Tag: EOL
Dying at Home – Our Grandfather’s Great Escape
Our 94-year-old grandfather's last journey was not a glorious affair, an inelegant denouement to a life marked by global travel and migration. Still, to us, as we pushed his wheelchair out of the hospital lobby, it felt like... read more
A New Algorithm Identifies Candidates for Palliative Care by Predicting When Patients Will Die
End-of-life care can be stressful for patients and their loved ones, but a new algorithm could help provide better care to people during their final months. A paper published in arXiv by researchers from Stanford describes... read more
Is this critically ill patient elderly or too old?
Life expectancy is increasing in industrialized countries. It is forecast that in the European Union 24.4 million people will be older than 85 years in 2040, more than doubling from the 10.4 million seen in 2010. In parallel,... read more
Delirium in Hospitalized Older Adults
Delirium, an acute confusional state, is common among hospitalized elders and is associated with poor outcomes. All patients with delirium should be evaluated for reversible causes. Behavioral disturbances should be managed... read more
Humanizing the Treatment of Hyperactive Delirium in the Last Days of Life
When patients with advanced cancer near the end of their life, it is important for physicians, nurses, and other health care personnel to respect and dignify the dying process of the patient. This requires a shift in focus... read more
Moral Distress in PICU and Neonatal ICU Practitioners
In this single-center, cross-sectional study, we found that moral distress is present in PICU and neonatal ICU health practitioners and is correlated with burnout, uncertainty, and feeling unsupported. The main outcome was... read more
Under-reporting of End-of-life Decisions in Critical Care Trials: A Call to Modify CONSORT Statement
Under-reporting of End-of-life Decisions in Critical Care Trials: A Call to Modify CONSORT Statement... read more
Burn Till You’re Out
When using the technical definition of burnout: "The reduction of a fuel to nothing", it clearly describes the state of being of the few people that I have met who are having a burnout. The problem is huge and almost... read more
Critical care at the end of life: a population-level cohort study of cost and outcomes
Despite the high cost associated with ICU use at the end of life, very little is known at a population level about the characteristics of users and their end of life experience. In this study, our goal was to characterize... read more
Persistent Gaps in Use of Advance Directives Among Nursing Home Residents Receiving Maintenance Dialysis
Patients with end-stage renal disease receiving dialysis have a symptom burden and prognosis comparable to patients with incurable cancer. They frequently and increasingly receive intensive procedures near the end of life.... read more
How to Ensure Your Medical Wishes Are Followed if You’re Critically Ill and Incapacitated
It happens every day in the intensive care units of hospitals throughout the country: Physicians ask the loved ones of someone kept alive by a ventilator and other medical devices whether the patient would want to live hooked... read more
We're Bad at Death. Can We Talk?
Despite growing recognition that more care isn't necessarily better care, particularly at the end of life, many Americans still receive an enormous dose of medicine in their final days. On average, patients make 29 visits... read more
Integrating Advance Care Planning into Practice
Advanced respiratory diseases progress over time and often lead to death. As their condition worsens, patients may lose medical decision making ability. Advance care planning (ACP) is a process in which patients receive information... read more
Early Palliative Care in Advanced Illness
As the on-call pulmonary critical care fellow, I listened to a family member plead with me to "do right by Mama." The emergency department team consulted me for possible intensive care unit (ICU) admission on a... read more
Pricey Technology Is Keeping People Alive Who Don’t Want to Live
As an ICU physician, I’ve used technologies like breathing machines and feeding tubes to save lives that would have been lost just a few decades earlier. But I’ve also seen the substantial costs, both human and financial,... read more
Learning to talk about death should start early in doctors' careers
At first glance, physicians’ poor understanding of death and the process of dying is baffling, since they are supposed to be custodians of health across the lifespan. Look deeper, though, and it may reflect less the attitudes... read more
Never Stop Caring
I read with interest the piece by Wilson et al regarding their examination of end-of-life care patterns in hospitalized patients on their vascular surgery practice in Oregon. I applaud the authors for examining their practices... read more
