Tailoring future CareSearch communications

  • 10 November 2020
  • Author: Ruth
  • Number of views: 0
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To better serve your information needs, we at the CareSearch Project want to know how we can better tailor our future communication materials. Have your say by answering this 5-minute survey.

Death in Central Australia – too much, and too soon

A guest blog post by Dr Christine Sanderson, Palliative Care Specialist, Territory Palliative Care - Central Australia, Alice Springs Hospital

  • 9 November 2020
  • Author: Guest
  • Number of views: 912
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Death in Central Australia – too much, and too soon

In Central Australia, statistics about closing the gap come to life. For the Part of Life blog series, Palliative Care Specialist Dr Christine Sanderson at Alice Springs Hospital discusses the palliative care needs of Aboriginal patients, and how her team work to provide quality and person-centred care.

The effect of bereavement on cognitive functioning among elderly people: Evidence from Australia

  • 9 November 2020
  • Author: CareSearch
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Atalay K, Staneva A.

This paper explores the effects of experiencing the death of a spouse, relative or close friend on cognitive functioning of Australian elderly. Using rich longitudinal data, we show that experiencing a loss is associated with a modest decline in cognitive function. Our results show that on average the effects are more pronounced for males and the strongest effects are associated with the loss of the spouse or a close friend. These events have significant effects on working memory and speed of information processing. We show that the decrease in cognitive functioning is accompanied by decreases in engagement in cognitive activities and declines in socialization. Our results are suggestive that programmes to support grieving individuals, including support for socialization activities, and extending active aging programmes could be important for promoting successful cognitive aging for the growing population of older adults.

The level of distress from fatigue reported in the final two months of life by a palliative care population; An Australian national prospective, consecutive case series

  • 9 November 2020
  • Author: CareSearch
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Ingham G, Urban K, Allingham SF, Blanchard M, Marston C, Currow DC.

Context:
Fatigue is the most commonly reported symptom in life-limiting illnesses, though not much is known about the distress it causes patients as they approach death.

Objectives:
To map the trajectory of distress from fatigue reported by an Australian palliative care population in the last 60 days leading up to death.

Methods:
A prospective, longitudinal, consecutive cohort study using national data from the Australian Palliative Care Outcomes Collaboration between 1 July 2013 and 31 December 2018. Patients were included if they had at least one measurement of fatigue on a 0-10 numerical rating scale in the 60 days before death. Descriptive statistics were used to analyse patients by diagnostic cohort and functional status.

Results:
A total of 116,604 patients from 203 specialist palliative care services were analysed, providing 501,104 data points. Distress from fatigue affected up to 80% of patients referred to palliative care, with the majority experiencing moderate or severe distress. Malignant and non-malignant diagnoses were equally affected, with the neurological cohort showing the greatest variability. The degree of distress correlated with a patient's functional level; it worsened as a patient's function declined until a patient became bedbound when the reporting of distress reduced.

Conclusions:
Distress from fatigue is high in this cohort of patients. Interventions to reduce this distress need to be a research priority.

'Supportive and Palliative Care Indicators Tool (SPICT) improves renal nurses' confidence in recognising patients approaching end of life'

  • 9 November 2020
  • Author: CareSearch
  • Number of views: 0
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Lunardi L, Hill K, Crail S, Esterman A, Le Leu R, Drummond C.

Background:
Identification of people with deteriorating health is essential for quality patient-centred care and optimal management. The Supportive and Palliative Care Indicators Tool (SPICT) is a guide to identifying people with deteriorating health for care planning without incorporating a prognostic time frame.

Objectives:
To improve renal nursing staff confidence in identifying patients approaching end-of-life and advocate for appropriate multidisciplinary care planning.

Design:
This pilot feasibility prospective cohort study conducted in the renal ward of a major metropolitan health service during 2019 included a preintervention/postintervention survey questionnaire. A programme of education was implemented training staff to recognise end-of-life and facilitate appropriate care planning.

Results:
Several domains in the postintervention survey demonstrated a statistically significant improvement in renal nurses' perception of confidence in their ability to recognise end of life. Of the 210 patients admitted during the study period, 16% were recognised as SPICT positive triggering renal physicians to initiate discussions about end-of-life care planning with patients and their families and to document a plan. Six months poststudy, 72% of those patients recognised as SPICT positive had died with a documented plan of care in place.

Conclusion:
The use of SPICT for hospital admissions and the application of education in topics related to end-of-life care resulted in a significant improvement in nurses' confidence in recognising deteriorating and frail patients approaching their end of life. The use of this tool also increased the number of deteriorating patients approaching end of life with goals of care documented.

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