Comment: Bringing palliative care on to the European agenda
Jose M Martin-Moreno and Carlos Centeno
pp 57-57
Since Recommendation 24 of the Council of Europe, palliative care has gained significant public support. In the two years following its publication in 2003, there were important advances in Austria, the Czech Republic, Denmark, France, Germany, Greece, Hungary, Latvia and Romania.
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Specialist occupational therapy for patients with brain tumour
Kathy Thompson
pp 58-61
‘It is vitally important for all the professionals involved with patients suffering from brain tumour – and their carers – to interact and hold them in their minds as individual people with personalities, rather than as patients with symptoms resulting from disease.’ – Gerard, husband of Mary, on whom this case study is based
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Exactly who is entitled to receive free NHS care?
Mark Taubert and Nikki Pease
pp 62-64
Using the case of a French national with advanced metastatic cancer, this article describes the issues around entitlement to free NHS treatment, what ‘ordinary resident’ status means, and organising entirely privately paid palliative care, GP and community services.
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Improving care for patients with intellectual disabilities
Lisa Duplock, David Oliver and Rachel Forrester-Jones
pp 66-68
The importance of investigating and addressing the needs of palliative care patients with intellectual disabilities (IDs) has been increasingly recognised in the past decade. The number of people with IDs in the aging population is increasing, with the result that there has been a rise in the number of people with IDs presenting with cancer, heart and respiratory disease, and dementia. Two recent studies have suggested methods and strategies, for implementation in palliative care services, to better support such patients.
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Case study masterclass 43: Fulfilling a patient’s wish to go home from intensive care
Lynda Tellett and Carol Davis
pp 69-70
Les is a 58-year-old married man with Ebstein’s anomaly, a congenital heart disease, which was diagnosed when he was a young man. The condition encompasses a wide spectrum of anatomical and functional abnormalities of the tricuspid valve. His main problem is long-standing tricuspid valve regurgitation and right ventricular failure. Over recent months, this has worsened and Les has developed chronic renal and liver failure, and rhythm problems. He also suffers from gout, insulin-dependent diabetes and peripheral neuropathy. He is normally an active man who loves the outdoors and working on his allotment.
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Case study masterclass 42 answers: An elderly patient with opioid-induced constipation
Anna Hume and Carol Davis
pp 71-71
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Using hypnosis in palliative care: a clinician's experience
Sara Booth
pp 72-75
The introduction of self-hypnosis training in my palliative care outpatient service, at the Addenbrooke’s Hospital in Cambridge, has helped my patients to cope better with life-threatening illness and improve their control over physical and psychological problems. I have been practising hypnosis for two years and have found it a helpful tool to improve the effectiveness of a range of therapeutic interventions that I offer patients needing palliative and supportive care. After a brief history of hypnosis, this article concentrates on my clinical experience (and touches briefly on the available literature). I hope that reporting on the practicalities of using this technique in clinical work will help to demystify it. Hypnosis is not a form of the ‘dark arts’, but a technique that palliative care patients can employ to improve their quality of life.
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EAPC Task Force on Family Carers: aims and objectives
Sheila Payne and Peter Hudson
pp 77-81
Virtually all of us, especially if we are female, will become a carer of a family member at some point in our lives. Some of us will take on this role without much warning or preparation. For some, it may be a brief period, perhaps lasting just a few weeks or months, as a relative enters the dying phase of a final illness. For others, it will last a long time, as care will be provided over many years, for example for a parent suffering from Alzheimer’s disease. Most of us will manage very well and draw on the support of our family and wider social networks. In fact, many of us will not even think of ourselves as being carers. Instead, we will regard our role as part of the complex pattern of reciprocal relationships that characterises most family, kinship and friendship systems. Caring is usually enmeshed in the web of mutual dependencies, responsibilities, demands and rewards that make up normal family life.
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Job competency profiles for hospice nurses
Claire Kelly and Andrea Clark
pp 82-85
In the UK healthcare system, the development of job competency profiles (JCPs) has been accelerated and supported by the Agenda for Change (AfC) – the NHS pay and grading system – but such an approach is not widespread in the hospice setting. The NHS Knowledge and Skills Framework (KSF) sets out the competencies required for nursing roles, promoting consistent skills and knowledge for specific staff groups. However, despite the implementation of competencies for a wide range of nursing roles, the NHS KSF struggles to address specialist functions and to articulate competencies that closely reflect the needs of patients in specialist settings. The relevance of the NHS KSF is also limited in the voluntary sector, because it is specifically aimed at the complex and unique NHS environment.
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The strengths and weaknesses of telephone interviews
Rhidian Hughes
pp 87-89
Telephone interviews were first used in, and continue to remain popular for, quantitative surveys. More recently, they have been used in qualitative studies, including for palliative care research. Whether or not to use telephone interviews is determined by the relative strengths and weaknesses of other research methods, the topic under consideration and the type of participants involved. This article begins with a few illustrative case examples and then appraises the relative strengths and weaknesses of telephone interviews.
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Raising public awareness about planning a funeral
Jackie Saunders, Sarah Coates and Caroline Wade
pp 90-93
Following a presentation by Allan Kellehear (now Professor of Sociology at the University of Bath) on health promotion in palliative care at the Fifth Annual Liverpool Care Pathway National Conference in 2007, two ward-based registered nurses from St Nicholas Hospice Care in Suffolk, Sarah Coates and Caroline Wade, were inspired to provide a community event on planning a funeral. They were aware that, in contemporary society, death, dying and funerals are a source of embarrassment – taboo subjects to be avoided until absolutely necessary and then faced with reluctance.
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Online courses for nurses working in palliative care
Robert Becker
pp 94-97
Information technology is now so widely used that it would be easy to assume that healthcare professionals have embraced it. Yet the evidence that we are harnessing the potential of such technology for education is fraught with contradiction. Just because we have the technology does not mean we have the knowledge, skills and confidence to use it effectively.
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European insight: SFAP: France is witnessing major developments in palliative care
Godefroy Hirsch
pp 100-101
On 22 April 2005, the law on patients’ rights and the end of life2 came into force. The French Parliament voted unanimously in favour of it. It is a particularly innovative one, and it illustrates the choices that have been made in this country concerning end-of-life issues. Some of its main points are listed below.
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