Literature Review

Coping and end-of-life decision-making in ALS: A qualitative interview study PLoS One, University of Auckland, New Zealand; by Olga Wenzel, Anke Erdmann, Gerald Neitzke, and Irene Hirschberg; 6/26/24 How do people with amyotrophic lateral sclerosis (PALS) deal with their diagnosis and engage in end-of-life decision-making? What informational or supportive needs do they have for counselling about life-sustaining treatment and end-of-life care? Which correlating conditions and influences relate to these needs and how do they connect to the wish to die or wish to live? ... We identified the coping strategies ‘avoid thinking about end-of-life’ and its counterpart, ‘planning ahead to be well-prepared,’ and differentiated the latter into the patterns ‘withdrawing from life and taking precautions against life-prolongation’ and ‘searching for a new meaning in life and preparing for life-sustaining treatment’.  ... These strategies may vary over time, resulting in different support needs. Our findings signify that deep insight is needed into PALS‘ coping processes to understand their decision-making about life-sustaining treatment. Healthcare professionals should be sensitive to illness experiences beyond medical aspects and foster coping as a biographical process to better support people with ALS.Editor's Note: Click on the title to access the full text of this insightful, relevant research. Hospice and palliative educators, use this to strengthen your disease-specific resources and training about care for persons with ALS.

A palliative care curriculum may promote resident self-reflection and address moral injury The Journal of Surgical Research; by Shruti Koti, Lyudmyla Demyan, Danielle Deperalta, Sophia Tam, Gary Deutsch; 6/22/24 online ahead of print Introduction: There is a lack of formal palliative care education for surgical trainees, and the demanding nature of surgical training and exposure to challenging clinical scenarios can contribute to moral injury. We developed a palliative care curriculum to promote self-reflection, aiming to address moral injury in residents.Conclusions: The described palliative care curriculum accomplishes several goals as follows: it educates residents on palliative care topics, teaches communication tools, encourages self-reflection, and provides space for building peer relationships. The ease of implementation makes this curriculum applicable across various types of institutions, offering the potential to positively impact surgical training on a national scale.

Chronic loneliness and the risk of incident stroke in middle and late adulthood: a longitudinal cohort study of U.S. older adults eClinical Medicine, Part of THE LANCET Discovery Science; by Yenee Soh, Ichiro Kawachi, Laura D. Kubzansky, Lisa F. Berkman, and Henning Tiemeier; 6/24/24 Loneliness has been implicated as a stroke risk factor, yet studies have examined loneliness at only one time point. The association of loneliness changes and risk of incident stroke remains understudied. Our aim was to examine the association of loneliness with incident stroke, particularly the role of loneliness chronicity. Chronic loneliness was associated with higher stroke risk independent of depressive symptoms or social isolation. Addressing loneliness may have an important role in stroke prevention, and repeated assessments of loneliness over time may help identify those particularly at risk.Editor's Note: This is the source research for an article we posted yesterday, 6/28/24, titled 

California hospice ownership changes from 2018-2020: A spatial analysis and case illustrationAmerican Journal of Hospice and Palliative Care; by Heather A. Davis, PhD, Christy Torkildson, PhD, RN, PHN, FPCN, HEC-C, Lisa C. Lindley, PhD, RN, FPCN, FAAN; 6/24Hospices in California have undergone significant and complicated ownership changes in recent years. ... Our findings showed that ownership changes were significant and complicated. An influx of for-profit organizations into the California market was primarily responsible for these changes. Additionally, lack of corporate financial public disclosure and voluntary hospice accreditation, certification, and reporting result in a lack of free, publicly available, definitive comprehensive data on for-profit hospice ownership. This hinders information gathering on and provider/familial choice-making regarding hospices. Our study provides critical insight into the impact of ownership changes and lack of definitive, free, publicly available information on adult hospices in California caring for children and has important clinical, research, and policy implications.

Experiencing and enduring patient distress: the distress of palliative care patients and its emotional impact on physicians in trainingBMC Medical Education; by Andréa Tarot, Maxence Pithon, Ashley Ridley, Virginie Guastella, Virginie Guastella, Morgane Plancon, Régis Aubry, Helène Vaillant Roussel, and Axelle Maneval; 6/26/24The extreme vulnerability experienced by patients in palliative care may result in significant distress. These patients require appropriate care while not pathologizing their natural distress. ... [The] aim of this study was to explore how professionals in training feel when confronted with the distress of patients undergoing palliative care. ... The interviews revealed the following five themes:

Travel is fatal to prejudice, bigotry, and narrow-mindedness. ~Mark Twain

Saturday newsletters focus on headlines and research - enjoy!

From nurse to CEO: 2 executives reflect on their paths to the top Becker's Hospital Review - Leadership & Management; by Erica Carbajal; 6/25/24 Throughout their careers, Laureen Driscoll, MSN, RN, and Kathy Tussey, DNP, RN, remained open to change and said yes more often than no, even to opportunities about which they were skeptical or knew would be a challenge. Today, Ms. Driscoll is chief executive of Providence's South Division, which spans 17 hospitals in Northern and Southern California, and Dr. Tussey is CEO of Harrison Memorial Hospital in Cynthiana, Ky. Neither envisioned pursuing a path to the top role when they began their healthcare careers as bedside nurses. ... Hospital and health system CEOs with a background in nursing appear to be few and far between, though the true proportion of nurse CEOs in healthcare is unclear due to a lack of data. Becker's recently caught up with Ms. Driscoll and Dr. Tussey to learn more about their career trajectories and their top pieces of advice for other nurses eyeing a path to the helm. 

Fixing the hospital-to-home health care transition Home Health Care News; by Andrew Donlan; 6/25/24 The transition between hospital discharge and home health care is often fraught with issues. Unfortunately, it also happens to be one of the most crucial parts of a patient’s care journey. With more sick and complex patients coming into home health care than ever, a swift start of home health care is also arguably more important than ever. ... The Discharge to Assess (D2A) Model was a response to this issue in England. The Supporting Older Adults at Risk (SOAR) program, following a similar framework to D2A, was also recently established in the U.S. A study of SOAR’s results within a pilot program in Pennsylvania was recently published in the Journal for Healthcare Quality.

Navy veteran in hospice care in Stark County made a final birthday wish. It came true. The Repository, Massillon, OH; by Steven M. Grazier; 6/26/24 Robert "Bob" Patterson's final birthday wish came true on Tuesday. He said he wanted it loud, festive and full of life. It appeared to be all that and more. The U.S. Navy veteran has been a Harley-Davidson buff and avid motorcycle rider for 62 years. He's called Rose Lane Nursing & Rehabilitation Center home the past couple of months and is in hospice care. Friday is Patterson's 85th birthday, but his last biker bash was celebrated Tuesday with hundreds of folks, which included family, friends, Rose Lane workers and fellow residents.  He was amped for the festivity. "I'm excited — really pumped up!" Patterson said moments before about 190 motorcycles rolled into Rose Lane.

Chronic loneliness can raise stroke risk in older adults, findings show McKnights Long-Term Care News; by Kristen Fischer; 6/24/24 A new study links loneliness to stroke risk, showing that those who are regularly lonesome have a 56% higher risk for stroke than those who are more socially connected. Situational loneliness wasn’t linked to a higher risk for stroke, which indicates that the stroke risk stems from chronic loneliness. Investigators led by a team from Harvard T.H. Chan School of Public Health published their report Monday in eClinicalMedicine. Research has already linked loneliness to an increased risk for cardiovascular disease. The new report is one of the first to evaluate the association between loneliness and stroke risk.

HHS to impose penalties on providers that block patients’ health information McKnights Home Care; by Adam Healy; 6/24/24In a bid to promote easier access and exchange of patients’ health records, the Department of Health and Human Services published a final rule Monday outlining penalties for providers that block access to electronic health information. ... Fragmented and inaccessible patient data can prevent long-term and post-acute care providers from seeing the full picture of a patients’ health. Hospitals, for example, are not required to share updates about a patient’s health with the patient’s post-acute care provider. As a result, home health and home care agencies frequently cannot access patients’ electronic health records to help assess and treat patients. Three disincentives: ... First, hospitals that commit information blocking can be subject to a reduction of three quarters of an annual market basket update. Second, clinicians eligible for the Merit-based Incentive Payment System will receive a zero score in the “promoting interoperability performance” MIPS category, which can be equivalent to roughly a quarter of the clinician’s MIPS score in a given year. Lastly, providers that participate in information blocking can have their Medicare Shared Savings Program or Accountable Care Organization eligibility revoked for at least one year. ...Editor's Note: Almost any solution raises additional challenges. How does HIPAA interface with this? How might a cyberattack at a hospital (or other healthcare agency) affect the patients' other agencies, putting them at risk as well?