Literature Review
The other side of the curtain
06/01/24 at 03:25 AMThe other side of the curtainJAMA; by Paige Stevens; 5/23/24Each day, clinicians have a sacred opportunity to foster the patient-physician bond and provide holistic care to patients. Too many times, the stress and hectic nature of my daily life as a physician has caused me to lose sight of this special connection and sometimes shortchanged the care that I provided. This journey has taught me more about being a physician than any of my years of formal education ever could. Now, having experienced medicine from the other side of the curtain, I am forever thankful that the physicians and nurses who cared for me took the time to learn my story and attend to all my needs—medical, emotional, and spiritual. These are the moments that I am most thankful for and the moments that will stay with me forever.
The balance between honesty and hope
06/01/24 at 03:20 AMThe balance between honesty and hopeJAMA Cardiology; by Sarah Godfrey; 5/24I am training to be a palliative cardiologist, often delivering heartbreaking news, but I was not prepared to receive it as a mother. Before [her new baby boy] N’s diagnosis, I would have said that our responsibility as physicians is to prepare families for the worst possible outcome. But how can we balance honesty and hope? Could that neurologist have prepared us for the potentially devastating outcome while also allowing us to believe more was possible? When I enter critical illness conversations now, I remember my desperate need for hope when I faced a parent’s worst nightmare. N has made me a better mother and physician, and he has taught me that we must allow hope to flourish even in the darkest of situations.
Beyond the diagnosis: A deep dive into the end stage liver disease experience from the patient perspective
06/01/24 at 03:15 AMBeyond the diagnosis: A deep dive into the end stage liver disease experience from the patient perspectiveAmerican Journal of Hospice and Palliative Medicine; Sheza Malik, MD, Venkat Arutla, MD, Tariq Alamin, MD, Fatima Warraich, MD, Tausif A. Syed, MD, Mahesh Nepal, MD, Muhammad Farhan Ashraf, MD, and Karin J. Dunnigan, MD; 5/24The study identified six primary themes: the significance of communication style in diagnosis delivery, the crucial role of family and social support, varied understanding and preferences for palliative care, diverse attitudes towards advanced care planning, preferences for coordinated healthcare experiences, and the emotional and psychological impact of ESLD. ... Our study underscores the complexity of ESLD patient care beyond medical treatment, highlighting the importance of clear communication, empathetic care, and the integration of family and palliative care services.
“When I do have some time, rather than spend it polishing silver, I want to spend it with my grandkids”: a qualitative exploration of patient values following left ventricular assist device implantation
06/01/24 at 03:15 AM“When I do have some time, rather than spend it polishing silver, I want to spend it with my grandkids”: a qualitative exploration of patient values following left ventricular assist device implantationBMC Palliative Care; by Avery C. Bechthold, Colleen K. McIlvennan, Daniel D. Matlock, Deborah B. Ejem, Rachel D. Wells, Jesse LeJeune, Marie A. Bakitas, J. Nicholas Odom; 5/24Values are broadly understood to have implications for how individuals make decisions and cope with serious illness stressors, yet it remains uncertain how patients and their family and friend caregivers discuss, reflect upon, and act on their values in the post-left ventricular assist device (LVAD) implantation context. This study aimed to explore the values elicitation experiences of patients with an LVAD in the post-implantation period. ... Clinicians should consider assessing the values of patients post-implantation to facilitate shared understanding of their goals/priorities and identify potential changes in their coping.
Procedural interventions for terminally ill children – Are we aiding palliation?
06/01/24 at 03:10 AMProcedural interventions for terminally ill children – Are we aiding palliation?Journal of Palliative Care; by Hannah Phillips, MD, Sarah Perry, MS, Laura A Shinkunas, MS, Erica M Carlisle, MD; 5/24Many children undergo surgery or an invasive procedure during their terminal hospital admission. The types of procedures, patients, and the intent of the procedures has not been well defined. Understanding these details may help pediatric surgeons better determine the clinical settings in which certain procedures will not enhance palliation or survival. ... 132 children met inclusion criteria. Most children were White and less than one year old. The most common type of diagnosis was cardiac in nature. Children underwent an average of three procedures. 75% were intubated and 77.5% had palliative care involved. Patients who were less than one year old at death were more likely to have been intubated, had longer terminal hospital stays, and had more procedures. Those who were intubated underwent more procedures and had longer hospital stays. Those with longer palliative care involvement had fewer procedures. ... Ongoing study may help refine which procedures may have limited impact on survival in the chronically ill pediatric population.
Challenges and solutions of conducting dementia clinical trials: A palliative care at home pilot for persons with dementia
06/01/24 at 03:05 AMChallenges and solutions of conducting dementia clinical trials: A palliative care at home pilot for persons with dementiaJournal of the American Geriatrics Society; by Leah V. Estrada, PhD, Laura Gelfman, MD, Meng Zhang, MD, Christian Espino, BA, Nathan Goldstein, MD; 4/24We enrolled 30 patients and their 30 caregivers in our pilot trial of home-based palliative care. We found two significant barriers to enrollment: (1) the electronic health record was insufficient to determine the severity ofpatients' dementia; and (2) rates of follow-up survey completion were low, with completion rates at 6 months between 14 and 44%. We created an iterative training process to determine dementia severity from electronic health records and applied person-centered approaches to improve survey completion. ... Electronic health records are not set up to include discrete fields for dementia severity, which makes enrollment of older adults with dementia in a clinical trial challenging. The strain of caring for a loved one with advanced dementia may also make participation in health-services research difficult for patients and their families. Novel approaches have the potential to counteract these challenges, improve recruitment and retention, and ultimately improve care for people with dementia and their caregivers.
Today's Encouragement
06/01/24 at 03:00 AMKeep your face always toward the sunshine - and shadows will fall behind you. ~Walt Whitman
Deaths of despair surged among Black people over past decade
06/01/24 at 03:00 AMDeaths of despair surged among Black people over past decadeJAMA Network; by Emily Harris; 5/24Guided by findings reported in 2015, researchers have thought that the uptick in midlife deaths of despair—those resulting from suicide, drug overdose, and alcoholic liver disease—disproportionately affected White people. Now, new data published in JAMA Psychiatry illustrate that the decrease in life expectancy from deaths of despair among people aged 45 to 54 years is not unique to White individuals.Publisher's Note: Some hospices exclude suicide, drug overdose, alcoholic liver disease, etc., from hospice utilization calculations or consideration - should we?
Saturday newsletters
06/01/24 at 03:00 AMSaturday newsletters focus on headlines and research - enjoy!
Hospice patient in Red Wing died after being given morphine by mistake
05/31/24 at 03:30 AMHospice patient in Red Wing died after being given morphine by mistakeBring Me the News (MN); by Tommy Wiita; 5/29/24A hospice patient at a Red Wing assisted living facility suffering a diabetic emergency died after being given morphine by mistake. A Minnesota Department of Health State Rapid Response Investigative Report found that the allegation of neglect against the Mayo Clinic Hospice at 906 College Way was substantiated as the staff member "failed to provide timely care, monitoring, and safe medication administration services. The report says the staff member provided five times the resident's prescribed dose of morphine "in error" and didn't provide interventions when the resident was having a seizure and had a critically low blood sugar of 29.
New study finds underutilization of early palliative care for patients with advanced cancer mostly attributable to provider and organizational characteristics
05/31/24 at 03:00 AMNew study finds underutilization of early palliative care for patients with advanced cancer mostly attributable to provider and organizational characteristics American Cancer Society; 5/28/24 A new study led by researchers at the American Cancer Society (ACS) shows despite considerable growth in early palliative care (PC) use, utilization among patients with advanced cancer remained low from 2010 to 2019. ... Early integration of palliative care is recommended for advanced-stage cancers, but evidence of its use and the role of provider and organizational characteristics in its uptake is limited. ... Early PC was defined as receipt of PC within 90 days post-diagnosis and before hospice admission, if any. ... Study authors stress the large variation between providers and organizations suggest important modifiable provider behaviors and organizational characteristics in early PC receipt, ...
Suicide rates among cancer patients are falling
05/31/24 at 03:00 AMSuicide rates among cancer patients are falling U.S. News / HealthDay; by Ernie Mundell; 5/30/24 Even as suicide rates have risen among Americans generally, one group appears to be bucking that trend: People diagnosed with cancer. Experts are crediting improved access to counseling and other "psychosocial care" with easing the emotional toll of cancer and keeping more patients from making tragic decisions.
Over 400 physicians from Delaware’s ChristianaCare move to unionize
05/31/24 at 03:00 AMOver 400 physicians from Delaware’s ChristianaCare move to unionize Portside; by Jennifer Henderson / MedPageToday; 5/28/24 More than 400 physicians from Delaware's Christiana Hospital, Wilmington Hospital, and Middletown Free-standing Emergency Department -- all part of the ChristianaCare health system -- filed to unionize with Doctors Council SEIU Local 10MD. "If successful, this will be the first physician union in Delaware and the first union of any kind at ChristianaCare," Doctors Council SEIU said in an announcement of the filing, which pointed to the ongoing corporatization of medicine as driving the physicians' efforts. Some of the specific concerns that physicians detailed in regard to their filing included understaffing and inadequate resources, corporate influence on medical decision making, limited input in matters affecting patient care and physician safety and autonomy, and moral injury caused by pressure to place profit over patients. Editor's Note: These "specific concerns" reflect consistent themes with other, recent healthcare unionization and strikes throughout the nation, within the scope of one's practice (e.g., physicians vs. nurses).
‘We don’t talk about death’: Winston-Salem journalist seeks to help people understand dying, deathbed visions
05/31/24 at 03:00 AM‘We don’t talk about death’: Winston-Salem journalist seeks to help people understand dying, deathbed visions Fox 8 WGHP - High Point, NC; by Bob Buckley; 5/29/24 There may not be anything that fascinates people more than death. It may be the thing many people avoid confronting the most. “In our culture, we’re pretty separated from death. And I don’t know the figures, but the vast majority … take place in hospitals. We don’t talk about death a lot in our culture,” said Phoebe Zerwick, a journalist based in Winston-Salem who recently wrote about deathbed visions for the New York Times Magazine. ... Zerwick became aware of the work of Dr. Christopher Kerr. ... “The biggest difference between hallucinations and these experiences is how the person is made to feel,” Dr. Kerr said. “Most hallucinations leave the person distressed and agitated and would be further confused. These experiences bring comfort. They bring meaning. They’re drawn from life. They really validate the life.” ... “I think the moral of the story is to be present and to be present with people when they are terminally ill. Be present when they’re dying,” Zerwick said.
19 myths about dying people need to stop believing
05/31/24 at 03:00 AM19 myths about dying people need to stop believing Million Dollar Sense; by Anuradha Supun; 5/29/24
AI, health care and the strange future of medicine
05/31/24 at 03:00 AMAI, health care and the strange future of medicine American Medical Association (AMA); transcript of AMA podcast "Moving Medicine," hosted by Todd Unger; 5/28/24AMA President Jesse Ehrenfeld, MD, MPH, leads a discussion with three other physicians on the use of AI in health care. Panelists are Claire Novorol, MD, PhD, the founder and chief medical officer of Ada Health, a digital health company using AI to help diagnose and treat patients; Mark Sendak, MD, MPP, a population health data science lead at Duke Institute for Health Innovation; and Alex Stinard, MD, an emergency room physician and regional medical director of Envision Health Care in Florida.
President and CEO of Baxter Health System issues note of thanks to public
05/31/24 at 03:00 AMPresident and CEO of Baxter Health System issues note of thanks to publicOzark Radio News (AR); by Daniel Williams; 5/29/24The president and CEO of Baxter Health in Mountain Home recently issued a word of thanks to the public, addressing those who provided help during the emergency situations in Arkansas on the morning of Sunday, May 26th."I would like to personally thank everyone who was involved in the Code Yellow Disaster event on Sunday morning at Baxter Health. ... Whether it was our ambulance crews who were first on the scene, our physicians, nurses, or ancillary staff at the hospital, or our staff checking on Home Health and Hospice patients for oxygen and other needs, everyone played a crucial role. Additionally, others like Air Evac assisted us in setting up a triage area ... Thank you all very much. I know that there is still a lot to deal with in the aftermath of the storms. Your continued commitment to help is still present and obvious."Editor's Note: Thank you, Ron Peterson (president and CEO) for exemplifying community collaboration, leadership, and humanity. News of natural disasters throughout our nation has become normal: tornados, hurricanes, floods, wildfires, blizzards, and more. Behind each incident are hospice patients, caregivers/families, professionals, volunteers, and community services who rally together to provide safety and support. (For readers, whom might you reach out and thank, for their crucial support through a past crisis?)
The Foundation of Community Hospice & Palliative Care raises $328,000 at C.A.R.S. Benefit Event
05/31/24 at 03:00 AMThe Foundation of Community Hospice & Palliative Care raises $328,000 at C.A.R.S. Benefit Event JaxChamber - Jacksonville News (FL); 5/29/24The Foundation of Community Hospice & Palliative Care is pleased to announce that the recent Children are Rock Stars (C.A.R.S) benefit event, presented by Ring Power and held at The Brumos Collection, raised an impressive $328,000. “We extend our heartfelt thanks to Ring Power and the dedicated C.A.R.S. committee for their incredible effort and unwavering support, which were instrumental in making this event a success,” said Annie Tuttle, Executive Director of The Foundation of Community Hospice & Palliative Care. “Their commitment to our cause and the generous contributions from our donors and sponsors have made a significant impact.”
Sixth annual Run, Walk n Roll 5K continues mission [more than $110k]
05/31/24 at 03:00 AMSixth annual Run, Walk n Roll 5K continues mission [more than $110,000] Grosse Pointe News; by GPN Staff; 5/29/24 Providing funding for pediatric palliative care is the goal of the sixth annual Run, Walk n Roll 5K. ... [This] year's event is virtual, so participants can run, walk or roll from anywhere throught the month of June. ... Since its inception, the event has raised nearly $600,000 for the palliative care program at C.S. Mott Children's Hospital in Ann Arbor. This year's event already has more than 70 sponsors, more than $110,000 raised and participants on six continents and across the U.S.
Executive Personnel Changes - 5/31/24
05/31/24 at 03:00 AMExecutive Personnel Changes - 5/31/24
Manassas Park teens complete inaugural nurse aide course while earning high school diploma
05/31/24 at 03:00 AMManassas Park teens complete inaugural nurse aide course while earning high school diploma ABC News 7 Washington DC; by Victoria Sanchez; 5/30/24 Ten Manassas Park seniors completed their high school nurse aide program and are on their way to being certified by the Virginia Board of Nursing, all while earning their diploma. The inaugural Nurse Aide Pathway class is a competitive, five-day-a-week program that teaches the teens 22 skills they need to become a CNA. They also learned outside the classroom during 40 hours of clinical rotations at a local hospice center. ... “This is the best opportunity I could ever have in high school and will forever be one of the best opportunities I ever have in my life,” said student Javi Sedeno Cisneros. He has an eye on earning an MD after becoming a CNA. ... During their time at the hospice center, the 17-year-olds experienced life lessons most of their peers won’t learn for years.... [Read more for this inspiring, innovative solution.]
Record numbers of nursing homes are shutting down in New England
05/31/24 at 03:00 AMRecord numbers of nursing homes are shutting down in New EnglandBoston.com; by Beth Treffeisen; 5/30/24[Personal story about multiple moves, due to shutdowns:] ... Her dad had to spend his entire life savings on care, about $400,000. “And now he’s being treated like this,” Jones said. “He gets moved around, shuffled around like an object.” The nursing home closures affect not only the patients, like Jones’s father, but also the larger health care system and local communities they serve. Experts in the field say the loss of long-term care facility beds has led to backups in emergency rooms, and family members are leaving the workforce to care for the elderly or sick. ... According to a Boston Federal Reserve report, there were 150 less nursing facilities in New England at the end of fiscal year 2023 than there were at the beginning of 2010, a 15 percent decrease.
Today's Encouragement: When he worked ...
05/31/24 at 03:00 AMWhen he worked, he really worked. But when he played, he really PLAYED. ― Dr. SeussEditor's Note: Celebrating both work and play, have a great Friday and weekend!
Other Business Headlines of Interest, updated 5/30/24 per nasdaq.com
05/31/24 at 03:00 AMOther Business Headlines of Interest, updated 5/30/24 per nasdaq.com
Golfers swing for a cause raising $15,000 for local nonprofit
05/30/24 at 03:15 AMGolfers swing for a cause raising $15,000 for local nonprofit Avow Cares; press release by Renee Stoll; 5/28/24 Hadinger Flooring hosted its 17th Annual Classic Golf Tournament on May 9, 2024, at Tiburon Golf Club, raising $15,000 for local nonprofit Avow. ... The event hosted 150 golfers from various regions around the United States. ... Avow is a nonprofit provider of hospice, palliative care and grief support services.