Browse Items · Pediatric Palliative Care Library

Barriers to conducting advance care discussions for children with life-threatening conditions.

BACKGROUND AND OBJECTIVE: Advance care discussions (ACD) occur infrequently or are initiated late in the course of illness. Although data exist regarding barriers to ACD among the care of adult patients, few pediatric data exist. The goal of this…

A pilot study of palliative medicine fellows' hospice home visits.

This was a prospective descriptive study of hospice physician home visits (HVs) conducted by Hospice and Palliative Medicine Fellows. Our objectives were 1) to improve our knowledge of hospice care at home by describing physician HVs 2) to identify…

Tracking the route to sustainability: a service evaluation tool for an advance care planning model developed for community palliative care services.

AIMS AND OBJECTIVES: The study aim was to develop a service evaluation tool for an advance care planning model implemented in community palliative care., BACKGROUND: Internationally, advance care planning programmes usually measure success by…

Is an advance care planning model feasible in community palliative care? A multi-site action research approach.

AIM: This article reports a study to determine the feasibility of an advance care planning model developed with Australian community palliative care services., BACKGROUND: An effective advance care planning programme involves an organizational wide…

Communication and advanced care planning in palliative and end-of-life care.

Communication about and planning for the end of life has evolved with medical and technological changes. This article presents a focused literature review of Advance Directives (ADs), Advanced Care Planning (ACP), and communication in palliative and…

Tags: 2012, Advance Care Planning, Advance Directives, Backlog, Clinical Nursing Research, Communication, DNAR, Humans, Journal Article, Meeker MA, Nursing Outlook, Palliative Care, Terminal Care, United States, Waldrop DP

Palliative medicine consultation for preparedness planning in patients receiving left ventricular assist devices as destination therapy.

OBJECTIVE: To assess the benefit of proactive palliative medicine consultation for delineation of goals of care and quality-of-life preferences before implantation of left ventricular assist devices as destination therapy (DT)., PATIENTS AND METHODS:…

Intensive care unit palliative medicine: some issues-part II.

Tags: 2011, Backlog, DNAR, Enck RE, Health Care Rationing/ec [economics], Health Care Rationing/og [Organization & Administration], Humans, Intensive Care Units/ec [Economics], Intensive Care Units/og [Organization & Administration], Journal Article, Medical, Palliative Care/ec [economics], Palliative Care/og [Organization & Administration], Resuscitation Orders, Sociology, The American Journal of Hospice & Palliative Care

End-of-life decision-making in Canada: the report by the Royal Society of Canada expert panel on end-of-life decision-making.

This report on end-of-life decision-making in Canada was produced by an international expert panel and commissioned by the Royal Society of Canada. It consists of five chapters. Chapter 1 reviews what is known about end-of-life care and opinions…

Palliative medicine consultation impacts DNR designation and length of stay for terminal medical MICU patients.

OBJECTIVE: The purpose of this study was to assess the impact of a palliative medicine consultation on medical intensive care unit (MICU) and hospital length of stay, Do Not Resuscitate (DNR) designation, and location of death for MICU patients who…

Developing a policy for do not resuscitate orders within a framework of goals of care.

BACKGROUND: Discussions about DNR (do not resuscitate) orders or code status are common but can be difficult and may not lead to accurate understanding between clinicians and patients. These discussion are often isolated from the larger context of a…

Tags: 2011, Backlog, Broderick A, Decision Making, DNAR, Hospital Administration/es [Ethics], Humans, Joint Commission Journal On Quality And Patient Safety / Joint Commission Resources, Journal Article, Kaldjian LC, Palliative Care/es [Ethics], Palliative Care/og [Organization & Administration], Patient Care Planning/es [Ethics], Patient Care Planning/og [Organization & Administration], Policy, Resuscitation Orders/es [Ethics], Terminal Care/es [ethics], Terminal Care/og [organization & Administration]

An advance directive in two questions.

It has been two decades since advance directives have become an integral part of health care. Impediments to their optimal usage are common and multifactorial. Decisions commonly have to be made when patients are unable to do so or choose not to…

Advance directives in a pediatric emergency department.

Parents of children with terminal illnesses are not always present when a life-threatening event occurs. For many of these children, an advance directive specifying alternate code orders has been written by the parent or legal guardian (hereafter the…

Attitudes and beliefs of palliative care physicians regarding communication with terminally ill cancer patients.

The subject of communication between palliative care physicians and their patients regarding their diagnosis and prognosis has not been extensively researched. The purpose of this survey was to compare the attitudes and beliefs of palliative care…

The role of palliative care in advanced muscular dystrophy and spinal muscular atrophy.

OBJECTIVE: This study examines the potential role for palliative care services in the care of individuals with muscular dystrophy and spinal muscular atrophy, and the support of their families., METHODOLOGY: Semistructured interviews were conducted…

How children die in hospital.

A retrospective analysis was performed to describe the course of terminal care provided to dying hospitalized children in terms of symptom assessment and management, and communication and decision-making, at the end of life. Seventy-seven of 236…

Physician-older patient communication at the end of life.

Communication with dying patients and their families requires special skills to assist them in this extremely stressful period. This article begins with a case that illustrates many of the challenges of communicating with the dying. It then reviews…

Care for dying patients.

1997

Tags: 1997, Advance Care Planning, Advance Directives, Backlog, Communication, Decision Making, DNAR, Emanuel EJ, Euthanasia, Family, Humans, Journal Article, Lancet, Palliative Care, Passive, Physician-patient Relations, Physicians, Terminal Care, Withholding Treatment

Hospital care of patients with dementia.

The impact of a palliative medicine consultation service in medical oncology.

This prospective study of consecutive patients describes the palliative medicine consult service in a tertiary level cancer center and its impact on patient care. All inpatients/outpatients referred to the Palliative Medicine Program in a 4-month…

Simple changes can improve conduct of end-of-life care in the intensive care unit.

PURPOSE: To describe changes to the conduct of withdrawal of life support (WOLS) in two teaching hospital tertiary care medical surgical intensive care units (ICUs) in a single centre over two distinct time periods., METHODS: We used a retrospective…

Integrating POLST into palliative care guidelines: a paradigm shift in advance care planning in oncology.

Because predicting and outlining guidance for all possible scenarios is difficult, advance directives are rarely sufficiently precise to dictate patient preferences in specific situations as a disease progresses. Nonetheless, advance care planning is…

Tags: 2006, Advance Care Planning, Advance Directives, Backlog, Bomba Patricia A, Decision Making, DNAR, Humans, Journal Article, Journal Of The National Comprehensive Cancer Network, Life Support Care/st [Standards], Medical Oncology, Neoplasms/px [psychology], Neoplasms/th [therapy], Palliative Care, Physician's Practice Patterns/og [Organization & Administration], Vermilyea D

Documenting end of life decisions in residential aged care facilities in South Australia.

OBJECTIVE: This research examined the provision of palliative care for residents with a non-cancer diagnosis including the use of advance directives and advance care planning as part of palliative care policies in residential aged care facilities in…

Pediatric advance care planning.

OBJECTIVE: This study describes the process and population involved in pediatric advance care planning at one Midwest medical center. The outcomes and the parents' perceptions of this planning are also discussed., METHODS: Pediatric patients with…

Tags: 2005, 7 died at home and 2 died at a hospital. Eight of the children's advance directives were followed during the dying process, 9 are deceased, Advance Care Planning/og [Organization & Administration], Advance Care Planning/organization & Administration, Backlog, Child, DNAR, DNAR Outcomes, Female, Hammes BJ, Humans, including preserving their child's quality of life and avoiding unnecessary suffering., individuals in the community raised concerns about the child's advance directive. CONCLUSIONS: Even though the topic of their child's death is difficult, Infant, Interviews As Topic, Journal Article, Journal of Palliative Medicine, Kempf M, Klevan J, Male, Newborn, Parents/psychology, Parents/px [psychology], Pediatrics, PedPal Lit, Preschool, the majority of the interviewed parents found the advance care planning process for the child helpful because it assured the best care for the child, while 1 was not. Th irteen parents were interviewed. Twelve stated that the process of advance care planning benefited their children and their family. Rarely, Williams MS, Wisconsin

Parent resuscitation preferences for young people with severe developmental disabilities.

OBJECTIVE: To determine the relationship of providing explanatory information regarding resuscitation to DNR status for parents and guardians of young people who reside in a pediatric skilled nursing facility., DESIGN: Retrospective,…

Tags: 2006, Adolescent, Adult, Advance Care Planning/og [Organization & Administration], Advance Care Planning/organization & Administration, Analysis of Variance, Attitude To Health, Backlog, Child, Choice Behavior, Consent Forms, Developmental Disabilities/co [Complications], Developmental Disabilities/complications/therapy, Developmental Disabilities/th [Therapy], DNAR, Documentation, Female, Friedman SL, Health Education/og [Organization & Administration], Health Education/organization & administration, Humans, Journal Article, Journal Of The American Medical Directors Association, Male, Massachusetts, Organizational Policy, Parents, Parents/ed [education], Parents/education/psychology, Parents/px [psychology], Preschool, Program Evaluation, Resuscitation Orders/psychology, Resuscitation Orders/px [Psychology], Retrospective Studies, Skilled Nursing Facilities/og [Organization & Administration], Skilled Nursing Facilities/organization & administration, Treatment Refusal/psychology, Treatment Refusal/px [Psychology]

Experience in the use of the palliative care outcome scale.

GOALS OF WORK: The objective of the study is to assess the Palliative Care Outcome Scale (POS) as a potential audit tool within a specialist cancer centre. It also aims to answer the following questions: does the tool identify problem areas and…

‘Do Not Attempt Resuscitation’ – Do Standardised Order Forms make a clinical difference above hand-written note entries?

SummaryAim To quantify any effect of Standardised Order Forms (SOFs), versus hand-written note entries for ‘Do Not Attempt Resuscitation’ – on the selection and survival of remaining cardiopulmonary resuscitation (CPR) attempts. Methods A…

Tags: 2009, Advance Directives, Backlog, Cardiopulmonary Resuscitation, DNAR, DNAR Outcomes, Edwards VM, Hall S, Hutchings H, Journal Article, Lewis KE, Patient Selection, Resuscitation, Routine data, Temblett P

Advanced care planning in children with life-limiting conditions – the Wishes Document

Can't we improve on advance directives?.

2008

Tags: 2008, Advance Care Planning/st [Standards], Advance Directives, Annals Of Internal Medicine, Backlog, Brasic GM, Decision Making, DNAR, Documentation, Family, Hammes BJ, Humans, Journal Article, Medical Records, Palliative Care/st [standards], Patients/px [psychology]

Alterations in end-of-life support in the pediatric intensive care unit.

OBJECTIVE: Our purpose was to examine alterations in end-of-life support in a multiinstitutional sample of PICUs., METHODS: This was a retrospective, descriptive study. Variables collected included end-of-life support category, race, length of stay,…

Tags: 2010, Advance Directives, Backlog, Brain Death, Child, DNAR, Humans, Intensive Care Units, Journal Article, Lee KJ, Life Support Care, Pediatric, Pediatrics, Resuscitation Orders, Scanlon MC, Terminal Care, Tieves K, Withholding Treatment

Attitudes of adolescent cancer survivors toward end-of-life decisions for minors.

OBJECTIVES: The present study aimed to investigate the attitudes of adolescent cancer survivors toward end-of-life decisions with life-shortening effects, including nontreatment decisions (NTDs), intensified alleviation of pain and symptoms (APS),…

Symptom pathways from referral to death: measuring palliative care outcomes.

This article reports on the first stage of a process to develop a clinical performance indicator for a community-based palliative care service that may inform the development of an agreed set of indicators for the whole sector. The study explores…

Paradoxes in advance care planning: the complex relationship of oncology patients, their physicians, and advance medical directives.

PURPOSE: Many seriously ill patients with cancer do not discuss prognosis or advance directives (ADs), which may lead to inappropriate and/or unwanted aggressive care at the end of life. Ten years ago, patients with cancer said they would not like to…

Easing of suffering in children with cancer at the end of life: is care changing?.

PURPOSE: In the past decade studies have documented substantial suffering among children dying of cancer, prompting national attention on the quality of end-of-life care and the development of a palliative care service in our institutions. We sought…

The triad that matters: palliative medicine, code status, and health care costs.

INTRODUCTION: Delayed discussion of a patient's code status can lead to shortsighted care plans that increase hospital length of stay (LOS) and costs., METHODS: Retrospective study compared intensive care unit (ICU) patients who accepted verses…

Tags: 2010, 80 And Over, Aged, Backlog, Celso BG, Code status, Critical Illness/ec [Economics], Critical Illness/ep [Epidemiology], Direct Service Costs/sn [Statistics & Numerical Data], DNAR, DNAR Outcomes, Emergency Service, Equipment and Supplies, Female, Health Care Cost, Hospice, Hospital Costs/sn [Statistics & Numerical Data], Hospital/ec [Economics], Hospital/ut [Utilization], Humans, Intensive Care/ec [Economics], Intensive Care/ut [Utilization], Journal Article, Laboratories, Length of Stay/ec [Economics], Length of Stay/sn [Statistics & Numerical Data], Male, Meenrajan S, Middle Aged, Operative/ec [Economics], palliation, Palliative Care/ec [economics], Palliative Care/ut [Utilization], Patient Admission, Radiology Department, Respiratory Care Units/ec [Economics], Retrospective Studies, Surgical Procedures, The American Journal of Hospice & Palliative Care, United States/ep [Epidemiology]

The use of pediatric advance directives: a tool for palliative care physicians.

Although laws such as the Patient Self-Determination Act encourage individuals to address their end-of-life treatment preferences using advance directives, the wishes of children have traditionally been ignored or, perhaps even worse, overruled.…

Tags: 2008, Advance Care Planning/es [Ethics], Advance Care Planning/og [Organization & Administration], Backlog, Child, Child Advocacy, Child Advocacy/es [Ethics], Child Advocacy/lj [Legislation & Jurisprudence], Child Advocacy/px [Psychology], Decision Making, DNAR, Humans, Journal Article, Minors/lj [legislation & Jurisprudence], Minors/px [Psychology], Palliative Care/es [Ethics], Palliative Care/og [Organization & Administration], Palliative Care/px [psychology], Parental Consent/es [Ethics], Parental Consent/lj [Legislation & Jurisprudence], Parental Consent/px [Psychology], Patient Participation/lj [Legislation & Jurisprudence], Patient Participation/px [Psychology], Pediatrics/es [Ethics], Pediatrics/og [Organization & Administration], Personal Autonomy, Right to Die/es [Ethics], Right to Die/lj [Legislation & Jurisprudence], The American Journal of Hospice & Palliative Care, United States, Zinner SE

Cardiopulmonary resuscitation in patients with cancer.

Cancer is the second leading cause of death in the United States, with most of these deaths taking place in the hospital setting. Discussions on end-of-life care and on cardiopulmonary resuscitation in particular are an important component in the…

Tags: 2007, Backlog, Cardiopulmonary Resuscitation, Decision Making, DNAR, Humans, Journal Article, Marik PE, Neoplasms/th [therapy], Palliative Care, Quality Of Life, Resuscitation Orders, The American Journal of Hospice & Palliative Care, Varon J

Role of advance directives in palliative care units: a prospective study.

Advance directives (ADs) might be useful in achieving improved communication and satisfaction with decision making at the end-of-life. Our aims were to better characterise patients with advanced oncological disease who decided to complete ADs and to…

Finding the right words: using the terms allow natural death (AND) and do not resuscitate (DNR) in pediatric palliative care.

When children are dying in a hospital setting, healthcare providers need to help families make important end-of-life care decisions. Most providers use the term do not resuscitate (DNR) when suggesting a course of action that involves not using…

Planning for the end of children's lives--the lifetime framework.

AIM: This paper describes the development of 'a best practice framework', following review of a sample of notes of children known to the Lifetime Service, where the child has a non-malignant life limiting condition, to improve child and family…

What is the evidence that palliative care teams improve outcomes for cancer patients and their families?.

Patients with advanced cancer experience a complex web of problems, all of which interact. Specialist palliative care services have developed to meet these needs, but their effectiveness should be considered. We sought to determine whether specialist…

Tags: 2010, Backlog, Cancer Journal (Sudbury, Mass.), DNAR, Evans CJ, Evidence-based Medicine, Family, Higginson IJ, Humans, Journal Article, Neoplasms/th [therapy], Palliative Care/ma [manpower], Patient Care Team, Treatment Outcome

Browse Items (55 total)