European Journal of Palliative Care - 1995

Palliative care in adolescence
Del McCarthy
pp 52-54
Following my recent attendance at the International Conference on Cancer Nursing in Vancouver, I became aware of the lack of information available on palliative care for adolescents. Hence I was prompted to share the experiences of the Adolescent Oncology Unit at the Middlesex Hospital, London. The unit was opened on 1 May 1990 and was established to provide services not then available to meet the special needs of teenagers with cancer.
Tramadol – a step towards the ideal analgesic?
Keith Budd
pp 56-60
In the late 1970s, tramadol was introduced as a weak opioid with an atypical clinical profile. At doses providing equianalgesic efficacy to pethidine, a similar potency was revealed but typical opioid adverse events, particularly respiratory depression and an effect upon smooth muscle, were significantly less pronounced. Such claims conflicted somewhat with its pharmacological classification as a µ-opioid agonist.
Delirium in palliative medicine
Augusto Caraceni,
pp 62-67
Delirium has been recognised for some time as a frequent complication of general illness, especially when associated with high fever. Delirium, or acute confusional state, can be considered a relatively stereotyped reaction of the brain to different offending insults, or an altered mental state on the continuum between coma or stupor and normal alertness. Some conditions, probably identifiable in functional or structural changes of the brain (the ageing process is the best example), can predispose to the development of delirium.
Sexuality of cancer patients – a palliative approach
Haya Yaniv
pp 69-72
It is true that we turn to palliation when a cure cannot be found, but palliation is certainly not equivalent to ‘there is nothing that can be done’. Concentrating on palliation does not mean that we are not good enough, that we have not tried hard enough or that we are professionally ‘impotent’.
Grief in children
Michel Hanus
pp 73-76
When children lose a mother or father – and I am talking here about loss through death – it is a dramatic and a seriously traumatic experience, and an event that may lead to problems in the distant future. There are, however, times when this death is fortunate for the child – for example, if the relationship with the parent had not been a very satisfactory one.
The supportive role of music
Susan Porchet-Munro
pp 77-80
The first publication on music therapy in palliative care appeared in 1978. Since then, it has gained recognition as a valuable intervention strategy and support in the care of terminally ill patients. This was evident when 70 professional music therapists presented diverse facets of their work at an international conference on music therapy in palliative care at Michael Sobell House in the UK in September 1994.
On the learning curve at Trinity Hospice
Oliver Meir,
pp 81-82
Personally, I did not feel sufficiently equipped to be able to meet these patients’ needs, without some training in palliative care, and not simply medical but in communication skills and psychology as well. It was for this reason that I contacted the Christophorus Hospice Society in Munich (Christophorus Hospiz Verein, München), which is attempting to establish palliative care in that city, with the long-term goal of setting up a hospice. As this has proved to be politically difficult, they are working at the moment on an ambulatory basis, with an educational programme open to everyone.
Rituals of death and dying in Israeli Jewish culture
Catherine Musgrave
pp 83-86
Central to death and mourning practices in Israeli Jewish culture is the concept that humans are created in God’s image and possess a worth transcending their utilitarian or societal value. In addition, God is regarded as the controller of life and death. Because of the halakhic (Jewish law) concept of the sacredness of life and the view that death is in the control of the Omnipotent One, deep religious meaning is invested in its death and dying rituals. These rituals may start during the dying process and can continue for years after the death of the loved one.