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Clinical review
Fatigure and depression in patients with advanced metastatic disease
Published: 2009 Vol: 3 No: 2 Patients with advanced cancer often experience symptoms that impact negatively on their quality of life in the final phase of the disease process. Such symptoms include fatigue and depression. Fatigue is common in patients with advanced cancer. Depression is also a significant symptom among palliative care patients and patients with advanced metastatic disease. Both symptoms may prove difficult...
Editorial
Emulating a role model will improve communication skills
Published: 2008 Vol: 2 No: 4
In the last three editorials, the theme of communication has been explored. Issues discussed include how nurses deal with complaints, engage in the process of ‘being there’ for patients and families, or communicate the importance of end-of-life care (EoLC) strategies to their colleagues, encouraging them to take an active role in planning EoLC. Effective communication skills underpin the...
Editorial
Care of the dying is not an option but a nursing necessity
Published: 2007 Vol: 1 No: 1
Nurses are the professionals who deliver the majority of care to dying people. About six out of 10 people die in acute hospital settings, with only two dying in their home and a further two dying in care homes. However, for most people in the UK, the last year of life will be spent at home.
Editorial
Hygiene care for dying people is a symptom management issue
Published: 2007 Vol: 1 No: 2
One Saturday I visited a dying patient at home. I was accompanied by a medical colleague. The patient had been discharged from hospital a week previously following an abdominal paracentesis (removal of excess fluid from the peritoneal cavity (ascites) by inserting a surgical drain through the abdominal wall). The patient had expressed a wish to die at home.
Editorial
Compassion in nursing and its importance in end-of-life care
Published: 2010 Vol: 4 No: 1 Nursing is skilled compassion.
Without compassion, one
cannot nurse. In essence,
compassion is sympathetic and
empathetic pity and concern for the
suffering or misfortune of others.
Many people confuse sympathy and
empathy, using the terms interchangeably.
However, they are quite different and
it is really important that the difference
is understood. Sympathy, as part of
compassion, means to have...
Editorial
The practice of end-of-life care is the essence of nursing
Published: 2008 Vol: 2 No: 2 I have just finished reading the latest report published by the Healthcare Commission (HCC) Spotlight on Complaints (HCC, 2008). It reiterates guidance issued in a previous report about the need for ‘providers to apologise to patients and their families when something has gone wrong’. Spotlight on Complaints states that, in one out of 10 cases referred to the HCC, the person making the complaint...
Editorial
The importance of therapeutic relationships at the end of life
Published: 2010 Vol: 4 No: 4
Dame Cicely Saunders once wrote that central to end-of-life care (EoLC) is the acknowledgement of potential, continued human growth and dignity despite weakness and loss. She also asserted that no member of the multiprofessional team is more central to such human discovery than the nurse (Saunders, 2006). Therapeutic nurse/patient relationships are highly valued by patients and nurses alike.
Editorial
End of Life Care Strategy: a key milestone in care of the dying
Published: 2008 Vol: 2 No: 3 The long-awaited, first ever End of
Life Care Strategy was launched in
England last month (Department
of Health (DH), 2008). It is a major,
government-funded initiative that sets out
a comprehensive framework for caring
for people, with dignity and respect, at the
end of their lives. It addresses end-of-life
care (EoLC) in all settings — hospitals,
the community and care homes — and
recognises...
Editorial
The detrimental effect of lack of nurses on end-of-life care
Published: 2010 Vol: 4 No: 2 End-of-life care (EoLC) is currently high on the political agenda. The government has stated that ‘better care for the dying should become a touchstone for success in the modern NHS’ (Department of Health (DH), 2008). The End of Life Care Strategy, launched in 2008, is a government-funded initiative setting out comprehensive guidance enabling the provision of dignified and respectful EoLC.
Editorial
Patients' symptoms cannot be managed by medication alone
Published: 2007 Vol: 1 No: 3 What does a ‘black box’ have to do with end-of-life care? The term ‘black box’ refers to a collection of different recording devices used in transportation, for example, the flight data and cockpit voice recorder in aircraft. The recovery of the black box is considered to be second only in importance to the recovery of bodies following a fatal air crash. Black box is also a term used in physics...
Editorial
Competence in end-of-life care does not need special skills
Published: 2009 Vol: 3 No: 3 T he husband of a colleague died
recently. He had been suffering
from long-term chronic health
problems and was physically disabled.
He had been living quite happily in a
care home for some months. When his
condition suddenly deteriorated he was
transferred to hospital where he was
admitted to an acute assessment ward.
He died a few days later.
Clinical skills
The dying touch: infection control at the end of life
Published: 2007 Vol: 1 No: 2
Vulnerable individuals who use healthcare services are susceptible to the possibility of acquiring a healthcare-associated infection (HCAI). Government guidance has concentrated on providing strategies that assist in the reduction of such infections. All organisations that provide health and social care should have policies and procedures in place to reduce the risk of patients acquiring an...
Editorial
Issues relating to nutrition and hydration at the end of life
Published: 2010 Vol: 4 No: 3
The personal narrative in this issue (pages 64–65) is a stark reminder of the despair relatives/ friends experience when they perceive care and communication at the end of life to be inadequate. Cessation of active management can be considered abandonment, especially when dying patients are made ‘nil by mouth’. The provision of food and fluids at the end of life requires examination in the...
Editorial
Debating issues around death and dying in general settings
Published: 2009 Vol: 3 No: 4 Over the last few weeks there has
been a stream of letters in UK
national newspapers debating
different aspects of care associated with
people who are dying. In particular, there
has been a critique of the Liverpool Care
Pathway for the Dying Patient (LCP)
documentation (Ellershaw and Wilkinson,
2003), hydration at the end of life and ‘do
not attempt resuscitation’ orders. For many
in health care...
Clinical skills
Principles of skin and wound care: the palliative approach
Published: 2007 Vol: 1 No: 1
The term ‘palliative care’ is used to describe care given to patients with advanced, life-limiting illness of any aetiology. It is a philosophy of care that is patient and family-centred, designed to meet the needs of the patient and family. Wound care for palliative care patients should be managed so that patient and family needs/concerns are the main focus of attention. Dressing products...
Editorial
What does 'being there' mean in the context of nursing?
Published: 2008 Vol: 2 No: 1 It is important for nurses to know themselves — their limitations, their ability to meet patients’ spiritual and psychological needs and where to turn if meeting those needs is problematic. The notion of ‘being there’ for patients is not a new concept. Palliative care literature often makes reference to this idea. The need for nurses to empathise, value, listen and build relationships with...
Editorial
'I don't care about the injection nurse - just stay with me!'
Published: 2009 Vol: 3 No: 1 A recurrent theme throughout
this issue of End of Life Care
is the importance of ‘staying’
with patients. ‘Staying’ is part of the
professional act of caring. It involves
remaining physically and emotionally
present for patients throughout their
pain or emotional anguish. It does not
necessarily involve trying to do something
practical.
Clinical skills
Assessment/management of the mouth at the end of life
Published: 2008 Vol: 2 No: 1 A dry and sore mouth tends to be viewed as a minor symptom in comparison to complex symptoms, such as pain and nausea, when experienced by patients with terminal disease. However, a clean and pain-free mouth has a big impact on patients’ physical, sociological and psychological functioning. Dry mouth (xerostomia) is a common symptom of many palliative care medications, most specifically opioids....
Clinical skills
Speech and language therapy techniques in end-of-life care
Published: 2009 Vol: 3 No: 1 The role of rehabilitation therapies in palliative and end-of-life care is gaining increasing recognition. At present, there are few speech and language therapists (SLTs) within multidisciplinary, palliative care teams in the UK, although the number is increasing. SLTs are specialists in assessing, diagnosing and supporting patients with communication needs and swallowing difficulties. The...