High-dose neuroleptics and neuroleptic rotation for agitated delirium near the end of life.

Reason For The Study: Agitated delirium presents unique challenges for hospice and palliative care clinicians. Haloperidol, the recommended neuroleptic, may be ineffective at low dose, or poorly tolerated at higher doses.

Main Findings: This article reports on two patients with refractory agitated delirium.

Inadvertent ophthalmic administration of atropine drops in a hospice patient.

This case report describes a patient who had atropine ophthalmic drops prescribed and dispensed by hospice to be administered sublingually as needed for control of secretions at the end of life. However, even as she stabilized and discharged from hospice, these remained on her medication list. At a subsequent hospitalization, this order was misinterpreted and the drops were ordered to be administered in both the eyes 3 times a day while in the hospital and were included in her discharge medication list.

Incorporating routine survival prediction in a U.S. hospital-based palliative care service.

Background: Prognostication is a core component of palliative care consultation. We sought to incorporate predicted survival into the routine practice of our hospital-based palliative care team.

Methods: The predicted survival was determined by the physician and/or nurse at the time of initial palliative care consultation using categories that parallel the rough time frames often shared with patients and used in planning care: (1) ≤3 days, (2) 4 days to 1 month, (3) >1 month to 6 months, (4) >6 months.

Survival, mortality, and location of death for patients seen by a hospital-based palliative care team.

Background: Little is known about patient outcomes after discharge planning by inpatient palliative care teams. A major difficulty is that successful discharge planning often effectively limits or ends the team's relationship with the patient and family. The goal of this study was to gather a clearer picture of what happened to our palliative care consult patients after discharge.