Aging, pain and palliative care
David I Wollner
pp 91-91
Men and women are living longer. The life expectancies for American men and women are currently estimated at 74.2 and 79.9 years respectively. France has one of the highest life expectancies, with 76.7 years and 83.8 years respectively. The population is aging worldwide, especially in more developed regions, but also in undeveloped and developing regions. There will be a 15-fold increase in American centenarians by 2050. The aging population presents many challenges to healthcare providers and policy makers.
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The need for dental involvement in palliative care
Simon Coulter, Ruth Gray and Max Watson
pp 94-97
Access to dental professionals by palliative care teams is increasingly seen as being important, particularly in the role of training palliative care professionals in the recognition, assessment and management of complex and specific oral problems. The delivery of impeccable oral health in hospices is dependent on palliative care professionals being cognizant of oral health disease and being able to identify and refer appropriate patients for dental care. Service delivery depends on good links with, and the availability of, domiciliary dental care.
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Could shoulder pain be suprascapular nerve entrapment?
James Penn and Zbigniew Zylicz
pp 98-100
Musculoskeletal pain is common in the end stages of many chronic diseases. Long periods of immobility, poor nutrition and cachexia are known causes of such complaints. However, few clinicians realise that some of this pain can be due to nerve entrapment. Factors that contribute to nerve entrapment pain are: weak muscles, loss of subcutaneous fat tissue, increased joint mobility and compression against bony edges. In this article, we describe one of the common musculoskeletal pain syndromes that is caused by traction of the suprascapular nerve.
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Case study masterclass 26: Managing a patient with complex pain and adenocarcinoma
Caroline Lucas
pp 101-102
John, a 76-year-old retired research scientist with a particular interest in physiology, presented to his GP with weight loss and tiredness. Previously, John had been well, apart from low back pain resulting from an old rugby injury. However, the back pain had changed in character over the previous few months and this had concerned him.
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Case study masterclass 25 answers: Palliative care of a paediatric patient with relapsed neuroblastoma
Torsten Hildebrandt, Jo Venables and Richard Hain
pp 101-102
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Another pain management model for developing countries
Jordanka Kirkova and Mellar Davis
pp 103-107
Chronic pain is multidimensional, precipitated by multiple factors, and accentuated by neuroplastic mechanisms. It is often divided into malignant and non-malignant aetiologies. This classification begs the question of how different the treatment of chronic malignant and non-malignant pain should be. Is this classification of chronic pain artificial and irrelevant? Different classifications of chronic pain influence models for pain services, such as pain clinics mainly for non-cancer pain and palliative programmes for cancer pain. This may be an acceptable model for developed countries, but may not be feasible in many developing countries.
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Ensuring the wellbeing of participants and researchers
Rhidian Hughes
pp 108-110
Much of social research is concerned with the study of beliefs, attitudes, values and perceptions. These topics raise many challenges for the application of social research methodologies, which include a host of ethical considerations. Particular issues arise in palliative care research. For example, when conducting research with palliative care patients and bereaved relatives, the process can bear some positive cathartic value. Equally, some participants may become upset or express emotional distress, which may trigger powerful feelings related to health, illness and death.
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Reflections on evaluation research in palliative care
Kristel JM Janssen and Paul FM Krabbe
pp 113-116
Two distinctive goals can be distinguished in medicine. For some patients, the goal is stabilisation followed by cure of the disease. For others, the goal is not directed at cure of the disease itself but only its stabilisation (for example, in chronic diseases). For the latter group, the main focus is predominantly on care. Irrespective of the focus, medical care has undoubtedly entered a period with an increasing emphasis on scientific evidence. This so-called evidence-based medicine movement combines scientific evidence with clinical experience to improve daily clinical practice.
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Hypnosis: principles of use and benefits in palliative care
Antoine Bioy and Chantal Wood
pp 117-120
Hypnosis has a very long history, mixed with that of both psychology and medicine. The practice, dating back over two hundred years, is today enjoying a revival within the field of medicine. This is mainly because its mechanisms of action are now better understood, giving it scientific legitimacy, but also because its effectiveness in dealing with a whole host of symptoms makes it possible to offer a patient a measure of both physical and psychological comfort.
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Psychological and spiritual care of Holocaust survivors
Katalin Hegedus
pp 122-123
The population of Hungary is ten million. The population is divided by religion into the following: Roman Catholics 70%, Protestants 25%, and Jews 5%, but few actually practise their religion regularly. Budapest has two million inhabitants, with a Jewish population of 80,000.
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Art therapy and symptom control: a team approach
Wilhelm Freiherr von Hornstein and Harald Gruber
pp 124-126
Mrs B is 58 years old, married with no children. Since December 1999, she has been suffering from a renal tumour with metastatic spread into her liver, bones, lungs and left atrium. After removal of the right kidney, she was fine apart from a heart disorder. In March 2004, tumour growth was diagnosed in her left atrium and her lungs. Following complicated heart surgery, the tumour was removed. After that, she participated in two clinical trials, which both had to be stopped because of progressive disease. She was admitted to our hospital (Tumor Biology Center) in February 2005 in a deteriorating state, having been recently diagnosed with liver metastases.
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Use of PDA technology in palliative care
Sylvain Falinower
pp 127-128
Nowadays, no one would deny that the universal use of mobile phones is here to stay. Unimaginable 20 years ago, when they were to be seen only in spy films, we cannot imagine life without them. While to some people a mobile phone may seem like an ‘electronic leash’, for others it is becoming a powerful means for healthcare professionals to transmit information, including patient records, when they are not at the patient’s bedside.
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