Article: Frailty and palliative care

People with frailty have physical, psychosocial and support needs amenable to palliative care interventions but studies reveal they are less likely to access palliative care than those with advanced cancer.  This article looks at why palliative care is relevant to patients with frailty, and what hinders them receiving it.

Hamaker, M. et al.  Frailty and palliative care. Frailty and palliative care  BMJ Supportive and Palliative Care,  2020.

Contact the library for a copy

NICE Guidance: End of life care for adults: service delivery (NG142)

This guideline describes the provision of end of life care services for adults approaching the end of their life with any condition and disease.  It advises on service models for care in acute settings by disease-specific specialists and their supportive services, and in community settings by primary care or specialists in palliative care (for example, in hospices).  It is intended to be used alongside the NICE guidelines on Care of dying adults in the last days of life.

Download guidance here

Article: Comparison of financial support for family care givers of people at the end of life across six countries

The aim of this research was to identify and compare sources of support for family caregivers of people approaching end of life across six countries with similarly performing healthcare systems.  The 6 countries were Australia, Canada, Ireland, New Zealand, the United Kingdom, and the United States. The study found some form of financial support is available in all six countries, however the type, extent, and reach of support vary. The support is administered by multiple agencies, eligibility criteria are numerous and complex, and there is considerable inequity in the provision.  The authors concluded there is significant potential for policy makers to learn from other countries experiences.

Gardiner, C. 2019.  Comparison of financial support for family care givers of people at the end of life across six countries: a descriptive study.  Palliative Medicine, 33 (9) p1189-1211.

Contact the library for a copy.

New Book: Palliative and end of life care in nursing

The book is written for nursing students and non-specialist staff to provide the essential knowledge in the care and management of people nearing the end of life.  Chapters include: communication in palliative care; exploring loss, bereavement and grief; and rehabilitation in palliative and end of life care.  Each chapter includes activities to help readers think and learn about the topic.  A useful book for those involved in teaching or mentoring new staff.   Chapters can be scanned and sent over.

Nicol, J. & Nyatanga, B. 2017.  Palliative and end of life care in nursing.  2nd edition.  Sage Publishing

Contact the library

eHospice: New study calls for improvements in out of hours palliative care

From eHospice, a piece discussing the new research by Marie Curie and the RCGP calling for improvements in out of hours palliative care.  Using the NHS  National Reporting and Learning System, the research explored the nature and causes of unsafe care delivered to patients receiving palliative care from primary care services.  A total of 1072 patient safety incident reports were identified.  A number of recommendations are made.

View eHospice pages here

For a copy of the research - contact the library. 

Article: What role do Death Doulas play in end of life care?

Following on from Birth Doula's that were established about a decade ago to provide support and guidance to mothers, and mothers-to-be, there is now a new role, that of a death doula emerging in the end of life care space.   The authors, from an Australian University carried out a literature search to explore the role and potential implications for palliative care.  It established that Death Doulas are working with people at the end of life in varied roles that are still little understood and can be described as similar to that of "an eldest daughter" and similar to some specialist palliative care nurses.

Rawlings, D. et al. 2018.  What role do Death Doulas play in end of life care? A systematic review.  Health and Social Care in the Community, September 26 [online]

Download article here

Article: Crash course in EPaCCS (Electronic Palliative Care Co-ordination Systems:) 8 years of successes and failures in patient data sharing to learn from

Electronic Palliative Care  Co-ordination Systems (EPaCCS) are England's pre-eminent initiative enabling advance care planning, improved communication and co-ordination at end of life.  Striking outcomes have been recorded around EPaCCS such as 77.8% of patients dying in their preferred place.  EPaCCS have, however been extremely challenging to develop and implement with many projects remaining "under development" or folding. Rigorous research is also non-existent.  This paper discusses current EPaCCS and the way forward, outlining 5 key challengers and 6 key drivers.  It then proposes a number of initiatives working on information standards, re-thinking of national funding and new levels of individual and community involvement.

Petrova, M. 2018.  Crash course in EPaCCS (Electronic Palliative Care Co-ordination Systems:) 8 years of successes and failures in patient data sharing to learn from.  BMJ Supportive and Palliative Care, 8 (4) p 447 - 455.

Article: Quality improvement priorities for safer out of hours palliative care

Patients receiving palliative care are often at increased risk of unsafe care with the out-of-hours setting presenting particular challenges.   This article aimed to explore the nature and causes of unsafe care from primary care services.  An analysis of patient safety incident reports from the National Reporting and Learning System was carried out.  A total of 1072 patient safety reports involving patients receiving sub-optimal palliative care via the out of hours primary care services were identified.  Almost two-thirds of reports described harm with outcomes such as increased pain, with emotional and psychological distress featuring highly.  Commonly identified contributory factors were a failure to follow protocol, lack of skills/confidence of staff and patients requiring medication via a syringe driver.

Williams, H. et al. 2018.  Quality improvement priorities for safer out of hours palliative care: lessons from a mixed-methods analysis of a national incident-reporting database.  Palliative Medicine, published online December 2018

Article: How to explore the end of life preferences for homeless people in the UK

There is a scarcity of research into the end of life preferences of homeless people in the UK. This article examines the barriers to this population accessing palliative care and outlines ways in which their preferences can be determined.

Webb, A. et al.  2018.  How to explore the end of life preferences for homeless people in the UK.  European Journal of Palliative Care, 25 (1) p 59-62.

Contact the library for a copy

New Book: Palliative care nursing at a glance

Written by an expert team of nurses, educators, academics and researches, the book provides a concise and easy to read overview of all the concepts and clinical decision making necessary for the provision of good quality palliative and end of life care.  Covers a wide range of conditions including heart failure, COPD, kidney disease, motor neurone disease, mental illness and learning disabilities.

Ingleton, C. & Larkin, P. J. 2015. Palliative care nursing at a glance.  Wiley Blackwell.

Contact the library for a loan

Article: What is the cost of palliative care in the UK? A systematic review

Little is known about the cost of a palliative care approach in the UK, and there is an absence of robust activity and unit cost data.  The aim of this paper was to explore different approaches for capturing activity and unit cost data. Ten  papers were identified which met the study inclusion criteria.  The majority of papers explored costs from a NHS perspective.  Particular challenges were noted with capturing activity and cost data for hospice care.  The authors were not able to provide an aggregate cost of palliative care in the UK and noted the costs of hospice care and informal care are often neglected in economic studies.

Gardiner, C. et al. 2018.  What is the cost of palliative care in the UK?  A systematic review.  BMJ Supportive & Palliative Care. 8 250 - 254.

Contact the library for a copy