Comment: Standards and norms for palliative care in Europe
Julia Riley
pp 265-265
The White Paper on standards and norms for hospice and palliative care in Europe, which is an official position paper of the European Association for Palliative Care (EAPC), is published in the European Journal of Palliative Care in two parts, the first of which appears in this issue. It is a welcome piece of research that one could consider to be well overdue. It sets out to establish uniformly accepted definitions of essential elements in palliative care.
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Can psychostimulants be used in palliative care?
Vinnie Nambisan
pp 266-269
Although psychostimulants (also known as central nervous system [CNS] stimulants) are not commonly used for symptom control in terminally ill patients, their use has been proposed, backed by increasing evidence, in the treatment of cancer-related fatigue, opioid-induced sedation and depression in the terminally ill. These symptoms can cause significant morbidity at, or nearing, the end of life.
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Using practitioner research to study vulnerable patients
Helen Noble, Jackie Bridges and Julienne Meyer
pp 270-273
This article describes how practitioner research – where practitioners themselves carry out the research – was used to explore the healthcare needs, and trajectories to death, of a group of patients with stage 5 chronic kidney disease (CKD) managed without dialysis. It highlights the strengths and weaknesses of practitioner research and the ethical issues that arise when it is used with a palliative care population. Specific examples are offered to show the success of the methodology when used with vulnerable patients who are often excluded from research.
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Case study masterclass 47: Flying home to die: repatriation of a terminally ill patient
Eileen Andrews, Rachel Sharkey and Tony White
pp 274-275
Rebecca, a 44-year-old Kenyan lady with rapidly progressive metastatic malignant melanoma, was admitted to hospital in the UK with a large pleural effusion. Her life expectancy was considered in terms of weeks. She was married with two teenage children, who lived with their father in Kenya. She expressed the wish to return to Kenya to spend her last days with her family.
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Case study masterclass 46 answers: Duodenal stenting in a 42-year-old man near the end of life
Anna Wilkinson
pp 276-276
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White Paper on standards and norms for hospice and palliative care in Europe: part 1
Lukas Radbruch and Sheila Payne
pp 278-289
In this official position paper of the European Association for Palliative Care (EAPC), Lukas Radbruch, Sheila Payne and the Board of Directors of the EAPC outline and explain the association’s recommendations for a common terminology and common quality norms
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The Marie Cure Delivering Choice Programme
Nicky Agelopoulos and Teresa Tate
pp 290-294
Marie Curie Cancer Care is a UK charity that specialises in providing high-quality care to palliative care patients, regardless of their diagnosis. The charity believes that the right to choose one’s place of end-of-life care and death is fundamental and that barriers impeding this right should be eliminated. In 2004, Marie Curie Cancer Care initiated a service redesign programme, the Delivering Choice Programme, intended to help localities improve services for palliative care patients, allowing patients to be cared for, and die in, the place of their choice.
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The role of health professionals in spiritual care: attitudes, practices and interventions
Simon Dein
pp 296-300
There has been increasing interest in spirituality in the health-related literature over the past decade. Although the term ‘spirituality’ is difficult to define, in this context it broadly relates to three areas: meaning and purpose in the sick person’s life; relationships and feeling valued by others; and the transcendent, including a sense of love and compassion. These aspects may or may not be expressed through formal religious beliefs and/or practices.
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Delivering palliative care to those with learning disabilities
Dorry McLaughlin, Owen Barr and Sonja McIlfatrick
pp 302-305
Palliative and end-of-life care is facing a period of unprecedented change, shaped by new patterns of care, new policy frameworks and increased knowledge. The concept has been broadened to include care given to people with advanced, irreversible disease as well as to those with a cancer diagnosis alone.
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European insight: DCP: Germany aims to offer specialist palliative care to all who need it
Christof Müller-Busch
pp 308-310
Palliative care in Germany got off to a rather difficult start. In 1971, when the film 16 Days Left. A Hospital for the Dying in London (a documentary film about St Christopher’s Hospice) was shown on German television, it led to many disputes and misunderstandings about the kind, and the setting, of end-of-life care. The health and social services as well as the churches were sceptical about palliative care and a public debate began about the ethical value of Sterbekliniken – the German translation of ‘hospitals for the dying’. Opponents saw them as ‘special ghettoes for the dying’, while others recognised the need for more attention to be paid to people at the end of life.
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