Literature Review

Palliative care for patients with cancer: ASCO guideline updateJournal of Clinical Oncology; by Justin J Sanders, Sarah Temin, Arun Ghoshal, Erin R Alesi, Zipporah Vunoro Ali, Cynthia Chauhan, James F Cleary, Andrew S Epstein, Janice I Firn, Joshua A Jones, Mark R Litzow, Debra Lundquist, Mabel Alejandra Mardones, Ryan David Nipp, Michael W Rabow, William E Rosa, Camilla Zimmermann, Betty R Ferrell; 7/24Evidence-based recommendations address the integration of palliative care in oncology. Oncology clinicians should refer patients with advanced solid tumors and hematologic malignancies to specialized interdisciplinary palliative care teams that provide outpatient and inpatient care beginning early in the course of the disease, alongside active treatment of their cancer. For patients with cancer with unaddressed physical, psychosocial, or spiritual distress, cancer care programs should provide dedicated specialist palliative care services complementing existing or emerging supportive care interventions... The Expert Panel suggests early palliative care involvement, especially for patients with uncontrolled symptoms and QOL concerns. Clinicians caring for patients with solid tumors on phase I cancer trials may also refer them to specialist palliative care. Additional information is available at www.asco.org/supportive-careguidelines. 

International consensus on sleep problems in pediatric palliative care: Paving the way[International] Sleep Medicine; by Anna Mercante, Judith Owens, Oliviero Bruni, Magda L. Nunes, Paul Gringras, Shirley Xin Li, Simonetta Papa, Ulrika Kreicbergs, Joanne Wolfe, Boris Zernikow, Ana Lacerda, Franca Benini, on behalf of the Pediatric Sleep and Palliative Care Group; 7/24Sleep problems constitute a common and heterogeneous complaint in pediatric palliative care (PPC), where they often contribute to disease morbidity and cause additional distress to children and adolescents and their families already facing the burden of life-threatening and life-limiting conditions. Despite the significant impact of sleep problems, clinical evidence is lacking... This study addresses the need to personalize sleep medicine’s approach to the palliative care setting and its peculiarities. It provides the first international consensus on sleep problems in PPC and highlight the urgent need for global guidance to improve sleep-related distress in this vulnerable population and their caregivers. Our findings represent a crucial milestone that will hopefully enable the development of guidelines in the near future.Publisher's Note: I am grateful that sleep issues are being studied and discussed more often, as they can be terribly disruptive to patients and family members.

Why Nurses QuitMedscape; by Jodi Helmer; 6/27/24Over 262,000 registered nurses (RNs) graduate yearly; 33 percent quit within the first 2 years. "Retention is a huge issue in nursing," says Jennifer Mensik Kennedy, PhD, MBA, RN, NEA-BC, FAAN, president of the American Nurses Association (ANA). "COVID highlighted the issue, but these problems existed well before [the pandemic], and what we're seeing is a failure to truly do something about it." ... Diagnosing the Problem: burnout, work environment, inadequate staffing. Finding a Cure: legislation, residencies and mentorship, improved work conditions, resources for self-care.

UVM Home Health & Hospice raises over $128,000 myChamplainValley.com, Colchester, VT; by Charlotte Ferguson; 7/1/24 UVM Home Health & Hospice raised over $128,000 in its annual 5K fundraiser last month. This was the most the fundraiser has ever brought in for the McClure Miller Respite House. Every dollar raised goes directly to the McClure Miller Respite House, ensuring that each patient receives high-quality, compassionate end-of-life care despite their financial circumstances.

Senior care experts detail how to build a coveted ‘destination workplace’ McKnights Home Care; by Josh Henreckson; 6/27/24 Faced with today’s complex array of financial, staffing and regulatory challenges, senior care operators need to rely on a broad range of workplace solutions, a panel of experts said. ... Providers should be actively listening to their employees’ needs and trying to meet the evolving desires of the labor market, they emphasized at McKnight’s “Meeting of the Minds” thought-leader discussion. This must take place whether they’re pursuing recruiting strategies, trying to improve staff retention, integrating new technological advances or investing in new benefits and professional development. “The one area that’s going to undergird everything for your success is paying attention to the most important capital, which is human capital,” said Navin Gupta, CEO at software provider Viventium. “Pay attention to the caregiver experience from recruitment … to retention to recognition and development — the entire journey."

[Certificate of Need] Diagnosis for 6.26.24: Checking the pulse of Florida health care news and policy Florida Politics, scroll down to "Death and Dying"; 6/26/24 Florida health care regulators this week announced they tentatively denied 21 Certificate of Need (CON) applications for new hospice programs and approved 9 others. Heavily populated Broward and Hillsborough counties drew the most interest, with seven providers wanting to establish new hospice programs in each area. [For details, click on the title's link and scroll down to "Death and Dying."]

DOJ slaps $20M opioid prescription penalty on OptumRx Fierce Healthcare; by Noah Tong; 7/2/24 OptumRx will pay $20 million to resolve claims the company violated the Controlled Substances Act by improperly filling certain opioid prescriptions, the Department of Justice recently announced. The agency claims OptumRx did not fill prescriptions correctly for "trinity prescriptions" like benzodiazepines and other muscle relaxants from April 2013 to April 2015. These prescriptions, which are addictive, may not have been “intended for legitimate medical use” and carry “significant risk of harm,” according to a news release. “Pharmacies providing opioids and other controlled substances have a duty under the Controlled Substances Act to ensure that they fill prescriptions only for legitimate medical purposes,” said Principal Deputy Attorney General Brian Boynton, head of the Justice Department’s Civil Division, in a statement. “The department will continue to work with its law enforcement partners to ensure that pharmacies do not contribute to the opioid addiction crisis.”

Aligning pill burden and palliative care needs in late-stage CVD: AHA TCTMD - Cardiovascular Research Foundation; by L.A. McKeown; 7/2/24 The first scientific statement from the American Heart Association (AHA) that focuses specifically on pharmacotherapy considerations in the palliative management of patients with CVD [cardiovascular diesease] urges a patient-centered, compassionate approach to de-escalating and deprescribing. ... In addition to shedding light on how and when to start deprescribing and de-escalating common cardiovascular drugs, the statement discusses palliative drugs for pain, shortness of breath, and appetite in the context of CVD, which [Katherine E.] Di Palo [PharmD (Montefoiore Medical Center, NY)] said the committee identified as a gap in knowledge given that much of the evidence for these drugs comes from patients with serious illnesses like cancer. ... Important Takeaways: Di Palo and colleagues note that palliative care complements cardiovascular care in several important ways, including reducing physical symptom burden, managing emotional and spiritual distress, providing sufficient support for caregivers, and helping patients choose treatment in line with their goals for care. Editor's Note: Click here for the American Heart Association's statement, which we posted on 7/2/24. 

Hospice Palliative Care Society launches Rec Room Programs Prince George Citizen, British Columbia, Canada; by Citizen staff; 7/2/24 The Prince George Hospice Palliative Care Society (PGHPCS) is offering  new  Rec Room Programs, furthering the organization’s commitment to expanding hospice services for the community. This new addition aligns with the strategic goal of creating a space for individuals with life-limiting illnesses, their caregivers, and those grieving. The Rec Room is dedicated to promoting healing and wellness through meaningful connections and tangible support. Programs offered include:

Pasadena Hindu Temple offers health planning series for seniors: Interactive session to cover advance care, palliative care, and hospice services Pasadena Now; 7/2/24 The Pasadena Hindu Temple is hosting a health and wellbeing series for seniors, focusing on future healthcare planning. ... Doctors Alka and Pradeep Kapoor, both board-certified in internal medicine, hospice, and palliative medicine, will present on topics including advance care planning, palliative care, and hospice care. The doctors, who have over 45 years of medical experience, are also certified in Post Acute and Long-term care medicine. ... Established in 2002, the Pasadena Hindu Temple has evolved into a hub for Indian heritage and Hindu worship in Southern California. Now operating as the Hindu Temple and Heritage Foundation (HTHF), the nonprofit organization offers various community services. Editor's Note: What cultures and faith communities are in your service areas? Do you reach out to all? Does your staffing reflect your community? Click here for U.S. Census information and search for your geographical areas. 

The hidden advantages of having an older workforce in home health care Home Health Care News; by Joyce Famakinwa; 7/2/24In home health and hospice, the amount of nurses who are at retirement age are set to surpass new RNs, according to data from the American Medical Group Association. St. John has noticed that working with more experienced nurses has meant less turnover. "Our highest turnover is in first-year nurses," she said. Another benefit of having a workforce full of mostly seasoned nurses is that they are better equipped to handle burnout, according to Barnett.

Four July 4th tips for families caring for loved ones with dementia Alzheimer's Association; 6/27/24 Fireworks and gatherings are staples of the 4th of July holiday, but these can create unique challenges for someone living with dementia. ... “Celebrating Independence Day can still be a fun, enjoyable experience for families impacted by dementia-related illnesses by making the proper adaptations such as being cautious about watching fireworks due to loud noises. It requires thoughtful planning to ensure their safety, comfort, and enjoyment.” said Jennifer Reeder, LCSW, SIFI, AFA’s Director of Educational and Social Services. “Being proactive, prepared, and adaptable, and creating a safe space, are the best ways caregivers can create a dementia-friendly 4th of July for their loved ones.” AFA encourages family caregivers to follow these four tips for the 4th of July:

Dwayne Johnson sings Moana song for a 4-year-old girl in home hospice care: 'It's my honor' People; by Tommy McArdle; 4/2/24 Dwayne Johnson said the Make-a-Wish Foundation connected him with the family of a young girl who "watches 'Moana' every day, all day." Dwayne made a special video for a major Moana fan.  On July 1, the actor, 52, shared a video on Instagram in which he said the Make-a-Wish Foundation had reached out to him with an urgent request to send a message to a 4-year-old girl named Lily Guerrero, who Johnson said is currently on home hospice care. "A 'rush' wish means what the implication sounds like, which is time is just not on our side when it comes to this particular wish," Johnson said in the video. "This rush wish is that Lily is on home hospice now and she watches Moana every day, all day, her dad said. Her wish is to have Dwayne Johnson sing 'You're Welcome' to her and have it recorded so she can listen to it over and over and over and over." [Click on the title's link to view the article and its video of Dwayne Johnson telling the public about Lily and singing to her.]