PubMed · 17233263
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
Bob Fazzi. 2006. Hospice programs: the same but...different.. https://pubmed.ncbi.nlm.nih.gov/17233263/
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
This paper illustrates a brief review of the development process of the palliative care team at the Seirei Mikatahara General Hospital. Palliative care team has been first instituted in 2002, and currently providing general support for cancer patients receiving chemotherapy not only for terminally ill patients. In future, we would start a regional palliative care program, including community palliative care team, to provide appropriate palliative care for all cancer population.
Spiritual issues arise frequently in the care of dying patients, yet health care professionals may not recognize them, may not believe they have a duty to address these issues, and may not understand how best to respond to their patients' spiritual needs. The case of a patient with a strong religious belief in a miraculous cure of metastatic pancreatic cancer is used to explore how better understanding of this belief and more explicitly spiritual conversation with the patient by his treating team might have provided opportunities for an improved plan of care. This article distinguishes spirituality from religion; describes the salient spiritual needs of patients at the end of life as encompassing questions of meaning, value, and relationship; delineates the role physicians ought to play in ascertaining and responding to those needs; and discusses the particular issue of miracles, arguing that expectations of miraculous cure ought not preclude referral to hospice care.
One fourth of US deaths take place in long-term care facilities. As the population ages and hospitals shorten length of stay, these settings will deliver more terminal care. Using an illustrative case of an older patient with metastatic melanoma whose life expectancy was weeks to months, we discuss when potential benefits outweigh the risks of transfer from the hospital to post-acute care settings. To improve continuity of care, we outline communication of treatment goals and orders that anticipate symptom escalation. We discuss criteria physicians can use to identify the settings most able to ensure access to high-quality palliative care. Physicians and patients must consider the advantages and disadvantages of inpatient hospice, nursing homes, and residential care facilities. Post-acute care settings vary in delivery of hospice and other palliative care services, professional nursing services, and support of activities of daily living. Finally, we discuss the evidence that palliative care can be improved in these settings, including innovations in advance care planning, staff training, and systematic changes in clinical care practices. Expanding, replicating, and disseminating these studies will be necessary to improve care for the growing number of persons who die in post-acute care settings.