Comment: We must help people to stay out of hospital at the end of life
Andrew Grey
pp 5-5
Caring for people in hospital at the end of life is expensive: research by the Nuffield Trust has shown that the largest share of the money spent on end-of-life care goes to hospital care, the bulk of it being for emergency admissions. Yet people who are dying continue to be admitted to hospital when they have no clinical need to be there, and do not want to be there.
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Pharmacological management of paraneoplastic sweating in a palliative care setting
Julien O’Riordan, Sharon Beatty and Ita Harnett
pp 6-9
Treating paraneoplastic sweating in palliative care patients has proven challenging, and the existing evidence regarding available pharmacological agents is poor. Julien O’Riordan, Sharon Beatty and Ita Harnett sum up that evidence and propose a practically applicable guide to the choice of medication for managing this highly distressing symptom.
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The 2015 Quality of Death Index: global palliative care rankings
Julie Ling
pp 10-12
After a first report five years ago, the Lien Foundation, a philanthropic organisation based in Singapore, recently published a new ‘Quality of Death Index’, which ranks palliative care in 80 countries. How was it put together? What does it tell us? How helpful is it? Julie Ling has been finding out.
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Case study masterclass 84: A misdiagnosis of sigmoid cancer and the perils of the ‘palliative’ label
Katie Jerram
pp 14-15
Helen is a 67-year-old woman from the Liverpool area. She used to live alone and worked in an office, although she stopped working for several months in 2009 to care for her mother. Her mother died and Helen has no surviving family. She also has no close friends, but she does have a partner who lives in greater London. In April 2013, she moved to his house, a small terraced property with downstairs toilets and upstairs bathroom and bedrooms. Helen has a diagnosis of locally advanced sigmoid colon carcinoma with fistulae to the abdominal wall and perineum. She also has a loop colostomy.
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Advance care planning and place of death in a paediatric palliative care unit in France
Alain de Broca, Anne Lutun, Antoine Gourmel, Sophie Debon, Thérèse Tinot, Virginie Peret and Catherine Devoldère
pp 16-18
What are the challenges and benefits of elaborating advance care plans with the families of paediatric patients? Alain de Broca, Anne Lutun, Antoine Gourmet, Sophie Debon, Thérèse Tinot, Virginie Peret and Catherine Devoldère share their experience in a regional paediatric palliative care unit in Picardy, France.
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When home care falters: out-of-hours visits to the emergency department
Charlotte Chidell and Jacqui White
pp 19-23
Why might palliative care patients living at home need to visit the emergency department? What are the challenges involved in providing quality care in the home setting, especially after hours? Charlotte Chidell and Jacqui White present results from a pilot study conducted in the state of Victoria, Australia.
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Diagnosing dying: listen to the family’s perception!
Erna Haraldsdottir
pp 24-25
The family’s perception of a patient’s condition can be of precious help when diagnosing dying. Erna Haraldsdottir uses a story from her personal life to show how unnecessary distress can be avoided if the family is consulted early by health professionals.
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Creativity and empowerment in a children’s hospice community
Ros Scott, Mark Sheridan, Alison Blair and Lilian Stewart
pp 28-31
The Children’s Hospice Association Scotland (CHAS) uses a model of care that combines clinical expertise and artistic activities. Ros Scott, Mark Sheridan, Alison Blair and Lilian Stewart explain the benefits of this approach through two examples of recent music and arts projects, CHAS the Opera and Art 21.
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Book review: Oxford Textbook of Palliative Medicine, 5th edn
Guy Schofield
pp 51-51
Dedicated to the memory of one of its founding editors, Professor Geoffrey Hanks, the fifth edition of the Oxford Textbook of Palliative Medicine aims to offer ‘a truly global perspective in this field’, focusing on developments in research and emphasising palliative care’s truly multidisciplinary nature.
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What message do Spanish media convey about palliative care?
José Miguel Carrasco and Carlos Centeno
pp 32-34
The image of palliative care portrayed by the media informs public opinion and can therefore affect palliative care development and practice. José Miguel Carrasco and Carlos Centeno have looked at some of the main Spanish media to find out how they talk about palliative care.
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How future doctors in Nepal are using reflective portfolios to learn compassion and empathy
Katrina Butterworth, Darren N Nichols and Terra Anne Manca
pp 36-41
At the Patan Academy of Health Sciences in Kathmandu, medical students complete reflective portfolios while following palliative care patients and their families for six months. Portfolio learning is a useful tool for teaching these future doctors the caring attitudes that are key to provide good quality palliative care. Katrina Butterworth, Darren N Nichols and Terra Anne Manca tell us more.
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Implementing spiritual care at the end of life in the Republic of Ireland
Fiona Timmins, Maryanne Murphy, Nicolas Pujol, Greg Sheaf, Sílvia Caldeira, Jacqueline Whelan, Elizabeth Weathers and Bernadette Flanagan
pp 42-44
As part of our occasional series on spiritual care in Europe, Fiona Timmins, Maryanne Murphy, Nicolas Pujol, Greg Sheaf, Sílvia Caldeira, Jacqueline Whelan, Elizabeth Weathers and Bernadette Flanagan describe spiritual care service provision at the end of life in Ireland.
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Palliative care for people with intellectual disabilities: the EAPC White Paper in a nutshell
Irene Tuffrey-Wijne
pp 45-47
The European Association for Palliative Care has recently published a White Paper from its Taskforce on Palliative Care for People with Intellectual Disabilities. Irene Tuffrey-Wijne explains how it was put together, what it contains, and why it is pivotal in the care of people with intellectual disabilities at the end of life.
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Case study masterclass 84 answers: A misdiagnosis of sigmoid cancer and the perils of the ‘palliative’ label
Katie Jerram
pp 48-48
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European Insight: Palliative care has become a national priority in Croatia
Julijana Franinovic Markovic and Vlasta Vucevac
pp 49-51
When the palliative care movement started in Croatia, in the early 1990s, war was raging. There has been remarkable progress since and palliative care is now part of the government’s national strategy for healthcare. But there are still many challenges ahead, first and foremost palliative care education.
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