Sage Palliative Medicine & Chronic Care

This episode features Danni Collingridge Moore (International Observatory on End of Life Care, Lancaster University, Lancaster, UK). The provision and quality of palliative care delivered in long-term care facilities (LTCFs) varies and does not always meet the needs of the residents. Interventions to improve palliative care have been shown to lead to improvements in the quality of care received by...

This episode features Dr Bridget Candy and Dr Megan Armstrong (Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK). Aromatherapy, massage and reflexology are widely used in palliative care. Patients themselves often report that these therapies are helpful. It is important to demonstrate value for money in health care service provision inc...

This episode features Dr Nicola White  and Dr Linda Oostendorp (Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London (UCL), London, UK). Recognising dying is a core clinical skill. There is inconsistent training in the United Kingdom and both medical students and doctors report feeling unsure and ill prepared when working with a dying patient and their...

This episode features Brett Scholz (Medical School, The Australian National University, Acton, ACT, Australia).  Consumer involvement is required by policy at all levels of health services. Some health disciplines have well-established research programmes focusing on consumer leadership. Palliative care is philosophically consumer-centred, but there has been less of a focus on consumer leadership...

This episode features Mary Scott (Ottowa Hospital Research Institute. Bruyere Research Institute). Many patients and families report improved satisfaction of care when palliative care when they are supported by palliative care specialist teams. Transitions of care from one setting to another are burdensome. Evidence suggests that palliative care can improve this transition from hospital to communi...

This episode features Dr Amara Nwosu (Palliative Care Institute Liverpool and Marie Curie Hospice Liverpool, Liverpool, UK).  Medical robots have mainly been used to support surgical procedures and for a variety of assistive uses in dementia and elderly care. There has been limited debate about the potential opportunities and risks of robotics in other areas of palliative, supportive and end-of-li...

This episode features André Filipe Ribeiro (Universidade do Porto, Porto, Portugal). The number of patients with morbidities and other complex injuries due to burns has grown over the years. This kind of burn injuries can have a high impact in the physical and psychological health, cause social transformations and changes in role functioning. Palliative care is an active and global specialty of ca...

This episode features Rebecca Anderson (Marie Curie Palliative Care Research Department,  University College London, London, UK).  Poor communication from healthcare professionals is a common complaint from relatives of patients at the end-of-life. Communication with relatives at this time is important for high quality end-of-life care and for relatives' long-term well-being. Common communication...

This episode features Professor Miriam Johnson (Hull York Medical School, UK). People with heart failure have poor access to palliative care. People with advanced heart failure have poorer access to palliative care than people with cancer and the evidence base in support of heart failure palliative care is less developed. This systematic review draws together the current literature, both observati...

This episode features  Dr Bridget Candy and Dr Megan Armstrong (Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK)      Conventional therapies are not always sufficient to provide satisfactory relief of symptoms to those at an advanced stage of a disease. Evidence on the effectiveness of complementary therapies improving the well-being o...

This episode features Deidre Morgan (Palliative and Supportive Services, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia).   Functional decline can be anticipated for people with life-limiting illnesses. Trajectories of functional decline differ in shapes and patterns. Understanding patterns of functional decline has implications for patient care and design of...

This episode features Katrin Gerber ( National Ageing Research Institute & Queensland University of Technology).   Research  suggests that people generally would like to receive their end of life care at home. This study aimed to examine the decision making process of how preferences are formed. This qualitative study involved interviews of 9 terminally patients and 8 family carers. The authors fo...

This episode features Sarah Combes (Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, UK).   Older people living with frailty are projected to become one of the largest future users of palliative care. Advance care planning can improve person centred end of life care. However advance care planning is relatively uncommon in frail elders due to many challen...

This episode features Dr Bella Vivat (Marie Curie Palliative Care Research Department, UCL, London, UK) and Professor Paddy Stone (Marie Curie Palliative Care Research Department, UCL, London, UK).   Sedative medication may be used to manage intractable symptoms at the end of patients' lives. No UK guidelines specifically address the detail of how sedatives should be used, but international guidel...

This episode features Dr Catriona Mayland (University of Sheffield, UK).   The Quality of Death Index showed variability in the international provision of care for the dying. In order to improve care, we need to have validated outcome measures to assess the current quality of care. One method of evaluation is to use the views from the bereaved relatives to assess their own perceptions and as proxy...

This episode features Dr Ann Dadich (Western Sydney University, Austrailia) Specialist home-based palliative care can improve symptom management and quality of life and prevent hospitalisation at the end-of-life. There is significant variation in how home-based palliative care is delivered, even within similar jurisdictions. The clinical practices and contextual factors that enable exemplary palli...

This episode features Dr Simon Etkind (Cicely Saunders Institute,  King's College London, London, UK).   To be person-centred, care should take into account individual preferences. Some influences on care preferences in older people have been described. These include the family and care context, individual response and illness-related factors. Older people living with frailty are at high risk of a...

This episode features Dr Huw Williams ( Cardiff University, UK) Around 2% –3 % of consultations in primary care are prone to patient safety incidents. Patients receiving palliative care are not immune to patient safety concerns. 'Out-of-hours' services are responsible for providing care for two-thirds of the working week (18:30 to 08:00 on weekdays, and all hours at weekends in the United Kingdom)...

This episode features Dr Sophie Rees ( University of Warwick, Coventry, UK ) and Dr Ann Hutchinson ( University of Hull, Hull, UK ) Cancer patients are at an increased risk of thrombosis. Current guidance for treatment is injected anticoagulants although there is some doubt as to the long-term acceptability of injections to patients. Many cancer patients are unaware of their increased risk of thro...

This episode features Dr Alex Chan (Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA). Routine assessment of many established quality indicators is nearly impossible because the information is embedded as unstructured free text within electronic clinical notes. A key example of this is timely documentation of patient care preferences in critically i...

This episode features Dr Hazel Coop and Dr Clare Marlow (WM CARES (West Midlands Collaborative Actioning Research in End of life and Supportive care), New Cross Hospital, Wolverhampton, UK). This regional survey  aimed to determine whether palliative care professionals in the West Midlands (United Kingdom) have discussions about digital legacy with their patients. A total of 210 questionnaire surv...

This episode features Dr Cathy Payne (Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK). This qualitative study aimed to explore the experiences and perceptions of patients and healthcare professionals on the feasibility and acceptability of palliative rehabilitation during advanced lung cancer treatment. The results of this study demonstrated that patient participants...

This episode features Dr Karen Neoh (St Gemma's Academic Unit of Palliative Care, University of Leeds, Leeds, UK). This national audit  aimed to determine national transfusion practice in hospices and compare this against National Institute for Health and Care Excellence and British Society of Haematology guidelines to develop recommendations to improve practice. The results demonstrated that pati...

This episode features Professor Mari Lloyd Williams (Academic Palliative and Supportive Care Studies Group, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK). This was a pilot trial to determine the effect of a focused narrative intervention on depression in palliative care patients when used in addition to usual care. The study found that focused narrative inter...