Sage Palliative Medicine & Chronic Care

This episode features Laura Health (Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK). COVID-19 has a mortality of between 1% and 2% and is the deadliest pandemic in living memory. The elderly, and those with pre-existing conditions tend to be most vulnerable to severe disease and death. Common symptoms experienced at the end of life include breathlessness and...

This episode features Benjamin Thomas (Palliative Care Service, Illawarra Shoalhaven Local Health District, Warrawong, NSW, Australia). Terminal delirium is a common symptom at the end of life, causing distress to patients and families. Traditional management for terminal delirium requires sedation, which limits interaction and rousability. This study is the first to report on the use of dexmedeto...

This episode features Dr Lucy Selman  (Palliative and End of Life Care Research Group, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK). Twitter is a rich repository of data reflecting contemporaneous public opinion. The idea of dying alone is contrary to the concept of a 'good death' in many cultures, and not being able to say goodbye is a known risk factor...

This episode features Dr Lucy Selman  (Palliative and End of Life Care Research Group, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK). During COVID-19, infection control measures have prevented many family members from being with seriously ill or dying loved ones, and impacted on after-death mourning practices and bereavement. Clinicians and funeral officia...

This episode features Dr Stephanie Ament (Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands). Identification of palliative care needs in patients with chronic heart failure may be more appropriate for the delivery of optimal care than the application of prognostic models to estimate the risk of dying. Interdiscipli...

This episode features Dr Geraldine Foley (Discipline of Occupational Therapy, School of Medicine, Trinity College Dublin, Trinity Centre for Health Sciences, Dublin, Ireland). Gerladine provides a summary of her letter, where she discusses how researchers have an opportunity to identify and learn from the benefits and/or challenges of conducting video-based online interviews with patients and care...

This episode features Professor María Arantzamendi (Institute for Culture and Society-ATLANTES, Universidad de Navarra, Pamplona, Spain). In the context of patients with incurable disease palliative sedation is used for refractory symptom control. A minority of articles measure the effect of palliative sedation and current assessment of parameters of such effect is limited. The literature about pa...

This episode features Jonathan Bayuo (Presbyterian University College, Abetifi, Eastern, Ghana and The Hong Kong Polytechnic University, Kowloon, Hong Kong). The immediacy of death in the burn unit is usually in the order of hours or days requiring the timely application of palliative care. Although the culture of burns/ critical care units is evolving the support the integration of palliative car...

This episode features Dr Catriona Mayland (University of Sheffield, Sheffield, UK). Advanced head and neck cancer patients have specific challenges due to the impact of the illness on vital functions such as eating, speaking and breathing. Identifying the palliative care needs of this specific cancer subgroup would help provide guidance about how services could best provide care. Advanced head and...

This episode features Jeanna Qiu (Harvard Medical School, Boston, MA, USA). Maintaining quality of life for patients with malignant fungating wounds requires collaboration of diverse healthcare specialties, from oncology and palliative care to wound care. Research has explored the experiences of patients with malignant fungating wounds and the nurses who treat them. It is essential to understand t...

This episode features Dr Bridget Candy (Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK). A systematic review of effectiveness data on aromatherapy, massage and reflexology in palliative care drew inconclusive conclusions. A systematic review of qualitative evidences shows palliative care patients highly value complementary therapy. No...

This episode features Dr Katie Ekberg (School of Early Childhood and Inclusive Education, Queensland University of Technology, Australia) and Dr Anthony Herbert (School of Early Childhood and Inclusive Education, Queensland University of Technology, Australia). The urgency of caring for children with complex and serious conditions ensures that care must continue during the Coronavirus Disease 2019...

This episode features Dr Yakubu Salifu (International Observatory on End of Life Care, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, Lancashire, UK). Caring for a family member with advanced prostate cancer in the home presents practical and emotional challenges, especially in resource-poor contexts, where there are increasing palliative cases withou...

This episode features Dr Dominika Lisiecka (Department of Nursing and Healthcare Sciences, School of Health and Social Sciences, Institute of Technology Tralee, Tralee, Ireland). Amyotrophic lateral sclerosis causes multiple neurodegenerative symptoms including dysphagia, which impacts on person's ability to eat and drink in a safe way and can contribute to chest infections, pneumonia and death. F...

This episode features Kerry Micklewright and Dr Morag Farquhar (School of Health Sciences, University of East Anglia, Norwich, UK). Informal carers play a vital role in supporting patients with chronic obstructive pulmonary disease (COPD). COPD carers may have unidentified support needs that could be a target for intervention by clinicians. The Carer Support Needs Assessment Tool (CSNAT) is an evi...

This episode features Minna Hökkä (Research Unit of Nursing Science and Health Management, Medical Department, Oulu University, Oulu, Finland). Palliative care is provided across a wide range of healthcare settings, from tertiary hospitals to primary care. It has been recognized that palliative care services should be delivered in at least two or three levels (i.e., palliative care approach, gener...

This episode features Rebecca Anderson (Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK). Honest prognostic communication with families of patients in the final hours and days of life is important for enabling a good death and for families' preparedness for that death. Prognostic uncertainty makes this communication challenging for cli...

This episode features Dr Emily Harrop (Marie Curie Research Centre, Division of Population Medicine, Cardiff University, Cardiff, UK). The support needs of people experiencing bereavement vary significantly. Bereavement support in palliative care involves different types and levels of provision to accommodate these needs. Specialist grief therapy is known to be effective for those with high-level...

This episode features Professor Catherine Walshe (International Observatory on End of Life Care, Lancaster University, UK).  Publication bias is known, but usually associated with direction of research findings. Bibliographic analysis of databases shows publication rates differ between countries, and an increase in total number of publications over time. No journal focused analysis has yet been un...

The palliative care needs of infants, children and young people differ to those of adults. The broad spectrum of paediatric life-limiting or life-threatening conditions mean that symptoms are varied and complex to manage. The UK National Institute for Health and Care Excellence (NICE) has emphasised pain management in paediatric palliative care as a research priority. This is the first systematic...

This episode features Emel Yorganci (Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, London, UK).  Usual care provided to patients is rarely described in detail in randomised controlled trials (RCTs) of a complex intervention in palliative care. To interpret the effectiveness of interventions tested within RCTs, the care provided in the comparison arm must be described. Appr...

This episode features Kim de Nooijer and Sophie van Dongen (Erasmus University Medical Center, Rotterdam, Netherlands).   Self-management has predominantly been studied in the context of chronic diseases, where it has been defined as 'the ability to manage the symptoms, treatment, physical and psychosocial consequences, and lifestyle changes inherent in living with the condition'. Patients with ad...

This episode features Dr Catriona Mayland (University of Sheffield, UK).  Few large studies describe initial disease trajectories and subsequent mortality in people with head and neck cancer. This is a necessary first step to identify the need for palliative care and associated services. This prospective cohort study recruited 5402 people with a new diagnosis of head and neck cancer from 76 UK can...

This episode features Dr Deokhee Yi (Cicely Saunders Institute of Palliative Care, King's College London). Large variation exists in the health service use near the end of life and a 10% of patients are especially high-cost users. A high proportion of care costs in the last year of life occur in the last 3 months. Patients nearing the end of life often prefer to be cared for at home, but habituall...