Chemotherapy: the palliative role
Shauna Gaebler
pp 144-147
The role of chemotherapy in palliative care is a contentious issue. With the ongoing debate about the appropriateness of such therapy, an important issue may be missed. There has always been a small percentage of patients receiving chemotherapy in palliative care and advances over the past ten years have increased the likelihood that chemotherapy will be used by the palliative care team (Table 1).
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The management of malodour
John Moyle
pp 148-151
Odours are sensed by Schultz cells in the nasal passages. The sensation passes via the olfactory bulb and the olfactory tract to the olfactory trigone. Here the pathway splits with connections to the hypothalamus and the temporal gyrus. The importance of this split is that, apart from conscious sensation of smell, there are also effects of malodours outside conscious control. These may include instinctive, uncontrollable effects such as nausea, revulsion and grimacing. It is even possible to monitor and measure EEG changes due to malodour.
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Diagnosing and treating depression in the terminally ill
Patricia Casey
pp 152-155
The word ‘depression’ has many meanings and nowhere is the clinical dilemma that it poses more apparent than in patients with serious and terminal physical illness.
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Navigating new information technologies
Jay Lynch
pp 157-161
In his book, I Am Right and You Are Wrong, psychologist, educator and author Edward De Bono writes that sometimes, humans require provocation in order to perceive new patterns. Occasionally provocative, this article is written to articulate the possibilities in a new and emerging relationship between palliative care and information technology (IT).
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Special care for elderly patients
Sylvie Lefebvre-Chapiro
pp 162-164
An analysis of where people have died in France over the last few decades showed a gradual trend away from dying at home to dying in healthcare or social institutions (hospitals, clinics and retirement homes). This recent western phenomenon results from a combination of new urban lifestyles, changes in the family unit, women in the workforce, better access to care, taboos surrounding death and also, in an ageing population, loneliness and economic problems.
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Spirituality in the secular sense
Divakaran Edassery and Suresh Kumar Kuttierath
pp 165-167
Addressing the spiritual needs of the patient has long been recognised as an integral part of palliative care. Since spirituality is usually considered to be linked to religious beliefs and since many people identify themselves with some religion, spiritual issues are generally regarded as the expression of an individual’s internal conflicts and interactions. Thus, the sense of shame and guilt, fear of death or life after death, mistrust of God and disillusionment with religion have all been recognised as spiritual issues faced by patients with incurable diseases.
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