By Joachim Cohen, Luc Deliens

ISBN-10: 0199599408

ISBN-13: 9780199599400

Around the world, greater than 50 million humans die every year and it's envisioned at the foundation of the stipulations resulting in dying that as much as 60% of them may gain advantage from a few kind of palliative care. it's a public overall healthiness problem to make sure that those humans can entry solid palliative or end-of-life care. Pursuing solid inhabitants wellbeing and fitness primarily additionally implies striving for a 'good adequate loss of life' and a superb caliber of care on the finish of lifestyles. Safeguarding a very good caliber of the top of lifestyles for sufferer populations for whom it's applicable calls for a public healthiness technique.

In so much constructed nations aging populations that more and more die from persistent illnesses after a protracted -often degenerative- death trajectory make up the general public future health demanding situations for palliative care. The very huge child increase new release will quickly achieve previous age and will be anticipated to pose powerful calls for in regards to the situations and care at their finish of lifestyles. simply via making use of a public healthiness method of palliative care (instead of person sufferer perspectives), can societies effectively support to arrange and plan end-of-life care according to those aspirations.

A Public healthiness point of view on finish of lifestyles Care offers a synthesis and evaluate of proper learn and empirical info at the finish of lifestyles which can undergo a foundation for a extra systematic 'public healthiness of the tip of life'. The booklet specializes in inhabitants well-being, instead of medical interventions or different elements of person overall healthiness, and discusses reviews utilizing varied methodologies (not purely epidemiological research). the point of interest is at the caliber of the end-of-life of populations, particularly from social sciences, environmental sciences, and arts views.

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The extent of patient-family caregiver congruence on preferred place of death was found to increase with higher patient-rated importance for dying at a preferred place, and patient-family concordance on preferred end-of-life care options (59). In contrast, the extent of patient-family caregiver congruence influence on preferred place of death decreased when patients understood their prognosis and when their family caregivers reported higher negative impact of caregiving on their life. This study highlights the importance of open patient-family communication about prognosis and end-of-life care options, not only to promote end-of-life care decisions that are consistent with the values and wishes of terminally ill cancer patients, but also to facilitate family caregivers’ understanding of patients’ actual preferences for end-of-life care, including place of death.

Furthermore, home deaths for cancer patients show decreasing trends in the UK (44), Italy (40), Greece (45), Korea (38), and Taiwan (47). Increasing trends for home deaths were reported in the US (42) and Canada (6). A great discrepancy between preferred and actual place of death One can conclude from the above review of epidemiologic studies on preferred and actual place of death for patients with all diseases, and specifically for cancer patients, that despite the predominant preference for dying at home, the reality is that few patients achieve 23 24 PLACE OF DEATH AND END-OF-LIFE CARE their preference.

New York: Oxford University Press; 2010. (2) Hanks G, Cherny NI, Christakis NA, Fallon M, Kaasa S, Portenoy RK. Oxford Textbook of Palliative Medicine, 4th edn. Oxford: Oxford University Press; 2009. (3) National cancer control programmes: Policies and managerial guidelines. Geneva: World Health Organization; 2002. (4) Davies E, Higginson IJ. Better palliative care for older people. World Health Organisation Europe; 2004. (5) Davies E, Higginson I. Palliative care: The solid facts. Copenhagen: World Health Organization Europe; 2004.

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A Public Health Perspective on End of Life Care by Joachim Cohen, Luc Deliens


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