Acute palliative care units: characteristics, activities and outcomes – scoping review

Abstract

Acute palliative care units (APCUs) are lacking in most cancer hospitals and even when palliative care units are present, they are predominantly based on a traditional hospice-like model for patients with short life expectancy. This scoping review examined the papers assessing the activities of APCU. Data from literature regarding APCU characteristics, activities and outcomes have shown important differences among different countries.In comparison with existing data on traditional hospices, APCU provided a whole range of palliative care interventions, from an early treatment of pain and symptoms at time diagnosis and during the oncological treatment, up to the advanced stage of disease when they may favour the transition to the best supportive care or palliative care only, also indicating the best palliative care service that may fits the clinical and social condition of individuals. Large differences in the characteristics of such units, including hospital stay and mortality, have been evidenced, in some cases resembling those of a traditional hospice. It likely that in some countries such units supply the lack of other palliative care services.Further studies on APCUs are needed, even on other outcome processes, to provide a more precise identification among the palliative care settings, which should not interchangeable, but complimentary to offer the full range of activities to be activated according to the different needs of the patients.

Tertiary Inpatient Palliative Care within Region-Wide Services: A Retrospective Examination of Psychosocial and Medical Demographics at Admissions

“…The rate of discharge home in our sample was 49.6%, including those in the final weeks or months of life, which is comparatively higher than other Canadian TPCUs (contrast 9.2-39%) [18,25,26]. Again internationally, this varies greatly with rates ranging from 10 to 91.2% [14]. Presumably, this is related to the availability of services and patterns of early/late palliative referrals (e.g., TPCU and hospice combined) [14][15][16][17][18].…”

“…It is also lower than the overall hospital mortality rate in Calgary for patients with cancer (41%) [8]. Internationally, the hospital mortality rate varies greatly (3.8-87%), possibly attributable to differing practices of early palliative referrals [14][15][16][17][18]. The rate of discharge home in our sample was 49.6%, including those in the final weeks or months of life, which is comparatively higher than other Canadian TPCUs (contrast 9.2-39%) [18,25,26].…”

“…Interdisciplinary treatment plans aim to collaboratively address multidimensional sources of suffering with the goal of ensuring comfort and quality of life. TPCUs may also serve as hospices, supporting dying and death [13,14].…”

The Effect of Back Massage Applied to Palliative Care Patients on Sleep Quality and Pain

“…Palliative care units are predominantly based on the traditional hospice-like model for patients with short life expectancy. Many care services, especially pain relief, are provided in these units (2). Especially end-stage malignancy patients constitute an important part of palliative care centers.…”

A Month of Diagnostic Imaging Studies in an Acute Supportive/Palliative Care Unit

“…In comparison with existing data on traditional hospices, acute supportive/palliative care units (ASPCU) offers a whole range of palliative care interventions, from an early treatment of pain and symptoms, even at time diagnosis and during the oncological treatment, up to the advanced stage of disease, when they may favour the transition to best supportive care or palliative care only. Moreover, APCUs may indicate the best palliative care service that ts the clinical and social condition of patients (2). This crossroad has a fundamental role to avoid disproportionate treatments and to provide the best available care (3,4).…”