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Volume 8
Journal of Palliative Care & Medicine
Hospice 2018
July 18-19, 2018
Page 14
conference
series
.com
July 18-19, 2018 Melbourne, Australia
5
th
World Congress on
Hospice and Palliative Care
Developing guidelines to manage diabetes during palliative and end of life care: A collaborative iterative
approach
Statement of the Problem:
Diabetes is an underlying cause of death in over 60% of deaths due to diabetes complications and
other comorbidities. People with diabetes have a shorter life expectancy than the population. Quality diabetes palliative and end
of life care requires a personalized approach and should be a proactive collaborative endeavor. Clinicians are reluctant to discuss
these issues with people with diabetes and there is limited guidance to support their decision-making.
Aim:
The aim is to develop and formatively evaluate guidelines for managing diabetes at the end of life that were evidenced-
based, clinically relevant, holistic and usable.
Method:
The standard guideline development procedures are used. In addition, palliative care clinicians used several successive
iterations of the draft guidelines to deliver care. Thus, the guidelines were tested before they were released into the public
domain. The interview was done for the people with diabetes receiving palliate care and families about their experiences and the
care issues they believed needed to be included in the guidelines.
Findings:
The literature review identified only five relevant papers, three of which provided advice based the initial paper, none
advocated a holistic approach. People with diabetes wanted blood glucose testing and diabetes medicines continued until ‘the
end’ as part of symptom control and comfort. Families were concerned about assuming diabetes self-care when their relative was
too ill to continue do so. Important aspects of diabetes palliative/end of life care were included in the final guideline that was not
mentioned in the literature review. Collaborating with key end users enhanced the likelihood they would be used.
Conclusion:
The guidelines are clinically relevant and encompass issues relevant to people with diabetes and clinicians. They
were developed collaboratively with end users and care recipients, which enhanced their relevance.
Biography
Trisha Dunning is the inaugural Chair in Nursing and a Member of the Centre for Quality and Patient Safety Research in the Barwon Health Deakin University
Partnership. Her research and care focus are on older people with diabetes and end of life care. She serves on many Professional Committees and Advisory
Boards, including Diabetes Victoria, College of Nursing Australia and the International Diabetes Federation. She was made a Member of the Order of Australia in
2004 for her work in nursing and diabetes.
trisha.dunning@barwonhealth.org.auTrisha Dunning
Deakin University, Australia
Trisha Dunning, J Palliat Care Med 2018, Volume 8
DOI: 10.4172/2165-7386-C1-013