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1. The Canadian Hospice Palliative Care Model for Palliative Care: Clinical Evidence and Guidelines

The Canadian Hospice Palliative Care Model for Palliative Care: Clinical Evidence and Guidelines The Canadian Hospice Palliative Care Model for Palliative Care: Clinical Evidence and Guidelines | CADTH.ca Find the information you need The Canadian Hospice Palliative Care Model for Palliative Care: Clinical Evidence and Guidelines The Canadian Hospice Palliative Care Model for Palliative Care: Clinical Evidence and Guidelines Last updated: November 5, 2018 Project Number: RB1276-000 Product Line (...) : Research Type: Devices and Systems Report Type: Summary of Abstracts Result type: Report Question What is the clinical evidence supporting the use of the Canadian Hospice Palliative Care Model for adults requiring palliative care in any setting? What are the evidence-based guidelines associated with the use of the Canadian Hospice Palliative Care Model for adults requiring palliative care in any setting? Key Message No relevant literature regarding the Canadian Hospice Palliative Care Model for adults

2018 Canadian Agency for Drugs and Technologies in Health - Rapid Review

2. Live Virus Vaccination in Hospital, Hospice, Nursing Home, and Long-Term Care Settings: Guidelines

Live Virus Vaccination in Hospital, Hospice, Nursing Home, and Long-Term Care Settings: Guidelines Live Virus Vaccination in Hospital, Hospice, Nursing Home, and Long-Term Care Settings: Guidelines | CADTH.ca Find the information you need Live Virus Vaccination in Hospital, Hospice, Nursing Home, and Long-Term Care Settings: Guidelines Live Virus Vaccination in Hospital, Hospice, Nursing Home, and Long-Term Care Settings: Guidelines Last updated: August 8, 2019 Project Number: RB1371-000

2019 Canadian Agency for Drugs and Technologies in Health - Rapid Review

3. Differences in do-not-resuscitate orders, hospice care utilization, and late referral to hospice care between cancer and non-cancer decedents in a tertiary Hospital in Taiwan between 2010 and 2015: a hospital-based observational study. Full Text available with Trip Pro

Differences in do-not-resuscitate orders, hospice care utilization, and late referral to hospice care between cancer and non-cancer decedents in a tertiary Hospital in Taiwan between 2010 and 2015: a hospital-based observational study. In 2009, the Taiwanese national health insurance system substantially expanded hospice coverage for terminal cancer patients to include patients with end-stage brain, dementia, heart, lung, liver, and kidney diseases. This study aimed to evaluate differences (...) in do-not-resuscitate (DNR) status and hospice care utilization between terminal cancer patients and advanced non-cancer patients after the policy change.Data were obtained from the Death and Hospice Palliative Care Database of Taipei Veterans General Hospital in Taiwan. The differences between cancer and non-cancer patients who died in this hospital between 2010 and 2015 were analyzed in terms of patient characteristics, rates of DNR orders, hospice care utilization, number of living days after DNR

2018 BMC Palliative Care

4. Provision of Palliative and Hospice Care to Children in the Community: A Population Study of Hospice Nurses. (Abstract)

Provision of Palliative and Hospice Care to Children in the Community: A Population Study of Hospice Nurses. Approximately 500,000 children in the United States suffer from life-limiting illnesses each year, many of whom are hospice eligible each year. Few hospice agencies, however, offer formal pediatric programs.To determine the levels of experience and comfort of hospice nurses who provide care to children and families in the community.A cross-sectional survey was developed to assess hospice (...) nurse experience/comfort across the domains of symptom management, end-of-life care, goals of care, family-centered care, and bereavement. The survey was pilot tested and distributed to hospice nurses across a tristate region.A total of 551 respondents across 71 hospices completed surveys. The majority of nurses reported no training in pediatric palliative or hospice care (89.8%), with approximately half reporting <5 years of hospice experience (53.7%) and no pediatric hospice experience (49.4

2018 Journal of pain and symptom management

5. Facilitating Home Hospice Transitions of Care in Oncology: Evaluation of Clinical Pharmacists' Interventions, Hospice Program Satisfaction, and Patient Representation Rates. (Abstract)

Facilitating Home Hospice Transitions of Care in Oncology: Evaluation of Clinical Pharmacists' Interventions, Hospice Program Satisfaction, and Patient Representation Rates. The importance of medication reconciliation and the pharmacist's role within the interdisciplinary team at the point of transition to home hospice is understudied. A transitions of care pilot initiative was developed to streamline the transition for patients at end of life from inpatient cancer center care to home hospice (...) . The initiative consisted of using a hospice discharge checklist, pharmacist-led discharge medication reconciliation in consultation with the primary team responsible for inpatient care, review of discharge prescriptions, and facilitation of bedside delivery of discharge medications.This was a single-center, prospective, pilot initiative. The objectives of this study were to characterize pharmacist interventions at the time of transition, to assess changes in hospice organizations' perceptions of discharge

2018 American Journal of Hospice and Palliative Medicine

6. The International Association for Hospice and Palliative Care (IAHPC): Advancing Hospice and Palliative Care Worldwide. Full Text available with Trip Pro

The International Association for Hospice and Palliative Care (IAHPC): Advancing Hospice and Palliative Care Worldwide. The International Association for Hospice and Palliative Care (IAHPC) is a membership-based organization dedicated to the development and improvement of hospice and palliative care worldwide. The mission of IAHPC is to improve the quality of life of adults and children with life-threatening conditions and their families. The vision of IAHPC is universal access to high-quality (...) health workers to provide cost-effective palliative care; at the national level, working with government representatives to improve national policies to ensure adequate care and access to medicines; and at the international level, advocating with the UN organizations to ensure that access to palliative care and to essential medicines for palliative care and pain treatment is stipulated and incorporated as an obligation of member states.Copyright © 2017 American Academy of Hospice and Palliative

2017 Journal of pain and symptom management

7. National Policies Fostering Hospice Care Increased Hospice Utilization and Reduced the Invasiveness of End‐of‐Life Care for Cancer Patients Full Text available with Trip Pro

National Policies Fostering Hospice Care Increased Hospice Utilization and Reduced the Invasiveness of End‐of‐Life Care for Cancer Patients In 2011, two national policies aiming to foster hospice services for terminal cancer patients took effect in Taiwan. The single-payer National Health Insurance of Taiwan started to reimburse full hospice services. The national hospital accreditation program, which graded all hospitals, incorporated hospice utilization in its evaluation. We assessed (...) the impact of these national policies.A cohort of 249,394 patients aged ≥18 years who died of cancer between 2008 and 2013 were identified from the National Death Registry. We retrieved utilization data of medical services and compared the health care utilization in the final month of life before and after the implementation of the new policies.After the policy changes, hospice utilization increased from 20.8% to 36.2%. In a multivariate analysis adjusting for patient demographics, cancer features

2017 The oncologist

8. Clinical and socio-demographic predictors of home hospice patients dying at home: A retrospective analysis of Hospice Care Association's database in Singapore. Full Text available with Trip Pro

Clinical and socio-demographic predictors of home hospice patients dying at home: A retrospective analysis of Hospice Care Association's database in Singapore. Hospice care can be delivered in different settings, but many patients choose to receive it at home because of familiar surroundings. Despite their preferences, not every home hospice patient manages to die at home.To examine the independent factors associated with home hospice patient dying at home.Retrospective analysis of Hospice Care (...) Association's database. Hospice Care Association is the largest home hospice provider in Singapore. The study included all patients who were admitted into home hospice service from January 1, 2004 to December 31, 2013. Cox proportional hazards modeling with time as constant was used to study the relationship between independent variables and home death.A total of 19,721 patients were included in the study. Females (adjusted risk ratio [ARR] 1.09, 95% CI 1.04-1.15), older patients (ARR 1.01, 95% CI 1.00-1.01

2017 Journal of pain and symptom management

9. Nationwide Quality of Hospice Care: Findings from the Centers for Medicare & Medicaid Services (CMS) Hospice Quality Reporting Program (HQRP). Full Text available with Trip Pro

Nationwide Quality of Hospice Care: Findings from the Centers for Medicare & Medicaid Services (CMS) Hospice Quality Reporting Program (HQRP). With increasing use of the Medicare hospice benefit, policymakers recognize the need for quality measurement to assure that terminally ill patients receive high-quality care and have the information they need when selecting a hospice. Toward these goals, Centers for Medicare & Medicaid Services has been collecting standardized patient-level quality data (...) via the Hospice Item Set (HIS) since July 1, 2014.This article presents a first look at the national hospice HIS quality data.We calculated seven quality measures using the HIS data. These measures are endorsed by the National Quality Forum and focus on important care processes hospice providers are required to perform at admission, including discussion of patient preferences regarding life-sustaining treatments, care for spiritual and existential concerns, and symptom management (pain, opioid

2017 Journal of pain and symptom management

10. The Provision of Spiritual Care in Hospices: A Study in Four Hospices in North Rhine-Westphalia Full Text available with Trip Pro

The Provision of Spiritual Care in Hospices: A Study in Four Hospices in North Rhine-Westphalia This article considers the role and the practices of spiritual care in hospices. While spiritual care was firmly established as one of the four pillars of practical hospice care alongside medical, psychological and social care by Cicely Saunders, the importance and functions of spiritual care in daily practice remain arguable. When speaking about spirituality, what are we actually speaking about (...) ? What form do the spiritual relations take between full-time staff and volunteers on the one hand, and the patients and their family members on the other? These were central questions of a qualitative study that we carried out in four hospices in North Rhine-Westphalia, Germany, to explore how spiritual care is provided in hospices and what significance spirituality has in hospices. The study shows that the advantages of a broader definition of spirituality lie in "spiritual care" no longer being

2017 Journal of religion and health

11. The Impact of Advance Care Planning on End-of-Life Care: Do the Type and Timing Make a Difference for Patients With Advanced Cancer Referred to Hospice? (Abstract)

The Impact of Advance Care Planning on End-of-Life Care: Do the Type and Timing Make a Difference for Patients With Advanced Cancer Referred to Hospice? This study aimed to determine the impact of advanced care planning (ACP) on potentially avoidable hospital admissions at the end of life (EOL) among a sample of hospice-referred patients with cancer, in order to present actionable considerations for the practicing clinician.This study was designed as a retrospective cohort using electronic (...) health record data that assessed likelihood of hospital admissions in the last 30 days of life for 1185 patients with a primary diagnosis of cancer, referred to hospice between January 1, 2014, and December 31, 2015, at a large academic medical center. Inverse probability treatment weighting based on calculated propensity scores balanced measured covariates between those with and without ACP at baseline. Odds ratios (ORs) were calculated from estimated potential outcome means for the impact of ACP

2019 American Journal of Hospice and Palliative Medicine

12. Advanced Heart Failure Treatment Modalities and Hospice Care: The Need for High Level Care Coordination. (Abstract)

Advanced Heart Failure Treatment Modalities and Hospice Care: The Need for High Level Care Coordination. Advanced heart failure therapies such as ventricular assist devices and home inotrope use are becoming more common. Technology advances as well as increased indications for use of such therapies is leading to a higher percentage of patients with end-stage heart failure receiving these therapies at end of life. We present a case of a young man with dilated cardiomyopathy who undergoes (...) advanced cardiac care in the setting of progressively declining cardiac function. Our case outlines the importance of acute care, palliative care, and hospice services being coordinated prior to and during acute-care services to provide goal-concordant and expeditious care. With advancing medical therapies for heart disease, increased coordination and collaboration of services are needed, particularly between hospice and acute-care services.

2019 American Journal of Hospice and Palliative Medicine

13. End-of-Life Care in Patients Exposed to Home-Based Palliative Care vs Hospice Only. Full Text available with Trip Pro

End-of-Life Care in Patients Exposed to Home-Based Palliative Care vs Hospice Only. The current evidence base regarding the effectiveness of home-based palliative care (HomePal) on outcomes of importance to multiple stakeholders remains limited. The purpose of this study was to compare end-of-life care in decedents who received HomePal with two cohorts that either received hospice only (HO) or did not receive HomePal or hospice (No HomePal-HO).Retrospective cohorts from an ongoing study of care (...) trends were also noted for the last 30 days of life, 25 ± 8 (HomePal, n = 5516), 24 ± 8 (HO), and 18 ± 11 (No HomePal-HO); HomePal patients had a significantly lower risk of hospitalizations (relative risk [RR] = .58-.87) and SNF stays (RR = .32-.77) compared with both HO and No HomePal-HO patients.Earlier comprehensive palliative care in patients' home in place of or preceding hospice is associated with fewer hospitalizations and SNF stays and more time at home in the final 6 months of life. J Am

2019 Journal of the American Geriatrics Society

14. Palliative care specialists in hospice and hospital/community teams predominantly use low doses of sedative medication at the end of life for patient comfort rather than sedation: Findings from focus groups and patient records for I-CAN-CARE. Full Text available with Trip Pro

Palliative care specialists in hospice and hospital/community teams predominantly use low doses of sedative medication at the end of life for patient comfort rather than sedation: Findings from focus groups and patient records for I-CAN-CARE. Little research has explored the detail of practice when using sedative medications at the end of life. One work package of the I-CAN-CARE research programme investigates this in UK palliative care.To investigate current practices when using sedative (...) medication at the end of life in London, UK, by (1) qualitatively exploring the understandings of palliative care clinicians, (2) examining documented sedative use in patient records and (3) comparing findings from both investigations.We conducted focus groups with experienced palliative care physicians and nurses, and simultaneously reviewed deceased patient records.In total, 10 physicians and 17 senior nurses in London hospice or hospital/community palliative care took part in eight focus groups

2019 Palliative medicine

15. Where and How Centenarians Die? The Role of Hospice Care. (Abstract)

Where and How Centenarians Die? The Role of Hospice Care. The effect of hospice care on place of death among centenarians remained unexplored. Using data obtained from National Health Insurance Research Database (2002-2010), we compared the differences in place and cause of death between centenarians and noncentenarians. These data were stratified into centenarian (n = 2495) and noncentenarian (n = 820 563) death. Data in place and cause of death and hospice care interventions were retrieved (...) . Poisson regression models were used to evaluate factors associated with the centenarians' place of death. Time series models were used to predict the number of centenarian deaths until 2025. Most (63.8%) of the centenarians died at their own homes, followed by 30.5% who died in hospital. Hospice home care was involved in only 0.3% of the centenarian deaths but in 1.8% of the noncentenarian deaths. The leading causes of death among centenarians were respiratory diseases (16.6%), circulatory diseases

2019 American Journal of Hospice and Palliative Medicine

16. Knowledge and attitudes regarding hospice care among outpatients and family members in two hospitals in China. Full Text available with Trip Pro

Knowledge and attitudes regarding hospice care among outpatients and family members in two hospitals in China. Access to hospice care is widely provided in Western countries, but the supply of such service is still in its initiative stage in China. As relatives are often involved in end-of-life decision making in China, a better understanding of their cognitions toward hospice care would help policy makers and physicians to overcome the barriers of providing such service. Thus, we conducted (...) this survey. Only 107 (19.5%) reported that they had known or heard of hospice care, with a mean knowledge score of 2.8 (standard deviation = 1.6). Of the respondents, 69.5% answered "strongly agree" or "agree" regarding the importance of providing hospice care in China. Participants who had known of hospice care were more likely to have favorite attitudes toward it.The awareness rate of hospice care is low in the study, which may lead to poor attitude and low enrollment rate. Considering the increasing

2019 Medicine

17. Patients' Needs Regarding Anxiety Management in Palliative Cancer Care: A Qualitative Study in a Hospice Setting. Full Text available with Trip Pro

Patients' Needs Regarding Anxiety Management in Palliative Cancer Care: A Qualitative Study in a Hospice Setting. Anxiety is a common symptom in the palliative phase, and symptom management depends on the competencies of individual professionals. This study aims to get insight into the needs of anxious hospice patients with advanced cancer regarding support.Semi-structured interviews were performed in admitted hospice patients with cancer. Patients admitted from May 2017 till May 2018 were (...) ' needs regarding anxiety provided important angles where health-care professionals can make a difference in order to support anxious patients in their final stage of life to realize tailored palliative care. Future research should focus on the development of a systematic approach for health-care professionals to manage anxiety in daily care of terminal patients.

2019 American Journal of Hospice and Palliative Medicine

18. Deactivating a Pacemaker in Home Care Hospice: Experiences of the Family Caregivers of a Terminally Ill Patient. (Abstract)

Deactivating a Pacemaker in Home Care Hospice: Experiences of the Family Caregivers of a Terminally Ill Patient. Although the experiences of family members who care for relatives at the end of life have been researched extensively, little is known about the needs and experiences of families caring for hospice patients with pacemakers.To better understand the experiences of family caregivers of a terminally ill patient who received hospice care at home and chose deactivation of a pacemaker.The (...) "; "It is really difficult to watch, but you want to be there"; and "I will not have part of this." Caregivers struggled with lack of support, understanding, and acceptance from medical providers when their family member decided to have her pacemaker deactivated, and they believed that the hospice model of care was appropriate to support and help them in that process.This research aids in understanding the ramifications of family-provided end-of-life care to a patient whose pacemaker has been deactivated

2019 American Journal of Hospice and Palliative Medicine

19. Frequency and Documentation of Medication Decisions on Discharge from the Hospital to Hospice Care. (Abstract)

Frequency and Documentation of Medication Decisions on Discharge from the Hospital to Hospice Care. To quantify the frequency and type of medication decisions on discharge from the hospital to hospice care.Retrospective cohort study.A 544-bed academic tertiary care hospital in Portland, Oregon.A total of 348 adult patients (age ≥18 y) discharged to hospice care between January 1, 2010, and December 31, 2016.Data were collected from an electronic repository of medical record data and a manual (...) medications (standard deviation [SD] = 4.8) on discharge to hospice care. The most prevalent medications prescribed on discharge were strong opioids (82.5%), anxiolytics/sedatives (62.9%), laxatives (57.5%), antiemetics (54.3%), and nonopioid analgesics (45.4%). However, only 67.8% (213/341) of patients who were prescribed an opioid on discharge to hospice care were also prescribed a laxative. Discharging providers made a mean of 15.0 decisions (SD = 7.2) per patient of which 28.5% were to continue

2019 Journal of the American Geriatrics Society

20. Effectiveness of a Volunteer Training Program on the Learning Support of Children in Hospice Palliative Care. (Abstract)

Effectiveness of a Volunteer Training Program on the Learning Support of Children in Hospice Palliative Care. Volunteers are expected to play a key role in children's hospice. However, there is a lack of information about how to cultivate effective volunteer training programs.To verify the effect of a training program on volunteers' confidence in providing learning support and sharing experiences with children with life-threatening conditions and their families in a children's hospice.In (...) this pre-post study, participants were 48 undergraduate and graduate students from 3 universities in Japan. They received 5 lectures on children's hospice learning support. They evaluated the training program by rating their self-confidence in meeting each of the 15 program goals on a questionnaire.An exploratory factor analysis of the questionnaire yielded 12 goals in 4 factors: understanding of one's own and others' mental state, accommodating the learning needs of children with life-threatening

2019 American Journal of Hospice and Palliative Medicine

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