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Suicide, fin de vie et soins palliatifs

AUBRY, Régis
" Le suicide ", Cerf , 2019 , p. 439-456

Do the Welsh have it? Evaluating a bereavement support service supporting people bereaved by dementia

ROLESTON, Caity ; WEST, Karen ; SHAW, Rachel
BEREAVEMENT CARE, été-hiver 2019, vol.38, n°2-3, p. 104-108

Potentially burdensome end-of-life transitions among nursing home residents with poor-prognosis cancer

LAGE, Daniel E. ; DUMONTIER, Clark ; LEE, Yoojin ; NIPP, Ryan D. ; MITCHELL, Susan L. ; TEMEL, Jennifer S. ; EL-JAWAHRI, Areej ; BERRY, Sarah D.
Cancer, 20/12/2019, p. 1-8

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Perceptions of medical status and treatment goal among older adults with advanced cancer

THOMPSON, Leah L. ; TEMEL, Brandon ; FUH, Charn-Xin ; SERVER, Christine ; KAY, Paul ; LANDAY, Sophia ; LAGE, Daniel E. ; TRAEGER, Lara ; SCOTT, Erin ; JACKSON, Vicki A. ; GREER, Joseph A. ; EL-JAWAHRI, Areej ; TEMEL, Jennifer S. ; NIPP, Ryan D.
Journal of geriatric oncology, 05/12/2019, Pagination inconnue

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Thème : Age de la vie, situations spécifiques liées à la fin de vie.

PERSONNE AGEE ; CANCER ; PRONOSTIC ; PERCEPTION ; PHASE TERMINALE

Background: Patient-reported medical status and treatment goal are measures of prognostic understanding with demonstrated relationships to important clinical and patient-reported outcomes in the general cancer population. Among older adults, relationships between these measures and other patient-reported (quality of life [QOL], symptoms, functional impairment) and clinical (hospitalization risk, survival) outcomes remains unclear.
Methods: We enrolled patients =70 with advanced gastrointestinal cancers, collecting patient-reported medical status (terminally ill vs not), treatment goal (curative vs non-curative), QOL (EORTC-Elderly Cancer Patients), symptoms (Edmonton Symptom Assessment System [ESAS]), and functional impairment (activities of daily living [ADLs]). We also obtained information about hospitalizations and survival. To explore relationships between patient-reported medical status, treatment goal, QOL, symptoms, functional impairment, hospitalizations, and survival, we used regression models adjusted for age, sex, and education.
Results: Of 103 patients, 49.5% reported terminally ill status and 64.0% a non-curative treatment goal. Terminally ill status was associated with worse QOL (EORTC illness burden: 53.59 vs 35.26, p = 0.001), higher symptom burden (ESAS: 28.15 vs 16.79, p = 0.002), more functional impairment (ADLs: 3.63 vs 5.24, p = 0.006), greater hospitalization risk (HR = 2.41, p = 0.020), and worse survival (HR = 1.93, p = 0.010). We did not find associations between patient-reported treatment goal and these outcomes.
Conclusions: In older adults with advanced cancer, report of terminally ill status was associated with other important patient-reported and clinical outcomes, suggesting disease severity may inform illness perceptions. We did not find similar associations for patient-reported treatment goal, indicating that questions related to medical status and treatment goal measure different constructs and more nuanced measures are needed.

Origine : PubMed

Exploring caregivers' perspectives on improving care for older people at the end of life in Thailand

SUPAPORN, Kanyanat ; ISARAMALAI, Sang-Arun ; SUTTHARANGSEE, Wandee
International Journal of Palliative Nursing, 07/2019, vol.25, n°7, p. 326-332

The trajectory of functional decline over the last 4 months of life in a palliative care population - a prospective, consecutive cohort study

MORGAN, Deidre D. ; TIEMAN, Jennifer J. ; ALLINGHAM, Samuel F. ; EKSTROM, Magnus P. ; CONNOLLY, Alanna ; CURROW, David
PALLIATIVE MEDICINE, 06/2019, vol.33, n°6, p. 693-703

Marital status and risk of physical frailty - a systematic review and meta-analysis

KOJIMA, Gotaro ; WALTERS, Kate ; ILIFFE, Steve ; TANIGUCHI, Yu ; TAMIYA, Nanako
Journal of the American Medical Directors Association, 15/11/2019, Pagination inconnue

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Thème : Age de la vie, situations spécifiques liées à la fin de vie.

REVUE SYSTEMATIQUE ; META-ANALYSE ; MARIAGE ; VULNERABILITE ; PERSONNE AGEE

OBJECTIVES: Evidence on associations between marital status and frailty is limited. The objectives of this study were to perform a systematic review for associations between marital status and physical frailty and to perform a meta-analysis to combine findings.
DESIGN: Systematic review and meta-analysis.
SETTING AND PARTICIPANTS: Community-dwelling older people with mean age =60 years.
METHODS: Systematic literature search using 5 databases was conducted in February 2019 to identify longitudinal and cross-sectional studies examining associations between marital status and Fried's phenotype-based frailty status. Additional studies were searched for by reviewing the reference lists of relevant articles and conducting forward citation tracking of included articles. Odds ratio (OR) of marital status and frailty was pooled using a random-effects meta-analysis. Subgroup analysis and analyses stratified by gender and marital status (married, widowed, divorced or separated, and never married) were completed.
RESULTS: A total of 1565 studies were found, from which 3 studies with longitudinal data and 35 studies with cross-sectional data were included. Although longitudinal studies suggested that married men had lower frailty risks than unmarried men while married women had higher frailty risks than widowed women, meta-analysis was not possible because of different methodologies. Meta-analyses of cross-sectional data from 35 studies including 80,754 individuals showed that unmarried individuals were almost twice more likely to be frail than married individuals (pooled odds ratio = 1.88, 95% confidence interval = 1.70-2.07). A high degree of heterogeneity was observed (I2 = 69%) and was partially explained by reasons for not being married and study location. Stratified analyses showed that pooled risks of frailty in the unmarried compared with the married were not statistically different between women and women (P for difference = .62).
CONCLUSIONS AND IMPLICATIONS: Three and 35 studies, respectively, were found providing longitudinal and cross-sectional data regarding associations between marital status and frailty among community-dwelling older people. A meta-analysis of cross-sectional data showed almost twice higher frailty risk in unmarried individuals compared with married individuals. Marital status should be recognized as an important factor, and more longitudinal studies controlling for potential confounding factors are needed.

Origine : PubMed

Medication use in older, terminally ill cancer patients - are all medications appropriate? A longitudinal audit

POUDEL, Arjun ; BERRY, Robyn ; McCARTHY, Alexandra ; WALPOLE, Euan ; YATES, Patsy ; NISSEN, Lisa
PALLIATIVE MEDICINE, 10/2019, vol.33, n°9, p. 1232-1235

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Providing dignified continence care to older people at end of life

NAZARKO, Linda
International Journal of Palliative Nursing, 10/2019, vol.25, n°10, p. 504-512

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Being the next of kin of an older person living in a nursing home - an interview study about quality of life

ROSEN, Helena ; BEHM, Lina ; WALLERSTEDT, Birgitta ; AHLSTROM, Gerd
BMC GERIATRICS, 21/11/2019, vol.19, n°1, p. 1-12

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Hospice enrollment among cancer patients in Texas covered by medicare managed care and traditional fee-for-service plans - a statewide population-based study

ELTING, Linda S. ; LIAO, Kai-Ping ; GIORDANO, Sharon H. ; GUADAGNOLO, B. Ashleigh
Supportive care in cancer, 23/11/2019, p. 1-9

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Increasing nephrologist awareness of symptom burden in older hospitalized end-stage renal disease patients

JAWED, Areeba ; MOE, Sharon M. ; MOORTHI, Ranjani N. ; TORKE, Alexis M. ; EADON, Michael T.
American journal of nephrology, 19/11/2019, p. 1-6

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Thème : Médecine.

NEPHROLOGIE ; ETUDE PROSPECTIVE ; CONTROLE SYMPTOME ; PERSONNE AGEE ; FIN VIE

BACKGROUND: End-stage renal disease (ESRD) patients have significant symptom burden. Reduced provider awareness of symptoms contributes to underutilization of symptom management resources.
METHOD: We hypothesized that improved nephrologist awareness of symptoms leads to symptom improvement. In this prospective, multicenter interventional study, 53 (age >65) ESRD inpatients underwent symptom assessment using the modified Edmonton Symptom Assessment System (ESAS) at admission and 1-week post-discharge. Physicians caring for the enrollees were asked if they felt their patients would die within the year, and then sequentially randomized to receive the results of the baseline survey (group 1) or to not receive the results (group 2).
RESULTS: Fifty-two patients completed the study; 1 died. Baseline characteristics were compared. For 70% of the total cohort, physicians reported that they would not be surprised if their patient died within a year. There was no difference in baseline scores of the patients between the 2 physician groups. Severity ratings were compared between in-hospital and post discharge scores and between physicians who received the results versus those that did not. Total ESAS scores improved more in group 1 (12.9) than in group 2 (9.2; p = 0.04). Among individual symptoms, there was greater improvement in pain control (p = 0.02), and nominal improvement in itching (p = 0.03) in group 1 as compared to group 2. There were 3 palliative care consults.
CONCLUSIONS: Our findings reinforce the high symptom burden prevalent in older ESRD patients. The improvement in total scores, and individual symptoms of pain and itching in group 1 indicates better symptom control when physician awareness is increased. Residual symptoms post hospitalization and low utilization of palliative care resources are suggestive of a missed opportunity by nephrologists to address the high symptom burden at the inpatient encounter, which is selective for sick patients and/or indication of inadequacy of dialysis to control these symptoms.

Origine : PubMed

Development of a scale based on nursing outcome classification "dignified life closure" (1307) to assess end-of-life dignity of patients in care homes for the elderly

PUENTE-FERNANDEZ, Daniel ; PALMA-AYLLON, Elena ; SANCHEZ-GARCIA, María Remedios ; HUESO-MONTORO, César ; ESTEBAN-BURGOS, Ana Alejandra ; MONTOYA-JUAREZ, Rafael
International journal of nursing knowledge, 19/11/2019, Pagination inconnue

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Best evidence for advance care planning in older adults with dementia and their families - an umbrella review protocol

KONNO, Rie ; INOUE, Kumiyo ; SCHULTZ, Tim ; WIECHULA, Rick
JBI database of systematic reviews and implementation reports, 20/11/2019, p. 1-8

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The clinical frailty scale predicts inpatient mortality in older hospitalised patients with idiopathic Parkinson's disease

TORSNEY, K. M. ; ROMERO-ORTUNO, R.
The journal of the Royal College of Physicians of Edinburgh, 06/2018, vol.48, n°2, p. 103-107

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End-of-life care for frail older people

HARWOOD, Rowan H. ; ENGUELL, Hannah
BMJ supportive and palliative care, 15/11/2019, Pagination inconnue

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Addressing palliative and end-of-life care needs with native American elders

ISAACSON, Mary J.
International Journal of Palliative Nursing, 02/04/2018, vol.24, n°4, p. 160-168

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Communication quality predicts psychological well-being and satisfaction in family surrogates of hospitalized older adults - an observational study

TORKE, Alexia M. ; CALLAHAN, Christopher M. ; SACHS, Greg A. ; WOCIAL, Lucia D. ; HELFT, Paul R. ; MONAHAN, Patrick O. ; SLAVEN, James E. ; MONTZ, Kianna ; BURKE, Emily S. ; INGER, Lev
Journal of general internal medicine, 01/01/2018, vol.33, n°3, p. 298-304

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Disease trajectories and end-of-life care for dementias - latent topic modeling and trend analysis using clinical notes

WANG, Liqin ; LAKIN, Joshua ; RILEY, Clay ; KORACH, Zfania ; FRAIN, Laura N. ; ZHOU, Li
AMIA ... Annual symposium proceedings. AMIA symposium, 2018, vol.2018, p. 1056-1065

Multimorbidity and opioid prescribing in hospitalized older adults

SCHEAR, Sarah ; PATEL, Kanan ; DENG, Lisa X. ; MIASKOWSKI, Christine ; MARAVILLA, Ingrid ; GARRIGUES, Sarah K. ; THOMPSON, Nicole ; AUERBACH, Andrew D. ; RITCHIE, Christine S.
JOURNAL OF PALLIATIVE MEDICINE, 05/11/2019, Pagination inconnue

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