Difficulties in navigating the intersection of generalist and specialist palliative care services: A cross‐sectional study of bereaved family's experiences of care at home in New Zealand

2021 ◽  
Author(s):  
Jackie Robinson ◽  
Rosemary Frey ◽  
Deborah Raphael ◽  
Andrew Old ◽  
Merryn Gott
Keyword(s):  
Palliative Care ◽  
New Zealand ◽  
Cross Sectional Study ◽  
Specialist Palliative Care ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services ◽  
Palliative Care Services ◽  
Care At Home ◽  
At Home

Differences between incarcerated and non-incarcerated patients who die in community hospitals highlight the need for palliative care services for seriously ill prisoners in correctional facilities and in community hospitals: A cross-sectional study

2017 ◽  
Vol 32 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Alex Rothman ◽  
Shannon McConville ◽  
Renee Hsia ◽  
Lia Metzger ◽  
Cyrus Ahalt ◽  
...  
Keyword(s):  
Palliative Care ◽  
The United States ◽  
Cross Sectional Study ◽  
Correctional Facilities ◽  
Sectional Study ◽  
Community Hospitals ◽  
Cross Sectional ◽  
Care Services ◽  
Palliative Care Services ◽  
Seriously Ill

Background: Incarcerated populations worldwide are aging dramatically; in the United States, prisoner mortality rates have reached an all-time high. Little is known about the incarcerated patients who die in community hospitals. Aim: Compare incarcerated and non-incarcerated hospital decedents in California. Design: Cross-sectional study. Setting/participants: All state hospital decedents ( N = 370,831) from 2009 to 2013, decedent age over time examined with additional data (2001–2013). Results: Overall, 745 incarcerated and 370,086 non-incarcerated individuals died in California hospitals. Incarcerated decedents were more often male (93% vs 51%), Black (19% vs 8%) Latino (27% vs 19%), younger (55 vs 73 years), had shorter hospitalizations (13 vs 16 days), and fewer had an advance care plan (23% vs 36%, p < 0.05). Incarcerated decedents had higher rates of cancer, liver disease, HIV/AIDs, and mental health disorders. Cause of death was disproportionately missing for incarcerated decedents. The average age of incarcerated decedents rose between 2001 and 2013, while it remained stable for others. Conclusion: Palliative care services in correctional facilities should accommodate the needs of relatively young patients and those with mental illness. Given the simultaneous growth in the older prisoner population with the rising age of incarcerated hospital decedents, community hospital clinicians should be prepared to care for seriously ill, incarcerated patients. Significant epidemiologic differences between incarcerated and non-incarcerated decedents in this study suggest the importance of examining the differential palliative care needs of incarcerated patients in all communities.

scholarly journals Understanding the impact of the Covid-19 pandemic on delivery of rehabilitation in specialist palliative care services: An analysis of the CovPall-Rehab survey data

2021 ◽  
pp. 026921632110633
Author(s):  
Joanne Bayly ◽  
Andy Bradshaw ◽  
Lucy Fettes ◽  
Muhammed Omarjee ◽  
Helena Talbot-Rice ◽  
...  
Keyword(s):  
Palliative Care ◽  
Online Survey ◽  
Rehabilitation Services ◽  
Free Text ◽  
Specialist Palliative Care ◽  
Advanced Illness ◽  
Cross Sectional ◽  
Care Services ◽  
Palliative Care Services ◽  
The Impact

Background: Palliative rehabilitation involves multi-professional processes and interventions aimed at optimising patients’ symptom self-management, independence and social participation throughout advanced illness. Rehabilitation services were highly disrupted during the Covid-19 pandemic. Aim: To understand rehabilitation provision in palliative care services during the Covid-19 pandemic, identifying and reflecting on adaptative and innovative practice to inform ongoing provision. Design: Cross-sectional national online survey. Setting/participants: Rehabilitation leads for specialist palliative care services across hospice, hospital, or community settings, conducted from 30/07/20 to 21/09/2020. Findings: 61 completed responses (England, n = 55; Scotland, n = 4; Wales, n = 1; and Northern Ireland, n = 1) most frequently from services based in hospices (56/61, 92%) providing adult rehabilitation. Most services (55/61, 90%) reported rehabilitation provision becoming remote during Covid-19 and half reported reduced caseloads. Rehabilitation teams frequently had staff members on sick-leave with suspected/confirmed Covid-19 (27/61, 44%), redeployed to other services/organisations (25/61, 41%) or furloughed (15/61, 26%). Free text responses were constructed into four themes: (i) fluctuating shared spaces; (ii) remote and digitised rehabilitation offer; (iii) capacity to provide and participate in rehabilitation; (iv) Covid-19 as a springboard for positive change. These represent how rehabilitation services contracted, reconfigured, and were redirected to more remote modes of delivery, and how this affected the capacity of clinicians and patients to participate in rehabilitation. Conclusion: This study demonstrates how changes in provision of rehabilitation during the pandemic could act as a springboard for positive changes. Hybrid models of rehabilitation have the potential to expand the equity of access and reach of rehabilitation within specialist palliative care.

scholarly journals The use of involuntary treatment among older adults with cognitive impairment receiving nursing care at home: A cross-sectional study

2018 ◽  
Vol 88 ◽  
pp. 135-142 ◽  
Author(s):  
Vincent R.A. Moermans ◽  
Michel H.C. Bleijlevens ◽  
Hilde Verbeek ◽  
Frans E.S. Tan ◽  
Koen Milisen ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Nursing Care ◽  
Cross Sectional Study ◽  
Involuntary Treatment ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care At Home ◽  
At Home

scholarly journals Risk factors for hip fracture in New Zealand older adults seeking home care services: a national population cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Rebecca Abey-Nesbit ◽  
Philip J. Schluter ◽  
Tim Wilkinson ◽  
John Hugh Thwaites ◽  
Sarah D. Berry ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
New Zealand ◽  
Hip Fracture ◽  
Home Care ◽  
Home Care Services ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services

scholarly journals What does it take to deliver brilliant home-based palliative care? Using positive organisational scholarship and video reflexive ethnography to explore the complexities of palliative care at home

2018 ◽  
Vol 33 (1) ◽  
pp. 91-101 ◽  
Author(s):  
Aileen Collier ◽  
Michael Hodgins ◽  
Gregory Crawford ◽  
Alice Every ◽  
Kerrie Womsley ◽  
...  
Keyword(s):  
Palliative Care ◽  
Service Management ◽  
Video Recording ◽  
Care Services ◽  
Home Based ◽  
Palliative Care Services ◽  
Care At Home ◽  
Or Team ◽  
Different Levels ◽  
At Home

Background: Despite the increasing number of people requiring palliative care at home, there is limited evidence on how home-based palliative care is best practised. Aim: The aim of this participatory qualitative study is to determine the characteristics that contribute to brilliant home-based palliative care. Design: This study was inspired by the brilliance project – an initiative to explore how positive organisational scholarship in healthcare can be used to study brilliant health service management from the viewpoint of patients, families, and clinicians. The methodology of positive organisational scholarship in healthcare was combined with video-reflexive ethnography. Setting/participants: Home-based specialist palliative care services across two Australian states participated in the study. Clinicians were able to take part in the study at different levels. Pending their preference, this could involve video-recording of palliative care, facilitating and/or participating in reflexive sessions to analyse and critique the recordings, identifying the characteristics that contribute to brilliant home-based palliative care, and/or sharing the findings with others. Results: Brilliance in home-based palliative care is contingent on context and is conceptualised as a variety of actions, people, and processes. Care is more likely to be framed as brilliant when it is epitomised: anticipatory aptitude and action; a weave of commitment; flexible adaptability; and/or team capacity-building. Conclusion: This study is important because it verifies the characteristics of brilliant home-based palliative care. Furthermore, these characteristics can be adapted for use within other services.

Preferred Place of Death—A Study of 2 Specialist Community Palliative Care Services in Australia

2021 ◽  
pp. 082585972110180
Author(s):  
Emily Saurman ◽  
Sam Allingham ◽  
Kylie Draper ◽  
Julie Edwards ◽  
Jeanette Moody ◽  
...  
Keyword(s):  
Palliative Care ◽  
Care Facility ◽  
Aged Care ◽  
Cross Sectional Study ◽  
Place Of Death ◽  
Residential Aged Care ◽  
Cross Sectional ◽  
Care Services ◽  
Palliative Care Services ◽  
Individual Variables

Choice and preference are fundamental to person-centered care and supporting personal choice at the end of life should be a priority. This study analyzed the relationship between a person’s preferred place of death and other individual variables that might influence their actual place of death by examining the activity of 2 specialist community palliative care services in Australia. This was a cross-sectional study of 2353 people who died between 01 August 2016-31 August 2018; 81% died in their preferred place. Sex, type of life-limiting illness, and length of time in care were the only variables significantly related to dying in one’s preferred place. Women were more likely to die in their preferred place than men (84% v 78%) and people with a non-cancer diagnosis were 7% more likely to die in their preferred place than those with cancer, particularly when that place was their private residence (74% v 60%) or Residential Aged Care Facility (98% v 89%). Someone in care for 0-7 days had 4.2 times greater odds of dying in their preferred place (OR = 4.18, 2.20-7.94), and after 21 days in care, people had 4.6 greater odds of having a preference to die in a hospital (OR = 4.63, 3.58-5.99). Both community palliative care services have capacity and a model of care that is responsive to choice. These findings align with known referral patterns and disease trajectories and demonstrate that it is possible to support the majority of people in the care of community palliative care services to die in their preferred place.

scholarly journals Thriving among older people living at home with home care services—A cross‐sectional study

2020 ◽  
Vol 76 (4) ◽  
pp. 999-1008 ◽  
Author(s):  
Kristina Lämås ◽  
Karin Bölenius ◽  
Per‐Olof Sandman ◽  
Ådel Bergland ◽  
Marie Lindkvist ◽  
...  
Keyword(s):  
Home Care ◽  
Older People ◽  
Home Care Services ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services ◽  
At Home

scholarly journals Experiences of relatives with outpatient palliative care: a cross-sectional study

2020 ◽  
Vol 26 (5) ◽  
pp. 230-237
Author(s):  
André Fringer ◽  
Sabrina Stängle ◽  
Iren Bischofberger ◽  
Daniel Büche ◽  
Renate Praxmarer ◽  
...  
Keyword(s):  
Palliative Care ◽  
Home Care ◽  
Response Rate ◽  
Cross Sectional Study ◽  
Descriptive Statistics ◽  
Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Dying At Home ◽  
At Home

Aim: The authors aimed to evaluate the experiences of the relatives of dying people, both in regard to benefits and special needs, when supported by a mobile palliative care bridging service (MPCBS), which exists to enable dying people to stay at home and to support patients' relatives. Design: A cross-sectional survey. Methods: A standardised survey was performed, asking 106 relatives of dying people about their experiences with the MPCBS (response rate=47.3%). Descriptive statistics were analysed using SPSS 23. Findings: Many relatives (62.5%) reported that their dying relations when discharged from a facility to stay at home were not symptom-free. The MPCBS helped relatives maintain home care, and this was reported to be helpful. Support provided by the MPCBS made it easier for 77.6% of relatives to adjust care as soon as situations changed, and helped ensure that symptoms could be better controlled, at least for 68.2% of relatives. Younger relatives felt more encouraged by the MPCBS to care for their relatives dying at home.

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