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End-of-life care can be improved
November 02, 2006Researchers have evaluated improvements in the end-of-life care in intensive care units (ICU) and have shared their findings in a special supplement to Critical Care Medicine, the journal of the Society of Critical Care Medicine. The supplement is dedicated entirely to end-of-life care in the critical care setting.
"Improving the quality of care received by critically ill and dying patients in the ICU remains an ongoing challenge," explains guest co-editor J. Randall Curtis, M.D., M.P.H., professor of medicine at the University of Washington in Seattle. "Over the past five years there have been encouraging signs of improvement in end-of-life care in the ICU. Interventions have been developed, evaluated, and published to improve the care that patients and their families receive relating to the end of life in the ICU."
Approximately one in five deaths in the United States now occurs in the ICU or shortly after receiving intensive care. The ICU is likely to remain an important setting for end-of-life care because of the severity of illness in these patients and because many families and patients with chronic, life-limiting diseases will opt for a trial of intensive care.
Critical care researchers are taking the lessons learned from previous observational studies and using them to develop and test generalizable interventions that improve the quality of ICU end-of-life care. The Critical Care Medicine supplement includes 20 articles evaluating end-of-life issues, including palliative care in the ICU, attitudes toward withholding and withdrawing life support, ethical and legal issues, quality indicators, communications between physicians and nurses, interventions for children at the end of life, and promising future directions.
"We believe this supplement documents the tremendous progress that has been made in the past decade and represents the state of the art for assessing and improving end-of-life care in the ICU," comments guest co-editor Mitchell Levy, M.D., professor of medicine at Brown University School of Medicine in Providence, R.I.
Quality End-of-Life Palliative Care
A paper by Ira Byock, M.D., a professor at Dartmouth Medical School and director of palliative medicine at Dartmouth Hitchcock Medical Center in Lebanon, N.H., describes recent developments in the integration of palliative and critical care.
Palliative and end-of-life care in the ICU is an appropriate and under-developed area for quality assessment and improvement, according to Richard Mularski, M.D., M.S.H.S., from the Veterans Affairs Greater Los Angeles Healthcare System. Dr. Mularski and a number of the other contributors to this supplement combined forces to develop an article that provides a practical framework for examining processes of care that might be quality measures. This article proposes 18 candidate quality measures that could be implemented in ICUs tomorrow. Dr. Mularski and colleagues suggest that further work also is needed to demonstrate such measures are valid and reliable.
End-of-Life Interventions
Considering that 20% of deaths in the United States occur in ICUs and that the quality of life in an ICU at the end of life often is rated as poor, improving the quality of end-of-life care in this setting is seen as an important endeavor. In an article on measuring quality improvement, Dr. Curtis and co-author Ruth A. Engelberg, Ph.D., from the University of Washington in Seattle, examine data supporting potential process and outcome measures that could be used to evaluate the success of interventions designed to improve end-of-life care in the ICU.
Dr. Levy notes that this supplement documents a need for additional research and quality improvement in order to realize the potential for improving the care delivered to critically ill patients at the end of life as well as the care provided to their families.
The supplement resulted from the conference, "Improving the Quality of End-of-Life Care in the ICU: Interventions that Work," which was funded by the Robert Wood Johnson Foundation and hosted by the Society of Critical Care Medicine on February 17-19, 2006, in Miami, Fla.
Society of Critical Care Medicine
Critical care researchers are taking the lessons learned from previous observational studies and using them to develop and test generalizable interventions that improve the quality of ICU end-of-life care. The Critical Care Medicine supplement includes 20 articles evaluating end-of-life issues, including palliative care in the ICU, attitudes toward withholding and withdrawing life support, ethical and legal issues, quality indicators, communications between physicians and nurses, interventions for children at the end of life, and promising future directions.
"We believe this supplement documents the tremendous progress that has been made in the past decade and represents the state of the art for assessing and improving end-of-life care in the ICU," comments guest co-editor Mitchell Levy, M.D., professor of medicine at Brown University School of Medicine in Providence, R.I.
Quality End-of-Life Palliative Care
A paper by Ira Byock, M.D., a professor at Dartmouth Medical School and director of palliative medicine at Dartmouth Hitchcock Medical Center in Lebanon, N.H., describes recent developments in the integration of palliative and critical care.
Palliative and end-of-life care in the ICU is an appropriate and under-developed area for quality assessment and improvement, according to Richard Mularski, M.D., M.S.H.S., from the Veterans Affairs Greater Los Angeles Healthcare System. Dr. Mularski and a number of the other contributors to this supplement combined forces to develop an article that provides a practical framework for examining processes of care that might be quality measures. This article proposes 18 candidate quality measures that could be implemented in ICUs tomorrow. Dr. Mularski and colleagues suggest that further work also is needed to demonstrate such measures are valid and reliable.
End-of-Life Interventions
Considering that 20% of deaths in the United States occur in ICUs and that the quality of life in an ICU at the end of life often is rated as poor, improving the quality of end-of-life care in this setting is seen as an important endeavor. In an article on measuring quality improvement, Dr. Curtis and co-author Ruth A. Engelberg, Ph.D., from the University of Washington in Seattle, examine data supporting potential process and outcome measures that could be used to evaluate the success of interventions designed to improve end-of-life care in the ICU.
Dr. Levy notes that this supplement documents a need for additional research and quality improvement in order to realize the potential for improving the care delivered to critically ill patients at the end of life as well as the care provided to their families.
The supplement resulted from the conference, "Improving the Quality of End-of-Life Care in the ICU: Interventions that Work," which was funded by the Robert Wood Johnson Foundation and hosted by the Society of Critical Care Medicine on February 17-19, 2006, in Miami, Fla.
Society of Critical Care Medicine
End-of-life Care Current Events and End-of-life Care News RSSDying from dementia
A growing number of older adults are dying from dementia. In an editorial in the October 15, 2009 issue of the New England Journal of Medicine, Greg Sachs, M.D., professor of medicine and director of the Division of General Internal Medicine and Geriatrics at the Indiana University School of Medicine and a Regenstrief Institute investigator, notes that end-of-life care for most older adults with dementia has not changed in decades and urges that these individuals be provided far greater access to palliative care, the management of pain and other symptoms.
Intensive care units poorly equipped to care for the dying
Almost half of the patients who die in intensive care units die within 24 hours, but the environment is not equipped to provide good end-of-life care. Most relatives are nevertheless happy with the care given, shows a thesis from the Sahlgrenska Academy.
Researchers at Boston University School of Medicine incorporate multisite geriatric clerkship
As the population ages, it is imperative that medical students are prepared to treat older adults, regardless of their specialty.
Hispanics Appear To Face Poorer Quality Nursing Home Care
Nursing homes serving primarily Hispanic residents provided poorer quality care compared to facilities whose patients were mostly white.
Living wills have an impact on pre-hospital lifesaving care
A new study conducted at the Hamot Medical Center in Erie, Pennsylvania, and published by Elsevier in the February 2009 issue of The Journal of Emergency Medicine shows that there is a lack of education and understanding in what sets a living will in motion in a pre-hospital setting. Education and implementation of code status designations can clarify this confusion.
Study finds race and ethnicity affect use of hospice services among patients with advanced cancer
Race and ethnicity appear to have an effect on whether a patient with terminal cancer uses hospice care services, according to a study led by researchers at Beth Israel Deaconess Medical Center (BIDMC).
Brown Expert Offers Guide to End-of-Life Care
Years ago, dying patients in most communities often had a single option if they needed hospice care. Now they have many more; competition reigns.
Family members of critically ill patients want to discuss loved ones' uncertain prognoses
Critically ill patients frequently have uncertain prognoses, but their families overwhelmingly wish that physicians would address prognostic uncertainty candidly, according to a new study out of the University of San Francisco Medical Center.
Hopkins Children's study: Parents of dying newborns need clearer explanation of options
Parent-doctor discussions about whether to maintain or withdraw life support from terminally ill or severely premature newborns are so plagued by miscommunication and misunderstanding that they might as well be in different languages.
Survey compares views of trauma professionals, the public on dying from injuries
Most trauma professionals and members of the general public say they would prefer palliative care following a severe injury if physicians determined aggressive critical care would not save their lives, according to a report in the August issue of Archives of Surgery, one of the JAMA/Archives journals.
More End-of-life Care Current Events and End-of-life Care News Articles
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Palliative and End-of-Life Care: Clinical Practice Guidelines (Palliative and End of Life Care Clinica) by Kim K. Kuebler MN RN ANP-CS (Author), Debra E. Heidrich MSN RN CHPN AOCN (Author), Peg Esper MSN RN CS AOCN (Author) Palliative and End-of-Life Care, 2nd Edition provides clinicians with the guidelines and tools necessary to provide quality, evidenced-based care to patients with life-limiting illness. This text describes the care and management of patients with advanced disease throughout the disease trajectory, extending from diagnosis of advanced disease until death. Four units provide the general principles of palliative and end-of-life care, important concepts, advanced disease management, and clinical practice guidelines. Clinical practice guidelines offer in-depth discussions of the pathophysiology of 19 different symptoms, interventions for specific symptom management (including in-depth rationales), and suggestions for patient and family teaching. Defines dying as a normal, healthy... |
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End of Life Care by Healthcomm UK | |
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60 Minutes - The Cost of Dying (November 22, 2009) Airdate 11/22/09 Dying in America is expensive. In 2008, Medicare paid $50 billion for doctor and hospital bills during the last two months of patients' lives. Many of those patients died while connected to machines, sedated, and often restrained. A palliative care physician tells Steve Kroft that there are things worse than a loved one dying: "It's having someone you love die badly." And it's also bad for the economy -- rising Medicare costs could bankrupt the country. This product is manufactured on demand using DVD-R recordable media. Amazon.com's standard return policy will apply. |
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Managing End of Life Care (Comprehensive Review of the Physical & Mental Aspects of Death & Dying) Also With: M.D. Walter M. Larimore (Primary Contributor) Dr. Larimore offers advice for helping patients and their families transition smoothly through a patient's end of life. | |
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(ethics, law, general, health) WHEN PROFESSIONALS WEEP, EMOTIONAL AND COUNTERTRANSFERENCE REACTIONS TO END OF LIFE CARE (Book + 8 CE Credits or 8 CME Credits) edited by Renee Katz, Ph.D., and Therese Johnson, M.A., ISBN 041590953 (continuing education, psychology, social work, psychiatry) by Red Toad Road Company TRAINING OBJECTIVES are to learn the following: The definitions of coutertransference, common countertransference reactions in end-of-life care, the importance of ethnic and cultural issues in countertransference, the Respectful Death Model, the potential value as well as harm of countertransference, and how to identify countertransference.......................... DESCRIPTION: This book explores the clinical and ethical issues of countertransference in end-of-life care, which is a crucible for strong emotional and countertransference reactions on the part of professionals providing such care. It explores the ubiquitous nature of countertransference as well as the potential benefits as well as the harm that can come of it. It also provides a very useful means of identifying... |
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End-of-life Care: A Nurse's Guide To Compassionate Care by Lippincott Williams & Wilkins End-of-Life Care: A Nurse's Guide to Compassionate Care : End-of-Life Care: A Nurse's Guide to Compassionate Care Pub Date: May 2006 Product Type: Print Author/s: Springhouse This sensitively written book offers a wealth of insight and practical advice for nurses in every specialty and setting providing end-of-life care. Nurses will learn how to address patients' spiritual concerns, ensure that physical needs are met, help patients maintain their dignity, and provide emotional support to grieving families. Nurses will also learn how to cope with their own feelings about dying and end-of-life care.Coverage includes stages of dying, nursing interventions for palliative care, pain control, alternative therapies, physical and psychological signs of grieving, and more.... |
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The End-of-Life Handbook: A Compassionate Guide to Connecting with and Caring for a Dying Loved One by David B. Feldman (Author), Stephen Andrew Lasher Jr. (Author), Ira Byock (Foreword) This book addresses both the emotional and psychological issues associated with death and dying and the practical and medical realities typically dealt with at this time--unusual among titles in this subject area. The authors, a psychologist and medical doctor, are passionate advocates for quality end-of-life care. Author Feldman's background in positive psychology brings an emphasis on hope, inspiration, meaning, and human connection at the end of life to the book. As medical technology progresses and life expectancies edge upward, families are being faced with ever-more-complicated choices as loved ones approach their final hours. This book offers readers much-needed guidance and support for making these often difficult decisions. |
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Larry Beresford by Growth House, Inc. News and analysis of the hospice industry by Larry Beresford.Kindle blogs are fully downloaded onto your Kindle so you can read them even when you're not wirelessly connected. And unlike RSS readers which often only provide headlines, blogs on Kindle give you full text content and images, and are updated wirelessly throughout the day. |
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December Ends (Institutional Use) Starring: Josh Janowicz, Alex Thayer, Justin Matthews, Jacob Reynolds, Bryant Botero Directed By: Lee Toland Krieger Also With: Lee Toland Krieger (Writer), Tim Harms (Producer) |
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Weill: Stranger Here Myself Kurt Weill (Composer), Robert Kapilow (Composer), Robert Kapilow (Composer), Bill Ruyle (Composer), Angelina Reaux (Composer) |
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