Older people living alone at the end of life in the UK: research and policy challenges

Source: Palliative Medicine,  2011, vol./is. 25/6(650-657), 0269-2163 (2011)

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Date of publication: September 2011

Publication type: Article

In a nutshell: In light of recent emphasis on place of death in UK policy, this article reviews some of the challenges faced by older people who live alone towards the end of life.  The implications of issues that impact on opportunity to achieve their preferred place of death are addressed including, finances, support mechanisms and the home environment.

Length of publication: 8 pages

Some important notes: This article is available in full text to all NHS Staff using Athens, for more information about accessing full text follow this link to find your local NHS Library 

Acknowledgement: BNI 

An exploration of palliative care provision in Scottish care homes

British Journal of Nursing vol. 21(1) p 8 – 15

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Date of Publication:  January 2012

Publication Type: Article

In a nutshell: This paper explores the suggestion that there is an imbalance between the ideal and the actual palliative care provision for some older people living and dying in care homes in Scotland. Successive studies demonstrate that care home residents are increasingly frail and disabled. Many experience challenging physical and psychosocial symptoms which could benefit from a palliative approach to alleviate suffering and promote comfort. However, palliative needs for people with non-malignant conditions, such as dementia, can be complex, and not easily identified or managed.

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library

Involving older people in commissioning: more power to their elbow?

Source: Joseph Rowntree Foundation

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Date of publication: December 2011

Publication type: Report

In a nutshell: This research set out to investigate what happens when older people are given the opportunity to shape service commissioning and delivery. The study also raises wider questions about the impact of their involvement, particularly whether it can change the nature of local power relations in the long term.

Length of publication: 76 pages

Acknowledgements: National End of Life Care Programme

End-of-life care in the community: attaining a critical balance

Source:  British Journal of Community Nursing 2011, v.16(11) p522

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Date of publication: November 2011

Publication type: Article

In a nutshell: The recently published report by the Care Quality Commission (CQC, 2011) Dignity and Nutrition for Older People, makes a number of negative observations about poor quality of care in the 100 hospitals they inspected. The report concluded that many hospitals are failing to meet basic needs of older people. It is important that we nurses provide essential care, as there is nothing basic about patients’ needs, wishes and aspirations at the end of their lives.

Length of publication: 1 page

Some important notes: Contact you local health library to obtain a copy of this article. Follow this link to find you local health library

 

UK telehealth initiatives in palliative care: a review

Source: International Journal of Palliative Nursing Vol. 17(6) p301-308

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Date of publication: June 2011

Publication type: Article

In a nutshell: This article explores the use of telehealth in palliative care and how it can be used to meet and support patients’ health needs in the community. Literature suggests that telehealth has much to offer people who are living with and dying from advanced illness.

Length of publication: 8 pages

Some important notes: An NHS Athens password is required to access this article online. Follow this link to register for Athens.

 

How common are palliative care needs among older people who die in the emergency department?

Source: Emergency Medical Journal 2011 Vol. 28(6), p491-495

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Date: October 2010

Publication type: Article

Publication length: 5 pages

In a nutshell: The objective of this study is to determine the prevalence and nature of
palliative care needs in people aged 65 years or more (65+) who die in emergency departments (EDs). This was a retrospective analysis of routine hospital data from two EDs in South London. Palliative care needs identified by diagnosis and symptoms, and problems likely to benefit from palliative care documented in clinical records 3 months prior to the final ED attendance were extracted. The article concludes that there is considerable palliative care need among older people who ultimately died in the ED, of whom only a minority were known to palliative care services. More older people in need of palliative care must be identified and managed earlier to avoid future undesired admissions and deaths in hospital.

Some important notes: An NHS Athens password is required to access this article online. To register for Athens follow this link.

Do nursing homes for older people have the support they need to provide end-of-life care? A mixed methods enquiry in England

Source: Palliative Medicine

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Date of publication: March 2011

Publication type: Article

In a nutshell: This study describes a mixed methods design identifying external influences on the quality of end-of-life care in nursing homes. Two qualitative case studies were conducted and a postal survey of 180 nursing homes surrounding the case study sites. In the case studies, qualitative interviews were held with seven members of nursing home staff and 10 external staff. Problems in accessing support for end-of-life care are reported. Results suggest that  that critical factors in improving end-of-life care in nursing homes include developing clinical leadership, developing relationships with GPs, the support of ‘key’ external advocates and leverage of additional resources by adoption of care pathway tools.

Length of publication: 13 pages

Some important notes: Contact your local health library for a copy of this article. To find you local health library, follow this link.

Ageing Population requires new approaches to end of life care

Source: National End of Life Care Intelligence Network

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Date of publication: November 2010

Publication type: News item

In a nutshell:   A new report entitled  Deaths in Older Adults in England compiled by the South West Public Health Observatory and produced by the National End of Life Care Intelligence Network (NEoLCIN) analyses the numbers of deaths in people aged over 75, broken down into five-year age bands up to the over 90s and provides data on the location and cause of death. The data shows that there will be a significant increase in numbers of people needing end of life care during the course of the next 30 years. 

Length of publication: 3 pages 

 

Looking from the outside in.

Source: Nursing Standard, v. 24(47) p20-1

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Date: July 2010

Publication type: Article

Publication length: 2 pages

In a nutshell: This article discusses provision of palliative care to elderly people with dementia by a specialist nurse employed by the organisation Housing 21. Housing 21 provide residential care and support services to elderly people in London.

Some important notes: An NHS Athens password is required to access this article online. Follow this link to register for an Athens Password.

Palliative care provision for older people in care homes

Title: Palliative care provision for older people in care homes

Source: British Journal of Community Nursing v15(4), p170-176

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Date of publication: April 2010

Publication type: Article

In a nutshell: The aim of this study was to demonstrate the current involvement of district nurses in care homes and identify the potential implications for future practice in providing palliative care in this setting. The findings suggested that even experienced district nurses, wanted support and education about when to commence palliative care. They also wanted earlier involvement with care home residents who have a life-limiting condition and care home managers were seen as being essential contributors towards planning care.

Length of publication: 7 pages

Some important notes: Please contact your library for a copy of this article. To find your local health library follow this link.

An end-of-life care initiative for people with dementia

Source: European Journal of Palliative Care 2009, vol. 16(5) p240-3

Date: Sept/ Oct 2009

Publication Type: Article

In a nutshell: This article examines research carried out in NHS North West Greater Manchester PCT  evaluating the use of the Gold Standards Framework and the Liverpool Care Pathway for the Dying Patient, as models of care to improve the quality of end-of-life care for older patients with dementia in long-term care settings. The effects on patients, their families, carers and staff were assessed.

Length of Publication: 3 pages

Acknowledgements: British Nursing Index

Notes: Contact your local health library to obtain a copy of this article. There are no links available to the abstract of this article.

Palliative care for older people – Exploring the views of doctors and nurses from different fields in Germany

Author: Torben Brueckner et al

Source: BMC Palliative Care

In a nutshell: Providing appropriate palliative care for older people is a major task for health care systems worldwide, and up to now it has also been one of the most neglected. Focusing on the German health care system, the researchers sought to explore the attitudes of health professionals regarding their understanding of palliative care for older patients and its implementation.

Click here for full text article

Document Type: Research Article

Document Length: 25 pages

NHS Confederation response to NICE consultation on end of life medicines

Title:  NHS Confederation response to NICE consultation on end of life medicines

 

Source:  National Electronic Library for Medicines 

Year of publication: 2008

Publication type: Response

In a nutshell: The NHS Confederation has responded to the recent consultation from NICE on proposals to supplement the advice it gives to its Appraisal Committees when they are asked to appraise life-extending medicines licensed for terminal illnesses affecting small numbers of patients.

The issues highlighted in the response are:  

1. The financial implications of the proposals are unclear, but could potentially be significant for PCTs.
2. There is some concern that treatments and services that are more cost effective but not subject to NICE guidance will lose out to pay for high cost end-of-life drugs as a result of these proposals.
3. While it is understood that these proposed changes of policy are an attempt to respond to expressed public values, more research into this topic is required.

Notes:  To access this response please contact your local NHS Library.

  

 

Help the Aged report: Pain in older people – reflections and experiences from an older person’s perspective

Title:  Pain in older people – reflections and experiences from an older person’s perspective

 

Source: Help the Aged http://policy.helptheaged.org.uk

  

For fulltext link here 

 

Year of publication: 2009

  

Publication type: Report

 

In a nutshell: This publication aims to highlight the issue of pain in older people by exploring their experiences of living and coping with persistent pain. Following on from two ‘listening events,’ conducted between August 2007 and April 2008 with 21 participants, several older people were invited to share their experiences and thoughts about pain in older age (part 1 of report). The second part of this report is a summary of key literature and policy, highlighting the fundamental issues relating to pain in older people and discussing the implications of the evidence. 

 

Length of publication: 43 page report

  

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Acknowledgement: This item was sourced from Palliative Care Matters