“We Are Strangers Walking Into Their Life-Changing Event”: How Prehospital Providers Manage Emergency Calls at the End of Life

Waldrop, Deborah P.; Clemency, Brian M.; Lindstrom, Heather A.; Cordes, Colleen

doi:10.1016/j.jpainsymman.2015.03.001

Cited by 36 publications

(75 citation statements)

References 18 publications

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“…This view is commensurate with the WHO position on palliative care [1]. Previous studies in which EMS providers have been interviewed concerning prehospital palliative care have demonstrated the consideration for family dynamics as an important part of managing palliative situations [7,12].…”

Section: Discussionmentioning

confidence: 54%

“…Thus, in the prehospital setting it is important to take these patient rights into account particularly when managing palliative patients [3]. Current literature suggests this can be attained through integration of emergency and palliative healthcare; something the interviewees of this study recognised as a need in South Africa [7,9,35].…”

Section: Discussionmentioning

confidence: 87%

“…Such treatment is typically performed by palliative care specialists who work in-hospital. However, emergency medical services (EMS) often encounter patients requiring palliative care as these patients may have acute exacerbations of illness, progress towards end-of-life or require transport to a medical facility [3][4][5][6][7][8][9]. As the first point of medical contact, EMS providers are thus uniquely positioned to deliver early palliative care in the home [10].…”

Section: Introductionmentioning

confidence: 99%

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South African paramedic perspectives on prehospital palliative care

2020

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Background Palliative care is typically performed in-hospital. However, Emergency Medical Service (EMS) providers are uniquely positioned to deliver early palliative care as they are often the first point of medical contact. The aim of this study was to gather the perspectives of advanced life support (ALS) providers within the South African private EMS sector regarding pre-hospital palliative care in terms of its importance, feasibility and barriers to its practice. Methods A qualitative study design employing semi-structured one-on-one interviews was used. Six interviews with experienced, higher education qualified, South African ALS providers were conducted. Content analysis, with an inductive-dominant approach, was performed to identify categories within verbatim transcripts of the interview audio-recordings. Results Four categories arose from analysis of six interviews: 1) need for pre-hospital palliative care, 2) function of pre-hospital healthcare providers concerning palliative care, 3) challenges to pre-hospital palliative care and 4) ideas for implementing pre-hospital palliative care. According to the interviewees of this study, pre-hospital palliative care in South Africa is needed and EMS providers can play a valuable role, however, many challenges such as a lack of education and EMS system and mindset barriers exist. Conclusion Challenges to pre-hospital palliative care may be overcome by development of guidelines, training, and a multi-disciplinary approach to pre-hospital palliative care.

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

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South African paramedic perspectives on prehospital palliative care

2020

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“…This takes on critical importance when transporting patients from long-term care facilities, as trauma mortality in the frail elderly can be quite high. Prehospital personnel can and do uphold advanced directives and established end of life wishes while managing family emotions near death [ 19 , 20 ]. The role of the hospital trauma service and state trauma system at this point is to support the medics as they seek to obtain and uphold established advanced directives.…”

Section: Communication During Prehospital Trauma Carementioning

confidence: 99%

Prioritizing Communication in the Provision of Palliative Care for the Trauma Patient

2020

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Purpose of Review Communication skills in the ICU are an essential part of the care of trauma patients. The goal of this review is to summarize key aspects of our understanding of communication with injured patients in the ICU. Recent Findings The need to communicate effectively and empathetically with patients and identify primary goals of care is an essential part of trauma care in the ICU. The optimal design to support complex communication in the ICU will be dependent on institutional experience and resources. The best/worst/most likely model provides a structural model for communication. Summary We have an imperative to improve the communication for all patients, not just those at the end of their life. A structured approach is important as is involving family at all stages of care. Communication skills can and should be taught to trainees.

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“…The disease in effect informs the way she will define, interpret and react to the new situation and make meaning based on her perceptions. This is an example of how symbolic interactionism can help in understanding the roles or identity that persons attribute to themselves, and the loss that AD inflicts as it progresses (Waldrop, Clemency, Lindstrom, & Clemency, 2015).…”

Section: Symbolic Interactionismmentioning

confidence: 99%

Fostering compassionate care for persons with Alzheimer's disease in nursing facilities.

Cotton¹

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and her behaviors worsened, we were finally given a diagnosis: Alzheimer's disease. I did not know at the time the extent to which her diagnosis would impact me, the rest of my childhood, and how I learned to understand caregiving. From the onset of the disease to the final days, I watched as my mother took care of my grandmother day in and day out. My mother would work all day at her job, come home and make dinner for me, and then spend the rest of her evening taking care of my grandmother. Alzheimer's is not a disease that simply impacts the person, but the persons' family, friends, and communities but most importantly, it is the caregiver that is often impacted the most. These early experiences taught me that the caregiving journey could be difficult and arduous, so I want to acknowledge the work of caregivers for persons with Alzheimer's disease. In particular, I would like to say thank you to three caregivers that have taught me so much along the way-Margie, Zelda, and Doris. I would also like to thank my committee. Each of you has given me the support that I needed along the way. Annatjie, you are the MENTOR. I am not sure I would have made it without your help and encouragement. You are so brilliant and amazing, and I am v so thankful for all the guidance you have given me through this journey. Joseph, words cannot express how grateful I am for you! Thank you for encouraging me each step of the way. You are amazing! Pamela, your friendship and guidance is so helpful to me. Laughing (and sometimes crying) in the kitchen while eating too much fruit has saved me on many a day when I doubted my abilities to finish this dissertation. Terry, thank you for always checking in with me about my progress. Your feedback was so valuable to me. Dr. Jicha, when I first started to do research focused on Alzheimer's disease, it was your name that I kept seeing in the literature over and over again. You have done so much to advance this field of research, and I am so thankful that you said yes to being part of my committee. To my Institute for Sustainable Health & Optimal Aging family, your support while I was working on my dissertation was invaluable. Thanks for always cheering me on along the way. To my family and my friends, thanks for being my support system! Finally, to Bryce for all of his love and support. I would not have started this journey without your unwavering support. Thanks for buying the ticket and taking the ride.

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“We Are Strangers Walking Into Their Life-Changing Event”: How Prehospital Providers Manage Emergency Calls at the End of Life

Cited by 36 publications

References 18 publications

South African paramedic perspectives on prehospital palliative care

South African paramedic perspectives on prehospital palliative care

Prioritizing Communication in the Provision of Palliative Care for the Trauma Patient

Fostering compassionate care for persons with Alzheimer's disease in nursing facilities.

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