Talk:End-of-life care

Untitled
Notes to UCSF Med School Students (9/13/21): I really enjoyed the inclusion of popular media, and felt that it was content that was truly relatable and popular! 5/5 stars from Brownfat Zac Edit plan from UCSF Med School Students (8/30/21): Initial Analysis: There is a lack of information on hospice and palliative care (what is it, when are patients generally referred, what kinds of services are available, how long are patients there, how much does it cost, myths) Link to euthanasia Update signs of dying Add more to the spiritual section Hospitals have chaplains, what services are available Add non-western practices for end of life care “Decision to begin” has a judgemental tone “Attitudes of Professionals” section only includes one article from Florida, doesn’t include all of the end of life care team, unfairly paints residents in a bad light and can lead of medical mistrust Home-based end of life care section is sparse and could include more actionable information on how to access/provide home based end-of life care “Daughter from California” is problematic “In popular media” is lacking many other occurrences of end of life care

To add: Changing the judgemental language Redoing “Attitudes of Professionals” section “Home-based end of life care” section can include more actionable information on how to access/provide home based end-of life care Add to “In popular media” 9/13/21 - Great job using objective language to discuss the attitudes of professionals section of this article.

To Augment: “Home-based end of life care” section can include more actionable information on how to access/provide home based end-of life care Add to “In popular media” Integrate hospice/palliative care better into the article (Not just in the “See also”)

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 30 August 2021 and 21 September 2021. Further details are available on the course page. Student editor(s): Nitipawar, Srg58, DIRECTEDbyDESIRE1996.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 20:34, 16 January 2022 (UTC)

Some sections could use more information
I would suggest elaborating on the integrated care pathway section. (more information) as well as the spiritual care pathway section (more information) Libby732 (talk) 14:21, 3 October 2020 (UTC)

CP133 2019 Group 19 Proposed Edits
Add more information about Right to Die in the introductory part. Add an additional section for the relevant policies on the subject that are either approved or in the process of getting approved. The subjects like symptoms and signs should be more towards the top of the page. Add more detail about the different options there are, such as hospice care, nursing home, assisted living, in-home living, and palliative care. — Preceding unsigned comment added by Lucy H Ahn (talk • contribs) 05:52, 16 October 2019 (UTC)

Include risk for respiratory depression and early death. Insert: Opioids can cause respiratory depression and according to the WHO, 45% of opioid users experience nonfatal overdoses. Careful use of opioids is important to improve the quality of life while avoiding overdoses. Amunoz18 (talk) 23:43, 16 October 2019 (UTC)

Edit the first sentence to make it more professional, clear, and concise. Add to the beginning paragraph that end-of-life care is a subcategory of palliative care and include a link to palliative care. Move the "National Perspectives" section in the end. Add information on how pharmacists are involved in hospice and end-of-life care. Lexjennifer (talk) 23:44, 16 October 2019 (UTC)

Add states in the US that participate in the end of life option act. Include this under the US national view section. Also include link to California End of Life Option Act wikipedia page at the end of the article. Ebang21 (talk) 23:47, 16 October 2019 (UTC)Ebang21

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 23 September 2019 and 13 December 2019. Further details are available on the course page. Student editor(s): Lexjennifer, Amunoz18. Peer reviewers: Chang2021.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 20:34, 16 January 2022 (UTC)

CP 133 2019 Group 18 Peer Edits
Angela: Hello group 19! It's great to see that most edits you have made have been retained.

1. From the edits that have been made, I believe it's improved the article by bettering defining End-of-Life and providing information relevant to where EoLC is practiced within the U.S, as well as symptomatic management. I liked how each member worked on different sections of the article to help improve general information regarding EoLC. Based on the plans noted on the talk page here, group 19 has achieved its goals in improving this article.

2. The edits submitted represent a neutral perspective because they contain mostly facts, such as the states practicing physician-assisted EoLC and opioids use, which included citations and statistics. Additionally, I noticed Jennifer made an edit that helped change a sentence to make it more of a neutral position (re: nurses). Group 19 is doing a great job so far in improving this article! Chang2021 (talk) 16:21, 3 November 2019 (UTC)

Harini: Hi Group 19!

1. From your edit suggestions, I like the idea of adding in the 'Right to Die' concept to supplement the information already provided. The article has pretty good information on the clinical/medical side of end of life signs, symptoms and ways of care. However, there is minimal information on the ethics of end-of-life, so Right to Die would fit in there

2. I also appreciated adding in more information on which states participate in physician-assisted EoLC. I think it would also be interesting and more holistic to add in thoughts or practices of EoLC in other countries, especially Asian countries. Overall, this is a solid example of a neutral display of information and sticking to the facts, great job!

WikiProject class rating
This article was automatically assessed because at least one WikiProject had rated the article as stub, and the rating on other projects was brought up to Stub class. BetacommandBot 03:58, 10 November 2007 (UTC)

Needs lots of work
It seems to me that I've seen several articles on this general topic in the last few days. Terminal illness, for example. Should we review these and find ways to improve them as a coherent group? WhatamIdoing (talk) 20:45, 18 December 2007 (UTC)

Licenced Murder?
The appalling problem with your current page is that at no stage do you seem to consider that physicians are merely 'service providers', and that the decision that a patient is at the 'end of their life' and not worthy of any further treatment can only be made BY THE PATIENT - you are expressing an archaic view that patients have to accept whatever prognosis they are given, and can't just walk away and seek attention from practitioners who are as game for a shot at life extension as they are. The level of deliberate 'upstaging' of cancer in elderly patients in the uk, for example, is disgraceful. There is absolutely no evidence that cancer treatments are any less effective in 'elderly ' patients than in the young, and fitness to undergo them are the main criteria for efficacy and survival - sadly, the performance indicator of fitness for treatment (the Karnofsky status') is subjective, and can be fiddled by any practitioner whose waiting list is attracting complaints from Managerial Employers. The entire 'liverpool pathway' scheme is full of drugs that hasten death under the guise of relieving symptoms - informed consent to cease treatments means that patients are told the truth, but here in the uk, elderly citizens will be told a load of old hooey, and sadly, are of a generation who trust authority absolutely. I dont like the notion that there is anything called 'end of life' - 'palliative medicine' can include dialysis for example, and keep someone alive for a decade, but if a patient is 70, as things stand, they can be told they are at the 'end of their life' if they live in an area with a shortage of dialysis provision, and have to accept it. —Preceding unsigned comment added by Sheriffspayne (talk • contribs) 15:33, 22 August 2008 (UTC)

Link Proposal
I'd like to add a link to a Survivorship A to Z article on end-of-life issues - the article is here. It provides additional information and resources for people experiencing end-of-life issues. What do you think?

Prestonmarkstone (talk) 17:31, 28 August 2008 (UTC)

I made the above proposal nearly three weeks ago - if no one objects, I'm going to add the aforementioned link to the "external links" section of this article. Thanks.

Prestonmarkstone (talk) 23:11, 15 September 2008 (UTC)

US national perspective - dispute
The Congress of the USA had hoped that the 1991 Patient Self Determination Act together with the 1986 Hospice Care Entitlement that is reimbursed by Medicare would greatly reduce expensive end-of-life care in Intensive Care and Critical Units of US Acute Care Hospitals when  elderly/disabled terminal patients on Medicare  would freely choose to shorten their lives to shorten their suffering from  terminal illnesses and die in their own personal residences or in nursing-home residences. However, since the physicians and for-profit clinics were not placed under the provisions of the 1991 PSDA and the states didn't implement the goals of the 1991 PSDA in state laws,   the Hospice Entitlement paid for out of the Medicare Purse has failed to achieve the savings anticipated in the 1991 PSDA. I was unable to find a neutral source for any of this and I have serious doubts on substantial parts of this, such as Congressional intent. In addition, style seems to be off - we don't use, e.g., "Congress of the USA", conjunctions, or "Medicare Purse". L235 (t / c / ping in reply ) 22:14, 28 September 2015 (UTC)
 * Per this dispute, and because no one has objected, I am semi-BOLDly removing the disputed section. L235 (t / c / ping in reply ) 05:03, 1 October 2015 (UTC)

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Spiritual care in end of life care
Is there any actual significance? It seems to be Australian focused, so probably should be moved to National Perspectives as otherwise I am really not understanding what it is trying to say or do as a section. Koncorde (talk) 10:30, 20 December 2019 (UTC)
 * Koncorde, I agree this section needs development. In the US, the National Consensus Project recognizes it as one of the 8 domains of palliative care, which is an integral part of EOL care (Page 32) though evidence is limited. Let me dig deeper and see what I can find. Moksha88 (talk) 07:51, 22 December 2019 (UTC)
 * Thanks Moksha. The wider article itself seems to be written in some unusual tone. I can't quite put my finger on it, maybe because I don't usually edit medical stuff, but it reads overly like it's paraphrasing an informational pamphlet rather than explaining the mechanisms or value of the care? The spiritual section just stuck out even more than the other content.
 * If you look at Palliative Care in contrast to this one, maybe you can put your finger on it a bit better than I can. Not saying the article is wholesale terrible btw, just there's something off about the contents composition. I don't know whether it's because it reads like WP:SYNTH a bit because it just seems to be lots of closed statements? Lack of a historical perspective? Lack of objective goals / patient goals being explained? There's something odd. Koncorde (talk) 10:49, 22 December 2019 (UTC)
 * I think I know what is bothering me. It's the lack of context throughout. So for instance I would expect to see statements such as "End of life care is recognised by leading national organisations as..." and "policies about End of life Care have been developed in coordination with..." and "concerns about the quality of EoL care were raised by..." then examples of who what where why and when led to its development and implementation in practice. At the moment the article is a bit of a "What" only situation, describing some non-specific examples and kinda overly general.
 * I only stumbled across this article while following a disruptive IP so this is far from my specialisation, but hopefully my explanation makes some sense from a lay reader as to what the issue I have when reading the article. Koncorde (talk) 12:04, 22 December 2019 (UTC)
 * Koncorde, your insights are much appreciated. I'm currently working on Palliative care but will place this one on my radar. Many of the medical articles need an overhaul. Moksha88 (talk) 03:07, 23 December 2019 (UTC)

Signs that death may be near
This section seems relevant, but when I checked the reference I saw that it is a text about cancer patients, whose generalization for all cases of end-of-life car is not stated. I have no grounds in healthcare, but for me there's no clear evidence that it's something applicable for different health conditions. I think someone in the field should check it and make proper clarifications if necessary, or bring another source (or even clarifying that it's just for cancer, if the case). Bruno Moreira-Guedes (talk) 22:23, 18 January 2020 (UTC)

Removal of sentence
Hey all,

Removed a sentence from the end of the lead section, which read as follows:

While I think there's probably some value in this piece of information, it was not useful where it was at the time of writing at the end of the lead section, and I couldn't easily find another place to put it. The phrasing also needs work. Thanks. JeanLackE (talk) 05:12, 10 September 2020 (UTC)

Wiki Education assignment: UCSF SOM Inquiry In Action-- Wikipedia Editing 2022
— Assignment last updated by Nbear93 (talk) 17:21, 12 September 2022 (UTC)

Improvement Plan: — Preceding unsigned comment added by Slimytheelder (talk • contribs) 06:48, 15 September 2022 (UTC)

Feedback for UCSF SOM Inquiry in Action -- Wikipedia Editing 2022
I like the Conciseness of EoL introduction section, but did identify some contradicting information. In the introduction it states that EoL Care refers to the healthcare provided to an individual, but then the linked "Healthcare" page states that this is care provided by health professionals and allied members, but in the intro of this page it states that EoL care encompasses the care being provided by family members (that may not have any sort of health professional training). Clarification of this would be helpful.

I really like the addition/update of the "Disparities in end-of-life care" section. It is a very important topic to better understand where disparities may be present. I would suggest not using language such as "good access" and instead be more descriptive. In addition, the inclusion of outcomes data from the systematic review would be helpful to gain a better understanding of the extent of the disparities.

Additions to the Spirituality and Religion section are interesting and are helpful in providing some context to the many layers of EoL Care. Alej.chavez (talk) 20:37, 16 September 2022 (UTC)

Additional comments: I don't see a work plan post preceding our comments, but article looks pretty good in its current state. I would recommend adding more citations and removing emotionally charged/personal language in the Family and friends section. Raguramm7 (talk) 23:28, 17 September 2022 (UTC)