Palliative care

In its latest report on palliative care, the health committee of the House of Commons recorded the Department of Health's admission that the lack of palliative care for patients without cancer was the greatest inequity of all.1 In the United Kingdom, people die in hospices almost solely from cancer, although it accounts for only 25% of all deaths.1 w1 Yet patients dying from dementia have been shown to have healthcare needs comparable to those of cancer patients.2 The palliative care approach provides appropriate control of symptoms, emphasises overall quality of life, takes a holistic appr

This paper reports a welfare rights intervention for carers of dying people through seminars to help them organise family finances to deal with additional costs of the final illness, funeral costs and reconstruction of family finances after death. Seminars on financial affairs were provided to 103 carers and service users, and were evaluated by questionnaires. The seminars were very positively received by attenders, who felt better informed, but were not necessarily more confident in dealing with financial problems.

Support for family caregivers is a core function of palliative care. However, there is a lack of consistency in the way needs are assessed, few longitudinal studies to examine the impact of caregiving, and a dearth of evidence-based interventions. In order to help redress this situation, identification of suitable instruments to examine the caregiving experience and the effectiveness of interventions is required.

Background: The trend for terminally ill patients to receive much of their end-of-life care at home necessitates the design of services to facilitate this. Care at home also requires that informal care be provided by family members and friends.

Nausea and vomiting represent a significant problem in patients with advanced cancer which not only affects their quality of life but also the lives of informal carers. The application of nursing assessment tools, underpinned by a thorough knowledge regarding the physiology and aetiology of nausea arid vomiting in this group of patients enables nurses to plan and provide effective interventions, in collaboration with other members of the multidisciplinary team. This article describes the physiological basis of nausea and vomiting.

BACKGROUND: There is a growing population of older patients with End Stage Renal Disease (ESRD) managed without dialysis in Thailand, and services have yet to be developed to specifically respond to the needs of this group. As a consequence this population are likely to have unmet needs with respect to health care and suffer from symptoms that could be better managed.

OBJECTIVE: This qualitative study explored experiences and health care needs during the last year of life among older people with ESRD, managed without dialysis, from the perspective of bereaved carers.

Background: When identifying patients for palliative care, medical specialists find it necessary to disclose “hidden” patients: the patient's relatives. The issue has been discussed sporadically in Bulgaria; the present study was part of a larger investigation that examined the opinion of medical specialists, patients, and their relatives.

There are an estimated half a million people in the UK who provide unpaid care for a relative or friend with a life-limiting or terminal illness at any one time. Every year thousands of people take on a caring role, whereas others find that this role has ended. This guide has been developed by an expert working group, and provides a framework for developing a carers’ assessment process. It offers advice on how to identify carers and gives an overview of the assessment methods currently used by palliative care providers.

Traditionally viewed as in opposition to palliative care, newer ideas about ‘health-promoting palliative care’ increasingly infuse the practices and philosophies of healthcare professionals, often invoking ideals of empowerment and participation in care and decision-making. The general tendency is to assume that empowerment, participation, and self-care are universally beneficial for and welcomed by all individuals. But does this assumption hold for everyone, and do we fully understand the implications of health-promoting palliative care for family caregivers in particular?