Literature Review

Design, creation, and 13-month performance of a novel, web-based activity for education in primary cardiology palliative care Journal of Pain and Symptom Management; by Jill M Steiner, Caroline L Doherty, Jill A Patton, Jadry Gruen, Sarah Godfrey, John Mulrow, Richard A Josephson, Sarah J Goodlin; 6/5/24 online ahead of print Cardiovascular disease (CVD) clinicians who care for seriously ill patients frequently report that they do not feel confident nor adequately prepared to manage patients' palliative care (PC) needs. With the goal, therefore, of increasing PC knowledge and skills amongst interprofessional clinicians providing CVD care, the ACC's PC Workgroup designed, developed, and implemented a comprehensive PC online educational activity. This paper describes the process and 13-month performance of this free, online activity for clinicians across disciplines and levels of training, "Palliative Care for the Cardiovascular Clinician" (PCCVC).Editor's Note: Reiterating, this "free, online activity [is] for clinicians across disciplines and levels of training." The trajectories for cardiovascular diseases can elicit enormous anxiety--due to their roller-coaster changes that can result in sudden death--in contrast to the more predictable trajectories for cancer. Whether you use this resource or another, educate your interdisciplinary clinical managers and team members to the all-important disease and care factors for cardiology palliative care, relevant to the scope of professionals' different roles. 

AccentCare expands hospice care business to Rhode Island HomeCare; 6/7/24 AccentCare, a nationwide provider of home health, hospice and personal care services, announced the opening of its Warwick hospice location and its expansion into Rhode Island after being awarded a Certificate of Need (CON) license in the state. “We are excited to expand our footprint in New England and to provide hospice services to more patients and families in the region,” said Andy Johnston, president of hospice & PCS, AccentCare. “We know the critical role hospice plays in extending the continuum of care to patients and adding dignity to the end of life. We are honored to begin providing high-quality, compassionate care in Rhode Island.” 

Knowing your own darkness is the best method for dealing with the darknesses of other people. – Carl Jung

Death with dignity: 50th anniversary of America’s first hospiceYankee Institute; by Andrew Fowler; 6/7/24 ... In the late 19th century, terminally ill patients faced undignified treatment or were even “refused admission to the hospital entirely” due to “availability of space and resources” or race and socio-economic class, according to Doctors, Death, and Denial: The Origins of Hospice Care in 20th Century America by Sarah E. Pajka. ... All of this shaped the outlook of Florence Wald — a former dean of the Yale University School of Nursing, and a Branford native. Growing up in the early 20th century, she recognized the flaws and inhumane nature of medical care toward terminal patients, telling the Associated Press (AP), on Nov. 26, 1971, that death is “a period of life that can have a lot of meaning. It can be content, full of joy, with lots of reminiscing.” But death needed to be “more human and meaningful,” as she stated in the same AP article. Throughout her career, Wald’s passion for palliative care revolutionized the medical profession, with her co-founding “The Connecticut Hospice,” the first in the United States, on June 11, 1974.  Since then, more than 5,200 hospices have been established in the country and millions have sought both in-patient and home care services. This is the story of how the first hospice was founded in Connecticut 50 years ago.  ... Editor's Note: This fascinating history of hospice's beginnnings illuminate core purposes, outcomes (are we measuring the right factors?), and current 21st century challenges. This article is published by the Yankee Institute, not Connecticut Hospice. This author frames this history as a stand against "euthanasia." Whatever one's ethical, political, or religious stand on today's MAiD issues (Medical Aid in Dying)--also referred to as physician assisted suicide--we invite you to find common ground in learning from our history and celebrating Florence Wald's co-founding of The Connecticut Hospice. For readers, what do you know about your hospice organization's history? What might you research and learn? Whom can you honor? Fifty years from now, what will be said of how your organization chose to address 2024's core hospice purposes, outcomes, and challenges?

Higher sepsis mortality in safety-net hospitals linked to fewer post-discharge care options Contagion Live - Infectious Diseases Today; by Kenneth Bender, PharmD, MA; 6/9/24 Purportedly higher sepsis mortality in safety-net hospitals reflects less a difference in acute care than opportunities to discharge to hospice. By extending the measure of sepsis-related mortality from in-hospital events to occurrences within 30 days after the diagnosis, the purported higher mortality rate of sepsis treated in safety-net hospitals decreased to parity with non-safety-net hospitals, in a retrospective national cohort study. The investigators note the particular challenges of safety-net hospitals, which care for a disproportionately high share of low-income and underinsured patients, include fewer resources and narrower operating margins, as well as patient populations with decreased access to preventative care and more complex disease presentations.

Paramedics helping hospice patients make final memories with family CKXS 99.1 News, St. Wallaceburg, Ontario; 6/7/24A new hospice program in Chatham-Kent is giving patients a chance to take one last end-of-life journey with their loved ones. Chatham-Kent EMS and the Chatham-Kent Hospice have partnered to create the Lasting Memories Program, which allows palliative patients to take a day trip to a location of their choosing. The program helps families create lasting memories of their loved ones in the final days through a trip to the farm, a ride to the lake, or enjoying a sporting event. Local paramedic Jon Benoit was credited for helping to get the program off the ground by coordinating services between the hospice and Medavie Health Services. “Medavie is really good about letting us use their ambulances and helping get this program running and supporting us through it… but the medics doing the actual program, it’s all volunteer time,” he said. Staff at the hospice work with families on coordinating the outing with volunteer paramedics, who escort them throughout the excursion, alleviating any health or medical concerns.

‘The last option’: Why doctor, resident unions continue to growModern Healthcare; by Mari Devereaux; 6/6/24A wave of labor organization continues among doctors, residents and fellows as more than 3,000 have joined unions so far this year, driven by worries about burnout, administrative burden and inadequate patient care. Doctors and support staff are seeking contracts across organizations that ensure reduced workloads and more one-on-one patient care time. However, where doctors want more decision-making power, residents are pushing for better benefits and higher pay.

Good Samaritan Hospice opens regions first freestanding hospice house CBS WDBJ TV - 7, Roanoke, VA; by Neesy Payne; 6/7/24 A grand opening celebration was held Friday, June 7, for the Sheila S. Strauss Hospice House. It’s the region’s first freestanding hospice house. It was a part of the original plans of Good Samaritan Hospice back in 1992, and 32 years later, it is now a reality. “Our primary focus will always be taking care of patients at home; but when that’s not possible, maybe someone has pain, or needs respite, or a situation just arises that they need a different level of care, then we will be able to provide that in a facility that looks and is designed to be as homelike as possible,” said President and CEO of Good Samaritan Hospice Aaron Housh. ... It includes 16 private rooms, a living room, dining room, a chapel, and a courtyard – all aimed to make residents and their families feel at home.

Sexual function in serious illness: Areej El-Jawahri, Sharon Bober, and Don DizonGeriPal Podcast; Eric Widera, Alex Smith, Areej El-Jawahri, Sharon Bober, Don Dizon; 6/6/24As Eric notes at the end of today’s podcast, we talk about many difficult issues with our patients. How long they might have to live. Their declining cognitive abilities. What makes their lives meaningful, brings them joy, a sense of purpose. But one issue we’re not as good at discussing with our patients is sexual health. On today’s podcast Areej El-Jawahri, oncologist specializing in blood cancers at MGH, says that sexual health is one of the top if not the top issue among cancer survivors. Clearly this issue is important to patients.

Palliative care in the intensive care unit: The standard of care AACN - American Association of Critical-Care Nurses; by Clareen Wiencek, PhD, RN, ACNP, FAAN; 6/7/24Intensive care unit–based palliative care has evolved over the past 30 years due to the efforts of clinicians, researchers, and advocates for patient-centered care. ... This article provides an overview of the current state of intensive care unit–based palliative care, examines how the barriers to such care have shifted, reviews primary and specialist palliative care, addresses the impact of COVID-19, and presents resources to help nurses and intensive care unit teams achieve optimal outcomes. [Access to the full article requires subscription or purchase of the individual article.]

You don't need a New Year to make a change. All you need is a Monday! Make this the week you change your life.

NAHC, NHPCO comment on revision of Hospice Certifying Physician Enrollment RequirementHomeCare; 6/7/24 The National Association for Home Care & Hospice (NAHC) and the National Hospice and Palliative Care Organization (NHPCO) responded to the Centers for Medicare & Medicaid Services (CMS) recently revised guidance regarding the implementation of the hospice certifying physician enrollment requirement. NAHC and NHPCO identified that some instruction provided by CMS was inconsistent with established law and regulations regarding the certification of a patient’s terminal illness for new hospice elections after the first benefit period. That instruction, if implemented, could have resulted in major negative impacts on hospices and the patients and families they serve. Both organizations requested that CMS retract the guidance to remain consistent with regulation and statute. On June 6, CMS rescinded its guidance in order to align with current regulations, offering clarity for providers.