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Telling Bad News
Published in Lisa Zammit, Georgeanne Schopp, Relational Care, 2022
Lisa Zammit, Georgeanne Schopp
Bad news is usually given with a diagnosis of a terminal disease process. These include a new chronic diagnosis, a significant unrecoverable decline, amputation, etc. Bad news does not affect the Body alone. It impacts the Mind and Spirit, causing extreme reactions. Patient and Family behaviors will range from complete cognitive shutdown to hysteria.
The ethics of healthcare in prison and dementia
Published in Joanne Brooke, Dementia in Prison, 2020
An ethical issue within dementia care is the need for continuing assessment of potential benefits and harms, and the need to balance care between the commitment to not cause any harm, whilst being obliged to withdraw and withhold treatments that are causing harm. This deliberation in timing the shift in the nature of care, as well as considering a reasonable ceiling of care, poses complex ethical questions. Dementia is a terminal disease and end-of-life care will, at some point, involve the withdrawal of treatment. During the trajectory of the illness, it is important for family members caring for a relative with dementia to reflect on their experiences, and for healthcare professionals to recognise the complex difficulties family members face daily, which should be a point of regular discussions (Hughes, 2002).
Palliative Care of Gastroparesis
Published in Victor R. Preedy, Handbook of Nutrition and Diet in Palliative Care, 2019
In patients with terminal disease, a decision has to be made regarding the benefits of interventions and issues related to quality of life. Many patients with terminal disease have been taking pain medications, which may cause worsening of GP symptoms as a result of drug effects on gastrointestinal motility. In patients with advanced or terminal disease, aggressive therapy may not be warranted. Patient autonomy should be protected.
Home Parenteral Nutrition in Patients with Advanced Cancer: A Systematic Review and Meta-Analysis
Published in Nutrition and Cancer, 2021
Francis J. O’Hanlon, Konstantinos C. Fragkos, Lucia Fini, Pinal S. Patel, Shameer J. Mehta, Farooq Rahman, Simona Di Caro
Definitions of advanced cancer were highly variable in the studies identified. A number of studies classified advanced or “terminal” disease as “incurable,” “irreversible,” “not responsive to further oncological treatment” or not having undergone treatment recently (16, 40, 43, 44, 47, 51, 53, 55), though numerous studies included patients still on single or combination oncological treatments (16, 52, 54–57). Others included 2–3 mo life expectancy in their definition (42), or encompassed disease stage ≥ III/IV and/or the presence of metastatic disease (39, 45, 47, 49, 54–57). Often, the terms “advanced” and “incurable” cancer were used synonymously to encompass the same group of patients. Wang et al. (46) noted that although all terminal cancer patients are oncologically “incurable,” not all incurable cancers are “biologically terminal.” Thus, the heterogeneous definitions of advanced cancer, may also explain the large variability of survival data obtained (median 1.5–10.4 mo) and to some extent may under-estimate the true proportion of “advanced cancer” patients eligible for HPN.
An analysis of totally implantable central venous port system infections in an urban tertiary referral center
Published in Journal of Chemotherapy, 2021
Ulrich Krümpelmann, Ahmed Boseila, Mathias Löhnert, Olaf Kaup, Jacob J. Clarenbach, Martin Görner
Among the patients who had CVP infections, we documented an in-house mortality of 18/206 (9%). All deaths occurred in patients with malignant neoplastic disease (18/173 = 10%) and with CVP-BSI, none in the share of patients with non-neoplastic disease or with CVP-LI. Fourteen deceased patients suffered from late-stage or terminal disease. In the literature, in-house mortality rates of cancer patients with a CVP-BSI have been reported to be 25% or 46%.30,31 In a recently published japanese study with 124 BSI caused by peripheral venous catheters and 110 BSI caused by central venous catheters all patients were treated with immediate catheter removal and systemic antibiotics. The central venous arm included 78 patients with neoplastic diseases and showed an all-cause mortality of 12.8%.32 One possible explanation for the lower mortality in our study could be the share of 25% CVP-LI in our patients.
Impact of spirituality on resilience and coping during the COVID-19 crisis: A mixed-method approach investigating the impact on women
Published in Health Care for Women International, 2020
Anka Roberto, Alicia Sellon, Sabrina T. Cherry, Josalin Hunter-Jones, Heidi Winslow
Resilience has been defined as the ability of an individual to recondition and rebuild a steady psychological and physical state when challenged with major adverse life events (Seiler & Jenewein, 2019). Being diagnosed with a terminal disease, the death of a loved one, the loss of income, abuse, and neglect, as well as being a witness to violence, are a few examples (Bryant et al., 2020; Dorji et al., 2017; Lydsdottir et al., 2019). Researchers in Milan found that applying a family resilience framework to the cancer trajectory provides a map of resources to help overcome the distresses of illness (Faccio et al., 2018).These traumatic life events are on the rise during the COVID-19 pandemic and can create triggering memories during future circumstances when emotions, thoughts, or sensations remind them of past traumas causing the body to go into a fight, flight or, freeze state of mind. This retriggering can lead to PTSD manifesting as anxiety, panic, dissociation also known as, feeling as if one is out of the body and depression.