Having the difficult conversations about the end of life. BMJ 2010; 341:c4862
Barclay, S. and Maher, J.
http://www.bmj.com/content/341/bmj.c4862.full
Clinicians need to create repeated opportunities for patients to talk about their future and end of life care, guided by the patient as to timing, pace, and content of such talks, and respecting the wishes of those who do not want to discuss such matters
Wednesday, 3 November 2010
Achieving a good death for all
Achieving a good death for all. BMJ 2010; 341:c4861.
Ellershaw, J., et al.
http://www.bmj.com/content/341/bmj.c4861.full
A good death for all is now recognised as a priority at societal and political levels. To achieve this goal we need a fundamental shift of emphasis: to train and educate healthcare professionals, to ensure rigorous assessment of new end of life care services that aim to improve quality and choice, and to explore best use of resources.
Ellershaw, J., et al.
http://www.bmj.com/content/341/bmj.c4861.full
A good death for all is now recognised as a priority at societal and political levels. To achieve this goal we need a fundamental shift of emphasis: to train and educate healthcare professionals, to ensure rigorous assessment of new end of life care services that aim to improve quality and choice, and to explore best use of resources.
Dying matters: let's talk about it
Dying matters: let's talk about it. BMJ 2010; 341:c4860
Seymour, J.E., et al.
http://www.bmj.com/content/341/bmj.c4860.full
As death has become less common in our daily lives, it has become harder to consider our own mortality or that of those close to us. Lack of openness about death has negative consequences for the quality of care provided to the dying and bereaved. Eradicating ignorance about what can be achieved with modern palliative care and encouraging dialogue about end of life care issues are important means of changing attitudes.
Seymour, J.E., et al.
http://www.bmj.com/content/341/bmj.c4860.full
As death has become less common in our daily lives, it has become harder to consider our own mortality or that of those close to us. Lack of openness about death has negative consequences for the quality of care provided to the dying and bereaved. Eradicating ignorance about what can be achieved with modern palliative care and encouraging dialogue about end of life care issues are important means of changing attitudes.
Recognising and managing key transitions in end of life care
Recognising and managing key transitions in end of life care. BMJ 2010; 341:c4863.
Boyd, K. and Murray, S.A.
http://www.bmj.com/content/341/bmj.c4863.full
Prognostic paralysis may delay a change in gear for too long. Being alert to the possibility that a patient might benefit from supportive and palliative care is central to delivering better end of life care.
Boyd, K. and Murray, S.A.
http://www.bmj.com/content/341/bmj.c4863.full
Prognostic paralysis may delay a change in gear for too long. Being alert to the possibility that a patient might benefit from supportive and palliative care is central to delivering better end of life care.
Long-term cognitive impairment and functional disability among survivors of severe sepsis
Long-term cognitive impairment and functional disability among survivors of severe sepsis. JAMA vol. 314(16), 2010; p. 1787-1794.
Iwashyna, T.J., et al.
http://jama.ama-assn.org/cgi/content/full/304/16/1787?etoc
Cognitive impairment and functional disability are major determinants of caregiving needs and societal health care costs. Although the incidence of severe sepsis is high and increasing, the magnitude of patients' long-term cognitive and functional limitations after sepsis is unknown. Severe sepsis in this older population was independently associated with substantial and persistent new cognitive impairment and functional disability among survivors. The magnitude of these new deficits was large, likely resulting in a pivotal downturn in patients' ability to live independently.
Iwashyna, T.J., et al.
http://jama.ama-assn.org/cgi/content/full/304/16/1787?etoc
Cognitive impairment and functional disability are major determinants of caregiving needs and societal health care costs. Although the incidence of severe sepsis is high and increasing, the magnitude of patients' long-term cognitive and functional limitations after sepsis is unknown. Severe sepsis in this older population was independently associated with substantial and persistent new cognitive impairment and functional disability among survivors. The magnitude of these new deficits was large, likely resulting in a pivotal downturn in patients' ability to live independently.
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