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To prepare the end of life, to plan important things, to spend the remaining time of life not only with medical treatments, but to live – these are frequently expressed wishes of people with progressive diseases. Prognostic statements are feared by professionals. At the same time, when talking about what lies ahead for those affected, professionals very often make over-optimistic promises. A broader definition of the term prognosis as well as a careful handling of expectations can help to define realistic goals together. [ABSTRACT FROM AUTHOR]

Copyright of Praxis (16618157) is the property of Aerzteverlag medinfo AG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Praxis (16618157) is the property of Aerzteverlag medinfo AG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Praxis (16618157) is the property of Aerzteverlag medinfo AG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The topic of death and the dying is a crucial aspect of patient care, especially for individuals with terminal illnesses. However, discussions about death and dying are often avoided during patient interactions. In this article, our aim is to explore the reasons behind our fear of death and dying and to assess the importance of addressing these issues in shaping and cultivating relationships with our patients and in our personal lives. We argue that being open to impermanence is a valuable tool in our work with patients and their families and should be integrated into conversations with them. Furthermore, discussions about death and dying should play a central role in medical and nursing education as well as professional development., Competing Interests: Die Autorinnen und Autoren haben keine Interessenkonflikte im Zusammenhang mit diesem Artikel deklariert, (© 2024 Aerzteverlag medinfo AG.)

Telemedicine in Palliative Care: Digital Communication in a Relationship-Based Speciality - Does It Make Sense? Abstract. Telemedicine in palliative care is established especially in countries with large geographical distances. Digital forms of communication (virtual consultations) are most frequently used and well-accepted by patients and caregivers. The main benefit lies in the reduction of the access barrier in the outpatient setting. Advantages are stress reduction for patients (travel, accessibility) and reduction in the care burden for relatives. Additional benefits compared to the physical visit for symptom-control, quality of life and costs are unclear. Risks are influenced by the lack of physical interaction and data security. To what extent telepalliative care makes sense in a high-density health system is difficult to predict. It is therefore important to use these new tools in a carefully adapted and scientifically verified way.

Compassionate Cities: Strengthening Social Resources in Communities for Mutual Support at the End of Life Abstract. People at the end of life often wish to remain at home for as long as possible. To make this possible to a greater extent, not only health professionals who accompany those affected and their relatives are needed, but also educational programmes to strengthen health literacy at the end of life. Within the framework of the project "Compassionate City Lab of the Bernese People", experiences in dealing with the end of life were collected and published, and a course on advance care planning for elderly people was developed. The project is funded by Health Promotion Switzerland and supported by a partnership between Bernese institutions of higher education, specialised palliative care and primary care, the community, and volunteers in the city of Bern and the Bernese Oberland.

Communicating Prognosis and Expectations in Advanced Disease - A Balancing Act in Practice Abstract. To prepare the end of life, to plan important things, to spend the remaining time of life not only with medical treatments, but to live - these are frequently expressed wishes of people with progressive diseases. Prognostic statements are feared by professionals. At the same time, when talking about what lies ahead for those affected, professionals very often make over-optimistic promises. A broader definition of the term prognosis as well as a careful handling of expectations can help to define realistic goals together.

Anticipation at the end of life - a critical appraisal for the clinical practice Abstract. Advance planning or anticipation in health care is based on prognosis, and that is no more (and no less) than dealing with probabilities. Knowledge about prognostic factors in medicine is needed here, and competencies how to communicate it. In medicine, advance planning is currently more and more regarded as an elementary right as an expression of the implementation of patient autonomy - but what content can or must be discussed and defined? The terminology on the subject of "advance planning" is inconsistent both nationally and internationally. In Switzerland, therefore, an attempt was made to contribute to a more uniform understanding in this respect with the new "framework concept for advance planning in health care". For clinical practice it can be summarized as follows: Advance planning requires the following attributes: Trust, shared experience of health crises and how to deal with them, communicative abilities of all those involved (not only on the part of medicine!), an understanding of the role of medicine between coach and mountain guide, a systemic approach with the involvement of relatives in important decisions, an established regional health network that functions perfectly up to the electronic documentation, full cost reimbursement of the sometimes very demanding decision-making processes, documentation and revision - and of all the awareness and self-reflection that advance planning is not about certainties but about probabilities.

Background: As the demand for palliative care (PC) in emergency wards continues to increase, emergency medicine is increasingly focusing on the care of extremely ill patients with incurable, chronic and/or advanced diseases. There is no consistent definition of the profile of PC or understanding of what PC involves. The mistake is often made of confusing PC with end-of-life or terminal care. The present study was intended to assess the situation at the Department of Emergency Medicine, Inselspital, Bern University Hospital (UNZ), which cares for about 32 400 patients annually. The plan was to find out how much staff members knew about PC and to survey their personal attitudes., Methods: The employees of the UNZ were surveyed with an online questionnaire by a special institution outside the hospital. This is based on an instrument [1] developed in a comparative study in an emergency ward in the USA and used for physicians., Results: 60 of 154 staff members (physicians and nurses) completed the questionnaire, corresponding to a response rate of 39%. The definition of palliative care (n=60) was very mixed and could be classified into 6 areas. In response to questions about specific services, the staff members mentioned that their access to existing patient data should be facilitated. They also expressed the wish for a 24 h palliative consultation service and thought that, during normal working days, more time should be allotted to discussing issues related to palliative care., Conclusions: It has been confirmed that the definition of palliative care is not consistent. Within the UNZ, there is no clear procedure, but lack of time for detailed discussions with patients needing palliative care. Patient wishes or living wills with the DNR/DNI procedure do not contradict the personal ethics of most staff members. UNZ staff members would welcome the 24 h availability of a specialized PC team, as well as the development of guidelines and increased training in PC.

Assessment in Palliative Care is a broad field trying to integrate various dimensions from physical, psychological, social and spiritual problems and suffering. Medical diagnosis alone may not successfully reflect this multidimensional aspects, as it may be true for nursing diagnosis. In addition, any assessment procedures in palliative care needs a) to be performed in an interprofessional way, i.e. integrating various perspectives, b) to avoid additional burden for the patient, and c) to allow repetitive longitudinal follow up in order to assess the outcomes of interventions. Derived from WHO definition of Palliative Care from 2002 we developed at our centre the problem- rather than diagnosis based SENS-Model and started its clinical implementation. This new tool to structure narratives from patients may facilitate not only to prioritize the various problems, but also to define tasks and responsibilities within the team including the evaluation of the intended benefit. Apart, SENS may help to avoid medicalisation and focus on pathological rather then salutogenetic interpretation. By this, SENS may develop towards a first problem - based ";classification and assessment system" in palliative care, possibly valuable for other chronic diseases and its multidimensional problems, too.