Examines views and preferences of terminally ill patients towards home-based palliative care services. Preferred activities and services by patients in a home-based palliative care; Variations across the trust areas i...
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Examines views and preferences of terminally ill patients towards home-based palliative care services. Preferred activities and services by patients in a home-based palliative care; Variations across the trust areas in patients' views on home care services; Irritation of patients over some aspects of hospital visits such as missing meals required by the hospital clinic.
Background and objectives: Pressure sores usually result from insufficient preventive measures. They are particularly onmipresent among dying persons in geriatric care. This study deals with prevalence, risk factors a...
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Background and objectives: Pressure sores usually result from insufficient preventive measures. They are particularly onmipresent among dying persons in geriatric care. This study deals with prevalence, risk factors and the significance of the nursing environment. Patients and methods: The prevalence of pressure sores among the dead was analysed in a prospective cross-sectional study based on 10,222 postmortem examinations in a crematorium in Hamburg. Results: The overall prevalence of pressure sores from grades I to IV was 11.2% (grade 1: 6.1%, grade 11: 3%, grade III: 1.1%, grade IV: 0,9%). A final logistic regression model showed that pressure sores of Grade III or IV were associated with female gender, date of death in the summer, marasmus, stroke history, neurological disease in general, kidney disease, preceding traumatic events and nursery home residence at the time of death. More than half of all the grade IV cases were diagnosed among nursing home residents whereas those who had died in hospitals contributed to only 11.5% of all the grade IV cases (dead from private homes 34.4%). Nursing home residence was associated with female gender, marasmus and stroke history which predisposed to a higher rate of pressure. Conclusions: Nursing homes are confronted with the highest proportion of pressure sores among dying people when compared to hospitals or private home care. Failure to meet the standards of preventive action against pressure sores point to the shortfalls in the present public health sector and nursing home regulations as well as the medical responsibility for supervision of nursing care. Apart from established standards of care, medicolegal assessment of high-grade pressure sores should also take ethical considerations into account when considering maximum therapy goals among dying persons.
This paper describes 10 indicators of quality assurance for DNR decisions developed by a New England hospital’s chaplaincy. It then looks at how these 10 indicators were applied to a specific case and subsequently to...
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Explores the reality of pain thru explications of the theological notions of "justification by pain," "justification by death," and "justification by faith." Notes particularly the facili...
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Explores the reality of pain thru explications of the theological notions of "justification by pain," "justification by death," and "justification by faith." Notes particularly the facilitating role of the hospital chaplain in the understanding of pain and its possible Christian meanings.
Addresses the issue of life and death choices from the perspectives of a Jewish chaplain. Explores the tension between the law (Halachah) and experience or story (Aggadah) and the impact of that tension on lives and d...
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Addresses the issue of life and death choices from the perspectives of a Jewish chaplain. Explores the tension between the law (Halachah) and experience or story (Aggadah) and the impact of that tension on lives and decisions. Cites persons and situations from biblical material, oral tradition, and modern times which illustrate the human struggle with these disputed issues. Explores different levels of pain and our understanding of and response to suffering. Invites reflection on the range of responses to pain that are humanly possible. Illustrates how meaning in life nurtures the desire to live. Claims this meaning aspect is not adequately addressed in the current dialogue. Focusses on the role of chaplains in listening and responding to persons and in helping to activate the impulse of hope. Suggests ways in which chaplains can be advocates for patients, prophetic voices within communities and institutions, and empowering of the gifts of others.
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