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The transition to palliative care is intensely emotional for patients, their caregivers, and healthcare providers because accepting palliation means ceasing curative treatment in favor of pain management for the remainder of life. This paper draws from the emotion management perspective to understand how a palliative care team can use emotions in consultations about end-of-life care. The study used ethnographic observations of a palliative care team's consultations with patients and semi-structured interviews with the care team. The study found that healthcare providers strategically leverage emotions to help patients transition to palliative care. Strategies include leveraging anger through the specter of physical pain, leveraging guilt through navigating moral dilemmas, and distancing from anger to build trust. Providers use situational clues and information from the patients' backgrounds to determine which strategy to deploy. If one strategy fails, team members often cycle through other strategies to help persuade patients and their families that palliative care is the best option. This paper argues that leveraging emotions is an integral part of transitioning to palliative care. The strategies outlined here could be useful for studying professional healthcare delivery in other settings. The cultural, organizational, and professional pressures affecting the emotional work of healthcare providers are discussed. [ABSTRACT FROM AUTHOR]

Nutrition is inseparable from our life. It is of particular importance in childhood and in illness. However, its significance should not be overrated. This holds true especially in case of incurable patients. We have to bear in mind that nutrition in every form and way of administration serves only as a supportive therapy and as such should not be provided against a patient's will that was expressed in a due manner. Each patient is entitled to a good quality and respectable life even at its end. Definitely, nutrition delivered through nasogastric tube and by means of percutaneous endoscopic gastrostomy does not contribute to the quality of life - just the opposite. Nutrition in the terminally ill has become a widely discussed ethical dilemma. Patients in the terminal stage of Alzheimer's disease and dementia should be given professional palliative care, and their autonomy and human dignity should always be respected. The aim of this paper is to define the specifics and the importance of nutritional support in the terminal stage of Alzheimer's disease and dementia. The relevant studies researched were identified by key words and followed by analytical activities and critical discussion. The recommended procedures of nutritional care in the terminal phase of dementia in Alzheimer's disease indicate that the patients should be fed by mouth as long as they are able to receive food, and, accordingly, a suitable adjustment in the diet should be adopted. Furthermore, it is appropriate to use sipping nutritional diets, that may slow down malnutrition, which is the result of the disease progression. Inadequate hydration may be compensated for with the help of hypodermoclysis. [ABSTRACT FROM AUTHOR]

This paper is of an overview nature and defines and specifies the construct of sexuality and intimacy in terminally ill clients - recipients of palliative and hospice care. The objective of the paper was to search for relevant studies aimed at the issue and define the specifics of the concept of sexuality/intimacy, sexual needs and barriers in their assessment in terminally ill clients. The principal method was an analysis of findings and their critical synthesis for the purposes of target saturation. According to the findings, sexuality/intimacy has specific expressions on the part of clients, their partners or family members, as well as healthcare or other professionals. The paper defines the barriers to the assessment of sexual needs and possibilities of their expression. It can be concluded that sexuality and intimacy (of various forms) is part of palliative care in many respects. As a result, sexual needs represent a relevant aspect in the assessment of overall quality of life. Certain barriers are defined by healthcare professionals, who have problems coping with the issue of sexuality, intimacy, sexual desires and needs. Sexual activity is an obvious entity of each individual is dynamic and present in any age and in various medical conditions, including incurable disease and the stage of dying. Each dying individual should be granted the right to speak about own sexual needs. [ABSTRACT FROM AUTHOR]

On one hand, roughly speaking, palliative care is a multidisciplinary approach aiming to improve the quality of life of people facing a life-threatening illness, and of their families. As such, it is included -- more or less -- in the health system of each country. On the other hand, due to the increased usage of Internet, mobile phones, and tablets, eLearning and mobile applications (in short apps) can effectively improve the quality of life. The purpose of this paper is to identify how palliative care could benefit from those IT tools. The domains of issues associated with illness and bereavement are presented corroborated to appropriated eLearning tools and mobile apps. We survey the nowadays eLearning tools and mobile apps for palliative care, and propose new ideas for their development in this direction. With this respect, we also mention possibilities of collaboration between IT developers and the specialists in palliation, specifying for each case the specialization needed by each part. Other approaches to these IT tools are given: by their type, by their users, by their specific domains. Much has been done in some parts of the world to improve the palliative care, including in the direction of IT; we specify how to make the respective tools useful here and elsewhere. Concluding, the paper can be seen as a collection of descriptions of existing tools, proposed tools, and ideas about making eLearning tools and apps for palliative care useful everywhere. Last but not least, we mention that the eLearning and mobile apps tools considered here are never supposed to substitute the specialists, but to give support to the patient, to the care giver of the patient and/or to the corresponding specialist. [ABSTRACT FROM AUTHOR]

Terror Management Theory (TMT), derived from Ernest Becker's The Denial of Death (1974), maintains that humans are motivated by the desire to overcome our fear of death by constructing meaning and significance in our lives in various ways, including making light of our mortality. In this paper, we examine the role of play as seriously ill children involved with a hospital based palliative care team live out what may be the remainder of their lives. We question the function that play has, if any, in mitigating the fear of death among dying children and their caregivers. We explore formal and informal manners of therapeutic play among children and adults occurring in moments of terrible stress, pain and the looming threat of death. We draw on playful representations of death from popular culture and from extended field research conducted with a pediatric palliative care team in a large regional children's hospital caring for seriously ill children and their families, as patients, families and caretakers struggle to make sense of their suffering, fear and loss. [ABSTRACT FROM AUTHOR]

The paper opens a debate on palliative care for the LGBT senior citizens in the Czech society. Given the topic, qualitative research paradigm has been chosen to answer the research question, namely the Interpretative Phenomenological Analysis. Data were collected using the technique of an unstructured, comprehensive interview. We have managed to get seven interviews in total. From the accounts of participants, it follows that, although, the society is more tolerant of the LGBT, it is still possible to encounter manifestations of intolerance, even among the medical staff. In their views on palliative care, the LGBT senior citizens don't differ from the mainstream society at all. They prefer care at home, they want to live and die at home. They have usual expectations of carers, such as empathy, authenticity, unconditional positive acceptance (respect), and the ability of friendly communication; beyond that, they should also know and respect certain specifics of the LGBT people. [ABSTRACT FROM AUTHOR]

The objective of the paper was to search for, analyse and describe available (selected) measuring and assessment tools (questionnaires), which specifically assess sexuality, sexual needs, sexual functioning, sexual dysfunctions and intimacy primarily in the target group of incurable patients, dying persons and recipients of palliative and hospice care. The research involved studies describing or directly using various assessment tools; these studies were searched for in relevant databases (SCOPUS, Web of Knowledge, ProQuest, Ebsco, etc.). For these studies, acceptance and rejection criteria were defined. It was revealed that the area of sexuality and intimacy is approached in various ways, often from the perspective of quality of life assessment. Both generic and specific tools were searched for. In addition to terminally ill patients (clients of palliative and hospice care), the target group also included patients with intellectual disability, multiple sclerosis, physical disability, burns, both women and men in specific situations (health- or life-related), etc. Sexuality in terminally ill and dying patients (in various settings - home or institutional) is largely determined especially by their sexuality prior to diagnosis, expectations in the area of intimate behaviour and sexuality, awareness of intimacy and sexuality (including its expression), and last but not least understanding and cooperation of the partners of the dying persons and healthcare professionals in an institutional environment. The need for intimacy is present until death, therefore, an opportunity to express own wishes and concerns in the area of own sexuality and intimacy should be a natural practice in every institution providing healthcare, social and palliative services. [ABSTRACT FROM AUTHOR]

Healthcare Industry is one of the most important sectors nowadays, which providing goods and services to patients with curative, preventive, rehabilitative, and palliative care. There are patients flow, medicine flow, material flow and information flow in this supply chain. Patients service level and cost expense increasing are important issues to take into consideration. Outpatient department is the main department requires more attention in term of patient logistics activity and process management. Based on this, the study focuses on patient logistics activity and cost analysis of each activity in a clinic in the outpatient department of the case study hospital. The crucial purpose is to analyze activity, determine resource use, estimate time processing in each activity, and calculate the unit cost of each patient activity in an outpatient clinic. Time Driven Activity Based Costing is used as a solution tool. The results might serve the clinic administrator for cost controlling system and process management and obtain a guideline for choosing the appropriated costing system for the hospital. [ABSTRACT FROM AUTHOR]

The article presents a study that analyzes the frames (‘cultural images' or ‘perspectives') that occur in the social debate on euthanasia in the Netherlands. It mentions that euthanasia undermines other forms of end-of-life care, such as palliative care. It mentions that physicians and caregivers can benefit from a wider perception of euthanasia to better guide people around the end of life.