Search results for "Life care"
showing 10 items of 33 documents
Three essays on actuarial social security theory
2015
Esta tesis se centra en dos de los instrumentos básicos para mejorar los sistemas de pensiones de reparto (PAYG pension systems): el balance actuarial (ABS) y las cuentas nocionales de aportación definida (NDC). Las investigaciones sobre dichos instrumentos consideran, en general, sólo la contingencia de jubilación. La tesis explora las posibilidades de generalizarlos añadiendo dos nuevas contingencias, la invalidez permanente (disability) y la dependencia (LTC). Los objetivos principales que esta tesis persigue son los siguientes: 1.- Desarrollar la base teórica necesaria para poder formular el balance de situación actuarial (ABS) tipo Suecia en un sistema de pensiones de reparto de presta…
Converting Retirement Benefit into a Life Care Annuity with Graded Benefits: How Costly Would it Actually Be?
2016
This paper deals with life care annuities, i.e. bundled products comprising a life annuity and long-term care insurance. It aims to assess the cost of converting retirement benefit into a life care annuity with graded benefits using a pre-existing public pay-as-you-go pension scheme. With this objective in mind, we present an actuarial method based on array calculus for valuing this type of life care annuity. The health dynamics of the annuitant rely on a reversible illness-death multistate framework. The paper contains a numerical example in which mortality and disability assumptions are based on data from the USA and Australia, although this should be viewed simply as an illustration. In …
Comparing counseling and dignity therapies in home care patients: A pilot study
2015
AbstractObjective:Several studies have successfully tested psychosocial interventions in palliative care patients. Counseling is the technique most often employed. Dignity therapy (DT) has recently emerged as a tool that can be utilized to address patients' needs at the end of life. The aims of our study were to examine the effects of DT and counseling and to offer useful information that could be put into practice to better meet patients' needs.Method:We developed a pilot randomized controlled trial at the Home Care Unit of the General University Hospital of Valencia (Spain). Some 70 patients were assigned to two therapy groups. The measurement instruments employed included the Patient Dig…
Symptom prevalence in the last days of life in Germany: the role of place of death.
2011
Investigations have shown that symptom prevalence varies according to the place of death. We sought to assess the symptom prevalence of chronically ill people in Germany and how this prevalence differs depending on the place of death. We sent questionnaires to 5000 bereaved people in Rhineland-Palatinate (Germany), whose relatives died between May 25 and August 24, 2008. In all, 3832 questionnaires were delivered and 1378 completed (response 36.0%). Most decedents had moderate-to-severe weakness (94.5%), fatigue (93.5%), need for help in daily activities (87.9%), and appetite loss (87.4%). Pain and dyspnea were most severe in hospitals; fatigue, confusion/disorientation, and problems with w…
Attitudes towards end-of-life issues in intensive care unit among Italian anesthesiologists: a nation-wide survey
2018
Background: The aim of this paper is to collect data on the practice of palliative care, withholding and withdrawal of life-sustaining therapies, and management of end of life (EOL) in Italian intensive care units (ICUs). Methods: Web-based survey among Italian anesthesiologists endorsed by the Italian Society of Anesthesiology Analgesia Reanimation and Intensive Care (SIAARTI). The survey consists of 27 close-ended and 2 open-ended questions. Results: Eight hundred and five persons responded to the full list of questions. The highest proportion of respondents was of 36â45 years of age (34%) and catholic (66%). Almost 70% of responders declared that palliative/supportive care are applied …
Specific challenges in end-of-life care for patients with hematological malignancies.
2019
Purpose of review The disease-related burden of patients with hematological malignancies is comparable with patients suffering from solid tumors. Palliative care offers relief from suffering independent of type of disease and prognosis. The prevalence of hematological malignancies is expected to increase in the next 20 years because of better therapeutic options with longer survival and because of the aging population. However, patients with hematological malignancies are underrepresented in palliative care as these diseases are associated with special care needs and prognostic uncertainty, which differ from the unambiguity of terminally ill patients with solid tumors. This review describes…
Variation in end-of-life care and hospital palliative care among hospitals and local authorities: A preliminary contribution of big data.
2021
Background: Many studies explore the clinical and ethical dimensions of care at the end-of-life, but fewer use administrative data to examine individual and geographic differences, including the use of palliative care. Aim: Provide a population-based perspective on end-of-life and hospital palliative care among local authorities and hospitals in France. Design: Retrospective cohort study of care received by 17,928 decedents 65 and over (last 6 months of life), using the French national health insurance database Results: 55.7% of decedents died in acute-care hospitals; 79% were hospitalized in them at least once; 11.7% were admitted at least once for hospital palliative care. Among 31 academ…
Palliative Care Professionals' Inner Lives: Cross-Cultural Application of the Awareness Model of Self-Care
2021
Compassionate professional qualities traditionally have not received the most attention in either critical or end of life care. Constant exposure to death, time pressure and workload, inadequate coping with personal emotions, grieving, and depression urge the development of an inner curricula of competences to promote professional quality of life and compassionate care. The COVID-19 pandemic highlights the universality of these problems and the need to equip ourselves with rigorously validated measurement and monitoring approaches that allow for unbiased comparisons. The main objective of this study was to offer evidence on the generalizability of the awareness model of self-care across thr…
LIFE CARE ANNUITIES (LCA) EMBEDDED IN A NOTIONAL DEFINED CONTRIBUTION (NDC) FRAMEWORK
2016
AbstractThis paper examines the possibility of embedding public long-term care (LTC) insurance within the retirement pension system, i.e. introducing life care annuities into a notional defined contribution framework. To do this, we develop a multistate overlapping generations model that includes the so-called survivor dividend and give special attention to the assumptions made about mortality rates for dependent persons and LTC incidence rates, which largely determine the contribution rate assigned to LTC. The proposed model could be of interest to policymakers because it could be implemented without too much difficulty, it would universalize LTC coverage with a “fixed” cost, and it would …
Palliative Care Principles and Anesthesiology Clinical Practice: Current Perspectives
2021
Background Palliative care is a person-centered approach aiming to relieve patient's health-related suffering and it is often needed when caring for critically ill patients to manage symptoms and identify goals of care. Aim To describe the integration of palliative care principles in anesthesiology clinical practice, within and outside the ICU and to analyze the additional challenges that COVID-19 pandemic is posing in this context. Methods For the purpose of this review, PubMed database was searched for studies concerning palliative care and end of life care, in contexts involving anesthesiologists and intensivists, published in the last 5 years. Results Anesthesiologists and intensivists …