The management of delirium in hospice practice
A D Macleod
pp 116-120
Delirium is a commonly encountered syndrome in the practice of palliative medicine. It is estimated that up to 85% of dying cancer patients develop delirium in their last weeks of life and 57% of ill AIDS patients. Indeed, it may be the exception for patients to remain mentally clear until death, and delirium has been considered the hallmark of dying.
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Developing palliative care services for patients with AIDS
Martha Downey
pp 121-123
Palliative care had its origins in the British hospice movement but has evolved in both concept and practice far beyond the original goal of improving terminal care. The modern hospice and palliative care movement was developed as a community response to those who were dying, mainly of cancer. The expectations of hospice providers, the models of care and even the policies and procedures reflect this history. It is clear that there are problems in applying the hospice model uncritically to patients with AIDS.
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Artificial hydration (AH) for people who are terminally ill
pp 124-124
The two papers that follow have been prepared by a joint working party of the National Council for Hospice and Specialist Palliative Care Services and the ethics committee of the Association for Palliative Medicine of Great Britain and Ireland.
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CPR for people who are terminally ill
pp 125-125
Experience has shown that, when drawing up and implementing cardiopulmonary resuscitation (CPR) policies, it is necessary to give particular consideration to the needs of terminally ill patients. Good practice suggests that decisions regarding CPR should involve a multiprofessional team, the patient and relatives and carers, but that the senior doctor has ultimate responsibility for the decision.
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Ethical decision-making in palliative care
Kilian Dunphy and Fiona Randall
pp 126-128
In September 1995, a working party drawn from the ethics committee of the Association for Palliative Medicine of Great Britain and Ireland and the National Council for Hospice and Specialist Palliative Care Services began work on two draft documents exploring the bases for ethical decision-making with respect to cardiopulmonary resuscitation (CPR) and artificial hydration (AH) in palliative care.
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Palliative care and the need for a metaphysical approach
Marie Frings
pp 129-132
‘Failing to broach the question of the hereafter when discussing palliative care is the same as giving a lecture on sailing boats without mentioning the sea.’ This statement, made by Christian Combaz in his discussion on the merits of old age, should encourage the development of metaphysical thought in palliative care. Indeed, in thinking about the hereafter, a metaphysical approach seems necessary to someone pondering the end of life. It is also becoming increasingly important to those who have regular dealings with the terminally ill in a professional capacity.
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Catharsis in palliative care
Christina Liossi and Kyriaki Mystakidou
pp 133-136
The word catharsis derives from the Greek Katharsis meaning ‘to clean or purify.’ The roots of catharsis can be traced in ancient religious practices of purification and cleansing and in ancient medicine’s purgings. Through the centuries, most cultures have had recognised contexts in which emotions are evoked, heightened in intensity and ultimately released or discharged, and cathartic procedures can be detected in many cultures’ healing practices.
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Palliative care in Chile
Maria Antonieta Rico
pp 138-139
Chile, a country of 14 million people, is currently going through an accelerated socioeconomic development that is moving Chilean people towards a demographic and epidemiologic revolution. There is a growth in the incidence of chronic nontransmissible diseases like cancer and other pathologies related to the aging of the population and changes in lifestyle. Life expectancy at birth is currently 75 years and infant mortality rate is 10.2 per thousand live births.
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