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Terminal care: evaluation of an advisory domiciliary service at St Christopher's Hospice.

In a matched, comparative study the provision of an advisory service to families who were nursing a patient with incurable cancer at home enabled the patient to stay at home longer than he otherwise would and helped the family and primary care team to cope with the added burden which resulted. Families seem to have been well satisfied with the help which was given and there were considerable savings in cost to the health service.

Aged↗

[Quality and identity of terminal care in the hospital exemplified by the SPES VIVA Palliative Project].

In an attempt to contribute to the improvement of fatally ill and dying patients in hospitals, the palliative care project SPES VIVA represents a model scheme by a care concept of contents, personal and spatial definitions [3]. In order to receive an indirect expert verification of success, doctors and nurses of our hospital and of another one were interrogated during the same period. Although we know of the problems inherent in the method, a total of 158 voluntar participants in the study enabled US to compare the results of a preceding poll by W. George et al. of 1988 [2] to prove at least some effects. The SPES VIVA work enhanced the identification of the employed with their work and gave us hints on how to improve the situation of dying patients in our hospital. In comparison with the group of doctors, nurses more often tend to see "too many life-prolongation measures".

Attitude of Health Personnel↗

[Management of malignant bowel obstruction in terminal care--is home care possible?].

Malignant bowel obstruction occurs in about 10% of those with advanced abdominal cancer and in about 25% of those with advanced pelvic cancer. Such patients usually develop nausea, vomiting, constipation, abdominal dilatation and colicky pain. Traditional therapy consists of intravenous fluids and decompression by duodenal tube, gastrostomy or operation but postoperative mortality is high. Treatment requires hospitalization and therefore such patients have not been considered candidates for home care. Palliative medical techniques can cope with this syndrome and allow home care. Hypodermoclysis, non-prokinetic antiemetics like haloperidol and scopolamine, octeotride, corticosteroids, and narcotics for severe abdominal pain can alleviate symptoms. Medications can be combined and infused subcutaneously in a syringe driver and patients can remain with their families in their natural environment. Such techniques can give these patients who have short life expectancies reasonable quality of life.

Abdominal Neoplasms↗

Terminal care.

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Humans↗