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Characteristics of patients who die in an acute palliative care unit.
Support Care Cancer
December 2024
Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, 90127, Palermo, Italy.
Article Synopsis
- The study assessed characteristics and death risk factors for advanced cancer patients in an acute palliative care unit (APCU).
- Fifty-four out of 450 patients (12%) died in the APCU, with significant differences noted in aspects like cognitive decline, referral source, cachexia, and symptom burden between those who died and those who were discharged alive.
- Key factors linked to dying in APCU included being referred from home palliative care, experiencing high symptom burdens, and being off cancer treatment, indicating the need for improved end-of-life care strategies for these patients.
Strategies to improve research participation by older people with cognitive impairment: a systematic review.
Gerontologist
December 2024
School of Medicine and Nursing Sydney, University of Notre Dame Australia, Darlinghurst, NSW, Australia.
Background And Objectives: Older people with cognitive impairment are unrepresented in clinical research. Our objective was to review evidence for strategies to support their research inclusion and participation.
Research Design And Methods: Systematic review of published reports of inclusion and participation strategies for older people with cognitive impairment in clinical research (PROSPERO CRD42020212092).
Delirium Motor Subtypes and Severity of Physical Symptoms in Patients with Advanced Cancer in Inpatient Hospice/Palliative Care Units: A Multicenter Prospective Cohort Study.
J Palliat Med
December 2024
Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
Article Synopsis
- Delirium alters cognitive function and may impact the severity of physical symptoms like pain and dyspnea in palliative care patients, but the specific effects of different motor subtypes of delirium are not fully understood.
- A study analyzed patient data from 23 hospices in Japan, focusing on advanced cancer patients who experienced delirium and its motor subtypes at the time of admission and later on.
- Results indicated that patients with hyperactive or mixed delirium had significantly higher odds of experiencing severe pain and dyspnea compared to those without delirium, while hypoactive delirium did not show a similar association.
Prevalence of falls in the last weeks of life and relationship between falls, independence and quality of dying in Japan: a large prospective cohort study.
BMJ Open
November 2024
Palliative and Supportive Care Division, Seirei Mikatahara Hospital, Hamamatsu, Japan.
Article Synopsis
- The study investigates the frequency and complications of falls in palliative care units (PCUs) for advanced cancer patients and how these relate to independence and quality of dying.
- Among 1,633 patients observed, 150 (9.2%) experienced falls in the last month of life, primarily due to needing to use the toilet, with serious injuries being very rare.
- The findings suggest that while falls can be common, they are not necessarily harmful and may reflect a patient's independence, indicating that healthcare providers should balance fall prevention with supporting patient autonomy.
Dexmedetomidine Versus Midazolam for End-of-Life Sedation and Agitation: Protocol for a Randomized Controlled Trial (The DREAMS Trial).
JMIR Res Protoc
September 2024
Graduate School of Medicine, University of Wollongong, Wollongong, Australia.
Article Synopsis
- The DREAMS trial investigated the effectiveness of dexmedetomidine versus midazolam for lighter sedation in terminally ill patients, aimed at alleviating distressing symptoms while maintaining some level of interaction with loved ones.
- Participants were adults receiving end-of-life care in Australia, who preferred lighter sedation, and were randomized to receive either drug through continuous subcutaneous infusion.
- The study assessed patients' levels of consciousness and agitation using specialized scales, and also collected comfort feedback from families and patients to evaluate the overall impact of the sedation methods.
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