Literature Review

Life is all about how you handle Plan B ~Suzy Toronto

Mid-Atlantic primary care providers’ perception of barriers and facilitators to end-of-life conversationPalliative Care and Social Practice; by Melanie A. Horning, Barbara Habermann; 8/24Primary care providers are ideal people to facilitate end-of-life conversations, but these conversations rarely occur in the out-patient setting. Reported barriers in descending order included resistance from patients and families, insufficient time, and insufficient understanding of prognosis and associated expectations. Reported facilitators in descending order included established trusting relationship with provider, physical and/or cognitive decline and poor prognosis; and discussion standardization per Medicare guidelines. The involvement of primary care providers is associated with earlier ACP [advance care planning].

Access to legacy-oriented interventions at end of life for pediatric oncology patients: A decedent cohort reviewPediatric Blood and Cancer; by Sarah Daniels, Nelson D Franqui-Rios, Suraj S Mothi, Elizabeth Gaitskill, Kathryn Cantrell, Erica C Kaye; 8/24Legacy-oriented interventions have the potential to offer pediatric oncology patients and families comfort at end of life and during bereavement. Certified child life specialists often provide these services, and presently little is known about whether disparities exist in the provision of legacy-oriented interventions. [In this study] fifty-two percent of patients received a legacy-oriented intervention. Older adolescents (≥13 years) were less likely ... to receive legacy-oriented interventions than younger ones. Patients with home/hospice deaths were also less likely ... to receive interventions compared to patients who passed away at SJCRH [St. Jude Children's Research Hospital] locations. Hispanic patients ... and those in palliative care ... were more likely to receive interventions.

Crowdsourced feedback to improve resident physician error disclosure skills-A randomized clinical trialJAMA Open Network; Andrew A. White, MD; Ann M. King, MA; Angelo E. D’Addario, MA; Karen Berg Brigham, JD, MPH; Joel M. Bradley, MD; Thomas H. Gallagher, MD; Kathleen M. Mazor, Ed; 8/24Residents must prepare for effective communication with patients after medical errors. The video-based communication assessment (VCA) is software that plays video of a patient scenario, asks the physician to record what they would say, engages crowdsourced laypeople to rate audio recordings of physician responses, and presents feedback to physicians. In this randomized clinical trial, self-directed review of crowdsourced feedback was associated with higher ratings of internal medicine and family medicine residents’ error disclosure skill, particularly for those without real-life error disclosure experience, suggesting that such feedback may be an effective way for residency programs to address their requirement to prepare trainees for communicating with patients after medical harm.

Novel drug treatments for pain in advanced cancer and serious illness: a focus on neuropathic pain and chemotherapy-induced peripheral neuropathyPalliative Care and Social Practice; by Mellar P Davis; 7/24This review will discuss haloperidol, miragabalin, palmitoylethanolamide (PEA), and clonidine as adjuvant analgesics or analgesics. Haloperidol [demonstrates] ... only low-grade evidence that [it] improves pain when combined with morphine, methadone, or tramadol in patients who have cancer, pain from fibrosis, radiation necrosis, or neuropathic pain. Miragabalin is a gabapentinoid approved for the treatment of neuropathic pain ... [and] in randomized trials, patients with diabetic neuropathy have responded to miragabalin. Multiple randomized trials and meta-analyses have demonstrated PEA's effectiveness in reducing pain severity arising from diverse pain phenotypes. Intravenous clonidine has been used in terminally ill patients with poorly controlled symptoms, in particular pain and agitation.

Palliative care is a viable option for frail elderly patients with neurocognitive disorders admitted for hip fractures BMC Musculoskeletal Disorders; by Justine Boulet, Etienne L Belzile, Norbert Dion, Chantal Morency, Mélanie Bérubé, Alexandra Tremblay, Stéphane Pelet; 8/10/24 Most patients presenting with a hip fracture regardless of their comorbidities are surgically treated. A growing body of research states that a certain type of elderly patient could benefit more from a palliative approach. ... The presence of [a nuerocognitive disorder] NCD and diminished prefracture autonomy strongly support counseling for palliative care. The high rate of complications when surgery is proposed for frail patients with multiple comorbidities suggests that the concept of palliative surgery needs to be revisited. 

Fraudulent hospices reportedly target homeless people, methadone patients to pad census Hospice News; by Jim Parker; 8/23/24 Fraudulent hospices in California reportedly have been targeting homeless people and methadone patients, promising them a steady supply of opioids in exchange for enrolling in hospice. Three hospice leaders came forward to Hospice News to report these practices. According to their reports, unscrupulous providers have canvassed both homeless encampments and methadone clinics seeking to sign up patients who are not terminally ill. In many cases, the sources said, these operators offer patients free access to board-and-care facilities and a daily supply of morphine. Another frequent practice among these hospices is to offer patients cash or other items in addition to drugs, they said. “This conduct raises serious fraud concerns on kickbacks or gifts to beneficiaries who do not appear to qualify for hospice,” Bill Dombi, president of the National Association for Home Care & Hospice (NAHC), told Hospice News. “More importantly, this conduct is predatory, taking advantage of individuals in addiction. Jail time is not enough punishment for the harm that such conduct creates.”Editor's Note: This is abhorrable. Click on the title's link to read more. While John Oliver's "Last Week Tonight" episode on 8/18/24 gained criticism from many hospice leaders, these fraudulent unethical behaviors (and others') lay the groundwork for such dire distrust from the public. These organizations' behaviors must be stopped. These persons and organizations must be held accountable. 

New bill in Congress would improve end-of-life carePublic News Service; Suzanne Potter; 8/23/24A bill just introduced in Congress would raise public awareness of issues surrounding the end of life, including palliative care, and hospice. The Compassionate Care Act [co-sponsored by Rep. Nanette Barragán, D-CA, and Sen. Richard Blumenthal, D-CT] would establish guidelines for advance care planning between health providers and patients... The bill would direct the government to develop education resources for providers, expand telehealth options and facilitate a study of a national advance care planning registry, which would allow patients to transfer their advance directives from state to state.

Carolina Caring’s second hospice resale shop location in Mountain View opens 8/28 FOCUS Newspaper; 8/21/24 Carolina Caring is delighted to announce the grand opening of its second Hospice Resale Shop location on Wednesday, August 28, at 10 a.m. This new shop will be located at 2920 S. Highway 127 in Mountain View, just a few miles from the nonprofit serious illness provider’s Catawba Valley Hospice House. ... Carolina Caring, founded in 1979, is an independent, community-based, nonprofit healthcare provider. ... Carolina Caring serves 12 counties across western North Carolina and the Charlotte Region.

Today, do something that your future self will thank you for. ~ Anonymous

Project Linus brings comfort to children in need through handmade blankets and quilts Concho Valley, College Station, TX; by Zoria Goodley; 8/21/24 Project Linus, a nonprofit organization dedicated to providing handmade blankets and quilts to children facing serious illness, trauma or other needs, continues its impactful mission across the United States. There are 17 chapters in the state of Texas alone. Patricia Perry, the Brazos Valley Chapter Coordinator, highlights the broad spectrum of needs the organization addresses.

Hospice Insights Podcast - Stories of successful hospice leadership: The CEO and Chief Medical Officer relationship JD Supra; by Husch Blackwell; 8/21/24 A strong and engaged Chief Medical Officer (CMO) may be a hospice CEO’s most important asset. But what does a successful CEO/CMO relationship look like and how must it evolve to meet today’s challenges? In this episode we get to find out, as Husch Blackwell’s Meg Pekarske is joined by HopeHealth CEO Diana Franchitto and Dr. Edward Martin, CMO, whose trusted relationship has been instrumental to the organization’s success and clinical expansion.

“What I wish I knew about dementia”: A caregiving only child’s experience The Healthy; by Dr. Patricia Varacallo, DO; 8/20/24 It's no secret dementia affects the brain of the patient, and tests the hearts of their loved ones. Through one woman's personal journey, experts advise on the emotional, medical, and financial aspects of caregiving for dementia. ... Drawing from Ann’s caregiving journey and insights from Dr. Wint and Lucille Carriere, PhD, Cleveland Clinic Angie Ruvo Endowed Caregiving Chair, we share their collective wisdom on what they wish more people knew about dementia.