Palliative Medicine:Scoping the level and extent of service provision to people with intellectual disability at end of life Poster Presentation

Background: Concerns exist about the end of life care
that people with intellectual disabilities receive. This population
are seldom referred to palliative care services and
inadequate data sets exist about their place of death.
Aim: To scope the extent of service provision to people
with intellectual disabilities at the end of life by specialist
palliative care and intellectual disability services in one
region of the United Kingdom.
Methods: As part of a larger doctoral study a regional survey
took place of a total sample (n=66) of specialist palliative
care and intellectual disability services using a postal
questionnaire containing forty items. The questionnaire
was informed by the literature and consultation with an
expert reference group. Data were analysed using SPSS to
obtain descriptive statistics.
Results: A total response rate from services of 71.2%
(n=47) was generated. Findings showed a range of experience
among services in providing end of life care to people
with intellectual disabilities in the previous five years, but
general hospitals were reported the most common place of
death. A lack of accessible information on end of life care
for people with learning disabilities was apparent. A few
services (n=14) had a policy to support this population to
make decisions about their care or had used adapted Breaking
Bad News guidelines (n=5) to meet their additional
needs. Both services recognised the value of partnership
working in assessing and meeting the holistic needs of
people with intellectual disabilities at end of life.
Conclusions: A range of experience in caring for people
with intellectual disabilities was present across services,
but more emphasis is required on adapting communication
for this population to facilitate them to participate in their
care. These findings could have international significance
given that studies in other countries have highlighted a
need to widen access to palliative care for this group of
people.

Nurses' experiences of pain management for people with advanced dementia approaching the end of life: a qualitative study

AIMS AND OBJECTIVES: To explore hospice, acute care and nursing home nurses' experiences of pain management for people with advanced dementia in the final month of life. To identify the challenges, facilitators and practice areas requiring further support.

BACKGROUND: Pain management in end-stage dementia is a fundamental aspect of end of life care; however, it is unclear what challenges and facilitators nurses experience in practice, whether these differ across care settings, and whether training needs to be tailored to the context of care.

DESIGN: A qualitative study using semi-structured interviews and thematic analysis to examine data.

METHODS: 24 registered nurses caring for people dying with advanced dementia were recruited from ten nursing homes, three hospices, and two acute hospitals across a region of the United Kingdom. Interviews were conducted between June 2014 and September 2015.

RESULTS: Three core themes were identified: challenges administering analgesia, the nurse-physician relationship, and interactive learning and practice development. Patient-related challenges to pain management were universal across care settings; nurse- and organisation-related barriers differed between settings. A need for interactive learning and practice development, particularly in pharmacology, was identified.

CONCLUSIONS: Achieving pain management in practice was highly challenging. A number of barriers were identified; however, the manner and extent to which these impacted on nurses differed across hospice, nursing home and acute care settings. Needs-based training to support and promote practice development in pain management in end-stage dementia is required.

RELEVANCE TO CLINICAL PRACTICE: Nurses considered pain management fundamental to end of life care provision; however, nurses working in acute care and nursing home settings may be under-supported and under-resourced to adequately manage pain in people dying with advanced dementia. Nurse-to-nurse mentoring and ongoing needs-assessed interactive case-based learning could help promote practice development in this area. Nurses require continuing professional development in pharmacology. This article is protected by copyright. All rights reserved.

No second chance: junior neonatal nurses' experiences of caring for babies at the end-of-life and their families

Death of an infant is acutely stressful for parents and professionals. Little is known about junior nurses' experiences providing end-of-life care in Neonatal units (NNU). This study aimed to better understand junior nurses' experiences providing end-of-life care in NNU. Neonatal nurses (n = 12) with less than 3 years experience participated in a focus group. Nominal Group Technique (NGT) was used to build consensus around the challenges faced, alongside suggested developments in improving future care provision. Primary analysis involved successive rounds of ranking and decision-making whilst secondary analysis involved thematic analysis. All issues, whether environmental, professional or social appeared driven by an awareness on the part of nurses, that there was no ‘second chance’ which created a huge pressure to ‘get if right’ for the infants and families. Regarding future care 2 areas of improvement identified were ‘Education and Training’ and Support. This paper unpacks these findings making recommendations for practice.

Nursing Home Care- Nursing Students as Carers discussing and addressing the negatives; a Northern Ireland Perspective

Abstract
The quality of nursing home care for some remains a significant cause of concern. This paper explores and discusses some of the significant critiques and limitations to nursing home care within the UK, particularly and including end of life care. The paper also explores some of the international literature by way of comparison.
Aim
To identify some of the characteristics contributing to the quality of holistic care within nursing homes
Methods
Two short narratives drawn from the experiences of nursing home care within Northern Ireland. The narrators (and co-authors to the paper) are first year student nurses who are also employed (part-time) as carers within nursing homes
Results
The paper identifies evidence of good nursing and care, together with evident quality in end of life care within nursing homes. The paper addresses the context of nursing home care and explores significant characteristics that reflect in the delivery of holistic care to nursing home residents, including the important role of a `culture’ of care, ongoing and specialist training( particularly and including within end of life care) and the important impact in the quality of nursing home leadership.
The paper concludes with some short recommendations to better develop practice within nursing homes

Annual report 1985-1986

This report summarizes the Commission's activities during the fiscal year which included accomplishments for FY 85-86, History and Organization of the Health and Human Services Finance Commission , Summary of Law/statutory authority, commission advisory committee, Medical Care Advisory Committee, Statewide Health Coordinating Council, management organization chart, and financial Statement for FY85-86.

Annual report 1986-1987

This report summarizes the Commission's activities during the fiscal year which included accomplishments for FY 85-86, History and Organization of the Health and Human Services Finance Commission , Summary of Law/statutory authority, commission advisory committee, Medical Care Advisory Committee, Statewide Health Coordinating Council, organizational chart, and financial Statement for FY86-87.

Annual report 1987-1988

This report summarizes the Commission's activities during the fiscal year which included accomplishments for FY 87-88, History and Organization of the Health and Human Services Finance Commission , Summary of Law/statutory authority, commission advisory committee, Medical Care Advisory Committee, Statewide Health Coordinating Council, management organization chart, and financial Statement for FY87-88.

Annual report 1988-1989

This report summarizes the Commission's activities during the fiscal year which included accomplishments for FY 88-89, History and Organization of the Health and Human Services Finance Commission , Summary of Law/statutory authority, commission advisory committee, Medical Care Advisory Committee, Statewide Health Coordinating Council, management organization chart, and year-end expenditure report.

Annual report 1989-1990

This report summarizes the Commission's activities during the fiscal year which included accomplishments for FY 89-90, History and Organization of the Health and Human Services Finance Commission , Summary of Law/statutory authority, commission advisory committee, Medical Care Advisory Committee, Statewide Health Coordinating Council, management organization chart, and financial Statement for FY 89-90.

Annual report 1990-1991

This report summarizes the Commission's activities during the fiscal year which included accomplishments for FY 90-91, History and Organization of the Health and Human Services Finance Commission , Summary of Law/statutory authority, commission advisory committee, Medical Care Advisory Committee, Statewide Health Coordinating Council, management organization chart, and expenditure report.

Annual report 1991-1992

This report summarizes the Commission's activities during the fiscal year which included accomplishments for FY 91-92, History and Organization of the Health and Human Services Finance Commission , Summary of Law/statutory authority, commission advisory committee, Medical Care Advisory Committee, Statewide Health Coordinating Council, management organization chart, and expenditure report.

Annual report 1992-1993

This report summarizes the Commission's activities during the fiscal year which included accomplishments for FY 92-93, History and Organization of the Health and Human Services Finance Commission , Summary of Law/statutory authority, commission advisory committee, Medical Care Advisory Committee, Statewide Health Coordinating Council, management organization chart, and expenditure report.

Annual report 1993-1994

This report summarizes the Commission's activities during the fiscal year which included accomplishments for FY 93-94, History and Organization of the Health and Human Services Finance Commission , Summary of Law/statutory authority, commission advisory committee, Medical Care Advisory Committee, Statewide Health Coordinating Council, management organization chart, and expenditure report.

Dream Building in the Carolina Sea Islands CHANCELLORS first ANNUAL REPORT 2005

The annual report highlights events, projects, and financing.

Legislative news

The South Carolina Department of Mental Health publishes on a bi-weekly basis Legislative News, with information on bills that are introduced which may impact the agency, mental health or health care issues, and employee issues.