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Home palliative sedation checklist may ease concerns
Date:2/18/2010

Los Angeles, London, New Delhi, Singapore and Washington DC (February 18, 2010) Can patients near death safely receive sedation at home, fully respecting their own and their families' wishes? This practice, which is on the rise, is coming under increasing scrutiny and debate by palliative care researchers and practitioners. Now palliative care specialists from a team based in Spain have documented their experiences and data, and developed a standard checklist to help other clinicians. Their research appears in the journal Palliative Medicine, published by SAGE.

Physicians use specific sedatives to relieve intolerable suffering as patients near death a practice known as palliative sedation (PS). The rate of PS use varies widely from 3-52% in terminally ill patients according to the literature - a wide range considering it is considered ethical and legally acceptable for those with irreversible and advanced disease. This raises questions over whether the definition of PS, or its setting could be behind these differences.

Despite a trend for PS in patients' homes increasing in recent years, academics know very little about what kinds of sedation are administered or who is receiving it at home. Some fear that using PS, particularly at home, should not replace thorough assessment and treatment of patients' physical symptoms, or their psychological or spiritual distress. A set of standard guidelines offers one solution.

Alberto Alonso-Babarro from Hospital Universitario La Paz, Madrid led the study into home PS, which was conducted in Madrid by a palliative home care team (PHCT) composed of two physicians, two nurses, a nurse assistant, a part-time social worker, and an administrative clerk. The PHCT regularly follows up patients with progressive, incurable diseases with many symptoms who are referred by acute care hospitals, medical oncologists or family physicians.

Alonso-Babarro and his team retrospectively reviewed
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Contact: Jayne Fairley
jayne.fairley@sagepub.co.uk
SAGE Publications UK
Source:Eurekalert

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