The American journal of hospice & palliative care
March 1, 2025
Kwonoh Park, Jae-Joon Kim, Sang-Bo Oh et al.
4 citations
In a phase II trial of terminally ill cancer patients with pain that did not respond to high-dose opioids, a 5-day continuous intravenous infusion of ketamine was gradually increased. Among 20 analyzed participants, 50% achieved a pain response: 40% had a complete response (fewer than three rescue opioids per day and pain at or below their personal goal) and 10% had a partial response (fewer than three rescue opioids). Most patients had mixed-type pain with a neuropathic component. The findings suggest that a slowly escalating ketamine infusion can be an effective option for refractory cancer pain when other treatments are limited.
The American journal of hospice & palliative care
March 1, 2025
John R Reed, Stephanie K Parks, Antony Kaniaru et al.
1 citation
Palliative care focuses on the holistic needs of patients and their families rather than on the pathology of a diagnosis, aiming to reduce the stress of illness. U.S. service members deployed to austere environments have significantly less access to such care than those in military treatment facilities in the U.S. Ketamine, widely used for analgesia and anesthesia in combat zones, preserves respiratory function, causes minimal hemodynamic changes, and yields lower pain scores compared to opioids. Its use for palliative care is a new clinical strategy to provide sedation and pain management for acute pain crises or comfort measures for the terminally ill, making it attractive for managing critically wounded patients during prolonged medical care when evacuation is impossible.
The American journal of hospice & palliative care
June 1, 2017
Madelaine Lawrence
Near-death and other transpersonal experiences—such as out-of-body experiences and after-death communications—occur not only in hospitals or during grief but also during catastrophic events like floods, wars, bombings, and death camps. Examples include a near-death experience during the Vietnam War, an out-of-body experience after a bomb explosion in the Iraq War, a near-death visit by a woman imprisoned at Auschwitz, and after-death communications from a person killed in Auschwitz and a World War I soldier. Interviews with two New York City policemen who responded on September 11, 2001, are also included. First responders and emergency healthcare professionals often lack awareness of these experiences, which could provide comfort to both victims and responders.
The American journal of hospice & palliative care
March 1, 2015
M Renz, M Schuett Mao, A Omlin et al.
Spiritual experiences of transcendence are common among advanced cancer patients and are associated with reduced pain, anxiety, and greater acceptance of illness and death, as well as a new spiritual identity. In a 12-month observational study of 251 hospitalized patients, 135 spontaneously communicated such experiences, which occurred across diverse religious affiliations and attitudes. The findings suggest that experience-based spiritual care could complement existing needs-based approaches in palliative care.
The American journal of hospice & palliative care
November 1, 2013
Madelaine Lawrence, Elizabeth Repede
Hospice chart audits and a survey of hospice nurses across the United States show that deathbed communications (DBCs) occur in the 30 days before death and are associated with a more peaceful dying process. Chart audits found that only 5 of 60 records (8.33%) included descriptions of DBCs, while 75 nurses reported 363 incidences, averaging 4.8 per nurse per 30 days. Of the nurses surveyed, 89% reported that patients who experienced a DBC had a peaceful and calm death, compared with 40.5% for those without a DBC. These communications positively impact the dying process but are underreported in patient records and textbooks.