Comment: Palliative care in renal disease: lessons for other conditions?
Fliss EM Murtagh
pp 213-213
Palliative care continues to extend beyond cancer, and this raises a number of challenges, both in palliative care and the relevant disease specialties. What are the palliative care needs of patients with conditions other than cancer? Who is best placed to meet them? Do models of specialist palliative care, largely derived from cancer, apply? Which are the most effective (and cost-effective)? In other words, what are the needs, who should address them, and how should this be done?
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Improving quality of life in patients with advanced motor neurone disease
David Oliver and Mayen Udoma
pp 214-217
Motor neurone disease (MND) is a progressive neurological disease characterised by the degeneration of motor neurons. It is a rapidly progressing disease and, in the advanced stages, symptom control and nutritional support are particularly challenging. Currently there is no cure for MND; therefore, all interventions aim to improve patients’ quality of life. Symptom management is a key component of patient care, and hospices are often involved in implementing appropriate interventions.
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Carcinoma erysipeloides, an unusual presentation
Samantha Kay and Steven Plenderleith
pp 218-219
Carcinoma erysipeloides is a rare presentation that remains significantly under-recognised in clinical practice, although it may be the presenting feature of malignancy. Previous studies have reported an occurence in approximately 1% of patients with metastatic breast cancer.
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Case study masterclass 58: A 70-year-old woman with motor neurone disease and changing advance care plans
Sarah Bailey and Bernadette Lee
pp 220-221
Valerie* is a married woman aged 70 and a retired sales executive. Fourteen months ago, having experienced progressive symptoms for four years, she was diagnosed with motor neurone disease (MND). Her symptoms were largely bulbar. The neurologist advised her to take riluzole but she decided against it. She was put under the care of the community palliative care team, and provided with support from a respiratory physiotherapist, speech and language therapist, and dietitian. She was able to stay at home, where she was well cared for by her husband. Being aware of her prognosis, Valerie talked a lot about assisted suicide.
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Case study masterclass 57 answers: Managing a patient with diabetes at the end of life
Claire Magee
pp 222-222
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From pioneer days to implementation: lessons to be learnt
Mary Baines
pp 223-227
I want to start by showing you this photograph of Cicely Saunders, and I am grateful to Avril Jackson, previously of the Hospice Information Service, for it. I like it because of her smile and because it shows her still at work – in fact giving prizes to hospice staff – though it was taken in 2001 when she was 83, just four years before her death.
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Characteristics and outcomes of renal patients referred to palliative care in a US hospital
Charina Gayomali, Steven Radwany, Teresa Albanese and Hallie Mason
pp 228-234
Over the last 50 years, increased access to dialysis has hugely improved the outlook for patients with renal failure. When renal replacement therapy first became available, patients selected for it tended to be young and without significant co-morbidity. Today, even older patients with greater co-morbidity receive haemodialysis (HD).
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Mentoring palliative care staff in low-income countries has benefits for all
Dorothy Logie, Liz Grant, Mhoira Leng and Scott A Murray
pp 235-237
In low-income countries, there are growing numbers of people trained in palliative care who need mentorship and a support network, but there are very few local individuals who are qualified to provide this. Mentoring can increase the confidence of, and quality of care offered by, care leaders and practitioners. The current human resource crisis in healthcare means that international support is required from those of us who can mentor colleagues in need of help.
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Guidance on postgraduate education for psychologists involved in palliative care
Saskia Jünger and Sheila Payne
pp 238-252
The aim of this Expert Paper from the European Association for Palliative Care (EAPC) Task Force on Education for Psychologists in Palliative Care is to provide guidance on curriculum development with respect to the postgraduate education of psychologists involved in palliative care. The differences between European countries regarding the basic education of psychologists, the definition of palliative care, palliative care delivery, and the role of psychologists in palliative care are considered.
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European insight: APCSW: palliative care social work is too important to lose
Pam Firth
pp 253-255
In the UK, the Association of Palliative Care Social Workers (APCSW) represents social work within palliative care, which is vital for families and communities but nonetheless under threat. The APCSW is joining forces with its European counterparts within a European Association for Palliative Care (EAPC) Task Force working on the competences and training needs of palliative care social workers.
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