Teamwork with families facing bereavement
Pam Firth and Pheobe Anderson
pp 157-161
Frances Sheldon’s article ‘Children and bereavement' has drawn our attention to the need to set up provision for bereaved children. Many hospices and palliative care teams are currently developing services. Those engaged in such work need to share experiences because it is only by study, research, discussion and listening to bereaved children themselves that we can improve our skills as counsellors and therapists.
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Intraspinal opioids and local anaesthetics for cancer pain
Franco De Conno, Carla Ripamonte and Chiara Ticozzi
pp 162-168
Intraspinal opioid analgesia is the introduction of an opioid drug into the epidural (peridural) or subarachnoid (intrathecal) spaces for the management of acute and chronic pain. In 1979, Wang et al first reported the analgesic effect of opioids administered by the intrathecal route in patients with cancer pain.
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Management of cancerassociated hypercalcaemia
Stuart Ralston
pp 170-174
Most readers will be familiar with the syndrome of cancerassociated hypercalcaemia. This is a common complication of malignant disease that occurs in up to 30% of patients with advanced cancer. Some tumours (such as cancer of the large intestine) seldom cause hypercalcaemia whereas others, such as myeloma, breast cancer, squamous cancers and genitourinary cancers, are common causes.
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Treatment of bone pain with bisphosphonates
Matthew Collinson and Christopher Tyrrell
pp 175-177
The development of bone metastases in patients with malignancy is very common (65% in patients with advanced breast cancer), and bone metastases have been found to be the commonest cause of cancer-related pain. Severe pain occurs in two out of three patients with bone metastases, and among cancer patients fear of pain is second only to fear of death itself
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Teaching palliative care: a challenge to nursing trainers
Bernadette Wouters
pp 178-183
In many countries, palliative care is a recent development, and specialists everywhere are agreed that its integration into health schemes will not happen until it becomes an integral part of the basic training of every student nurse. As Derek Doyle has wryly commented: ‘Death has a 100% incidence.’
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Organisational audit for specialist palliative care services
Marney Prouse
pp 184-186
Cancer Relief Macmillan Fund has launched its latest initiative: Organisational Audit for Specialist Palliative Care Services. The advice and co-operation of the King’s Fund Organisational Audit Unit was instrumental in refining the programme, which has been devised and tested by specialists in palliative care. It represents a new direction in palliative care quality by combining specifically designed standards with a survey by a team of specialists in palliative care and/or health care management. This, coupled with the ongoing support of the Cancer Relief Macmillan Fund survey manager, makes this initiative unique in the field.
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Rehabilitation in an inpatient palliative unit
Susanna Clementi
pp 187-189
The first public hospice in Italy, a palliative care unit (PCU), has been operating in Milan since October 1991. It is located at the ‘Pio Albergo Trivulzio’, an institute with more than 1,000 beds for geriatric patients, about half of which are for rehabilitation. The PCU has nine beds and admits advanced or terminal cancer patients referred by the home care programmes operating in the city area under the aegis of the Italian League Against Cancer and the Floriani Foundation.
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Euthanasia: another view
Giorgio Di Mola
pp 192-193
Regarding the document produced by David Roy and C Henry Rapin on the position of the EAPC vis-à-vis euthanasia legislation, published in Volume 1 Number 1 of the European Journal of Palliative Care, I would like to make the following observations.
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The hospice of the future Part II
Franco De Conno
pp 190-191
On 21 September 1994, at the National Institute for Cancer Study and Cancer Care in Milan, the final prizes were awarded for the first ‘Hospice Project’ competition. (For information on some of the prizewinning designs, see the last issue of this journal.)
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