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In late January 2020, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS CoV-2) was reported as an outbreak in Wuhan, China. Within 2 months it became a global pandemic. Patients with cancer are at highest risk for both contracting and suffering complications of its resultant disease, Coronavirus 19 (COVID-19). Healthcare systems across the world had to adapt quickly to mitigate this risk, while continuing to provide potentially lifesaving treatment to patients. Bringing care to the home through the use of telehealth, home based chemotherapy, and remote patient monitoring technologies can help minimize risk to the patient and healthcare workers without sacrificing quality of care delivered. These care models provide the right treatment, to the right patient, at the right time

In late January 2020, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS CoV-2) was reported as an outbreak in Wuhan, China. Within 2 months it became a global pandemic. Patients with cancer are at highest risk for both contracting and suffering complications of its resultant disease, Coronavirus 19 (COVID-19). Healthcare systems across the world had to adapt quickly to mitigate this risk, while continuing to provide potentially lifesaving treatment to patients. Bringing care to the home through the use of telehealth, home based chemotherapy, and remote patient monitoring technologies can help minimize risk to the patient and healthcare workers without sacrificing quality of care delivered. These care models provide the right treatment, to the right patient, at the right time, in the right place. Whether these patient-centered models of care will continue to be embraced by key stakeholders after the pandemic remains uncertain.

Previous research has shown how filial piety is strong among people of Iranian background and that traditional Iranian culture result in most families’ preferring to care for their elderly (and sick) family members at home. While acknowledging this, this article highlights what living in diaspora could mean in terms of cultural adaption and changing family values. By interviewing people with Iranian background living in Sweden (n = 20), whom all have been former primary caregivers to a relative living with dementia, we are able to show how the decision to cease caregiving at home is taken, and what underlying factors form the basis for such decision. Results indicate that although the existence of a Persian profiled dementia care facility is crucial in the making of the decision, it is the feeling of ‘sheer exhaustion’ that is the main factor for ceasing care at home. And, we argue, the ability to make such a decision based upon ‘being too tired’ must be understood in relation to transition processes and changes in lifestyle having an affect upon cultural values in relation to filial piety. Because, at the same time the changes on cultural values might not change accordingly among the elderly who are the ones moving into residential care, resulting in them quite often being left out of the actual decision.

Previous research has shown how filial piety is strong among people of Iranian background and that traditional Iranian culture result in most families’ preferring to care for their elderly (and sick) family members at home. While acknowledging this, this article highlights what living in diaspora could mean in terms of cultural adaption and changing family values. By interviewing people with Iranian background living in Sweden (n = 20), whom all have been former primary caregivers to a relative living with dementia, we are able to show how the decision to cease caregiving at home is taken, and what underlying factors form the basis for such decision. Results indicate that although the existence of a Persian profiled dementia care facility is crucial in the making of the decision, it is the feeling of ‘sheer exhaustion’ that is the main factor for ceasing care at home. And, we argue, the ability to make such a decision based upon ‘being too tired’ must be understood in relation to transition processes and changes in lifestyle having an affect upon cultural values in relation to filial piety. Because, at the same time the changes on cultural values might not change accordingly among the elderly who are the ones moving into residential care, resulting in them quite often being left out of the actual decision.

Previous research has shown how filial piety is strong among people of Iranian background and that traditional Iranian culture result in most families’ preferring to care for their elderly (and sick) family members at home. While acknowledging this, this article highlights what living in diaspora could mean in terms of cultural adaption and changing family values. By interviewing people with Iranian background living in Sweden (n = 20), whom all have been former primary caregivers to a relative living with dementia, we are able to show how the decision to cease caregiving at home is taken, and what underlying factors form the basis for such decision. Results indicate that although the existence of a Persian profiled dementia care facility is crucial in the making of the decision, it is the feeling of ‘sheer exhaustion’ that is the main factor for ceasing care at home. And, we argue, the ability to make such a decision based upon ‘being too tired’ must be understood in relation to transition processes and changes in lifestyle having an affect upon cultural values in relation to filial piety. Because, at the same time the changes on cultural values might not change accordingly among the elderly who are the ones moving into residential care, resulting in them quite often being left out of the actual decision.

Previous research has shown how filial piety is strong among people of Iranian background and that traditional Iranian culture result in most families’ preferring to care for their elderly (and sick) family members at home. While acknowledging this, this article highlights what living in diaspora could mean in terms of cultural adaption and changing family values. By interviewing people with Iranian background living in Sweden (n = 20), whom all have been former primary caregivers to a relative living with dementia, we are able to show how the decision to cease caregiving at home is taken, and what underlying factors form the basis for such decision. Results indicate that although the existence of a Persian profiled dementia care facility is crucial in the making of the decision, it is the feeling of ‘sheer exhaustion’ that is the main factor for ceasing care at home. And, we argue, the ability to make such a decision based upon ‘being too tired’ must be understood in relation to transition processes and changes in lifestyle having an affect upon cultural values in relation to filial piety. Because, at the same time the changes on cultural values might not change accordingly among the elderly who are the ones moving into residential care, resulting in them quite often being left out of the actual decision.

Previous research has shown how filial piety is strong among people of Iranian background and that traditional Iranian culture result in most families’ preferring to care for their elderly (and sick) family members at home. While acknowledging this, this article highlights what living in diaspora could mean in terms of cultural adaption and changing family values. By interviewing people with Iranian background living in Sweden (n = 20), whom all have been former primary caregivers to a relative living with dementia, we are able to show how the decision to cease caregiving at home is taken, and what underlying factors form the basis for such decision. Results indicate that although the existence of a Persian profiled dementia care facility is crucial in the making of the decision, it is the feeling of ‘sheer exhaustion’ that is the main factor for ceasing care at home. And, we argue, the ability to make such a decision based upon ‘being too tired’ must be understood in relation to transition processes and changes in lifestyle having an affect upon cultural values in relation to filial piety. Because, at the same time the changes on cultural values might not change accordingly among the elderly who are the ones moving into residential care, resulting in them quite often being left out of the actual decision.

Aim. To synthesise evidence to identify the components of effective psychosocial interventions in dementia care to inform clinical practice, policy and research. Background. With population ageing dementia represents a significant care challenge with 60% of people with dementia living at home. Design. Overview of systematic reviews with narrative summary. Data sources. Electronic searches of published systematic reviews in English using Cochrane Database of Systematic Reviews, DARE, EPPI-Centre, between September 2013 and April 2014. Review methods. Systematic reviews were appraised against Cochrane Collaboration levels of effectiveness. Components of psychosocial interventions were identified with their theoretical rationale. Findings were explored with a Patient, Public and Carer Involvement group.

Aim. To synthesise evidence to identify the components of effective psychosocial interventions in dementia care to inform clinical practice, policy and research. Background. With population ageing dementia represents a significant care challenge with 60% of people with dementia living at home. Design. Overview of systematic reviews with narrative summary. Data sources. Electronic searches of published systematic reviews in English using Cochrane Database of Systematic Reviews, DARE, EPPI-Centre, between September 2013 and April 2014. Review methods. Systematic reviews were appraised against Cochrane Collaboration levels of effectiveness. Components of psychosocial interventions were identified with their theoretical rationale. Findings were explored with a Patient, Public and Carer Involvement group.

Primary Health Care professionals have to provide palliative care to oncology terminal patients, and their families, without an specific training in this setting. Since mental health professionals are enrolled when needed in level 3 health services, the co-ordination with primary health care professionals must be improved. Objective: To evaluate the usefulness of a community mental nurse intervention, in co-ordination with primary health care services, on quality of life of terminal patients and work overload of the main caregivers Methodology: A prospective and quasi-experimental study has been designed including patients and their caregivers from the hospital of Area Sanitaria 4 of Madrid. The intervention is focused on 3 groups: Terminal patients, main caregivers and primary care nurses involved in the care of them. The output variables are the quality of life (using the Rotterdam Symptom Checklist) and the work overload of the main caregivers (using Zarit scale). Statistical analysis: Descriptive analysis of the sample characteristics. A covariance analysis will be performed in order to make a mean comparison of the scores on quality of life and caregivers work overload before and after the intervention., Los profesionales de los Equipos de Atención Primaria (EAP) se están viendo obligados a afrontar los problemas psicosociales de los enfermos oncológicos terminales atendidos en Atención Primaria, y de sus familias, sin poseer el entrenamiento necesario. Mientras que en el nivel especializado se tiende a integrar en la asistencia algún profesional especialista en salud mental, en el nivel básico la coordinación con los Centros de Salud Mental no está satisfaciendo las necesidades existentes. Objetivo: Evaluar una intervención de la enfermera especialista en salud mental complementaria al Programa de Atención Domiciliaria sobre la calidad de vida de pacientes oncológicos terminales que permanecen en sus domicilios y la sobrecarga del cuidador principal. Metodología: Se trata de un estudio prospectivo cuasi experimental que se realizará en el Área Sanitaria 4 de Madrid con enfermos referidos desde el hospital de referencia y sus cuidadores. La intervención propuesta comprende tres ámbitos de actuación: Enfermos terminales, cuidadores primarios y profesionales de enfermería de los equipos de Atención Primaria. Las variables estudiadas serán la calidad de vida de los enfermos medida a través del Rotterdam Symptom Checklist, y la sobrecarga de los cuidadores valorada con la Escala de Sobrecarga del Cuidador de Zarit. Análisis estadístico: Análisis descriptivo de las características de la muestra y una comparación de medias mediante el análisis de la varianza.

Résumé L’adolescent qui s’enferme durablement au domicile est dans une situation pathologique, car il se dessaisit de l’univers relationnel élargi de l’adolescence normale, et de l’investissement cognitif lié au monde extérieur. La demande d’aide de l’entourage est le plus souvent à la fois tardive et ambivalente du fait des réaménagements progressifs autour de cette situation, et pourtant urgente. L’expérience de l’urgence psychiatrique nous a conduits à proposer un mode de réponse en deux temps : l’accueil immédiat de la famille sans le patient, puisqu’il ne veut pas venir ; la démarche à domicile, pour aller à la rencontre de l’adolescent. Deux observations décrivent le risque suicidaire de ces situations : l’une aboutit à une sortie de la crise suicidaire sans poursuite ultérieure des soins, l’autre aboutit à un diagnostic d’état dépressif sévère et un accès aux soins durable., Summary An adolescent who keeps locked in at home puts himself in pathological situation since he gives up the enlarged relationship universe of a normal adolescence and the cognitive investment related to the outside world. Although it is urgent, parental request for help is often late and ambivalent because of the progressive reorganisations linked to this situation. Our experience in the psychiatric emergency situation lead us to propose a two tier response mode: immediate reception of the family without the patient since he does not want to attend and a visit to the home place to meet the adolescent. Two observations related to the suicidal risk describe this kind of situations : the first one reports on the end of a suicidal crisis, without further treatment though, while the second one stresses a diagnosis of a severe nervous break down, entailing a long term scheme of cares.

Résumé L’adolescent qui s’enferme durablement au domicile est dans une situation pathologique, car il se dessaisit de l’univers relationnel élargi de l’adolescence normale, et de l’investissement cognitif lié au monde extérieur. La demande d’aide de l’entourage est le plus souvent à la fois tardive et ambivalente du fait des réaménagements progressifs autour de cette situation, et pourtant urgente. L’expérience de l’urgence psychiatrique nous a conduits à proposer un mode de réponse en deux temps : l’accueil immédiat de la famille sans le patient, puisqu’il ne veut pas venir ; la démarche à domicile, pour aller à la rencontre de l’adolescent. Deux observations décrivent le risque suicidaire de ces situations : l’une aboutit à une sortie de la crise suicidaire sans poursuite ultérieure des soins, l’autre aboutit à un diagnostic d’état dépressif sévère et un accès aux soins durable., Summary An adolescent who keeps locked in at home puts himself in pathological situation since he gives up the enlarged relationship universe of a normal adolescence and the cognitive investment related to the outside world. Although it is urgent, parental request for help is often late and ambivalent because of the progressive reorganisations linked to this situation. Our experience in the psychiatric emergency situation lead us to propose a two tier response mode: immediate reception of the family without the patient since he does not want to attend and a visit to the home place to meet the adolescent. Two observations related to the suicidal risk describe this kind of situations : the first one reports on the end of a suicidal crisis, without further treatment though, while the second one stresses a diagnosis of a severe nervous break down, entailing a long term scheme of cares.