scholarly journals Enhancing palliative care delivery in a regional community in Australia

2006 ◽  
Vol 30 (3) ◽  
pp. 370 ◽  
Author(s):  
Jane L Phillips ◽  
Patricia M Davidson ◽  
Debra Jackson ◽  
Linda Kristjanson ◽  
Margaret L Bennett ◽  
...  
Keyword(s):  
Palliative Care ◽  
Service Delivery ◽  
Local Community ◽  
Care Delivery ◽  
Care Service ◽  
Palliative Care Service ◽  
Service Planning ◽  
North Coast ◽  
Care Needs ◽  
Integrated Network

Although access to palliative care is a fundamental right for people in Australia and is endorsed by government policy, there is often limited access to specialist palliative care services in regional, rural and remote areas. This article appraises the evidence pertaining to palliative care service delivery to inform a sustainable model of palliative care that meets the needs of a regional population on the mid-north coast of New South Wales. Expert consultation and an eclectic literature review were undertaken to develop a model of palliative care service delivery appropriate to the needs of the target population and resources of the local community. On the basis of this review, a local palliative care system that is based on a population-based approach to service planning and delivery, with formalised integrated network agreements and role delineation between specialist and generalist providers, has the greatest potential to meet the palliative care needs of this regional coastal community.

scholarly journals Adaptations to palliative home care in India in a COVID pandemic: An experiential narrative

2021 ◽  
Vol 73 ◽  
pp. 48-51
Author(s):  
Sunil Rameshchandra Dhiliwal ◽  
Ashish Gulia ◽  
Naveen Salins
Keyword(s):  
Palliative Care ◽  
Service Delivery ◽  
Care Service ◽  
Palliative Care Service ◽  
Personal Protection ◽  
Care Needs ◽  
Personal Protection Equipment ◽  
Complex Needs ◽  
Care Access ◽  
Home Based

India is in the midst of a fierce pandemic with a rapid surge of cases and the health-care system in a quandary. Care of patients with life-limiting illness needing palliative care has been compromised due to limitations in palliative care access and a paradigm shift in the hospital toward care of COVID. Therefore, it is imperative to augment the home-based services so that patients continue to remain at home with their care needs met so that their access to hospitals is restricted for acute and complex needs. To overcome practical aspects of home-based care service delivery, several adaptations were needed. An urban standalone home-based palliative care service provider made adaptations to personal protection, personal protection equipment, and team self-care that facilitated an effective service delivery and satisfaction.

scholarly journals Changing patterns of mortality during the COVID-19 pandemic: Population-based modelling to understand palliative care implications

2020 ◽  
Vol 34 (9) ◽  
pp. 1193-1201 ◽  
Author(s):  
Anna E Bone ◽  
Anne M Finucane ◽  
Javiera Leniz ◽  
Irene J Higginson ◽  
Katherine E Sleeman
Keyword(s):  
Palliative Care ◽  
Care Service ◽  
Descriptive Analysis ◽  
Palliative Care Service ◽  
Routine Data ◽  
Population Based ◽  
Service Planning ◽  
Care Homes ◽  
Care Needs ◽  
Health And Social Care

Background: COVID-19 has directly and indirectly caused high mortality worldwide. Aim: To explore patterns of mortality during the COVID-19 pandemic and implications for palliative care, service planning and research. Design: Descriptive analysis and population-based modelling of routine data. Participants and setting: All deaths registered in England and Wales between 7 March and 15 May 2020. We described the following mortality categories by age, gender and place of death: (1) baseline deaths (deaths that would typically occur in a given period); (2) COVID-19 deaths and (3) additional deaths not directly attributed to COVID-19. We estimated the proportion of people who died from COVID-19 who might have been in their last year of life in the absence of the pandemic using simple modelling with explicit assumptions. Results: During the first 10 weeks of the pandemic, there were 101,614 baseline deaths, 41,105 COVID-19 deaths and 14,520 additional deaths. Deaths in care homes increased by 220%, while home and hospital deaths increased by 77% and 90%, respectively. Hospice deaths fell by 20%. Additional deaths were among older people (86% aged ⩾ 75 years), and most occurred in care homes (56%) and at home (43%). We estimate that 22% (13%–31%) of COVID-19 deaths occurred among people who might have been in their last year of life in the absence of the pandemic. Conclusion: The COVID-19 pandemic has led to a surge in palliative care needs. Health and social care systems must ensure availability of palliative care to support people with severe COVID-19, particularly in care homes.

State-wide telephone support: enhanced palliative care service delivery

2021 ◽  
pp. bmjspcare-2021-003264
Author(s):  
Brian Le ◽  
Evelien Rosens ◽  
Esther McMillan-Drendel ◽  
David Marco ◽  
Theresa Williamson ◽  
...  
Keyword(s):  
Palliative Care ◽  
Service Delivery ◽  
Care Service ◽  
Palliative Care Service ◽  
Telephone Support

scholarly journals The Griffith Area Palliative Care Service: A Pilot Project

2003 ◽  
Vol 26 (2) ◽  
pp. 11 ◽  
Author(s):  
Ian Hatton ◽  
Keith Mcdonald ◽  
Lynette Nancarrow ◽  
Keith Fletcher
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Services ◽  
Care Delivery ◽  
Care Service ◽  
Palliative Care Service ◽  
Pilot Project ◽  
Service Development ◽  
Care Services ◽  
Rural And Remote Areas

In September 2000 the Commonwealth released, as part of its National Palliative Care Strategy under the AustralianHealth Care Agreements, a National Framework for Palliative Care Service Development. The new NationalFramework stressed an important set of values to guide models of palliative care delivery. It notes that the challenge isto secure the place of palliative care as an integral part of health care across Australia, routinely available within localcommunities to those people who need it. Care and support for people who are dying and their families need to bebuilt not only into health care services, but also into the fabric of communities and their support networks. While fewwould disagree with this, little is known about how best to achieve it in rural Australia. The Griffith Area PalliativeCare Service (GAPS) is a two-year pilot project delivering a palliative care service through a truly integrated approachto care for patients, their carers and families within the Griffith Local Government Area and Carrathool Shire areas.This paper describes how GAPS is successfully meeting the challenges of service provision to rural and remote areas.

scholarly journals Involvement of palliative care in euthanasia practice in a context of legalized euthanasia: A population-based mortality follow-back study

2017 ◽  
Vol 32 (1) ◽  
pp. 114-122 ◽  
Author(s):  
Sigrid Dierickx ◽  
Luc Deliens ◽  
Joachim Cohen ◽  
Kenneth Chambaere
Keyword(s):  
Palliative Care ◽  
Odds Ratio ◽  
Care Service ◽  
Palliative Care Service ◽  
Population Based ◽  
Decision Making Process ◽  
Care Needs ◽  
International Debate ◽  
Care Services ◽  
Palliative Care Services

Background: In the international debate about assisted dying, it is commonly stated that euthanasia is incompatible with palliative care. In Belgium, where euthanasia was legalized in 2002, the Federation for Palliative Care Flanders has endorsed the viewpoint that euthanasia can be embedded in palliative care. Aim: To examine the involvement of palliative care services in euthanasia practice in a context of legalized euthanasia. Design: Population-based mortality follow-back survey. Setting/participants: Physicians attending a random sample of 6871 deaths in Flanders, Belgium, in 2013. Results: People requesting euthanasia were more likely to have received palliative care (70.9%) than other people dying non-suddenly (45.2%) (odds ratio = 2.1 (95% confidence interval, 1.5–2.9)). The most frequently indicated reasons for non-referral to a palliative care service in those requesting euthanasia were that existing care already sufficiently addressed the patient’s palliative and supportive care needs (56.5%) and that the patient did not want to be referred (26.1%). The likelihood of a request being granted did not differ between cases with or without palliative care involvement. Palliative care professionals were involved in the decision-making process and/or performance of euthanasia in 59.8% of all euthanasia deaths; this involvement was higher in hospitals (76.0%) than at home (47.0%) or in nursing homes (49.5%). Conclusion: In Flanders, in a context of legalized euthanasia, euthanasia and palliative care do not seem to be contradictory practices. A substantial proportion of people who make a euthanasia request are seen by palliative care services, and for a majority of these, the request is granted.

A retrospective review of patients with hematological malignancy referred to an inpatient palliative care service in a tertiary hospital.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 117-117
Author(s):  
Yee Choon Meng ◽  
Mervyn Yong Hwang Koh ◽  
Zi Yan Chiam ◽  
Jun Jun Zhang ◽  
Yin Mei, Allyn Hum
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Retrospective Review ◽  
Hematological Malignancies ◽  
Hematological Malignancy ◽  
Care Service ◽  
Symptom Control ◽  
Palliative Care Service ◽  
Solid Organ ◽  
Care Needs

117 Background: Patients with hematological malignancies are referred to palliative care service later and less often than patients with solid organ tumor. However, there are no data in Singapore, on the referral pattern among patients with hematological malignancy. The objective of the study is to identify the characteristics and outcomes of patients with hematological malignancy referred to an In-patient Palliative Care Service (PCS). Methods: We performed a retrospective review of all patients with hematological malignancies referred to the in-patient PCS from December 2015 to December 2016. Basic demographics and outcomes of patients’ admission were collected as per protocol. Results: 53 patients were included in the study. 27 (50.9%) patients were male, 49 (92.5%) were ≥60 years old, 20 (37.7%) were receiving cancer treatment at the point of referral, and 24 (45.3%) had Palliative Performance Scale (PPS) ≤ 40%. The most common hematological diagnosis was lymphoma (N = 26, 49.1%). The top 3 reasons for referral were symptom management (N = 44; 83%), advance disease (N = 24; 45.3% and end-of-life discussion (N = 15, 28.3%). Among 44 patients referred for symptom control, 18 (40.9%) had pain, 12 (27.3%) had dyspnoea, 8 (18.2%) had confusion and 6 (13.6%) had fatigue or drowsiness. 30 patients (56.6%) died during the admission. Among 30 patients who died, the mean time from referral to death was 9.8 days; 16 (53.3%) died within 1 week from referral, 9 (30%) died between 1-4 weeks from referral and 5 (16.7%) died beyond 4 weeks after referral.5 patients (9.4%) had Advance Care Planning completed. Conclusions: Our review showed that patients with hematological malignancies are referred late in their disease trajectory and have high Palliative Care needs. Hence, collaborative effort to facilitate timely referral of patients with hematological malignancy to PCS will optimize end-of-life care.

scholarly journals Palliative Care Needs among Patients with Advanced Illnesses in Bhutan

2020 ◽  
Author(s):  
Tara Devi Laabar ◽  
Christobel Saunders ◽  
Kirsten Auret ◽  
Claire E Johnson
Keyword(s):  
Palliative Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Developed Countries ◽  
World Health ◽  
Small Community ◽  
Care Model ◽  
Care Needs ◽  
Quality Of Life Scale

Abstract Background: Palliative care improves the quality of lives of patients and families affected by advanced illnesses through the prevention and relief of suffering. While palliative care is well established in developed countries, it is inadequate or non-existent in most developing countries. Palliative care is an emerging concept in Bhutan, a tiny Himalayan Kingdom. A small community palliative care service is available in the national referral hospital with three dedicated inpatient palliative care beds. This study explored the needs for palliative care among patients diagnosed with advanced illnesses and is a component of a larger project aimed to inform a suitable palliative care model for the country. Methods: This is a cross-sectional descriptive study. A survey, using a structured questionnaire including the EORTC QLQ-C30, was carried out among patients with advanced illness in hospitals, primary care units and communities across the country. Purposeful and snowball sampling strategies were used to recruit study participants. Results: Seventy (76%), out of 93 eligible patients, agreed to participate in the survey. Participants reported low to moderate scores on physical, role, emotional, cognitive and social functioning, a moderate score for the global health/ quality of life scale and moderately high (worse) scores in symptoms including fatigue, pain, insomnia, loss of appetite and the financial impact from the disease. Conclusions: The symptom burden experienced by patients affected by advanced illnesses demonstrates the need for palliative care in Bhutan. These findings will help inform the development of a public health-focused palliative care model, modified to the Bhutanese context, as recommended by the World Health Organization.

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