Comment: Complexity – is it in the eye of the beholder?
Carol Davis
pp 213-213
In the UK, the distinction between palliative care and specialist palliative care is acknowledged to relate to complexity. Specialist palliative care is about complex symptom control, psychological problems, social factors, spiritual issues, end-of-life care and bereavement. Little is written about what makes a palliative care issue complex.
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Unilateral vocal cord paralysis in patients with lung cancer
Charlie Huins, Elizabeth Lobeck and Justin Roe
pp 214-217
Anumber of papers have reported on unilateral vocal cord paralysis (UVCP) and its consequences in a wide range of pathologies, as well as on interventions to improve patient function. This paper focuses on the potential negative effects of UVCP on patients with a diagnosis of lung cancer, as well as on the management considerations.
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Using ultrasound in hospices
Amy EH Kingston and John Moyle
pp 218-219
Abdominal paracentesis is a common procedure for symptom control in palliative care. In the past, it was often performed in hospices, without the use of ultrasound, to confirm the presence of ascites or to locate suitable drainage sites.
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The meaning of death and dying in Judaism
Samuel Lebens
pp 220-223
The title of this article is somewhat daunting, since Judaism is far from monolithic. There is a famous adage that, for every two Jews, you will find at least three views.
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Case study masterclass 46: Duodenal stenting in a 42-year-old man near the end of life
Anna Wilkinson
pp 224-225
Raj was a shopkeeper living with his wife and two teenage sons. He was an articulate, dignified, intelligent man, who was described in his medical notes as ‘lovely’ and ‘anxious’. In March 2009, at the age of 42 and after a long history of colorectal cancer, he had a stent inserted to palliate inoperable duodenal obstruction. He died a few weeks later after having been admitted with haematemesis.
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Case study masterclass 45 answers: Helping a young woman to fight the psychological side-effects of cervical cancer treatment
Jita Das and Carol Davis
pp 226-226
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Palliative care is starting to counter the medical nemesis
Michael Igoumenidis and Eleni Theodosopoulou
pp 228-230
In 1975, the Austrian philosopher Ivan Illich tried to send a warning message to medical professionals in the form of a controversial book, Medical nemesis: the expropriation of health. Judging by some of the editorials that appeared in prestigious medical journals at the time, although the medical community paid attention to what Illich was saying, it failed to take him seriously, dismissing his fears and largely ignoring the message. However, the book became very popular and what, in 1975, was a radical polemic is now, in some sense, mainstream.
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EAPC Research Network: the Junior Forum
Sophy Gretton, Joanne Droney, Ruth Branford, Guro Birgitte Stene, Anne Kari Knudsen and Stein Kaasa
pp 232-235
Palliative care research is entering a new and exciting era. Springing from the seeds of advocacy in the early 1980s, and facilitated by the foundation of the European Association for Palliative Care Research Network (EAPC RN) in 1996, palliative care research is today attracting international funding and recognition. It has risen to the fore of the national political agenda in several countries and is affirming its role in the international research arena.
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How to evaluate the communication skills of palliative care professionals
Christian Schulz, Julia Katerla, Mischa Möller, André Karger and Martin W Schnell
pp 236-239
Competence in end-of-life communication is central to the formation of a professional role model. Sometimes, communication is the only tool left to the carer of a dying patient. Such competence is not a mere matter of personality, but can be developed through training – and training can be evaluated. Communication in general can be described as consisting of specific, observable behaviours. It can, therefore, be taught, evaluated and assessed. Training programmes in end-of-life communication have been shown to be effective in various care settings.
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An end-of-life care initiative for people with dementia
Susan Ashton, Bob McClelland, Brenda Roe, Deborah Mazhindu and Robert Gandy
pp 240-243
Some disease trajectories are marked by a period of gradual decline until death. It is recognised that this phase is difficult to identify in people with dementia. There is limited evidence about the quality of dying for people with dementia in long-term care settings; it is acknowledged that, in such settings, there are difficulties in providing those patients with good quality palliative care.
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Palliative care and emergency medicine: how can they work together?
Christoph HR Wiese, Bernhard M Graf and Gerd-Gunnar Hanekop
pp 245-248
Specialised palliative home care allows more patients suffering from advanced cancer to be treated in their own homes. However, advanced cancer often results in increasingly frequent acute situations, which are predictable but also occur suddenly. Often, the emergency medical services are alerted.
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What does it mean to be a hospice volunteer in Poland?
Katarzyna Hess-Wiktor
pp 249-251
From 1981, when informal palliative care societies were first set up in Poland, volunteers have played a significant role. Today, although Polish hospice services are becoming increasingly professionalised, medical staff and the community still rely on, and appreciate the value of, unpaid help. Volunteers, along with patients’ families, undertake the demanding task of caring for those who are dying.
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European insight: HSPSCCNCP: foster palliative care and pain management in Greece
Athina Vadalouca, Eriphyli Argyras and Ionna Siafka
pp 256-258
Twelve years ago, palliative care in Greece was more a vague notion than an essential service integrated into medical practice. Only a few hospitals provided pain management and palliative care services. These services were all run on a voluntary basis and relied on the efforts of anaesthesiologists and a few other healthcare professionals. Then, in 1997, the Hellenic Society of Palliative and Symptomatic Care of Cancer and Non Cancer Patients (HSPSCCNCP) was founded by healthcare professionals working with terminally ill patients or people living with chronic pain.
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