July Digest of News for Palliative Care Specialists

Every month, the PACED team prepares a digest of international materials and news about palliative care.

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Palliative Care at Home or in a Hospital Setting? A Comparison of Survival Times of Advanced Cancer Patients.

In 2017 a large-scale study was conducted in Japan, and the results were published in 2023. The strengths of this study include large sample size and consideration of multiple variables, including patient characteristics, prognostic factors, symptoms, and medication treatment.

The most significant discovery was that the survival time of patients with an estimated prognosis of a few weeks or months who received palliative care at home was longer than that of patients receiving palliative care in a hospital setting. However, the survival time of patients with an expected prognosis of a few days was the same, whether at home or in a hospital setting.

The description and main results of the study can be found here:

The Optimal Model of Home Hospice Care in Providing Palliative Support - What Does it Look Like? Insights from England.

This study aimed to evaluate different models of home hospice care in England and identify the most effective approaches. Participating organisations included 24/7 services as well as non-round-the-clock services. Some were charitable organisations, while others were commercial, but the overarching goal of all models was to provide a "good/comfortable death."

Several key factors positively influenced the quality of home hospice services. These factors included organisational sustainability, utilisation of volunteer labour, coordination with healthcare and social support systems, professional staff, and support for the families of terminally ill patients.

You can find out more here:

Which countries have the best and worst palliative care systems?

"Society should also be judged by how well people die," says Eric Finkelstein, a professor and palliative care expert at Singapore's leading medical school, Duke-NUS, and the Duke Global Health Institute.

An interesting ranking demonstrates that adequate funding of the healthcare system is a key factor in delivering high-quality palliative care in most countries, but it is not always sufficient. For example, the United States are only in the third group of countries (43rd place out of 81). Twenty-one countries significantly underperform in the palliative care assessment. They are represented mainly by developing countries, but among them are also countries with relatively high living standards, such as the Czech Republic (66th place) and Portugal (75th place).

Unfortunately, the ranking does not include Central Asian countries. However, Belarus, Armenia, Georgia, Moldova, and Romania are mentioned.

The overview of the main findings can be found here:

Dogs in Palliative and Hospice Care — Why Patients Seek Animal Companionship.

Experts agree that pet dogs excel as supportive helpers.

Interactions with therapy dogs bring joy to patients and reduce feelings of isolation, alienation, anxiety, and depression. Although such visits may occasionally disrupt daily routines, their beneficial effects cannot be ignored.

Dogs have a long history of faithful companionship. These loyal animals are among the best sources of comfort for anyone, including hospice patients and their families.

You can read about examples of this practice here:

"Death Cafe" is a space where people can gather and discuss life, death, and other taboo topics.

Death Cafe is a global movement that originated in London in 2011. Participants come together to openly discuss the most taboo subjects related to life and death without judgement or embarrassment. People from different backgrounds and ages share their experiences and perspectives in honest conversations.

Death Cafe has spread worldwide, highlighting the need to talk about death — a topic that is mostly avoided.

Read more about this initiative here: