Dying and palliative care الموت

كُتِبَ عَلَيۡكُمۡ إِذَا حَضَرَ أَحَدَكُمُ ٱلۡمَوۡتُ إِن تَرَكَ خَيۡرًا ٱلۡوَصِيَّةُ لِلۡوَٰلِدَيۡنِ وَٱلۡأَقۡرَبِينَ بِٱلۡمَعۡرُوفِۖ حَقًّا عَلَى ٱلۡمُتَّقِينَ

it is prescribed that he should make a proper bequest to parents and close relatives- a duty incumbent on those who are mindful of God

يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُواْ شَهَٰدَةُ بَيۡنِكُمۡ إِذَا حَضَرَ أَحَدَكُمُ ٱلۡمَوۡتُ حِينَ ٱلۡوَصِيَّةِ ٱثۡنَانِ ذَوَا عَدۡلࣲ مِّنكُمۡ أَوۡ ءَاخَرَانِ مِنۡ غَيۡرِكُمۡ إِنۡ أَنتُمۡ ضَرَبۡتُمۡ فِي ٱلۡأَرۡضِ فَأَصَٰبَتۡكُم مُّصِيبَةُ ٱلۡمَوۡتِۚ تَحۡبِسُونَهُمَا مِنۢ بَعۡدِ ٱلصَّلَوٰةِ فَيُقۡسِمَانِ بِٱللَّهِ إِنِ ٱرۡتَبۡتُمۡ لَا نَشۡتَرِي بِهِۦ ثَمَنࣰ ا وَلَوۡ كَانَ ذَا قُرۡبَىٰ وَلَا نَكۡتُمُ شَهَٰدَةَ ٱللَّهِ إِنَّآ إِذࣰ ا لَّمِنَ ٱلۡأٓثِمِينَ

You who believe, when death approaches any of you, let two just men from among you act as witnesses to the making of a bequest, or two men from another people if you are journeying in the land when death approaches. Keep the two witnesses back after prayer, if you have any doubts, and make them both swear by God, ‘We will not sell our testimony for any price, even if a close relative is involved. We will not hide God’s testimony, for then we should be doing wrong.’

كُلُّ نَفۡسࣲ ذَآئِقَةُ ٱلۡمَوۡتِۗ وَنَبۡلُوكُم بِٱلشَّرِّ وَٱلۡخَيۡرِ فِتۡنَةࣰۖ وَإِلَيۡنَا تُرۡجَعُونَ

Every soul is certain to taste death: We test you all through the bad and the good, and to Us you will all return

كُلُّ نَفۡسࣲ ذَآئِقَةُ ٱلۡمَوۡتِۖ ثُمَّ إِلَيۡنَا تُرۡجَعُونَ

Every soul will taste death, then it is to Us that you will be returned

كُلُّ نَفۡسࣲ ذَآئِقَةُ ٱلۡمَوۡتِۗ وَإِنَّمَا تُوَفَّوۡنَ أُجُورَكُمۡ يَوۡمَ ٱلۡقِيَٰمَةِۖ فَمَن زُحۡزِحَ عَنِ ٱلنَّارِ وَأُدۡخِلَ ٱلۡجَنَّةَ فَقَدۡ فَازَۗ وَمَا ٱلۡحَيَوٰةُ ٱلدُّنۡيَآ إِلَّا مَتَٰعُ ٱلۡغُرُورِ

Every soul will taste death and you will be paid in full only on the Day of Resurrection. Whoever is kept away from the Fire and admitted to the Garden will have triumphed. The present world is only an illusory pleasure

لَا يَذُوقُونَ فِيهَا ٱلۡمَوۡتَ إِلَّا ٱلۡمَوۡتَةَ ٱلۡأُولَىٰۖ وَوَقَىٰهُمۡ عَذَابَ ٱلۡجَحِيمِ

After the one death they will taste death no more. God will guard them from the torment of Hell

It is written for you, when death is present for one of you and he is leaving behind some good, to make a will for parents and kinsfolk honorably, as something rightfully due from the godwary. The testament of the lords of wealth is one thing, and the testament of the lords of states is some- thing else. The testament of the lords of wealth goes out from the wealth, and the testament of the poor men from the states. At the end of their lives, the rich give out one-third of their wealth,13 and the poor give out limpidness of states and truthfulness of deeds. As much as the disobedient person is afraid for himself because of his bad deeds, the recogniz- er is afraid for himself ten times more because of the truthfulness of his deeds and the limpidness of his states. But there is a difference between the two: The disobedient person is afraid of the out- come and in dread of punishment, and

(O ye who believe! Let there be witnesses between you�) [5:106]. Abu Sa'id ibn Abi Bakr al-Razi informed us> Abu 'Amr ibn Hamdan> Abu Ya'la> al-Harith ibn Shurayh> Yahya ibn Zakariyya ibn Abi Za'idah> Muhammad ibn Abu'l-Qasim> 'Abd al-Malik ibn Sa'id ibn Jubayr> his father> Ibn 'Abbas who said: �Tamim al-Dari and 'Adiyy ibn Badda' used to come to Mecca. On one occasion, a man from Quraysh, from Banu Sahm, travelled with the two of them. However, this man died in a land where there was not a single Muslim and he had to entrust them with his belongings, with the understanding that they were to be given to his family. When the two of them arrived, they gave his belongings to his family but kept to themselves a silver bowl adorned with layers of gold. They denied having seen this bowl when they were asked about it. The two men were taken to the Prophet, Allah bless him and give him peace, wh

Prescribed made obligatory for you when any of you is approached by death that is by its causes and leaves behind some good material possessions is to make testament al-wasiyyatu is in the nominative because of kutiba and is semantically connected to the particle idhā ‘when’ if the latter is adverbial; but if this latter is conditional then it al-wasiyyatu indicates the response; the response to the conditional particle in ‘if’ is in other words implied to be fa’l-yūsi ‘let him make testament’; in favour of his parents and kinsmen honourably that is justly not giving more than the allotted share of a third nor preferring the richer person — an obligation haqqan here emphasises the import of what has preceded on those that fear God this verse has been abrogated by the ‘inheritance’ verse āyat al-mīrāth see Q. 411 and by the hadīth ‘Do not make testament for one already inheriting’ as repo

O you who believe let testimony between you when death that is one of its causes draws near to one of you at the time of a bequest be that of two men of justice among you ithnāni dhawā ‘adlin minkum ‘two men of justice among you’ is the predicate expressed with the sense of an imperative in other words ‘let two men bear witness … etc.’; the genitive annexation of shahāda ‘testimony’ and bayn ‘between’ is meant to allow for a range of alternatives; hīn ‘at the time of’ is a substitute for idhā ‘when’ or an adverbial qualifier of time for the verb hadara ‘draws near’; or of two others from another folk that is from other than your own religious community if you are travelling in the land and the affliction of death befalls you. Then you shall empanel them you shall detain them tahbisūnahumā ‘you shall empanel them’ is an adjectival qualification of ākharān ‘two others’ after the mid-aftern

We have not assigned everlastingness to any mortal before thee. If thou diest, will they be everlasting? Every soul shall taste death. When a speck of truthfulness appears in someone's heart, the reality of passion for death will show its head from his spirit, for the promise of encounter is there. What sort of spirit would forget the promise of encounter? What sort of heart would seek from someplace else the repose that comes only from contemplating the Real? “The person of faith has no ease without encoun- tering his Lord.” O dervish, no good fortune is more precious than death. Those who have the religion place the crown of magnificence and generosity on their heads at the gate of death. Those who reap the fruit of the Shariah will find the sigil of good fortune at the door of death. Death is the sanctuary of “There is no god but God.” Death is the doorstep of the kingdom of the resur

Every soul shall taste of death; you shall surely be paid in full your wages the requital of your deeds on the Day of Resurrection. Whoever is moved away distanced from the Fire and admitted to Paradise will have triumphed he will have attained his ultimate wish. Living in the life of this world is but the comfort of delusion; of inanity enjoyed for a little while then perishing.

حَدَّثَنِي عَبْدُ اللَّهِ بْنُ مُحَمَّدٍ، حَدَّثَنَا عَبْدُ الْمَلِكِ بْنُ عَمْرٍو، حَدَّثَنَا زُهَيْرُ بْنُ مُحَمَّدٍ، عَنْ مُحَمَّدِ بْنِ عَمْرِو بْنِ حَلْحَلَةَ، عَنْ عَطَاءِ بْنِ يَسَارٍ، عَنْ أَبِي سَعِيدٍ الْخُدْرِيِّ، وَعَنْ أَبِي هُرَيْرَةَ، عَنِ النَّبِيِّ صلى الله عليه وسلم قَالَ ‏ "‏ مَا يُصِيبُ الْمُسْلِمَ مِنْ نَصَبٍ وَلاَ وَصَبٍ وَلاَ هَمٍّ وَلاَ حُزْنٍ وَلاَ أَذًى وَلاَ غَمٍّ حَتَّى الشَّوْكَةِ يُشَاكُهَا، إِلاَّ كَفَّرَ اللَّهُ بِهَا مِنْ خَطَايَاهُ ‏"‏‏.‏

Narrated Abu Sa`id Al-Khudri and Abu Huraira:The Prophet (ﷺ) said, "No fatigue, nor disease, nor sorrow, nor sadness, nor hurt, nor distress befalls a Muslim, even if it were the prick he receives from a thorn, but that Allah expiates some of his sins for that

حَدَّثَنَا إِبْرَاهِيمُ بْنُ الْمُنْذِرِ، قَالَ حَدَّثَنِي مُحَمَّدُ بْنُ فُلَيْحٍ، قَالَ حَدَّثَنِي أَبِي، عَنْ هِلاَلِ بْنِ عَلِيٍّ، مِنْ بَنِي عَامِرِ بْنِ لُؤَىٍّ عَنْ عَطَاءِ بْنِ يَسَارٍ، عَنْ أَبِي هُرَيْرَةَ ـ رضى الله عنه ـ قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ مَثَلُ الْمُؤْمِنِ كَمَثَلِ الْخَامَةِ مِنَ الزَّرْعِ مِنْ حَيْثُ أَتَتْهَا الرِّيحُ كَفَأَتْهَا، فَإِذَا اعْتَدَلَتْ تَكَفَّأُ بِالْبَلاَءِ، وَالْفَاجِرُ كَالأَرْزَةِ صَمَّاءَ مُعْتَدِلَةً حَتَّى يَقْصِمَهَا اللَّهُ إِذَا شَاءَ ‏"‏‏.‏

Narrated Abu Huraira:Allah's Messenger (ﷺ) said, "The example of a believer is that of a fresh tender plant; from whatever direction the wind comes, it bends it, but when the wind becomes quiet, it becomes straight again. Similarly, a believer is afflicted with calamities (but he remains patient till Allah removes his difficulties.) And an impious wicked person is like a pine tree which keeps hard and straight till Allah cuts (breaks) it down when He wishes." (See Hadith No. 558, Vol)

وَحَدَّثَنَاهُ قُتَيْبَةُ بْنُ سَعِيدٍ، حَدَّثَنَا عَبْدُ الْعَزِيزِ يَعْنِي الدَّرَاوَرْدِيَّ، ح وَحَدَّثَنَا أَبُو بَكْرِ بْنُ أَبِي شَيْبَةَ حَدَّثَنَا خَالِدُ بْنُ مَخْلَدٍ، حَدَّثَنَا سُلَيْمَانُ بْنُ بِلاَلٍ، جَمِيعًا بِهَذَا الإِسْنَادِ ‏.‏

This hadith has been narrated by Sulaiman b. Bilal with the same chain of transmitters

وَحَدَّثَنَا أَبُو بَكْرٍ، وَعُثْمَانُ، ابْنَا أَبِي شَيْبَةَ ح وَحَدَّثَنِي عَمْرٌو النَّاقِدُ، قَالُوا جَمِيعًا حَدَّثَنَا أَبُو خَالِدٍ الأَحْمَرُ، عَنْ يَزِيدَ بْنِ كَيْسَانَ، عَنْ أَبِي حَازِمٍ، عَنْ أَبِي هُرَيْرَةَ، قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ لَقِّنُوا مَوْتَاكُمْ لاَ إِلَهَ إِلاَّ اللَّهُ ‏"‏ ‏.‏

Abu Huraira reported Allah's Messenger (ﷺ) as saying:Exhort to recite" There is no god but Allah" to those of you who are dying

حَدَّثَنَا أَبُو بِشْرٍ، بَكْرُ بْنُ خَلَفٍ وَمُحَمَّدُ بْنُ بَشَّارٍ قَالاَ حَدَّثَنَا يَحْيَى بْنُ سَعِيدٍ، حَدَّثَنَا عَبْدُ الْحَمِيدِ بْنُ جَعْفَرٍ، عَنْ أَبِيهِ، عَنْ حَكِيمِ بْنِ أَفْلَحَ، عَنْ أَبِي مَسْعُودٍ، عَنِ النَّبِيِّ ـ صلى الله عليه وسلم ـ قَالَ ‏ "‏ لِلْمُسْلِمِ عَلَى الْمُسْلِمِ أَرْبَعُ خِلاَلٍ يُشَمِّتُهُ إِذَا عَطَسَ وَيُجِيبُهُ إِذَا دَعَاهُ وَيَشْهَدُهُ إِذَا مَاتَ وَيَعُودُهُ إِذَا مَرِضَ ‏"‏ ‏.‏

It was narrated from Abu Mas’ud that the Prophet (ﷺ) said:“The Muslim has four things due from the Muslim: He should answer [by saying Yarhamuk-Allah (may Allah have mercy on you)] to him if he sneezes (and says Al-Hamdulillah); he should accept his invitation if he invites him; he should attend his funeral if he dies; and he should visit him if he falls sick.”

حَدَّثَنَا أَبُو بَكْرِ بْنُ أَبِي شَيْبَةَ، حَدَّثَنَا مُحَمَّدُ بْنُ بِشْرٍ، عَنْ مُحَمَّدِ بْنِ عَمْرٍو، عَنْ أَبِي سَلَمَةَ، عَنْ أَبِي هُرَيْرَةَ، قَالَ قَالَ رَسُولُ اللَّهِ ـ صلى الله عليه وسلم ـ ‏ "‏ خَمْسٌ مِنْ حَقِّ الْمُسْلِمِ عَلَى الْمُسْلِمِ رَدُّ التَّحِيَّةِ وَإِجَابَةُ الدَّعْوَةِ وَشُهُودُ الْجِنَازَةِ وَعِيَادَةُ الْمَرِيضِ وَتَشْمِيتُ الْعَاطِسِ إِذَا حَمِدَ اللَّهَ ‏"‏ ‏.‏

It was narrated from Abu Hurairah that the Messenger of Allah (ﷺ) said:“Five are the rights of the Muslim: Returning his greeting, accepting his invitation; attending his funeral; visiting the sick; and answering (saying Yarhamuk-Allah) to the one who sneezes, if he praises Allah (says Al-Hamdu Lillah).”

الباب الثالث في سكرات الموت وشدته وما يستحب من الأحوال عند الموت

| الباب الثالث في سكرات الموت وشدته وما يستحب من الأحوال عنده

ومن أقسام الخائفين، من يخاف سكرات الموت وشدته، أو سؤال منكر ونكير، أو عذاب القبر.

فهذه سكرات الموت على أولياء الله وأحبابه في حالنا ونحن المنهمكون في المعاصي وتتوالى علينا مع سكرات الموت بقية الدواهي فإن دواهي الموت ثلاث

قد عرفت فيما سبق أحوال الميت فى سكرات الموت وخطره فى خوف العاقبة ثم مقاساته لظلمة القبر وديدانه ثم لمنكر ونكير وسؤالهما ثم لعذاب القبر وخطره إن كان مغضوبا عليه

إحداهما أعظم، وهو أن يغلب على القلب والعياذ بالله شك، أو جحود عند سكرات الموت وأهواله، فيقتضي ذلك العذاب الدائم.

Disparities in Palliative and Hospice Care and Completion of Advance Care Planning and Directives Among Non-Hispanic Blacks: A Scoping Review of Recent Literature.: Objectives: Published research in disparities in advance care planning, palliative, and end-of-life care is limited. However, available data points to significant barriers to palliative and end-of-life care among minority adults. The main objective of this scoping review was to summarize the current published research and literature on disparities in palliative and hospice care and completion of advance care planning and directives among non-Hispanc Blacks. Methods: The scoping review method was

Good end-of-life care in nursing home according to the family carers' perspective: A systematic review of qualitative findings.: Background: Nursing homes are becoming a common site where delivering end-of-life care for older adults. They often represent the junction between the curative and the palliative phase. Aim: To identify the elements that nursing home residents' family carers perceive as good end-of-life care and develop a conceptual model of good end-of-life care according to the family perspective. Design: Systematic review (PROSPERO no. 95581) with meta-aggregation method. Data sources: Five electronic databas

Defining priorities for improving end-of-life care in Canada.: Background: High-quality end-of-life care should be the right of every Canadian. The objective of this study was to identify aspects of end-of-life care that are high in priority as targets for improvement using feedback elicited from patients and their families. Methods: We conducted a multicentre, cross-sectional survey involving patients with advanced, life-limiting illnesses and their family caregivers. We administered the Canadian Health Care Evaluation Project (CANHELP) questionnaire along

Advance Care Planning, Palliative Care, and End-of-life Care Interventions for Racial and Ethnic Underrepresented Groups: A Systematic Review.: Context: Persons from underrepresented racial and ethnic groups experience disparities in access to and quality of palliative and end-of-life care. Objectives: To summarize and evaluate existing palliative and end-of-life care interventions that aim to improve outcomes for racial and ethnic underrepresented populations in the United States. Methods: We conducted a systematic review of the literature in the English language from four databases through January 2020. Peer-reviewed studies that impl

Provision of spiritual support to patients with advanced cancer by religious communities and associations with medical care at the end of life.: Importance: Previous studies report associations between medical utilization at the end-of-life (EoL) and religious coping and spiritual support from the medical team. However, the influence of clergy and religious communities on EoL outcomes is unclear. Objective: To determine whether spiritual support from religious communities influences terminally ill patients' medical care and quality of life (QoL) near death. Design, setting, and participants: A US-based, multisite cohort study of 343 pati

Death anxiety interventions in patients with advanced cancer: A systematic review.: Background: Death anxiety is a common issue in adult patients with advanced cancer and can have a large impact on quality of life and end-of-life care. Interventions are available to assist but are scarcely used in everyday practice. Aim: To assess quantitative studies on interventions for adult patients with advanced cancer suffering from death anxiety. Data sources: MEDLINE, PsycINFO, Embase and CINAHL were searched to identify quantitative or mixed studies on death anxiety or relatable existe

Relationships between Islamic religiosity and attitude toward deceased organ donation among American Muslims: a pilot study.

Background: Religion-rooted beliefs and values are often cited as barriers to organ donation among Muslims. Yet how Islamic religiosity relates to organ donation attitude among Muslims is less studied. Methods: Using a community based participatory research approach, we recruited adults from mosque communities to self-administer a questionnaire assessing levels of Islamic religiosity, attitude toward deceased organ donation, and sociodemographic descriptors. Results: Of the 97 respondents, there were nearly equal numbers of men and women. Over a third were Arab American (n=36), and nearly a quarter were either South Asian (n=23) or African American (n=25). Respondents viewing difficulties in life as punishment from God had a decreased odds of believing deceased organ donation to be justified (OR 0.85, P<0.05). Other measures of Islamic religiosity, such as intrinsic religiosity, positive…

matched on Attitude to Death (mesh)

Religiousness, religious doubt, and death anxiety.

Terror Management Theory (TMT) (Greenberg, Pyszczynski, & Solomon, 1986) suggests that culturally-provided worldviews (e.g., religion) may protect individuals from experiencing death anxiety, and several studies have supported this position. However, if one's worldview can offer protection, doubts concerning one's worldview could undermine this protection. The current study investigated whether age, gender, religiousness, and religious doubt were associated with death anxiety. Using data from 635 younger, middle-aged, and older adults, a structural equation model with age, gender, religiousness, and religious doubt predicting death anxiety was tested. The model had a good fit (chi2 (76) = 193.467, p < .001; GFI = .961, CFI = .976, TLI = .967, RMSEA = .049) and accounted for 12.3% of the variance in death anxiety. Results were consistent with TMT, as religiousness was inversely associated…

matched on Attitude to Death (mesh)

The witnessing of disenfranchised grief: reliability and validity.

Background and purpose: To examine the psychometric properties of a newly designed instrument: Witnessing of Disenfranchised Grief (WDG). Methods: The 22-item questionnaire was administered to a community-based sample of convenience (N = 201). Each subject reported having experienced a loss by death or miscarriage. There was no stipulation regarding the timing of the loss. Results: The tool was found to be one dimensional with factor loadings of 0.40-0.78, inter-item correlation ranging from p < .01 to p < .05, and a Cronbach's alpha of 0.91. A loss that was viewed as witnessed resulted in decreased manifestation of some grief symptoms. Conclusions: The WDG is a measure of the degree to which one who grieves perceives their loss to be witnessed.

matched on Attitude to Death (mesh)

Terror management theory and self-esteem revisited: the roles of implicit and explicit self-esteem in mortality salience effects.

Three studies tested the roles of implicit and/or explicit self-esteem in reactions to mortality salience. In Study 1, writing about death versus a control topic increased worldview defense among participants low in implicit self-esteem but not among those high in implicit self-esteem. In Study 2, a manipulation to boost implicit self-esteem reduced the effect of mortality salience on worldview defense. In Study 3, mortality salience increased the endorsement of positive personality descriptions but only among participants with the combination of low implicit and high explicit self-esteem. These findings indicate that high implicit self-esteem confers resilience against the psychological threat of death, and therefore the findings provide direct support for a fundamental tenet of terror management theory regarding the anxiety-buffering role of self-esteem.

matched on Attitude to Death (mesh)

A longitudinal study on quality of life and depression in ALS patient-caregiver couples.

Objectives: To evaluate the modification of quality of life (QoL) and depression in a series of amyotrophic lateral sclerosis (ALS) patient-caregiver couples during a period of 9 months and compare them to patients' ALS Functional Rating Scale (ALS-FRS). Methods: Depression was assessed with Zung Depression Scale (ZDS) and QoL with McGill Quality of Life Questionnaire (MQoL). Caregivers' burden was assessed with Caregiver Burden Inventory (CBI), and patients' feeling to be a burden with the Self-Perceived Burden Scale (SPBS). Results: Thirty-one ALS patient-caregiver couples were interviewed at baseline and after 9 months. The mean ALS-FRS score was 28.7 (SD 7) at baseline and 24.1 (6.9) at the second interview (p = 0.0001). Patients' mean MQoL score slightly increased from 6.8 (1.6) to 7 (1.1) (p = 0.07); their ZDS score slightly increased (43.2 [8.7] at baseline and 45.7 [9.3] at the s…

matched on Attitude to Death (mesh)

Preparedness for the death of a loved one and mental health in bereaved caregivers of patients with dementia: findings from the REACH study.

Background: Although it has been suggested that family and friends who are prepared for the death of a loved one have less distress, the relationship between preparedness and bereavement mental health is inconclusive. Objectives: To determine the relationship between preparedness for the death and mental health in bereaved caregivers of dementia patients and explore predictors of preparedness. Design: A prospective study of family caregivers of persons with dementia. Standardized assessment instruments and structured questions were used to collect data at study entry and at 6, 12, and 18 months. Multiple caregiving-related variables were collected. Bereaved caregivers reported whether they were "not at all" prepared or prepared for the death of their loved one. Subjects: Two hundred twenty-two bereaved caregivers Results: Twenty-three percent of caregivers were not prepared for the death…

matched on Attitude to Death (mesh)

Advance care planning in Asian culture.

Ageing has been recognized as one of the most critically important health-care issues worldwide. It is relevant to Asia, where the increasing number of older populations has drawn attention to the paramount need for health-care investment, particularly in end-of-life care. The advocacy of advance care planning is a mean to honor patient autonomy. Since most East Asian countries are influenced by Confucianism and the concept of 'filial piety,' patient autonomy is consequently subordinate to family values and physician authority. The dominance from family members and physicians during a patient's end-of-life decision-making is recognized as a cultural feature in Asia. Physicians often disclose the patient's poor prognosis and corresponding treatment options to the male, family member rather to the patient him/herself. In order to address this ethical and practical dilemma, the concept of '…

matched on Terminal Care (mesh), Palliative Care (keyword), Advance Care Planning (mesh), end of life (text)

Physicians' Views on Advance Care Planning and End-of-Life Care Conversations.

Objectives: To evaluate physicians' views on advance care planning, goals of care, and end-of-life conversations. Design: Random sample telephone survey. Setting: United States. Participants: Physicians (primary care specialists; pulmonology, cardiology, oncology subspecialists) actively practicing medicine and regularly seeing patients aged 65 and older (N=736; 81% male, 75% white, 66% aged ≥50. Measurements: A 37-item telephone survey constructed by a professional polling group with national expert oversight measured attitudes and perceptions of barriers and facilitators to advance care planning. Summative data are presented here. Results: Ninety-nine percent of participants agreed that it is important to have end-of-life conversations, yet only 29% reported that they have formal training for such conversations. Those most likely to have training included younger physicians and those c…

matched on Terminal Care (mesh), Palliative Care (keyword), Advance Care Planning (mesh), end of life (text)

'Because it's the wife who has to look after the man': A descriptive qualitative study of older women and the intersection of gender and the provision of family caregiving at the end of life.

Background: Research indicates that women are the primary family caregivers for others at life's end and, because of ageing populations, will keep fulfilling this role as they age. Yet, little is known about how the gendered nature of caregiving contributes to older women's understandings of providing care. Aim: To explore how gender norms constructed older women's views about the appropriate roles of women and men in providing palliative and end-of-life care for family members. Design: Six focus groups were conducted with 39 community dwelling older adults (36 women and 3 men) using two vignettes to prompt discussion about experience of end of life caring and attitudes towards Advance Care Planning. This article reports on data gathered from female participants' reactions to Vignette 1 which prompted significant discussion regarding the intersection of gender and older women's caregivin…

matched on Terminal Care (mesh), Palliative Care (keyword), Advance Care Planning (mesh), end of life (text)

They know!-Do they? A qualitative study of residents and relatives views on advance care planning, end-of-life care, and decision-making in nursing homes.

Background: Residents living in long-term care facilities are a vulnerable population. For many residents, a nursing home is their place of death. Palliative care and end-of-life decisions are important components of their care provision. Aim: To study the views of cognitively able residents and relatives on advance care planning, end-of-life care, and decision-making in nursing homes. Design: A qualitative study with in-depth interviews with nursing home residents and focus group interviews with relatives of nursing home residents. Analysis is based on interpretive description. Setting/participants: In total, 43 informants from nine nursing homes participated in the study (25 nursing home residents and 18 relatives). All included residents had capacity to provide informed consent and lived in long-term care. Results: The main findings of this study were the differing views about decisio…

matched on Terminal Care (mesh), Palliative Care (keyword), Advance Care Planning (mesh), end of life (text)

Spirituality, quality of life, psychological adjustment in terminal cancer patients in hospice.

The purpose of this study was to show the different components of spirituality in the last few weeks of life for advanced cancer patients admitted to hospice and to evaluate quality of life (QoL), pain, anxiety, depression and psychological adjustment to cancer. One hundred and fifteen patients were interviewed with a series of rating scales: the Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being Scale, the Hospital Anxiety and Depression Scale, the Visual Analogue Scale for pain, the Brief Coping Orientation to Problem Experienced and the Functional Assessment of Cancer Therapy Scale - General Measure. Workers and single patients with higher education level showed a worse QoL. Moreover, anxiety and pain were negatively associated with QoL, while spirituality and 'Instrumental Support' coping style were positively associated with QoL. In the Italian sample, it was ob…

matched on Hospice Care (mesh), Palliative Care (keyword), Terminally Ill (mesh), end of life (text)

Opening end-of-life discussions: how to introduce Voicing My CHOiCES™, an advance care planning guide for adolescents and young adults.

Objective: Each year, more than 11,000 adolescents and young adults (AYAs), aged 15-34, die from cancer and other life-threatening conditions. In order to facilitate the transition from curative to end-of-life (EoL) care, it is recommended that EoL discussions be routine, begin close to the time of diagnosis, and continue throughout the illness trajectory. However, due largely to discomfort with the topic of EoL and how to approach the conversation, healthcare providers have largely avoided these discussions. Method: We conducted a two-phase study through the National Cancer Institute with AYAs living with cancer or pediatric HIV to assess AYA interest in EoL planning and to determine in which aspects of EoL planning AYAs wanted to participate. These results provided insight regarding what EoL concepts were important to AYAs, as well as preferences in terms of content, design, format, an…

matched on Terminal Care (mesh), Palliative Care (keyword), Advance Care Planning (mesh), end of life (text)

The wish to hasten death: a review of clinical studies.

It is common for patients who are faced with physical or psychological suffering, particularly those in the advanced stages of a disease, to have some kind of wish to hasten death (WTHD). This paper reviews and summarises the current state of knowledge about the WTHD among people with end-stage disease, doing so from a clinical perspective and on the basis of published clinical research. Studies were identified through a search strategy applied to the main scientific databases. Clinical studies show that the WTHD has a multi-factor aetiology. The literature review suggests-perhaps in line with better management of physical pain-that psychological and spiritual aspects, including social factors, are the most important cause of such a wish. One of the difficulties facing clinical research is the lack of terminological and conceptual precision in defining the construct. Indeed, studies freq…

matched on Attitude to Death (mesh), Terminally Ill (mesh)

Supporting the Grieving Child and Family.

The death of someone close to a child often has a profound and lifelong effect on the child and results in a range of both short- and long-term reactions. Pediatricians, within a patient-centered medical home, are in an excellent position to provide anticipatory guidance to caregivers and to offer assistance and support to children and families who are grieving. This clinical report offers practical suggestions on how to talk with grieving children to help them better understand what has happened and its implications and to address any misinformation, misinterpretations, or misconceptions. An understanding of guilt, shame, and other common reactions, as well an appreciation of the role of secondary losses and the unique challenges facing children in communities characterized by chronic trauma and cumulative loss, will help the pediatrician to address factors that may impair grieving and …

matched on Attitude to Death (mesh)

Dignity therapy: family member perspectives.

Purpose: Dignity Therapy is a novel therapeutic intervention designed to address psychosocial and existential distress among the terminally ill. This brief, individualized approach to end-of-life care invites patients to discuss issues that are most important to them and to articulate things they would most want remembered as death draws near. These discussions and recollections are recorded, transcribed, and edited into a generativity document, which are usually given to family or loved ones. While the marked benefits of Dignity Therapy on patients' psychosocial and existential distress have been reported elsewhere, this paper presents data on bereft family members' perspectives regarding the impact of dignity therapy on patients and themselves. Subjects and methods: Sixty family members of deceased terminally ill patients who previously took part in Dignity Therapy completed a question…

matched on Palliative Care (mesh), Terminally Ill (mesh), end of life (text), terminal illness (text)

Chaplains Working in Palliative Care: Who They Are and What They Do.

Background: Palliative care (PC) programs utilize chaplains to address patients' spiritual care needs; however, there is no comprehensive description of chaplaincy in PC programs nationally. Objective: To describe chaplains working in PC across the United States, including their integration on the PC team and visit content. Design: National online survey conducted February-April 2015. Subjects: We invited participation from hospital-based chaplains belonging to four national professional chaplain associations who spent 15% or more of their working hours with PC teams. Measure(s): We developed a 41-item survey to investigate main outcomes of chaplain demographics, practice information, integration into the PC team, and visit content. Results: 531 valid responses were received. We report on respondents who were full-time chaplains (n = 382). Almost half were women (46%), and the majority w…

matched on Palliative Care (mesh), Attitude to Death (mesh), Palliative Care (keyword)

'Old and ill': death anxiety and coping strategies influencing health professionals' well-being and dementia care.

Objectives: This paper examined the psychological factors that influence the well-being of health professionals who work with people with dementia and the types of care (person-centred or task-oriented) provided to these patients. Methods: The literature was reviewed to identify the factors influencing the well-being of, and types of care provided by, health professionals working with people experiencing dementia. Results: Based on our review of the literature, we propose that approaches to care and the well-being of health professionals working with dementia patients are influenced by the characterisation of dementia as a terminal illness that typically occurs in older people. Drawing upon terror management theory, we argue that exposure to dementia patients is likely to promote awareness of one's own mortality and death-related anxiety. A theoretical model is presented which posits tha…

matched on Attitude to Death (mesh), terminal illness (text)

Measuring Advance Care Planning: Optimizing the Advance Care Planning Engagement Survey.

Context: A validated 82-item Advance Care Planning (ACP) Engagement Survey measures a broad range of behaviors. However, concise surveys are needed. Objectives: The objective of this study was to validate shorter versions of the survey. Methods: The survey included 57 process (e.g., readiness) and 25 action items (e.g., discussions). For item reduction, we systematically eliminated questions based on face validity, item nonresponse, redundancy, ceiling effects, and factor analysis. We assessed internal consistency (Cronbach's alpha) and construct validity with cross-sectional correlations and the ability of the progressively shorter survey versions to detect change one week after exposure to an ACP intervention (Pearson correlation coefficients). Results: Five hundred one participants (four Canadian and three US sites) were included in item reduction (mean age 69 years [±10], 41% nonwhit…

matched on Advance Care Planning (mesh)

Religious coping and behavioral disengagement: opposing influences on advance care planning and receipt of intensive care near death.

Objective: This study examines the relationships between methods of coping with advanced cancer, completion of advance care directives, and receipt of intensive, life-prolonging care near death. Methods: The analysis is based on a sample of 345 patients interviewed between January 1, 2003, and August 31, 2007, and followed until death as part of the Coping with Cancer Study, an NCI/NIMH-funded, multi-site, prospective, longitudinal, cohort study of patients with advanced cancer. The Brief COPE was used to assess active coping, use of emotional-support, and behavioral disengagement. The Brief RCOPE was used to assess positive and negative religious coping. The main outcome was intensive, life-prolonging care near death, defined as receipt of ventilation or resuscitation in the last week of life. Results: Positive religious coping was associated with lower rates of having a living will (AO…

matched on Terminal Care (mesh), Attitude to Death (mesh), Advance Care Planning (mesh)

Stages of change for the component behaviors of advance care planning.

Objectives: To develop stages-of-change measures for advance care planning (ACP), conceptualized as a group of interrelated but separate behaviors, and to use these measures to characterize older persons' engagement in and factors associated with readiness to participate in ACP. Design: Observational cohort study. Setting: Community. Participants: Persons aged 65 and older recruited from physician offices and a senior center. Measurements: Stages of change for six ACP behaviors: completion of a living will and healthcare proxy, communication with loved ones regarding use of life-sustaining treatments and quantity versus quality of life, and communication with physicians about these same issues. Results: Readiness to participate in ACP varied widely across behaviors. Whereas between approximately 50% and 60% of participants were in the action or maintenance stage for communicating with lo…

matched on Advance Care Planning (mesh)

Psychiatric disorders and mental health service use in patients with advanced cancer: a report from the coping with cancer study.

Background: Psychological morbidity has been proposed as a source of distress in cancer patients. This study aimed to: 1) determine the prevalence of diagnosable psychiatric illnesses, and 2) describe the mental health services received and predictors of service utilization in patients with advanced cancer. Methods: This was a cross-sectional, multi-institutional study of 251 eligible patients with advanced cancer. Eligibility included: distant metastases, primary therapy failure, nonpaid caregiver, age > or =20 years, stamina for the interview, English or Spanish-speaking, and adequate cognitive ability. Trained interviewers administered the Structured Clinical Interview for the Diagnostic Statistical Manual IV (DSM-IV) modules for Major Depressive Disorder, Generalized Anxiety Disorder, Panic Disorder, Post-Traumatic Stress Disorder, and a detailed questionnaire regarding mental health…

matched on Terminally Ill (mesh)

Palliative care to support the needs of adults with neurological disease.

Neurological diseases cause physical, psychosocial, and spiritual or existential suffering from the time of their diagnosis. Palliative care focuses on improving quality of life for people with serious illness and their families by addressing this multidimensional suffering. Evidence from clinical trials supports the ability of palliative care to improve patient and caregiver outcomes by the use of outpatient or home-based palliative care interventions for people with motor neuron disease, multiple sclerosis, or Parkinson's disease; inpatient palliative care consultations for people with advanced dementia; telephone-based case management for people with dementia in the community; and nurse-led discussions with decision aids for people with advanced dementia in long-term care. Unfortunately, most people with neurological diseases do not get the support that they need for their palliative …

matched on Palliative Care (mesh)

Ambiguous loss in family caregivers of loved ones with cancer, a synthesis of qualitative studies.

Purpose: The purpose of this synthesis of qualitative studies is to explore manifestations of ambiguous loss within the lived experiences of family caregivers (FCG) of loved ones with cancer. Grief and loss are familiar companions to the family caregivers of loved ones with cancer. Anticipatory loss, pre-loss grief, complicated grief, and bereavement loss have been studied in this caregiver population. It is unknown if family caregivers also experience ambiguous loss while caring for their loved ones along the uncertain landscape of the cancer illness and survivorship trajectory. Methods: We conducted a four-step qualitative meta-synthesis of primary qualitative literature published in three databases between 2008 and 2021. Fourteen manuscripts were analyzed using a qualitative appraisal tool and interpreted through thematic synthesis and reciprocal translation. Results: Five themes were…

matched on Palliative Care (mesh)

"Getting it right when it goes wrong - Effective bereavement care requires training of the whole maternity team".

Stillbirth or neonatal death is one of the most traumatic and distressing life experiences with negative psychosocial effects. Perinatal grief is natural and understandable, and, if not recognized and well supported, may lead to long-term harmful effects. Harm may also be caused to the other surviving siblings, families, and next generation. This can be helped by effective bereavement care. Bereavement care is an area of enormous needs, relatively untraveled road. Though the loss cannot be undone, but a negative impact can be minimized by compassionate supportive care. This chapter will focus on the need of a trained team for effective bereavement care. Principles of evidence-based best practices from the literature will be reviewed and translated into key practice implications. An emphasis is laid on a structured training involving the whole team. We hope this will help in day-to-day si…

matched on Hospice Care (mesh)

Models of supportive care in oncology.

Purpose of review: Supportive care services have evolved overtime to meet the growing supportive care need of patients with cancer and their families. In this review, we summarize existing definitions of supportive care, highlight empiric studies on supportive care delivery, and propose an integrated conceptual framework on supportive cancer care. Recent findings: Supportive care aims at addressing the patients' physical, emotional, social, spiritual, and informational needs throughout the disease trajectory. Interdisciplinary teams are needed to deliver multidimensional care. Oncology teams have an important role providing supportive care in the front lines and referring patients to supportive care services such as palliative care, social work, rehabilitation, psycho-oncology, and integrative medicine. However, the current model of as needed referral and siloed departments can lead to h…

matched on Palliative Care (mesh)