016 ◽  
Vol 51 (2) ◽  
pp. 313
Author(s):  
James Mittelberger ◽  
Dana Lustbader ◽  
Daniel Hoefer ◽  
Kathleen Kerr ◽  
Michael Rabow
Keyword(s):  
Palliative Care ◽  
Care Program ◽  
Palliative Care Program ◽  
Community Based ◽  
Design Build

A Palliative Care Program for Volunteers in a Community Setting: A Mixed-Methods Pilot Study

2019 ◽  
Vol 37 (6) ◽  
pp. 455-464 ◽  
Author(s):  
Jiwon Lee ◽  
Jong-Eun Lee
Keyword(s):  
Palliative Care ◽  
Mixed Methods ◽  
Pilot Study ◽  
Meaning In Life ◽  
Palliative Care Service ◽  
Care Program ◽  
Palliative Care Program ◽  
Community Based ◽  
Volunteer Program ◽  
Coping With Death

Background: The objective of community-based palliative care is to improve the quality of life of patients and their families and to share the responsibility of caregiving. However, the evidence of the efficacy of volunteer services in community-based palliative care is insufficient. Purpose: This pilot study sought to uncover the feasibility and efficacy of a volunteer program in palliative care. Methods: The study used a sequential mixed-methods design. A total of 19 volunteers participated in the training program, and 6 trained volunteers provided services for a period of 10 weeks to 5 families. Quantitative data were collected on death anxiety, coping with death, and meaning in life for volunteers before and after the training and after completing their services. Qualitative data were collected about volunteering experiences. Results: Significant increases in coping with death and meaning in life after training and in meaning in life after providing services were observed among volunteers. Three categories (“Volunteer’s growing influence at home,” “Discovering meaning-in-life through volunteering,” and “Death as the final journey in life”) emerged from the qualitative findings. The caregivers’ satisfaction score was high. Conclusions: A palliative care program was found to be useful for volunteers in finding meaning in life, motivating continued volunteering. Moreover, caregivers were satisfied with the palliative care service of volunteers.

The Impact of a Community-Based Serious Illness Care Program on Healthcare Utilization and Patient Care Experience

2019 ◽  
Vol 67 (4) ◽  
pp. 825-830 ◽  
Author(s):  
Timothy P. Daaleman ◽  
Natalie C. Ernecoff ◽  
Christine E. Kistler ◽  
Alfred Reid ◽  
David Reed ◽  
...  
Keyword(s):  
Patient Care ◽  
Healthcare Utilization ◽  
Care Program ◽  
Community Based ◽  
Serious Illness ◽  
Care Experience ◽  
The Impact

End-of-Life Care for Children Enrolled in a Community-Based Pediatric Palliative Care Program

2014 ◽  
Vol 17 (5) ◽  
pp. 589-591 ◽  
Author(s):  
Lisa M. Niswander ◽  
Philene Cromwell ◽  
Jeanne Chirico ◽  
Alyssa Gupton ◽  
David N. Korones
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Care Program ◽  
Pediatric Palliative Care ◽  
Life Care ◽  
Palliative Care Program ◽  
Community Based

scholarly journals Providing Home-Based Support for Children with Chronic Conditions in an Urban Slum: Experiences from a Community-Based Palliative Care Program in Bangladesh

2021 ◽  
Vol 8 ◽  
pp. 2333794X2199915
Author(s):  
Mostofa Kamal Chowdhury ◽  
Khadija Shopna ◽  
Anisha Lynch-Godrei ◽  
Mehr Jain ◽  
Nadia Farheen ◽  
...  
Keyword(s):  
Palliative Care ◽  
Chronic Conditions ◽  
Health Workers ◽  
Care Program ◽  
Urban Slum ◽  
Caregiver Training ◽  
Care Needs ◽  
Community Based ◽  
Cross Sectional ◽  
Children With Chronic Conditions

We describe the palliative care needs of children with chronic conditions and their caregivers in an urban slum in Bangladesh. In this cross-sectional study, we interviewed 25 caregivers whose children receive support from a community-based program lead by community health workers, that provides medication, medical supplies, food, caregiver training, and psychological support free of charge. The chronic conditions of children in the program included cerebral palsy (80%), congenital heart disease (8%), neurodegenerative conditions (4%), cancer (4%), and intellectual disabilities (4%). Common symptoms included cough or breathing problems (64%), fever (56%), and pain (56%). Most caregivers (96%) reported they were unable to do any paid work due to their child’s needs and in all families, the child’s condition had a significant impact on their financial situation. Community-based palliative care programs can be developed to support children with chronic conditions who may not access care from acute care facilities.

scholarly journals Evaluating the care provision of a community-based serious-illness care program via chart measures

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Christine E. Kistler ◽  
Matthew J. Van Dongen ◽  
Natalie C. Ernecoff ◽  
Timothy P. Daaleman ◽  
Laura C. Hanson
Keyword(s):  
Quality Of Care ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Care Program ◽  
Academic Community ◽  
Care Provision ◽  
Community Based ◽  
Serious Illness ◽  
Home Based

Abstract Background Although quality-of-care domains for home-based primary and palliative programs have been proposed, they have had limited testing in practice. Our aim was to evaluate the care provision in a community-based serious-illness care program, a combined home-based primary and palliative care model. Methods Retrospective chart review of patients in an academic community-based serious-illness care program in central North Carolina from August 2014 to March 2016 (n = 159). Chart review included demographics, health status, and operationalized measures of seven quality-of-care domains: medical assessment, care coordination, safety, quality of life, provider competency, goal attainment, and access. Results Patients were mostly women (56%) with an average age of 70 years. Patients were multi-morbid (53% ≥3 comorbidities), functionally impaired (45% had impairment in ≥2 activities of daily living) and 32% had dementia. During the study period, 31% of patients died. Chart review found high rates assessment of functional status (97%), falls (98%), and medication safety (96%). Rates of pain assessment (70%), advance directive discussions (65%), influenza vaccination (59%), and depression assessment (54% of those with a diagnosis of depression) were lower. Cognitive barriers, spiritual needs, and behavioral issues were assessed infrequently (35, 22, 21%, respectively). Conclusion This study is one of the first to operationalize and examine quality-of-care measures for a community-based serious-illness care program, an emerging model for vulnerable adults. Our operationalization should not constitute validation of these measures and revealed areas for improvement; however, the community-based serious-illness care program performed well in several key quality-of-care domains. Future work is needed to validate these measures.

Northwest Cancer Specialists (NCS) Cares: Coordinated, Advocacy, Resources, Education, and Support: A Palliative Care Program in an Outpatient Oncology Practice

2013 ◽  
Vol 67 (1-2) ◽  
pp. 109-113 ◽  
Author(s):  
Susan Hedlund
Keyword(s):  
Palliative Care ◽  
Care Program ◽  
Pilot Project ◽  
Palliative Care Program ◽  
Community Based ◽  
Interprofessional Communication ◽  
Patient Awareness ◽  
Advance Care ◽  
Cancer Specialists ◽  
Oncology Practice

A large community-based oncology practice developed a pilot project to enhance staff and patient awareness of the benefits of palliative care, advance care planning, and earlier intervention with patients with advancing disease. The results were ongoing implementation of palliative care conferences at all sites, greater numbers of referral to hospice, lessened chemotherapy given in the last 2 weeks of life, and the hiring of two social workers as a result of needs identified. Staff reported greater satisfaction with interprofessional communication.

Using information technology to power an integrated, community-based oncology palliative care model.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 166-166
Author(s):  
Dudley Gill ◽  
Andrew Allan Hertler ◽  
Lianne Matthews ◽  
RaeLynn Carr
Keyword(s):  
Information Technology ◽  
Palliative Care ◽  
Hospital Admissions ◽  
Performance Status ◽  
Metastatic Breast ◽  
Care Program ◽  
Palliative Care Program ◽  
Community Based ◽  
Care Community ◽  
Oncology Practice

166 Background: There is a need to improve palliative care program access for patients with cancer. The identification of candidates for palliative care at the point of diagnose can improve care and reduce costs. This pilot program was launched in July 2015 by four stakeholders: Health plan; Regional palliative care provider; Community oncology practice; and Oncology quality management provider. Methods: Objectives are to increase patient satisfaction, reduce unnecessary utilization and costs. Data captured by information technology at the point-of-care are used to: Evaluate Diagnosis, Stage, Treatment Intent, Performance Status, and Line of Therapy criteria to identify patients with recurrent/metastatic disease who would potentially benefit from palliative care; Trigger a palliative care program referral; and Initiate the chemotherapy treatment preauthorization process. Retrospective analysis will evaluate: Patient (Concordance with goals & cultural preferences, Member quality of care at end-of-life, Length of stay on hospice, Death in place of patient’s preference), Hospital (Deaths in acute/facility ICU), and Clinical (Referrals to palliative care and hospice; Use of chemotherapy 2 weeks prior to death). Results: See table below. Conclusions: There is an opportunity to inform physicians and oncology practice mid-level staff about the differences between palliative and hospice care. Community-based supportive care services can prevent avoidable hospital admissions. There have been two instances where having a palliative care nurse visit patients at their homes prevented hospital emergency department admissions. Educating patients about the benefits of palliative care can be challenging. For example, a patient with recurrent/metastatic breast cancer, an ECOG status of 2 and who had received beyond 4th line treatment was not interested in the program. [Table: see text]

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