Terminal illness: attitudes in both an acute care and an extended care teaching hospital.
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Biomedical subjects
Publications and source records attributed to R Shedletsky.
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The relative merits of the hospice, palliative care units, and geriatrics departments as settings for management of the dying patient are considered.
Seventeen older patients with a diagnosis of Organic Brain Syndrome were placed on a four-week trial of melperone for treatment of behavioural disturbances associated with dementia. Efficacy evaluation of the drug revealed improved ratings of the patients in the areas of agitation/irritability, anxiety, unsociability, and mental alertness. Thirteen of the fourteen patients who completed the trial were rated generally as showing at least minimal improvement while on the drug. There were no serious side effects noted, with drowsiness the most frequent finding. These favourable results are suggestive of the usefulness of this drug, and point to the need for double-blind, comparative studies.
The effect of 3 hours of ambulatory activity on the mental function of 12 elderly persons with postural hypotension was examined. There was little difference between the mean combined mental status and set test scores when the subjects were supine (42.3) and when they were erect after 3 hours of ambulatory activity (42.2). A control group of persons of similar age and health who did not have hypotension also exhibited little difference in mean scores (49.9 v. 51.5 respectively). The mean scores of the two groups of subjects did not differ significantly. After 6 months the mean scores of the two groups were 40.9 and 44.7 respectively. It appears that elderly individuals with postural hypotension do not exhibit any appreciable deterioration in mental function with ambulation or after a 6-month period.
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