Literature Review

Education is the ability to listen to almost anything without losing your temper or your self-confidence. ~Robert Frost

Music therapist helps patients navigate end-of-life journey on Long Island CBS New York / YouTube; by Jenna DeAngelis; 10/15/24 The healing power of music is being brought to hospice patients on Long Island, by Yuzuko DeGrottole, LCAT, MT-BC, a board-certified music therapist with MJHS Hospice.  “Everyone has a song that takes them to a special place. “Are you going to sing with me?” [Sings a beautiful Jewish song.] That's the power of music. It moves us. It connects us, and for Sarah Jacobowitz it just makes her feel good. “I like it.  It makes me happy.”  The 95-year-old Holocaust Survivor is proud of her Jewish Heritage which she celebrates in song since she's bedridden.  Yuzuko brings the music to her, even learning to sing in many languages for her patients. Music communicates with you directly to your heart. Music brings up a lot of emotion, with or without words. … Sarah's son who often sits bedside says music therapy hits all the right notes. Sarah is attentive instead of just sleeping all day or just doing nothing. Music brings back memories and it gives her pleasure just to be alive.Editor's note: Having a board-certified music therapist is significantly more valuable--therapeutically, clinically, meaning-making, mission-oriented--than simply having musicians play music. For more information visit "Facts for Music Therapy in Hospice Care" by American Music Therapy Association and the Certified Board for Music Therapists.

One of the most important things you can do on this Earth is to let people know they are not alone. ~ Shannon L. Adler

Ethical considerations in the design and conduct of clinical trials of artificial intelligenceJAMA Network Open; Alaa Youssef, PhD; Ariadne A. Nichol, BA; Nicole Martinez-Martin, JD, PhD; David B. Larson, MD, MBA; Michael Abramoff, MD, PhD; Risa M. Wolf, MD; Danton Char, MD, MS; 9/24In this qualitative study, interviews with 11 investigators involved in clinical trials of AI [artificial intelligence] for diabetic retinopathy screening confirmed the applicability of current ethical principles but also identified unique challenges, including assessing social value, ensuring scientific validity, fair participant selection, evaluation of risk-to-benefit ratio in underrepresented groups, and navigating complex consent processes. These results suggest ethical challenges unique to clinical trials of AI, which may provide important guidance for empirical and normative ethical efforts to enhance the conduct of AI clinical trials. These considerations call for further guidance on where to focus empirical and normative ethical efforts to best support conduct clinical trials of AI and minimize unintended harm to trial participants.

Physician altruism and spending, hospital admissions, and emergency department visitsJAMA Health Forum; Lawrence P. Casalino, MD, PhD; Shachar Kariv, PhD; Daniel Markovits, JD, DPhil; Raymond Fisman, PhD; 10/24This cross-sectional study found that Medicare patients treated by altruistic physicians had fewer potentially preventable hospitalizations and emergency department visits and lower spending. Policymakers and leaders of hospitals, medical practices, and medical schools may want to consider creating incentives, organizational structures, and cultures that may increase, or at least do not decrease, physician altruism. Further research should seek to identify these and other modifiable factors, such as physician selection and training, that may shape physician altruism. Research could also analyze the relationship between altruism and quality and spending in additional medical practices, specialties, and countries, and use additional measures of quality and of patient experience.

Applying a health equity lens to better understand end-of-life prognosticationAMA Journal of Ethics; by Newsha Nikzad, Joelle Robertson-Preidler, Faith E. Fletcher; 10/24Racial and ethnic inequity exists throughout the lifespan, including at the end of life (EOL). Although prognostication is inherently fraught with uncertainty, many underrepresented minorities get prognoses that are overly optimistic, which can exacerbate inequity by depriving patients of details needed to make informed decisions and plan for EOL care. This article applies a health equity lens to facilitate better ethical and clinical understandings of how to care for patients of color more equitably at the EOL.

Home health care and place of death in Medicare beneficiaries with and without dementiaGerontologist; Hyosin Dawn Kim , Paul R Duberstein, Anum Zafar, Bei Wu, Haiqun Lin , Olga F Jarrín; 11/24Home health care supports patient goals for aging in place. Use of home health care during the last 3 years of life was associated with reduced rates of inpatient death without hospice, and increased rates of home death with hospice. Increasing affordable access to home health care can positively affect end-of-life care outcomes for older Americans and their family caregivers, especially those with dementia.

Socioeconomic trends in palliative care: A six-year studyCureus; by Andrej Sodoma, Muhammad Wahdan Naseeb,Samuel Greenberg, Nicholas J. Knott, Jonathan Arias, Argirios Skulikidis, Mary Makaryus; 10/24Our study investigates trends in PC utilization, focusing on socioeconomic characteristics. The National Inpatient Sample (NIS) from 2015 to 2020 was used to identify adults hospitalized in the United States (US). International Classification of Diseases, Tenth Revision (ICD-10), was used for PC encounters, code Z51.5. An equal number of random records, stratified by year and without this code, were selected to serve as controls [5.2M visits]. Men were more likely to receive PC consults. Medicare/Medicaid holders’ PC access was limited compared to private insurance holders. Racial minorities, particularly Hispanics and Blacks, were less likely to engage in PC. Compared to urban teaching hospitals, rural hospitals had a decreased rate of PC utilization. Smaller hospitals had significantly fewer PC referrals than large hospitals. A lower socioeconomic status was associated with a reduced propensity to utilize PC services compared to an upper socioeconomic status.

Low rates of hospice utilization in blood cancer patientsCU Anschutz News; by Tari Advani; 10/24Patients with hematologic malignancies enroll in hospice at significantly lower rates than patients with solid malignancies and are more likely to die in the hospital. Cost of transfusions in comparison to standard per diem reimbursement for hospice is greatest limitation to hospices offering transfusions to blood cancer patients and this lack of option for transfusion is limiting hospice utilization by patients with blood cancers overall and leading to late enrollment when it happens. It is felt that innovative hospice payment models to improve end-of-life care for patients with blood cancers would be the most useful course of action.

Family and friends deliver early Christmas cheer to woman in final days of her life  CBS News, Antioch, IL; by Dana Kozlov and Tracy O'Brien; 10/16/24 Driving by a home in the far northwest suburbs, you might wonder what happened to Halloween, as each day more Christmas decorations keep showing up. The answer is a touching tribute to a loving mom, wife and friend; with a special message for everyone. Voices of holiday cheer rang outside a home on a warm fall day in Antioch during a festive gathering for Jamie Haley, a woman loved by many, watching from the front window. "It couldn't be better. I could not be happier," Jamie said. Hearing those words, you wouldn't realize Haley is in the final stages of her life, with hospice coming daily. Known for her lifelong love of Christmas, her family is bringing the joy of the season to her in a big way. "Everybody is showing up and strangers are showing up," said her daughter, Anna. "It's Christmas for as long as it can be. We just love her so much.  … We are going to love her until we have to miss her." ... [Click on the title's link to continue reading this beautiful story.]

Advice from a pumpkin: be well-rounded, get plenty of sunshine, give thanks for life's bounty, have thick skin, keep growing, be outstanding in your field, think big! ~ Unknown

Update on 3 nonprofit hospices impacted by Helene Hospice & Palliative Care Today; Chris Comeaux with Cordt Kassner and Joy Berger; 10/17/24Chris Comeaux shared updates on hospices impacted by the recent natural disaster. While no patients or staff were lost, some completely lost their homes or experienced significant property damage.  The final loss of life remains uncertain due to unaccounted people. Hospices nationally have shown unity in supporting local counterparts through financial aid, supplies, and volunteer efforts coordinated by many nonprofits. Certain areas may lack electricity until March. Hospices face challenges like displaced skilled nursing facilities, but resources are being mobilized. Chris announced a tabletop discussion in November to learn from this experience and highlighted the need for continued patient monitoring, especially in evacuation zones. To read more and contribute:

Forbes Leadership Strategy: 5 reasons you should seek to work with people who think differently Forbes; by Kate Vitasek; 10/17/24 One of the most common pitfalls we see in the business world is when organizations exclusively work with people who think like they do. While at first glance, this could seem like it would help the organization become more unified, in the long run, it can actually do more harm than good. Instead, you should seek to work with people who think differently from you. By bringing in people with unique perspectives and backgrounds, you can unlock a host of valuable benefits that will serve you well in both the short- and long-term.