Abstract
InnovAiT is produced on a 3-year cycle. However, many articles do not significantly go out of date in that time. This section of InnovAiT summarises articles from the previous cycle of InnovAiT that GPs and GPs in training might still find useful today.
What is palliative care?
Dr Catherine Vincent
InnovAiT 2015 8(6): 326–335
This special issue of InnovAiT considered palliative care: A core part of the GP role. This article explores where palliative care may begin and summarises guidance informing management. Early recognition that patients are in the last year of life can be especially difficult in non-malignant conditions but aids planning and communication.
Ethics in palliative care
Dr Conn Haughey and Professor Max Watson
InnovAiT 2015 8(6):336–339
Palliative care can present unique ethical dilemmas involving, for example, resuscitation, capacity, truth-telling and autonomy. This article gives an overview of the ethics, law and professional responsibility of palliative care dilemmas and how the four pillars of principilism, respect for autonomy, beneficence, non-maleficence and justice, can help with ethical decision making.
Prescribing in end of life care
Dr Rachel Campbell and Professor Max Watson
InnovAiT 2015 8(6): 340–347
Prescribing in end of life care presents some unique difficulties and a good understanding of opioid prescribing, management of side effects and adjustments with, for example, renal impairment is essential for the delivery of high-quality palliative care. This article references the websites www.pallcare.info and www.palliativedrugs.com for information on interactions and contraindications.
Syringe drivers
Dr Catherine Doherty and Professor Max Watson
InnovAiT 2015 8(6): 349–353
The use of syringe drivers in palliative care can cause concern for GPs. This article considers indications for use and practical aspects, such as opiate dose conversion. Your local palliative care team can help with syringe driver prescriptions and drug dosing when converting from oral medication.
Nutrition and palliative care
Professor Max Watson and Dr Alison Rodgers
InnovAiT 2015 8(6): 354–359
Cachexia results from the catabolic processes in terminal illnesses and good nutrition is important at all stages of palliative care. However, food supplements are often prescribed inappropriately when diet can be modified using normal foods. This article considers the nutritional needs of patients in different stages of disease and recommends prescribing supplements with advice from a dietitian.
Rapid palliative discharge home
Dr Ian Warwick and Professor Max Watson
InnovAiT 2015 8(6): 360–363
The key to successful discharge of patients to the community for palliative care is, as ever, good communication. This article considers ways to ensure that care is planned and co-ordinated to ensure transfer of patients without compromising care and appropriate medication.
Self-care: Managing compassion fatigue
Dr Louise McNutt and Professor Max Watson
InnovAiT 2015 8(6): 364–367
Looking after dying patients can place particular burdens on carers and health professionals. Healthy doctors are likely to make better decisions. It is possible for GPs to neglect their own health. This article considers strategies to recognise and manage compassion fatigue for the benefit of all concerned.