Search

In Germany, nursing homes are characterised by challenging conditions for adequately supporting residents at their end of life, which have even amplified due to the COVID-19 pandemic. This article therefore analyses how hospice and palliative care in nursing homes has changed due to the COVID-19 pandemic and how the pandemic has affected residents, relatives and employees. Semi-structured interviews with employees, residents and relatives were conducted before and during the COVID-19 pandemic in two nursing homes in North Rhine-Westphalia, Germany. In a pre-post comparison, data were qualitatively evaluated using content analysis according to Mayring. Shifts, congruities and discrepancies in challenges in hospice and palliative care were identified between T0 and T1. Due to contact restrictions, important parts of end-of-life care were missing, and the roles of individuals providing hospice and palliative care were redefined. The interviewed groups experienced changes differently and contradictory statements on satisfaction and expectations about hospice and palliative care were reported. Employees and relatives predominantly perceived the pandemic to be very stressful, while residents endured this period more composedly. Employees stated that, despite the pandemic, they were mostly able to meet residents' requests. However, relatives and residents expressed that minor requests were not reliably fulfilled, neither at T0 nor at T1. Drawing together the different perspectives from employees, residents and relatives offers a bigger picture of challenges in hospice and palliative care in nursing homes and the pandemic effects. Stronger communication of requests and needs as well as greater collaboration, especially under crisis conditions, are essential for a better quality of end-of-life care. There is an urgent need to break down the taboos around the topics of dying and death in nursing homes., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Bußmann et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The article addresses commercial socially assistive robots (SAR). There is evidence of the impact of SAR on older persons in institutional settings. Family care at home has not yet been the subject of systematic research; however, especially at home SAR could help to prevent loneliness, provide emotional support, and foster communication., Objective: Inspired by evidence on the potential impact of SAR, the article analyzes their potential for supporting family care at home. A participatory research and development (R&D) project stands as an example of how SAR can improve communication and relations at home., Material and Methods: Apart from the results of selected randomized controlled trials (RCT) in institutional settings, the article provides results from tests that were run in the R&D project., Results: SAR can increase the quality of life of users at home. They are capable of improving relations within family care. They inspire communication, change routines, and provide relief to family caregivers; however, it takes trained human companions to support the use of SAR at home and address ethical aspects., Conclusion: If SAR are supposed to deliver their potential for care at home, older persons and their caregivers must be actively involved in research and development. These processes must be systematically evaluated., (© 2022. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

A patient recently treated with surgery and radiation for oropharyngeal cancer presented with impending hypoxic respiratory and cardiac arrest in a difficult airway scenario. A CriCath cannula in combination with the Ventrain device and its active expiratory ventilation technology enabled oxygenation and ventilation for 60 minutes until a surgical airway was established. This case report is the first to describe the intended use of Ventrain technology in an emergent "can't ventilate-can't intubate" scenario.

Peripherally inserted central catheters are being used in increasing numbers. Common (thrombosis, infection, phlebitis, malfunction, or disconnection) and rare complications (pericardial tamponade) have been well explored. We describe 2 serious complications that resolved without sequelae. Both complications occurred in the context of limited provider competence. We conclude that vascular access is more than "just" placing a catheter; it can have serious clinical impact and has evolved into a specialist skill. With increasing use of intravascular catheters, the need for a formalized training becomes urgent.

In Germany, the topic 'Ethnicity and Age' is a central concomitant of demographic and social change and has become a big challenge for existing structures of community care for elders. In this context, the Kreis Unna implemented a model project, which aimed at informing minority ethnic elders about the German care and welfare system. The project also tried to promote their usage of services and offers for elders in a sustainable way. Within the frame of the project, two information series were held. The first addressed minority ethnic elders and informed them about the German care and welfare system. The second qualified staff in the field of care and work for elders for the special needs of minority ethnic elders. The project was supported and evaluated by the Institute for Gerontology at the University of Dortmund. By viewing the results of the evaluation, it becomes evident that the two information and qualification series proved successful for both groups and, in general, are transferable to other municipalities. However, it also became clear that reducing barriers of access to the German care and welfare system is a very difficult process for both sides. A better usage of institutions and services of community care for elders by minority ethnic elders can only be accomplished by constant measures.

We report on a 36 year old patient who collapsed at home and was resuscitated by prehospital medical emergency services. He presented on scene unconscious with severe ST-elevations on the ECG and hardly palpable pulses. His previous medical history included only idiopathic hypertension and his professional background as manager of a company was associated with high stress levels. The prehospital diagnosis was myocardial infarction with cardiogenic shock. A hypovolemic shock was excluded from the differential diagnosis because of the age of the patient, lack of a precipitating trauma and inconsistent symptoms. The patient died after terminating prolonged resuscitation. A post mortem showed as cause of death the rupture of a splenic artery aneurysm. We emphasize that a cardiovascular collapse in a young patient without specific history or trauma still can be caused by hypovolemic shock due to intra-abdominal or -thorac bleeding.

In Germany, 'Ethnicity and Age' is a central topic of demographic and social change and has become an important issue within gerontological/social political discourses and also a large challenge for existing structures of community care for the elderly. So far, on the scientific as well as the practical level, only a few attempts have been made in Germany to take a look at the experience of other countries. Based on the author's thesis, the following essay aims to bridge this gap. Within the broader context of comparing different welfare systems, it analyzes and compares specific experiences in the field of developing and opening up social services for elderly from black and ethnic minority groups in Germany and Great Britain. Focus is placed on the comparison of life situations of black elderly and legal frameworks of community care for elderly.