Comment: Is palliative care synonymous with end-of-life care?
Friedemann Nauck and Birgit Jaspers
pp 223-223
In the framework of palliative medicine and palliative care, there are many terms that start with ‘end of life’, such as end-of-life decisions, end-of-life issues and end-oflife provisions. There is no doubt at all that palliative care includes dealing with end-of-life issues and that people or their carers confronted with an incurable disease have to make end-of-life decisions. End-of-life provisions, however, are very common among the general public, such as last wills, living wills, and life insurance.
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The treatment of fatigue in palliative care patients
Lise Pedersen, Tina Noergaard Munch and Mogens Groenvold
pp 225-229
Fatigue is a highly prevalent symptom among patients with cancer and other chronic illness and is probably the most frequently reported symptom in palliative cancer patients. A recent study showed that more than 90% of cancer patients in palliative care suffered from fatigue. Furthermore, cancer patients have rated fatigue as the symptom that has the most negative impact on their daily living and quality of life when compared with nausea, depression and pain (which is the symptom ranked most highly by their oncologists). Thus, fatigue seems to be one of the most important cancer-related symptoms – both quantitatively and qualitatively.
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Palliative urinary diversion in malignant ureteric obstruction
Anna Spathis, Viv Lucas and Damian Hanbury
pp 230-232
Without intervention, bilateral malignant ureteric obstruction inevitably results in death from uraemia. The development of methods to bypass obstruction has led to a dilemma in patients with advanced malignancy. For some patients, intervention may substitute a painless and relatively humane death from uraemia for a short period of poor quality life, symptomatic from the underlying cancer.
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Case study masterclass 12: Pain from head and neck cancer that was difficult for everyone
Carol Davis and Barry Evans
pp 234-235
Vera Spraggs, a lifelong smoker and drinker, had multiple medical problems including hypertension, ischaemic heart disease and chronic renal failure. Aged 62, she was referred to the local cancer centre with a 2.5 x 3 cm squamous cell carcinoma of the right lateral border of her tongue. She was concerned about the morbidity of total glossectomy and, in any case, she was deemed unfit for a long general anaesthetic so she underwent a right hemi-glossectomy.
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Case study masterclass 11 answers: Sequelae of cauda equina compression
Carol Davis and Barry Evans
pp 235-235
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The interface between acute and palliative care: acute stroke
Angie Rogers
pp 236-238
While palliative care has been advocated for all dying patients from its outset, it has been most closely associated with the care of people with incurable cancer. Recently, there has been growing interest in the palliative care needs of people dying from non-malignant disease. Most noticeably in the UK, the National Service Framework for Coronary Heart Disease has recognised the importance of palliative care in the management of patients with heart failure.
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Recommendations for the use of non-analgesic drugs in palliative care
Nathalie Cheminot, Michèle Salamagne and Nathalie Dumarcet
pp 239-242
In palliative care, drug prescriptions are often issued on the basis of indications or are administered in ways that are not included in their prescribing information. It is essential to have specific recommendations for these unlicensed uses for both the GPs and specialists who are prescribing the medicines.
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Bridging the gap: European collaboration in palliative care education
Robert Becker and Elsy Jonsson
pp 244-246
Over the last seven years, the Shropshire and Mid Wales Hospice has hosted over 50 Swedish student nurses on two-week placements to enable them to gain both clinical and educational experience in palliative care. Dalarna University has also hosted educators and clinicians on a regular basis from the hospice. This venture has been developed as a way of providing valuable experience in a specialist palliative care unit to nurses in a rural part of Sweden where such facilities are not immediately available
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Palliative care associations – the Belgian experience
Caroline Buisseret, Caroline Frank, Anne-Françoise Nollet and Marie Laure Soulier
pp 247-249
The first palliative care association in Belgium was formed in 1980 when a team of nurses started taking care of terminally ill patients at home. This team became the foundation of the palliative care movement in our country.
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Researching the homeopathic approach to symptom control
Elizabeth Thompson
pp 250-252
Complementary therapies in general seem to be popular and there appears to be a desire by the public to integrate conventional and complementary therapies into their care. A recent survey suggested that women with breast cancer were using complementary and alternative medicine (CAM) to deal with the side-effects of cancer treatments and for symptom control. The hope of cure was less frequently reported.
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Hotline for palliative care
Ingeborg Hermann, Bart Van den Eynden, Peter Demeulenaere, Joke Denekens and Paul Van Royen
pp 254-255
Although terminally ill patients frequently utter the wish to die at home, they are often transferred from home to a residential healthcare setting because of poor pain and symptom management. GPs have a lack of palliative care knowledge and skills and are often unaware of the latest developments in pain and symptom management and need support and education. To meet these needs, a palliative care hotline was established by the palliative network of the Antwerp region, the Palliative Hulpverlening Antwerpen.
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