Hospices Not Deactivating Defibrillators In Patients -- Implantable Cardioverter Defibrillators Cause Unnecessary Suffering In End-of-Life Patients
Researchers from Mount Sinai School of Medicine have found that patients admitted to hospice care who have an implantable cardioverter defibrillator (ICD) are rarely having their ICDs deactivated and are receiving electrical shocks from these devices near the end of life. This first-of-its-kind study of hospice patients with ICDs is published in the March 2, 2010 issue of the Annals of Internal Medicine. Mount Sinai researchers surveyed 900 hospices, 414 of which responded. Ninety-seven percent of the responding hospices admitted patients with ICDs. On average, nearly 60 percent of patients did not have the shocking function of the ICD deactivated. Only 20 percent of hospices had a question on their intake forms to identify patients with ICDs, and just 10 percent reported having a policy in place to discuss deactivation with patients and their families.
Better Care At Any Hour For Palliative Patients
Accessing out of hours care is still a challenge for UK palliative care patients, even several years after the introduction of phone help line services like NHS24 and NHS Direct. Scottish researchers have specific recommendations for a more detailed and regular communication strategy to improve patients' care, which are published by SAGE in the journal Palliative Medicine. Palliative care patients can expect help from familiar primary care team professionals around a third of the time but when unexpected events occur out of hours (OOH), an unfamiliar team often steps in, and the patient may be sent to hospital inappropriately, or against their wishes. Most patients state they would prefer to die at home.
Home Palliative Sedation Checklist May Ease Concerns
Can patients near death safely receive sedation at home, fully respecting their own and their families' wishes? This practice, which is on the rise, is coming under increasing scrutiny and debate by palliative care researchers and practitioners. Now palliative care specialists from a team based in Spain have documented their experiences and data, and developed a standard checklist to help other clinicians. Their research appears in the journal Palliative Medicine, published by SAGE. Physicians use specific sedatives to relieve intolerable suffering as patients near death a practice known as palliative sedation (PS). The rate of PS use varies widely from 3-52% in terminally ill patients according to the literature a wide range considering it is considered ethical and legally acceptable for those with irreversible and advanced disease.
New Book Suggests Workplace Gendered Tradeoffs Lead To Economic Inequalities For Women
Despite big changes over recent decades, workplace gender inequalities endure in the United States and other industrialized nations around the world. These inequalities are created by facets of national social policy that either ease or concentrate the demands of care giving within households and shape expectations in the workplace, according to University of Washington sociologists. In a new book, "Gendered Tradeoffs: Family, Social Policy and Economic Inequality in Twenty-One Countries, " Becky Pettit and Jennifer Hook contend workplace equality for women boils down to not only whether women are included in the work force but on how they are included. Pettit is an associate professor of sociology and Hook is research scientist in the School of Social Work.
Bupa Supports Prime Minister's Aim For People To Be Treated At Home
On Monday, the Prime Minister gave a speech in which he called for more people to be treated in their own homes by the NHS in future. As a partner to the NHS, in providing healthcare in their own homes to 14, 000 patients, many with complex conditions, Bupa the leading international healthcare company, strongly supports his comments. Steve Flanagan, managing director of Bupa Home Healthcare said: "We agree with the Prime Minister's views that it is better for patients to be treated in their own homes. "Our experience of caring for 14, 500 NHS patients in their own homes shows it can be more cost-effective, helps avoid hospital-acquired infections, and produces higher levels of patient satisfaction.
'A Troubling Picture' Of Long-Term Care Hospitals
"Lawsuits, state inspections and federal statistics paint a troubling picture of the care offered at some hospitals, " writes The New York Times in an investigation of long-term care hospitals that dominates the front page. The Times focuses on the Select Medical Corporation, "a publicly traded Pennsylvania company that runs 89 long-term hospitals, more than any other company, " but also points out that "more than 400 similar facilities ... have opened nationally in the last 25 years. Few of them have doctors on staff, and most are owned by for-profit companies." "In 2007 and 2008, Select's hospitals were cited at a rate almost four times that of regular hospitals for serious violations of Medicare rules, according to an analysis by The New York Times.
One In Five Nursing Homes Receive Poor Quality Ratings, Analysis Finds
USA Today : "One in five of the nation's 15, 700 nursing homes have consistently received poor ratings for overall quality, a USA Today analysis of new government data finds. More than a quarter-million patients live in homes given another set of low scores within the past year, according to data released today by Medicare, which first released the star ratings of the nation's nursing homes in late 2008. The ratings are derived from inspections, complaint investigations and other data collected mostly in 2008 and 2009. ... nearly all homes that repeatedly received few overall stars - one or two stars - were owned by for-profit corporations, the data show.
Early Foster Care Boosts Quality Of Institutionalized Children's Ties To Caregivers
A new study of young children in orphanages in Bucharest, Romania, has found that children placed in foster care before age 2 were more apt to develop secure attachments to their foster parents than those who entered foster care after age 2. The study is based on data from the Bucharest Early Intervention Project, the first randomized controlled trial of foster care as an alternative to institutional care. It was carried out by researchers at Tulane University School of Medicine, the University of Maryland, Harvard Medical School/Children's Hospital Boston, and the University of California, Los Angeles, and appears in the January/February 2010 issue of Child Development.
Quality Of Caregiver Relationship Is Crucial For HIV-Infected Children
A new study of children in Ukraine has found that for the growing number of HIV-infected children, the quality of care and the relationship between children and their caregivers play an important role in their development. Based on their findings, the researchers highlight the importance of comprehensive but focused intervention efforts to improve these relationships by changing caregivers' working schedules and providing training to enhance the stability and sensitivity of care. Published in the January/February 2010 issue of the journal Child Development, the study was conducted by scientists at Leiden University in the Netherlands. One of the researchers, doctoral student Natasha Dobrova-Krol, is of Ukrainian origin.
Pitt Researchers Say Caregivers Of ICU Patients Are Collateral Damage Of Critical Illness
Intensive care unit patients are not the only ones likely to be severely depressed in the aftermath of hospitalization. Family and friends who care for them often suffer emotional and social hardship, too, according to a prospective study from the University of Pittsburgh School of Medicine that is the first to monitor patients and caregivers during a one-year period for predictors of depression and lifestyle disruption. The findings, published this month in Chest, indicate that the informal caregivers of ICU survivors endure even more stress than those caring for Alzheimer's disease patients, noted senior author Michael R. Pinsky, M.D., professor and vice chair for academic affairs, Department of Critical Care Medicine.