scholarly journals What matters most in end-of-life care: perceptions of seriously ill patients and their family members

2006 ◽  
Vol 174 (5) ◽  
pp. 627-633 ◽  
Author(s):  
D. K. Heyland
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Family Members ◽  
Life Care ◽  
Seriously Ill Patients ◽  
Seriously Ill ◽  
What Matters

Seriously Ill Patients' Beliefs Regarding How Their Preferences For End-Of-Life Care Will Be Promoted

2012 ◽  
Author(s):  
Mary McKenzie ◽  
Kelly Vranas ◽  
Elizabeth Cooney ◽  
Tatiana Silva ◽  
Susan Metzger ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Seriously Ill Patients ◽  
Seriously Ill

Planning for End of Life

Pained ◽  
2020 ◽  
pp. 217-218
Author(s):  
Michael D. Stein ◽  
Sandro Galea
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
College Education ◽  
Growing Up ◽  
Life Care ◽  
Treatment Paradigm ◽  
Life Sustaining Treatment ◽  
The One ◽  
Seriously Ill Patients ◽  
Seriously Ill

This chapter discusses the planning for end-of-life care. Results of a 2017 survey show that older adults are likelier than younger people to have documented their end-of-life wishes. Yet few adults with or without written documents have discussed end-of-life care with their doctors. Age, education, and discussions about death were predictors of having such a plan. Those with a college education or higher were most likely to have a written document, compared to those with some college, high school, or less education. Also, talking about death while growing up correlated with having written documents about wishes for medical care. Care settings encouraging or mandating doctors to use an advanced directive toolkit, such as the one created by the National Physician Orders for Life-Sustaining Treatment Paradigm, can improve the communication gap with providers and help seriously ill patients better express their wishes for end-of-life care.

Factors Considered Important at the End of Life (DRAFT)

2018 ◽  
Author(s):  
Ravi B. Parikh ◽  
Oreofe O. Odejide
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Survey Study ◽  
Good Death ◽  
Life Care ◽  
Care Providers ◽  
Broad Variation ◽  
Definition Of ◽  
Seriously Ill Patients ◽  
Seriously Ill

The chapter describes the national survey study by Steinhauser and colleagues, which assessed perspectives of seriously ill patients, family members, physicians, and other care providers (i.e., nurses, social workers, and chaplains) regarding the importance of several factors at the end of life. Survey respondents were asked to rate and rank the importance of attributes of quality at the end of life. This chapter highlights attributes that met consensus among all groups of respondents, those that were important to patients but not physicians, and attributes that had broad variation across all groups. It also includes items that were ranked the most important and least important by all groups. This chapter emphasizes areas of agreement as well as areas of diversity in the definition of a “good death” and discusses implications of these findings in providing end-of-life care.

Fact file 9: Palliative care

2017 ◽  
Author(s):  
Daisy Fancourt
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Improve Quality ◽  
Spiritual Support ◽  
Life Care ◽  
Seriously Ill Patients ◽  
Seriously Ill

Palliative care is support for seriously ill patients and their families. The aim of palliative care is to minimize pain and discomfort as much as possible and provide psychological, social, and spiritual support. An important part of palliative care is end-of-life care, which aims to improve quality of life as much as possible while patients are alive and then help them to die with dignity....

scholarly journals Conversations About Death and Dying, End-of-Life Care Plans and Preferences Between Aging Parents and Adult Children

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 417-417
Author(s):  
Hyo Jung Lee ◽  
Jacobbina Jin Wen Ng
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Adult Children ◽  
End Of Life Care ◽  
Death And Dying ◽  
Family Members ◽  
Life Care ◽  
Joint Decision ◽  
Aging Parents ◽  
Care Plans

Abstract This study aims to investigate whether attitude and perception on late-life death and dying, end-of-life care plans and preferences could be better understood from current values shared between aging parents and their adult children in the multi-cultural city-bound country, Singapore. We are in the process of interviewing 20 aging parent-adult child dyads. Up to date, six semi-structured interviews were completed and transcribed. We performed Content analysis to analyze the transcripts. Preliminary findings showed that both aging parents and adult children rarely discussed this issue, although parents had their own plans or preferences. The major barriers against open conversations about death and dying of aging parents include: the perception of not-yet time to talk about this issue (without knowing when the right time is) and tendency to have conversations about death in tandem with finances, but not death itself. Although specific end-of-life care plans or arrangements were not thought out thoroughly, aging parents expressed a high level of trust and reliance on close family members’ decisions regarding their end-of-life care. They tended to agree on joint decision-making process within family, even though adult children had no or unmatched ideas about their aging parents’ end-of-life wishes. This did not necessarily align with previous findings in Western countries, underscoring individuals’ control over their own death and dying process. Open conversation within family, family-involved advance care planning, or joint decision-making processes may be warranted to promote quality of life and death in older Singaporeans and well-being of their family members of all ages.

scholarly journals Course and predictors of posttraumatic stress-related symptoms among family members of deceased ICU patients during the first year of bereavement

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Siew Tzuh Tang ◽  
Chung-Chi Huang ◽  
Tsung-Hui Hu ◽  
Wen-Chi Chou ◽  
Li-Pang Chuang ◽  
...  
Keyword(s):  
Social Support ◽  
Posttraumatic Stress ◽  
End Of Life ◽  
End Of Life Care ◽  
Family Members ◽  
Life Care ◽  
Ptsd Symptoms ◽  
Icu Patients ◽  
Clinically Significant ◽  
Bereaved Family

Abstract Background/Objective Death in intensive care units (ICUs) may increase bereaved family members’ risk for posttraumatic stress disorder (PTSD). However, posttraumatic stress-related symptoms (hereafter as PTSD symptoms) and their precipitating factors were seldom examined among bereaved family members and primarily focused on associations between PTSD symptoms and patient/family characteristics. We aimed to investigate the course and predictors of clinically significant PTSD symptoms among family members of deceased ICU patients by focusing on modifiable quality indicators for end-of-life ICU care. Method In this longitudinal observational study, 319 family members of deceased ICU patients were consecutively recruited from medical ICUs from two Taiwanese medical centers. PTSD symptoms were assessed at 1, 3, 6, and 13 months post-loss using the Impact of Event Scale-Revised (IES-R). Family satisfaction with end-of-life care in ICUs was assessed at 1 month post-loss. End-of-life care received in ICUs was documented over the patient’s ICU stay. Predictors for developing clinically significant PTSD symptoms (IES-R score ≥ 33) were identified by multivariate logistic regression with generalized estimating equation modeling. Results The prevalence of clinically significant PTSD symptoms decreased significantly over time (from 11.0% at 1 month to 1.6% at 13 months post-loss). Longer ICU stays (adjusted odds ratio [95% confidence interval] = 1.036 [1.006, 1.066]), financial insufficiency (3.166 [1.159, 8.647]), and reported use of pain medications (3.408 [1.230, 9.441]) by family members were associated with a higher likelihood of clinically significant PTSD symptoms among family members during bereavement. Stronger perceived social support (0.937 [0.911, 0.965]) and having a Do-Not-Resuscitate (DNR) order issued before the patient’s death (0.073 [0.011, 0.490]) were associated with a lower likelihood of clinically significant PTSD symptoms. No significant association was observed for family members’ satisfaction with end-of-life care (0.988 [0.944, 1.034]) or decision-making in ICUs (0.980 [0.944, 1.018]). Conclusions The likelihood of clinically significant PTSD symptoms among family members decreased significantly over the first bereavement year and was lower when a DNR order was issued before death. Enhancing social support and facilitating a DNR order may reduce the trauma of ICU death of a beloved for family members at risk for developing clinically significant PTSD symptoms.

Nursing Home Resident, Family, and Staff Perspectives on Hospital Transfers for End-of-Life Care

2021 ◽  
pp. 003022282199770
Author(s):  
Janet Sopcheck ◽  
Ruth M. Tappen
Keyword(s):  
Emergency Department ◽  
Nursing Home ◽  
End Of Life ◽  
End Of Life Care ◽  
Family Members ◽  
Terminally Ill ◽  
South Florida ◽  
Care Planning ◽  
Life Care ◽  
Advance Care

Residents who are terminally ill often experience transfers to the emergency department resulting in hospitalizations, which may be potentially avoidable with treatment in the nursing home. This qualitative study explored the perspectives of 15 residents, 10 family members, and 20 nursing home staff regarding end-of-life care and the circumstances prompting resident transfers. Data analysis of participant interviews conducted January to May 2019 in a South Florida nursing home identified four themes related to transfer to the hospital: time left to live, when aggressive treatments would be unavailing, not knowing what the nursing home can do, and transfer decisions are situation-dependent. Study findings underscore the importance of increasing resident and family awareness of treatments available in the nursing home and person-centered advance care planning discussions. Further research should explore the reasons for residents’ and family members’ choice of aggressive therapies and their goals for care at the end of life.

scholarly journals Decision-making styles of seriously ill male Veterans for end-of-life care: Autonomists, Altruists, Authorizers, Absolute Trusters, and Avoiders

2014 ◽  
Vol 94 (3) ◽  
pp. 334-341 ◽  
Author(s):  
Ursula K. Braun ◽  
Rebecca J. Beyth ◽  
Marvella E. Ford ◽  
Donna Espadas ◽  
Laurence B. McCullough
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Male Veterans ◽  
Decision Making Styles ◽  
Seriously Ill

End-Of-Life Care for the Dying Child: What Matters Most to Parents

2011 ◽  
Vol 27 (4) ◽  
pp. 279-286 ◽  
Author(s):  
Norbert J. Weidner ◽  
Marcella Cameron ◽  
Rebecca C. Lee ◽  
Judy McBride ◽  
Emily J. Mathias ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
What Matters
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