4 min

"Challenges and opportunities for improvement when people with an intellectual disability or serious mental illness also need palliative care: A qualitative meta-ethnography‪"‬ SAGE Palliative Medicine & Chronic Care

    • Science

This episode features Dr Nivedita Ashok, (University College London, London, UK).
 
What is already known about the topic?
Individuals with intellectual disability or serious mental illness have high rates of mortality due to physical comorbidities. These populations have specific needs that should be met to provide optimum palliative care and maintain optimum mental healthcare at the end-of-life. While research exists describing the problems these populations face, little is known about how to improve care for them.  
What this paper adds?
By focusing on lived experiences of patients/service users, carers and healthcare professionals this paper synthesises existing evidence into multivoiced perspectives on what works, does not work, plus challenges and opportunities for improvement. Assumptions and misunderstandings about the role of mental capacity assessment to appropriately involve the patient in decision-making are common, while adapting training for palliative care staff to address concerns and beliefs about mental illness helps to avoid diagnostic overshadowing. Professionals need help to work across divides between physical and mental healthcare services, so people can receive palliative care in familiar locations and/or from familiar people.  
Implications for practice, theory, or policy
A significant research deficit exists regarding provision of optimal palliative care to people with psychosis, personality disorders, bipolar affective disorder and depression. Assessing capacity may be optimally achieved by involving professionals across specialities and organisations. Proactive identification of service arrangements for care needs of persons with serious mental illness will help optimise care.  
Full paper available from:    
https://journals.sagepub.com/doi/10.1177/02692163231175928
  
If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: 
a.nwosu@lancaster.ac.uk
 

This episode features Dr Nivedita Ashok, (University College London, London, UK).
 
What is already known about the topic?
Individuals with intellectual disability or serious mental illness have high rates of mortality due to physical comorbidities. These populations have specific needs that should be met to provide optimum palliative care and maintain optimum mental healthcare at the end-of-life. While research exists describing the problems these populations face, little is known about how to improve care for them.  
What this paper adds?
By focusing on lived experiences of patients/service users, carers and healthcare professionals this paper synthesises existing evidence into multivoiced perspectives on what works, does not work, plus challenges and opportunities for improvement. Assumptions and misunderstandings about the role of mental capacity assessment to appropriately involve the patient in decision-making are common, while adapting training for palliative care staff to address concerns and beliefs about mental illness helps to avoid diagnostic overshadowing. Professionals need help to work across divides between physical and mental healthcare services, so people can receive palliative care in familiar locations and/or from familiar people.  
Implications for practice, theory, or policy
A significant research deficit exists regarding provision of optimal palliative care to people with psychosis, personality disorders, bipolar affective disorder and depression. Assessing capacity may be optimally achieved by involving professionals across specialities and organisations. Proactive identification of service arrangements for care needs of persons with serious mental illness will help optimise care.  
Full paper available from:    
https://journals.sagepub.com/doi/10.1177/02692163231175928
  
If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: 
a.nwosu@lancaster.ac.uk
 

4 min

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