Latest news with #palliativecare
The Independent
10 hours ago
- Health
- The Independent
Charity completes renovations at home of disabled boy after father's death
The widow of an electrician who died following mental health struggles has thanked volunteers for completing the renovation project he had started for their disabled son. Shaun Fletcher, 44, had been working on improvements to the family home near Swaffham, Norfolk, before he took his own life last December. His son Toby, 16, requires round-the-clock palliative care due to quadriplegic cerebral palsy and dystonia – uncontrolled and sometimes painful muscle movements. As Toby's ground floor bedroom was an empty shell and his mother Sarah Fletcher was unable to access overnight support, she had to carry him upstairs to bed and care for him each night. Mother-of-six Mrs Fletcher turned to national construction charity Band of Builders for help to complete Toby's room. More than 150 volunteers rallied round and completed the project in 12 days, completing all renovations as well as landscaping the front and back of the house. Addressing volunteers after they had finished the project, Mrs Fletcher said: 'We can't thank you all enough; you're all superheroes. 'It's felt like we've been living on a building site for a few years, and I can't believe how much has been done to complete it in such a short space of time. 'Toby's room is incredible, and this means we can finally get overnight support for him. 'The house is amazing and a poignant legacy for Shaun, and we now have a home where my family can start to heal.' Toby was born 13 weeks premature, which resulted in a lack of oxygen to his brain and led to cerebral palsy and dystonia. His condition affects his muscle control, leading to painful involuntary movements that make it difficult for him to gain weight. He is also deaf and is fed directly into his bowel. To help manage his dystonia he has a deep brain stimulator, with electrodes in his brain connected to a battery pack in his abdomen. He requires round-the-clock care, including numerous medications throughout the day and night. He is housebound and relies on stretcher transport for all appointments. Gavin Crane, chief executive of Band of Builders, said as many as 40 tradespeople were on site for each of the 12 days – including groundworkers, electricians, bathroom fitters, plumbers, decorators, landscapers, solar panel engineers and smart home specialists. 'This was our most ambitious project to date and everyone who supported us – be it volunteers, businesses, suppliers of materials, and the local community who provided food and refreshment – has reminded us all what kindness looks like. 'What happened to this family resonates with so many members of our community and across the construction industry. 'Grief, pressure and mental health concerns are all things we understand too well. 'We hope that in finishing what Shaun started, we've done him proud and that wherever he is, he knows his family is now safe in a completed home surrounded by the love and empathy of some amazing people.' Tim Winstanley, senior brand manager at Dewalt, which sponsored the project, said everyone was 'deeply moved by the compassion and dedication shown by every volunteer'.
CBC
12 hours ago
- Health
- CBC
Complex health needs of unhoused populations are preventing palliative care access, Lakehead U. review finds
Social Sharing Individuals experiencing homelessness are facing sustained barriers to accessing palliative care, largely stemming from stigmas associated with previous experiences with healthcare providers. That's according to a new scoping review from Lakehead University, published in the journal BMC palliative care on July 18. The review examined 45 studies on palliative care within unhoused populations, including 18 from Canada. It is part of a broader study funded by Health Canada looking into palliative care access among vulnerable populations, said Ravi Gokani, an associate professor at Lakehead University's School of Social Work, and a co-author of the study. The complexities of healthcare needs for unhoused individuals can create barriers to the kind of care available, as well as an ongoing lack of the healthcare professionals qualified to provide the necessary care, the study says. "One of the key findings is that there is a need for a focus on the relationship between the healthcare providers and the people seeking access," Gokani says. Palliative care is aimed at improving the quality of life for patients experiencing serious illness, often towards the end of their lives. Across Canada, palliative care services have been rising over the past few years. According to Health Canada, 58% of Canadians who died in 2021-2022 had accessed palliative care, while seniors aged 65 to 84 were the most likely to receive this type of care. However, when it comes to unhoused populations in North America, the review points out the average age of death is 34 to 47. Many times, unhoused individuals may not know that they need end-of-life care until it is too late. "They're seeing doctors very intermittently," said Brendan Carlin, executive director of Shelter House in Thunder Bay. "By the time it gets to that point, it's too late or they just say 'why would I get this care? I'm gonna pass away anyway.'" One of the biggest barriers restricting access to palliative care for unhoused individuals is the lack of trust they themselves may hold against healthcare providers, feelings originating from previous negative experiences, the review says. Carlin says negative interactions can include cases of mistreatment due to stigmas surrounding homelessness, or racism that they've experienced at the hands of healthcare providers. The review also points out organizational policies are the most common palliative care provider-related barrier for unhoused individuals. Policies that may be put in place to protect staff, such as ensuring the safety of their working environment and substance use polices can prove to be prohibitive to allowing unhoused individuals access to care, Gokani says. "Generally, the findings suggest harm reduction policies don't impede access, but abstinence-based policies do impede access to palliative care." Another organizational policy that can be prohibitive is the definition they may have for family, potentially restricting patients from seeing some of the individuals to whom they are closest. "Some of our clients don't have a lot of family support, if any at all, and when you're unhoused, you tend to spend your time with lots of people," Carlin said. "When you're going to a hospital and it has to be blood relatives or whatever, you just think, well why would I want to go there?" Seeking collaborative solutions Integrated models combining palliative care with shelter support services or a system navigator can prove to be beneficial in improving access to palliative care, the review says. In these instances, individuals most in need of end-of-life support can get the care they need from staff and individuals they feel comfortable with. The review also noted embedding palliative care specialists within shelters made it easier for the subject to be discussed between unhoused individuals and medical professionals. Thunder Bay's Shelter House is making progress in integrating palliative care within its own services. Beginning this fall, the shelter will offer a pair of palliative care units within its expanded Kwae Kii Win Managed Alcohol Program. Carlin says the palliative care units will be bigger than the standard rooms offered to clients in the program, making room for visitors and medical equipment. He says the new palliative care program will be jointly managed by NorWest Community Health Centres.
Medscape
23-07-2025
- Health
- Medscape
Earlier Palliative Cancer Care Cuts End-of-Life ED Visits
TOPLINE: A recent retrospective study found that earlier outpatient palliative care referrals for patients with advanced cancer were associated with a small increase in overall emergency department (ED) visits but significantly fewer end-of-life ED visits and improved advance care planning. METHODOLOGY: ED visits near end of life are common among patients with advanced cancer and often indicate unmet needs. Although early outpatient palliative care can improve symptom management and care coordination as well as prevent unnecessary ED visits, it is crucial to distinguish patients who require ED visits from those better managed with planned care. To understand how earlier palliative care referrals may impact end-of-life ED visits, researchers conducted a retrospective cohort study of 3560 patients with advanced cancer (median age, 68 years; 60.2% men) referred to outpatient palliative care at Seoul National University Hospital between 2018 and 2022. Patients received consultation-based palliative care services from a team of physicians, nurses, and social workers — provided 5 days per week, with telephone support available on weekdays. Researchers analyzed ED visits after outpatient palliative care referral, looking at the association between the timing of palliative care referral and end-of-life ED visits as well as the completion of advance care planning documentation in outpatient palliative care and ED settings. Researchers also analyzed end-of-life ED visits — defined as those occurring within 30 days before death — and factors associated with overall and end-of-life ED visits. TAKEAWAY: Overall, 25.8% of patients visited the ED, and 10.6% had an end-of-life ED visit. Earlier palliative care referral was associated with a 4% greater likelihood of an ED visit overall (odds ratio [OR], 1.04), possibly because these patients had longer follow-up, but a 16% reduced likelihood of an ED end-of-life visit (OR, 0.84). Factors associated with overall ED visits were age younger than 65 years (OR, 1.25), residence area (OR, 2.92), and planned treatment (OR, 2.60); factors associated with end-of-life visits were residence area (OR, 3.29), hematologic malignancy (OR, 2.79), and planned cancer treatment at referral (OR, 2.60). Among 2132 patients who completed advance care planning documentation after referral, 48.0% of ED visitors and 52.8% of nonvisitors completed it at outpatient palliative care clinics, while 20.0% of ED visitors completed it in the ED. End-of-life ED visits were more severe and were associated with longer median stays (11.6 vs 8.5 hours), higher rates of hospital admission or transfer (59.7% vs 41.5%), and higher rates of respiratory infections (13.5% vs 4.9%) than other ED visits. Regarding interventions, cardiopulmonary resuscitation was performed more frequently during end-of-life ED visits than overall ED visits (3.2% vs 1.2%), with mechanical ventilation and vasopressors used nearly twice as often during end-of-life ED visits. IN PRACTICE: A substantial proportion of patients with advanced cancer visited the ED, including during the final month of life. Earlier palliative care referrals were associated with fewer end-of-life ED visits, 'emphasizing the importance of timely integration of [palliative care] to reduce unnecessary interventions and ensure goal-concordant care,' the authors wrote. The researchers also noted that the findings underscore the need for structured advance care planning discussions across care settings to enhance the quality of end-of-life care. SOURCE: This study, led by Ye Sul Jeung, MD, Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Seoul, Republic of Korea, was published online in JAMA Network Open. LIMITATIONS: The single-center design limited the generalizability of the findings to other settings. This study could not capture data from other EDs where patients may have sought care, potentially leading to incomplete information. Moreover, this study did not consider the complex decision-making processes leading to ED visits, and lacked data on symptom burden or home circumstances to assess the necessity of the visits. DISCLOSURES: This research was supported by a grant from the Patient-Centered Clinical Research Coordinating Center, funded by the Ministry of Health and Welfare, Republic of Korea. The authors disclosed having no conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
RNZ News
20-07-2025
- Business
- RNZ News
Award-winning journalist Peter Ryan dies, leaving 'significant legacy'
Peter Ryan. Photo: Supplied / Peter Ryan Former ABC journalist and Walkley Award-winner Peter Ryan OAM has died aged 64 in Sydney, his family has confirmed. Ryan retired from the ABC in June after 45 years in the industry, as he moved into palliative care. He had metastatic thyroid cancer, first diagnosed in 2014, and wanted to focus on his wife Mary Cotter, daughter Charlotte, and other family and friends. Ryan's many career highlights included being the ABC's Washington bureau chief, head of TV news and current affairs in Victoria, executive producer of Business Breakfast, founding editor of Lateline Business, which later became The Business, and the ABC's business editor. He was a senior business correspondent from 2016 until he retired. ABC News director Justin Stevens said Peter left a "significant legacy." "Through his mentorship, friendship, and professionalism, he directly touched the lives of many at the ABC," he said. "Through his journalism, he had a profound impact on the lives of Australians and our society. It was a privilege to know him and work alongside him." In 2017, Ryan won a Walkley award for his exposé on the Commonwealth Bank scandal. His coverage contributed to the calling of the banking royal commission, and in 2018, he was the National Press Club finance journalist of the year for his coverage of the commission. Ryan began his career as a copyboy and cadet on Sydney's Daily Mirror before he joined the ABC and took on foreign correspondent, senior manager, and executive producer roles. In 2022, he was recognised with the Order of Australia medal for his significant service to journalism. When Ryan retired, Treasurer Jim Chalmers said: "Peter Ryan is an absolute legend. Every day as you wake up and you think about what's happening in the economy, if you only needed to listen to one voice to be sure that you got its essential elements, it would be Peter's." When he left the ABC, Ryan wrote a note for "younger and older colleagues alike". He ended with "a few words of editorial advice": "Avoid cynicism - be passionate," he said. "A good team can often be a very small team - I've worked in some of the best. "Be proactive - come to the table with a great story so no-one else comes up with a dud that might waste your time. "Work closely with top people - shut up and absorb like a sponge. "Maintain a fastidious contact book - some low-profile contacts could soon move into higher-powered roles or, more importantly, work in backrooms where the big decisions are often made. "Show up to work early and prove that you're ready to take on the big story of the day. Try to have a Plan B in your back pocket just in case your original brilliant idea doesn't go anywhere and the EP comes walking your way. "Finally: Be kind and caring to people who need it." -ABC
ABC News
20-07-2025
- Business
- ABC News
Walkley Award-winning ABC journalist Peter Ryan dies, leaving 'significant legacy'
Former ABC journalist and Walkley Award-winner Peter Ryan OAM has died aged 64 in Sydney, his family has confirmed. Ryan retired from the ABC in June after 45 years in the industry, as he moved into palliative care. He had metastatic thyroid cancer, first diagnosed in 2014, and wanted to focus on his wife Mary Cotter, daughter Charlotte, and other family and friends. Ryan's many career highlights included being the ABC's Washington bureau chief, head of TV news and current affairs in Victoria, executive producer of Business Breakfast, founding editor of Lateline Business, which later became The Business, and the ABC's business editor. He was a senior business correspondent from 2016 until he retired. ABC News director Justin Stevens said Peter left a "significant legacy." "Through his mentorship, friendship, and professionalism, he directly touched the lives of many at the ABC," he said. "Through his journalism, he had a profound impact on the lives of Australians and our society. It was a privilege to know him and work alongside him." In 2017, Ryan won a Walkley award for his exposé on the Commonwealth Bank scandal. His coverage contributed to the calling of the banking royal commission, and in 2018, he was the National Press Club finance journalist of the year for his coverage of the commission. Ryan began his career as a copyboy and cadet on Sydney's Daily Mirror before he joined the ABC and took on foreign correspondent, senior manager, and executive producer roles. In 2022, he was recognised with the Order of Australia medal for his significant service to journalism. When Ryan retired, Treasurer Jim Chalmers said: "Peter Ryan is an absolute legend. Every day as you wake up and you think about what's happening in the economy, if you only needed to listen to one voice to be sure that you got its essential elements, it would be Peter's." When he left the ABC, Ryan wrote a note for "younger and older colleagues alike". He ended with "a few words of editorial advice": "A good team can often be a very small team — I've worked in some of the best. "Be proactive — come to the table with a great story so no one else comes up with a dud that might waste your time. "Work closely with top people — shut up and absorb like a sponge. "Maintain a fastidious contact book — some low-profile contacts could soon move into higher-powered roles or, more importantly, work in backrooms where the big decisions are often made. "Show up to work early and prove that you're ready to take on the big story of the day. Try to have a Plan B in your back pocket just in case your original brilliant idea doesn't go anywhere and the EP comes walking your way.
