Comment: Palliative chemotherapy: are we asking the right questions?
Carol Davis
pp 161-161
I endeavour to keep myself up to date with 21st-century management of patients with at least some of the diseases that I see commonly in my clinical practice. In pursuit of this quest, I have just read parts of a recently published report, the 2012 Annual Report of the National Oesophago-gastric Cancer Audit (NOGCA).
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An overview of antiemetic medications and the considerations for their use in palliative care
Paul Glare, Tanya Nikolova, Roma Tickoo, Jeanna Miller and Marijana Bras
pp 162-167
Nausea and vomiting are common, distressing symptoms in palliative care. Anti-emetic medications are the mainstay of treatment. The armamentarium is broad, covering many different drug classes. There are two different approaches to selection of anti-emetics in palliative care. Mechanistic prescribing is based on the putative aetiology of the symptom and the known receptor affinities within the implicated structures of the emetic pathway.
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The impact of cardiac resynchronisation therapy on palliative management of advanced heart failure
Nadia Khan, Prithwish Banerjee and Dan Munday
pp 168-171
Congestive heart failure (CHF) is a complex syndrome occurring when the heart is unable to maintain an adequate cardiac output to meet the oxygen demands of tissues. Improved survival after acute coronary events and an aging European population demographic has meant the prevalence of heart failure has steadily increased and is set to rise dramatically over the next few decades.
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Case study masterclass 63: Using a lidocaine patch from a broken rib
Verity Rawson and Carol Davis
pp 172-173
Edna is a 74-year-old woman with multiple myeloma, which was initially treated with high-dose melphalan. After a relapse six months ago, she began a course of lenalidomide, but this was poorly tolerated, with recurrent bouts of sepsis and diarrhoea. She lives alone, has carers three times daily, and remains quite frail since the relapse. Edna is admitted from home under the care of the haematologists in order to manage right-sided chest pain.
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Case study masterclass 62 answers: Safeguarding a vulnerable patient and his wife
Rosalind Jarvis and Sally List
pp 174-174
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OPCARE9 – A European perspective on the last days of life
Massimo Costantini and Urska Lunder
pp 175-177
The objectives of the OPCARE9 project, conducted over a three-year work programme (from March 2008 to March 2011), included developing innovative ways of addressing the gap in knowledge about care of the dying and of identifying effective interventions able to improve the quality of care at the end of life.
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OPCARE9 – a southern hemisphere perspective
Jean B Clark and Gustavo De Simone
pp 178-180
Palliative care personnel and organisations in Argentina and New Zealand, two countries significantly distant from Europe, accepted an invitation to join the European collaboration that developed into OPCARE9. Choosing to participate was straightforward as the offer came from international colleagues with whom relationships had been established based on a shared passion for palliative and end-of-life care. In particular, end-of-life care supported by the Liverpool Care Pathway for the Dying Patient (LCP) had created a tangible link around the globe.
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OPCARE9 – future directions for optimising the care of cancer patients in the last days of life
Stephen Mason and John Ellershaw
pp 181-184
OPCARE9 was a three-year European Commission Seventh Framework Programme (FP7) Co-ordination and Support Action collaborative project to optimise the care of cancer patients in the last days of life. The project was managed within an international collaborative framework, integrating knowledge from a range of healthcare environments and cultures.
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The importance of publishing studies with negative results in palliative care
David C Currow and Amy P Abernethy
pp 186-190
The minimisation of bias is the underpinning of rigorous research; the goal is to most closely approximate ‘truth’ in a reliable and reproducible way while simultaneously optimising the resources needed to reach the conclusion.
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Implementing spiritual care at the end of life: the Netherlands
Carlo Leget
pp 191-192
Traditionally a country where the Roman Catholic tradition was widespread in the southern and eastern parts, and Protestantism in the northern and western regions, after World War II Dutch society has changed into a culturally diverse and strongly secularised landscape where Roman Catholic (27%), Protestant (16.6%), Muslim (5.7%), Hindu (1.3%), Buddhist (1%) and people with no faith system (48.4%, of whom humanist organisations claim to represent 9.4%) live together.
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Where’s the humanity? Assisted dying is not the solution to providing dignity
Dimity Grant-Frost
pp 193-194
I can clearly remember sitting at the bedside of a middle-aged Jamaican man with cancer who I had been caring for during his admission with spinal cord compression. He had struggled desperately to come to terms with the weakness in his legs but had remained low in mood throughout his hospital stay. As we spoke that day, large tears spilled down his cheeks while he recounted his first experience of faecal incontinence, which had occurred as he lay in bed during the early hours of that morning.
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Hospice volunteering: work, socially useful leisure or just filling in time?
Jacqueline H Watts
pp 195-197
Work as paid employment is economic in character and is undertaken across the life course usually as a means of sustaining self and dependents. Orientations to work, however, are complex and are shaped by education, cultural values and family practices that influence the choice of career or occupation. The choices and decisions people make about their work are also shaped by the structure of the labour market, which operates to economically ‘value’ some forms of work more than others (as well as some types of worker over others), and there now exists a wide body of literature that debates the experience and meaning of work in contemporary society.
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A day in the life of … Natalie Davies, Speech and Language Therapist
Natalie Davies
pp 198-200
The multidisciplinary team based at Meadow House Hospice sees patients in the community as well as inpatients at the hospice itself. When my day starts at 9 am I never know what is ahead, which keeps me on my toes and always presents a challenge.
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European insight: The Association of Hospice and Palliative Care Chaplains
Steve Barnes
pp 202-204
The Association of Hospice and Palliative Care Chaplains (AHPCC) is a community of palliative care chaplains in the UK who gather regionally and nationally for mutual support and encouragement. Is its characteristic informality about to change? Steve Barnes muses over spiritual care and the evolving role of the AHPCC.
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