Deaths from dementia set to quadruple by 2040

The number of people who will die from dementia could almost quadruple over the next 20 years, suggests a study published in BMC Medicine | Story via OnMedica

hospital-bed-315869_1280Researchers analysed mortality statistics for England and Wales from 2006 to 2014 to estimate the prevalence of palliative care need in the population.

By using explicit assumptions about change in disease prevalence over time and official mortality forecasts, they modelled palliative care need up to 2040 as well as making projections for dementia, cancer and organ failure.

They calculated that by 2040, annual deaths in England and Wales could rise by at least 25.4% from 501,424 in 2014 to 628,659 in 2040.  If age and sex-specific percentages with palliative care needs remained the same as in 2014, the number of people requiring palliative care could grow by 25% from 375,398 to 469,305 people a year.

However, if the upward trend observed from 2006 to 2014 continued, they said, the increase could be as much as 47% more people needing palliative care by 2040 in England and Wales.

In addition, disease-specific projections showed that dementia (increasing from 59,199 to 219,409 deaths/year by 2040) and cancer (increase from 143,638 to 208,636 deaths by 2040) would be the main drivers of the growing need.

The authors concluded: ‘Our analysis indicates that palliative care need will grow far more over the next 25 years than previously expected’.

Full reference: Etkind, S. N et al. How many people will need palliative care in 2040? Past trends, future projections and implications for services. BMC Medicine 2017 15:102.

People who are dying should be asked about their spiritual beliefs

NICE has published new guidance calling on healthcare professionals to ask adults in the final days of life about their religious or spiritual beliefs.

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Cultural preferences and spiritual beliefs should be included in discussions about the care a person, and those close to them, want to receive, says NICE.

Knowing if someone holds a religious belief can be important for providing the care they desire. For example, someone who is Catholic may wish to receive the last prayers and ministrations.

The 2016 End of Life Care Audit reported nearly half of all deaths in England occurred in hospital. Spiritual wishes were only documented for one in 7 people who were able to communicate their desires.

Read the full overview here

Read the full guidance here

How well do we currently care for our dying patients in acute hospitals: the views of the bereaved relatives?

Mayland, C.R. et al. BMJ Supportive & Palliative Care. Published Online: 17 January 2017

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Background: The National Care of the Dying Audit—Hospitals (NCDAH) is used as a method to evaluate care for dying patients in England. An additional component to the 2013/2014 audit was the Local Survey of Bereaved Relatives Views using the ‘Care Of the Dying Evaluation’ (CODE) questionnaire.

Conclusions: Adopting a postbereavement survey to NCDAH appears to be feasible, acceptable and a valuable addition. On the whole, the majority of participants reported good or excellent care. A small but significant minority, however, perceived poor quality of patient care with clear and timely communication urgently needed.

Read the full abstract here

Treatment targeted at underlying disease versus palliative care in terminally ill patients

Reljic, T. et al. BMJ Open. 7:e014661

Objective: To assess the efficacy of active treatment targeted at underlying disease (TTD)/potentially curative treatments versus palliative care (PC) in improving overall survival (OS) in terminally ill patients.

Results: Initial search identified 8252 citations of which 10 RCTs (15 comparisons, 1549 patients) met inclusion criteria. All RCTs included patients with cancer. OS was reported in 7 RCTs (8 comparisons, 1158 patients). The pooled results showed no statistically significant difference in OS between TTD and PC (HR (95% CI) 0.85 (0.71 to 1.02)). The heterogeneity between pooled studies was high (I2=62.1%). Overall rates of adverse events were higher in the TTD arm.

Conclusions: Our systematic review of available RCTs in patients with terminal illness due to cancer shows that TTD compared with PC did not demonstrably impact OS and is associated with increased toxicity. The results provide assurance to physicians, patients and family that the patients’ survival will not be compromised by referral to hospice with focus on PC.

Read the full article here

End of life care for infants, children and young people

NICE has published new NICE guidance: End of life care for infants, children and young people with life-limiting conditions: planning and management (NG61).

This guideline covers the planning and management of end of life and palliative care in for infants, children and young people (aged 0–17 years) with life-limiting conditions. It aims to involve children, young people and their families in decisions about their care, and improve the support that is available to them throughout their lives.

Additional link: NICE news report

New go-to website for resources and learning in palliative and end of life care

Nicola Spencer introduces the enhanced Ambitions for Palliative and End of Life Care website which will be the new go-to place for resources and learning | NHS England

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Struggling to keep up to date and informed on changes impacting on palliative and end of life care? Not sure where to find the latest resources and improvement examples?

Then you will be pleased to hear we have launched a tailor made national End of Life Care (EoLC) Knowledge Hub providing you with a ‘one stop shop’ of palliative and EoLC information.

This hub provides anyone involved in the commissioning or provision of palliative and end of life care with a quick and easy way to source information, including helpful tools and resources to drive delivery of the Ambitions for Palliative and End of Life Care – a national framework for local action.

Read the full overview here

Find the website here

Doctors caring for dying patients need more support

British Medical Association’s call comes as poll highlights impact treating patients at end of their life has on doctors | The Guardian

marseille-142394_960_720.jpgThe British Medical Association has called for more support for doctors caring for dying patients after a survey found fewer than one in five physicians feel they get sufficient assistance. The poll highlighted the deep-seated effect that treating patients at the end of their life has on doctors, with 93.9% saying it has an emotional impact on them.

More than a third (37.2%) of the 457 doctors who responded to the online poll said they cared for dying patients frequently or all the time. A similar proportion (34.6%) said they occasionally cared for people at the end of their life, with 28.2% saying they never did. Only 14.7% said they had accessed formal or informal support networks, either locally or nationally.

Read the full news story here