Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-21T12:12:44.706Z Has data issue: false hasContentIssue false
  • English
  • Français

Snapshot of an acute palliative care unit in a tertiary cancer hospital

Published online by Cambridge University Press:  16 October 2013

Akhila Reddy ,
Marieberta Vidal ,
Maxine de la Cruz ,
Sriram Yennurajalingam  and
Eduardo Bruera
Akhila Reddy*
Affiliation:
Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
Marieberta Vidal
Affiliation:
Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
Maxine de la Cruz
Affiliation:
Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
Sriram Yennurajalingam
Affiliation:
Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
Eduardo Bruera
Affiliation:
Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
*
Address correspondence and reprint requests to: Akhila Reddy, Department of Palliative Care and Rehabilitation Medicine, Unit 1414, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030. E-mail: asreddy@mdanderson.org
Get access Rights & Permissions [Opens in a new window]

Abstract

Most palliative care (PC) programs in the United States provide consultation services that assist the primary medical team with issues ranging from controlling patients' symptoms to initiating end-of-life discussions. This approach may be sufficient to address many patients' needs. However, for certain patients with complex medical and psychosocial issues, a better alternative is a more streamlined approach that can be provided in an acute palliative care unit (APCU), where the PC staff assumes the role of the primary team. An APCU is a specialized unit that delivers highly sophisticated care with professionals from various disciplines working together to improve the quality of life of patients and their families. However, descriptions of the process of delivering PC in the APCU are limited. In this special report, we portray a single day with a series of patients whose care was managed at our APCU to illustrate the unique components of an APCU that allow holistic care for patients with multiple complex medical and psychosocial issues.

Keywords

Acute palliative care unitSupportive oncologyEnd-of-life careSymptom managementInterdisciplinary palliative care
Type
Case Report
Information
Palliative & Supportive Care , Volume 12 , Issue 4 , August 2014 , pp. 331 - 337
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Casarett, D., Johnson, M., Smith, D., et al. (2011). The optimal delivery of palliative care: A national comparison of the outcomes of consultation teams vs. inpatient units. Archives of Internal Medicine, 171(7), 649–655.Google Scholar
Elsayem, A., Swint, K., Fisch, M.J., et al. (2004). Palliative care inpatient service in a comprehensive cancer center: Clinical and financial outcomes. Journal of Clinical Oncology, 22(10), 2008–2014.Google Scholar
Elsayem, A., Calderon, B.B., Camerines, E.M., et al. (2011). A month in an acute palliative care unit: Clinical interventions and financial outcomes. The American Journal of Hospice & Palliative Care, 28(8), 550–555.Google Scholar
Ferrell, B., Connor, S.R., Cordes, A., et al. (2007). The national agenda for quality palliative care: The National Consensus Project and the National Quality Forum. Journal of Pain and Symptom Management, 33(6), 737–744.Google Scholar
Higginson, I.J., Finlay, I.G.Goodwin, D.M., et al. (2003). Is there evidence that palliative care teams alter end-of-life experiences of patients and their caregivers? Journal of Pain and Symptom Management, 25(2), 150–168.Google Scholar
Hui, D., Elsayem, A., de la Cruz, M., et al. (2010 a). Availability and integration of palliative care at U.S. cancer centers. JAMA: The Journal of the American Medical Association, 303(11), 1054–1061.Google Scholar
Hui, D., Elsayem, A., Palla, S., et al. (2010 b). Discharge outcomes and survival of patients with advanced cancer admitted to an acute palliative care unit at a comprehensive cancer center. Journal of Palliative Medicine, 13(1), 49–57.Google Scholar
Lagman, R., Walsh, D., Heintz, J., et al. (2008). A day in the life: A case series of acute care palliative medicine—the Cleveland model. The American Journal of Hospice & Palliative Care, 25(1), 24–32.Google Scholar
Mori, M., Elsayem, D., Reddy, S.K., et al. (2012). Unrelieved pain and suffering in patients with advanced cancer. The American Journal of Hospice & Palliative Care, 29(3), 236–240.Google Scholar
Reddy, A., Hui, D., Bruera, E., et al. (2012). A successful palliative care intervention for cancer pain refractory to intrathecal analgesia. Journal of Pain and Symptom Management, 44(1), 124–130.Google Scholar
Stone, C., Lawlor, P.G., Nolan, B., et al. (2011). A prospective study of the incidence of falls in patients with advanced cancer. Journal of Pain and Symptom Management, 42(4), 535–540.Google Scholar
Teno, J.M., Clarridge, B.R., Casey, V., et al. (2004). Family perspectives on end-of-life care at the last place of care. JAMA: The Journal of the American Medical Association, 291(1), 88–93.CrossRefGoogle ScholarPubMed
Wright, A.Zhang, A.B., Ray, A., et al. (2008). Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment. JAMA: The Journal of the American Medical Association, 300(14), 1665–1673.Google Scholar
Yennurajalingam, S., Dev, R., Lockey, M., et al. (2008). Characteristics of family conferences in a palliative care unit at a comprehensive cancer center. Journal of Palliative Medicine, 11(9), 1208–1211.Google Scholar