Comment: Dispelling the myths about the so-called ‘death list’
Diana Madill
pp 5-5
Recently, UK newspaper the Daily Mail reported that ‘GPs have been asked to select one in every 100 of their patients to go on a list of those likely to die over the next 12 months. The patients will be singled out for “end-of-life care”, potentially saving the NHS more than £1 billion a year’. The list is referred to in the title of the article as a ‘death list’.
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Medical management of end-stage heart failure in the hospice setting
Katie Rose, Rosalyn Foo and Jonathan Martin
pp 6-8
Mr A was a 67-year-old Moroccan man living in a deprived inner city area of the UK. This article outlines the clinical course of the final months of his life, with a focus on the medical management of heart failure in the hospice setting.
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Palliative surgery in cancer patients: what do we know about it?
Anke Mols, Stella Reiter-Theil, Daniel Oertli and Carsten T Viehl
pp 9-13
Surgery plays an important role in palliative concepts. A growing interest in palliative surgery for cancer patients has emerged in the scientific literature in recent years, but it is still far behind the interest generated by surgical research in curative cancer treatment and solid, reliable data are lacking. Surgical therapy in the palliative setting tries to improve conditions and symptoms such as obstruction of viscera, pain, bleeding, malodour, pathological fractures, brain metastasis and so on.
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Book review: Heart Failure: From Advanced Disease to Bereavement
Jonathan Dowman
pp 13-13
This is a clearly structured and transparently written guidebook directed at medical, nursing and allied professional specialists in heart failure, a more general cardiology population and palliative care staff. It aims to guide the identification of advanced heart failure and advise on its holistic management.
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Case study masterclass 66: Managing an elderly cancer patient with percutaneous nephrostomy
Ramesh Thulavavenkateswaran and Ananda Kumar Dhanasekaran
pp 14-15
John is a 78-year-old retired teacher. His wife died ten years ago. He lives on his own in a flat and is mobilising well unaided. He has a son who lives 100 miles away. Four years ago, he was diagnosed with prostate cancer, with a Gleason score of 9 (4 + 5). There were no curative options, as the cancer was locally advanced and also because of John’s age – his estimated life expectancy was less than ten years.
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Case study masterclass 65 answers: Addressing the risk of falls in a man with advanced cancer
Carol A Stone
pp 16-16
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Electronic co-ordination systems can empower patients and improve care
Claire Henry and Anita Hayes
pp 17-19
Despite surveys consistently showing that most people in England would prefer to die in their own home, some 51% of deaths currently take place in hospital. In 2008, England’s national End of Life Care Strategy identified the co-ordination of services as a key area for improvement to ensure that an individual receives the care they need and have consented to, at the appropriate time and in their preferred setting.
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Palliative care and the electronic medical record: what progress?
Lucy Balding
pp 20-23
The medical record has evolved over time. Hippocrates is credited with first recording clinical observations in a chronological manner, thus creating a time-oriented medical record. Today’s patient-centred medical record was first introduced at the Mayo Clinic, Minnesota, USA, although it has evolved in structure and content since.
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Book review: Oxford Textbook of Palliative Medicine, 4th edn
Stephen G Oxberry
pp 23-23
A developing specialty requires a reference textbook that develops with it, and the Oxford Textbook of Palliative Medicine is just that. Its fourth edition demonstrates the textbook’s responsiveness to changing times and an emerging evidence base, capturing the multidisciplinary aspects of palliative care well with its wide editorship – comprised of key clinicians in the field.
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Introduction of electronic patient records in a hospice inpatient unit
Nicola Butterfield
pp 24-27
Healthcare information systems have evolved to play a major role in healthcare provision in modern society, and the introduction of the electronic patient record aims to improve patient safety and documentation quality.
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The NICE guide for commissioners: another milestone on the way to improving end-of-life care
Tessa Ing
pp 28-30
Professor Sir Mike Richards, National Clinical Director for Cancer and End of Life Care, describes how those two topics were regarded when he was a practising clinician: if he wanted to discuss cancer, he got to see the chief executive; if the topic was end-of-life care, it was a junior manager. I like to think that end-of-life care features in the chief executive’s in-tray these days.
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Implementing spiritual care at the end of life: the UK
Bella Vivat
pp 32-33
In the 2001 UK census, 85.7% of the 58.8 million population identified as White British, 5.2% as Other White and 1.2% as White Irish. The other main minority ethnic groups were Indian (1.8%), Pakistani (1.6%), Chinese (0.4%), Black Caribbean (0.5%), Black African (0.4%) and Other Black (0.4%). This ethnic diversity links with religious diversity.
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Extending advance care planning over the care career
Malcolm Payne
pp 34-37
Palliative care has, internationally, been an important driver of the development of advance care planning (ACP), as practitioners have sought to clarify and formalise patients’ advance decision-making where they are likely to lose capacity to make treatment decisions at the end of life.
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The interdisciplinary journal club: a learning opportunity
Boris Cantin, Gian Domenico Borasio and Michel Beauverd
pp 38-39
In palliative care, few papers have been published on the topic of journal clubs. However, journal clubs may have positive implications for clinical practice and can also generate ideas for research studies.
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How community involvement is changing palliative care in Kerala
Naveen Pappachan
pp 40-41
In many parts of the developing world, patients diagnosed with chronic or terminal illness are sent back home without adequate care provision, especially in terms of pain relief. However, in the southern Indian state of Kerala, the Neighbourhood Networks for Palliative Care, working alongside the Institute of Palliative Medicine in Calicut, have brought about a revolution in palliative care.
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EAPC Early Researcher Awards: looking back
Jenny van der Steen, Catherine Walshe and Martin Fegg
pp 42-44
Since 2009, through the annual Early Researcher Awards – formerly the Young Investigator Awards – the European Association for Palliative Care (EAPC) has been supporting novice scientists and clinicians who are making an outstanding contribution to palliative care research and/or academic teaching. Three years after receiving the award, the 2009 winners, Jenny van der Steen, Catherine Walshe and Martin Fegg, describe what paths their respective careers have taken since, in our new series echoing testimonies on the EAPC blog.
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A day in the life of … Joanna Vriens, Clinical Research Fellow
Joanna Vriens
pp 46-47
I am a palliative medicine specialist registrar and have taken two years out of my training to complete a medical doctorate at Imperial College London. The research I’ve undertaken is a pharmacokinetic study; this type of study investigates what the body does to a drug (compared with pharmacodynamic studies, which look at what effect the drug has on the body).
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European insight: Palliative Care for People with Learning Disabilities Network
Irene Tuffrey-Wijne
pp 48-50
Around 2.5% of the population have intellectual disabilities (in the UK also known as ‘learning disabilities’). They are among the most vulnerable and marginalised people in society. Historically, people with intellectual disabilities were often hidden or sent to live in long-stay institutions, away from the world. Thankfully, things have changed in recent decades.
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