End-of-life preferences in elderly patients admitted for heart failure

Formiga, Francesç; Chivite, David; Ortega, Consuelo Varela; Casas, Susana; Ramón., José; Pujol, Ramón

doi:10.1093/qjmed/hch135

Cited by 99 publications

(68 citation statements)

References 33 publications

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“…ACP remains uncommon. 9,65,105,[140][141][142][143] National surveys report no strong resistance to or discomfort about talking about death among the public. 65,134 However, despite sustained campaigns to encourage public and professional engagement in ACP, only 5-6% of respondents have documented their preferences for EOLC.…”

Section: Uptake and Initiation Of Advance Care Planningmentioning

confidence: 99%

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Care and communication between health professionals and patients affected by severe or chronic illness in community care settings: a qualitative study of care at the end of life

Pollock

Wilson

2015

Health Serv Deliv Res

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(2015) Care and communication between health professionals and patients affected by severe or chronic illness in community settings: a qualitative study of care at the end of life. Health Services Delivery and Research, 3 (31). ISSN 2050-4349 Access from the University of Nottingham repository: http://eprints.nottingham.ac.uk/35464/2/FullReport-hsdr03310.pdf Copyright and reuse:The Nottingham ePrints service makes this work by researchers of the University of Nottingham available open access under the following conditions. This article is made available under the Creative Commons Attribution Non-commercial licence and may be reused according to the conditions of the licence. For more details see: http://creativecommons.org/licenses/by-nc/2.5/ A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription.For more information, please contact eprints@nottingham.ac.uk This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/). HEALTH SERVICES AND DELIVERY RESEARCHEditorial contact: nihredit@southampton.ac.ukThe full HS&DR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hsdr. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Services and Delivery Research journalReports are published in Health Services and Delivery Research (HS&DR) if (1) they have resulted from work for the HS&DR programme or programmes which preceded the HS&DR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. HS&DR programmeThe Health Services and Delivery Research (HS&DR) programme, part of the National Institute for Health Research (NIHR), was established to fund a broad range of research. It combines the strengths and contributions of two previous NIHR research programmes: the Health Services Research (HSR) programme and the Service Delivery and Organisation (SDO) programme, which were merged in January 2012.The HS&DR programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services including costs and outcomes, as well as research on implementation. The programme will enhance the strategic focus on research that matters to the NHS and is keen to support ambitious evaluative research to improve health services.For more information about the HS&DR programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hsdr This reportThe research reported in this issue of the journal was funded by the HS&DR programme or one of its preceding programmes as project number 10/2002/23. The contractual start date was in April 2012. The final report began...

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Section: Uptake and Initiation Of Advance Care Planningmentioning

confidence: 99%

“…Evidence accumulates about the complex situational factors underlying decisions and the varied preferences which may subsequently be expressed. 22,59,66,69,142,180 The focus on place has deflected attention from how death is experienced in different settings. 69,72,73,77,179 Patients tend to adopt a pragmatic stance to place of death.…”

Section: 132139mentioning

confidence: 99%

Care and communication between health professionals and patients affected by severe or chronic illness in community care settings: a qualitative study of care at the end of life

Pollock

Wilson

2015

Health Serv Deliv Res

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“…The care context, in which 'cure' is the goal, may present an important barrier to engaging clinicians and individuals in inherently time-consuming conversations about quality-of-life and endof-life planning and care, with which they may be far less comfortable. In addition, a review of cardiovascular deaths in one Canadian metropolitan health region suggested that few patients with CVD died at home or in hospice (J Brown, personal communication), despite evidence suggesting that 50% to 75% of patients with HF would, if given the opportunity and support, choose to die at home (25). While this may not mean we need to increase the number of patients who die at home, all patients at the end of life should have access to support and comfort in the location of their choice.…”

Section: Care Contextmentioning

confidence: 99%

End-of-life planning in heart failure: It should be the end of the beginning

Howlett

Morrin

Fortin

et al. 2010

Canadian Journal of Cardiology

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Cardiovascular disease (CVD) is a chronic, progressive, incurable condition characterized by periods of apparent stability interspersed with acute exacerbations. Despite many important advances in its treatment, approximately one-third of deaths in Canada each year result from CVD. While this might lead one to assume that a comprehensive medical approach exists to the management of this inevitable outcome, the reality is much different. The current Canadian medical model emphasizes the management of acute exacerbations of CVD during which end-of-life issues figure frequently and prominently, although in a setting that is inappropriate to address the comprehensive needs of patients and their families. As a result, end-of-life care was made a theme of the recently reported Canadian Heart Health Strategy and Action Plan (www.chhs-scsc.ca). From this, several recommendations are made, central to which is the need to reframe CVD as a condition ideally suited to a chronic disease management approach. In addition, replacement of the term 'palliative care' with the term 'end-of-life planning and care' is proposed to foster earlier and more integrated comprehensive care, which, it is proposed, denotes the provision of advanced care planning, palliative care, hospice care and advanced directives, with a focus on decision making and planning. Finally, end-of-life planning and care should be a routine part of assessment of any patient with CVD, should be reassessed whenever important clinical changes occur and should be provided in a manner consistent with relevant CVD practice guidelines. Specifically, a Canadian strategy to improve end-of-life planning and care should focus on the following:• Integrated end-of-life planning and care across the health care system; • Facilitated communication and seamless care provision across all providers involved in end-of-life planning and care; • Adequate resources in the community for end-of-life planning and care; • Specialized training in sensitive communication and supportive care as part of core training for all members of the interdisciplinary care team; • Measurement of key performance indicators for end-of-life planning and care; and • Research into effective end-of-life planning and care. Heart failure is an advanced form of CVD with very high morbidity, mortality and burden of care, making it an ideal condition for implementation and testing of interventions to improve end-of-life planning and care. Les maladies cardiovasculaires (MCV) sont des maladies chroniques, évolutives et incurables caractérisées par des périodes de stabilité apparente entrecoupées d'exacerbations aiguës. Malgré les nombreux progrès importants du traitement, environ le tiers des décès au Canada découlent d'une MCV. On pourrait penser qu'il existe une approche médicale approfondie pour prendre en charge cette issue inévitable, mais la réalité est bien différente. Le modèle canadien actuel fait ressortir la prise en charge des exacerbations aiguës des MCV pour lesquelles les enjeux de fin de vie ont une ...

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“…However, there are indications that the disease symptoms often fluctuate in patients with non-cancer illnesses, such as end-stage chronic obstructive pulmonary disease (COPD) or heart failure, and the course of the disease is therefore difficult to predict. [3][4][5] It can be expected that the shift towards palliative care in these patients may only take place shortly before death and that identifying a time point for transition to palliative care is more difficult for people with COPD, for instance. 6 The course of the disease in patients with incurable cancer maybe relatively predictable, with a clearer demarcation between the curative and palliative stages.…”

Section: Introductionmentioning

confidence: 99%