Literature Review

Tools for tomorrow: a scoping review of patient-facing tools for advance care planning Palliative Care and Social Practice; by Sean R. Riley, Christiane Voisin, Erin E. Stevens, Seuli Bose-Brill, Karen O. Moss; 6/24/24 first published online Our scoping review reveals an evolving landscape of ACP tools [Advanced Care Planning], marked by increasing diversity in delivery methods and a trend toward personalized, adaptable resources. The integration of technology and patient- and family-centered approaches signifies promising progress in end-of-life care, offering new paths for engagement with patients and families. Critics questioning the utility of ACP may need to revisit their perspectives in light of these innovative developments. Our findings highlight the need for further research on the effective implementation and integration of these tools as well as other unique approaches into healthcare systems and community-based settings. Ultimately, the continual advancement of these tools may reshape health services research, leading to more patient- and family-centered care and improving end-of-life decision-making processes outcomes for all people thereby promoting health equity.

Acupuncture as a support in palliative care at Sun City Center HAW The Tidewater News, Ruskin, FL; 7/22/24 Sun City Center Health and Wellness (HAW) is dedicated to providing comprehensive care for patients managing serious illnesses, championing the use of acupuncture as a key supportive treatment in palliative care. This practice, grounded in traditional Chinese medicine, offers relief from common symptoms and enhances overall well-being. ... The role of acupuncture in palliative care is gaining recognition for its potential to improve the quality of life for patients dealing with serious illnesses.

Hospice enrollment and central nervous system–active medication prescribing to Medicare decedents with dementia JAMA Psychiatry; by Lauren B. Gerlach, DO, MS; Lan Zhang, PhD; Joan Teno, MD, MS; Donovan T. Maust, MD, MS; 7/17/24  Central nervous system (CNS)–active medications, including benzodiazepines and antipsychotics, are commonly prescribed in hospice for behavioral and physical symptom management.1 Such medications are not without risks, especially among patients living with Alzheimer disease and related dementias (ADRD), where potential harms may outweigh benefits for some patients.2 We explored the extent to which hospice enrollment is associated with CNS–active medication exposure among Medicare decedents with ADRD.

These are the most common jobs in each state in the US USA Today; by Sara Chernikoff; 7/22/24 The most common job in the U.S. is a three-way tie, according to data from the Bureau of Labor Statistics. Home health care and personal aides, retail workers and fast food counter workers ranked at the top of the list with 3.6 million workers in each occupation. ... The desire for home health and personal care aides is on the rise as the share of the elderly U.S. population grows exponentially. This occupation is the fastest growing among most states, news outlet Stacker, reported. ... Home health care aides typically assist people living with disabilities or with chronic illness. Personal care aides are often hired to care for people in hospice care, according to BLS. Advanced degrees are not required for most home health aides, rather those employed by home health or hospice agencies may need to complete formal training or pass a standardized test.Editor's Note: (1) Federal requirements for nursing aides in hospice care are defined in the CMS Hospice of Conditions Participation §418.76 and for home health in the CMS Home Health Conditions of Participation §484.80. Additionally, extensive state laws exist, with differences between states. (2) Pair this with theprevious article in today's newsletter, Homecare Homebase opens nominations for 2024 Home Care Aide Scholarship Program.

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!

The Uniform Determination of Death Act is not changing. Will physicians continue to misdiagnose brain death?The American Journal of  Bioethics; Michael Nair-Collins; 7/24Efforts to revise the Uniform Determination of Death Act [UDDA] in order to align law with medical practice have failed. It has long been common practice to declare some patients dead by neurologic criteria even though they do not meet the legal standard for death. Thus, legally living people will continue to be declared dead, not because of a mistake, but because of a choice. The decision to continue misdiagnosing death according to the law will create routine violations of civil rights, will continue to violate the DDR [dead donor rule] that allegedly is such an important red line for organ transplantation, and will contribute to a well-deserved mistrust in the determination of death.

Psychiatric manifestations of neurological diseases: a narrative reviewCureus Journal of Medical Science; Anthony J. Maristany, Brianna C. Sa, Cameron Murray, Ashwin B. Subramaniam, Sean E. Oldak; 7/24Neurological diseases like Alzheimer's, FTD [frontotemporal dementia], Parkinson's, MS [multiple sclerosis], stroke, epilepsy, Huntington's, ALS [amyotrophic lateral sclerosis], TBI [traumatic brain injury], andMSA [multiple system atrophy] are not only characterized by neurological symptoms but also by various psychiatric manifestations, complicating diagnosis and treatment. For instance, Alzheimer's induces cognitive decline and emotionaldistress, Parkinson's leads to motor impairments and mood disorders, and MS intertwines physicalsymptoms with emotional disturbances. Understanding these complex relationships is crucial forcomprehensive care. Collaboration, innovation, and ethical commitment are essential for improvingoutcomes.

The home-based experiences of palliative and hospice care for children and caregivers (EXPERIENCE) Measure: evaluation of psychometric propertiesJournal of Pain and Symptom Management; by Jackelyn Y Boyden, Mary Ersek, Kimberley A Widger, Judy A Shea, Chris Feudtner; 6/24Home-based pediatric palliative and hospice care (PPHC) supports the hundreds of thousands of children with serious illness and complex care needs and their families in the home setting. The EXPERIENCE Measure is a tool with evidence for reliable and valid scores to evaluate family-reported home-based PPHC experiences at the time care is being received.

Medicare-Covered Services Near the End of Life in Medicare Advantage vs Traditional MedicareJAMA Health Forum; by Lauren Hersch Nicholas, Stacy M Fischer, Alicia I Arbaje, Marcelo Coca Perraillon, Christine D Jones, Daniel Polsky; 7/24Financial incentives in Medicare Advantage (MA), the managed care alternative to traditional Medicare (TM), were designed to reduce overutilization. For patients near the end of life (EOL), MA incentives may reduce potentially burdensome care and encourage hospice but could also restrict access to costly but necessary services. MA enrollment was associated with lower rates of potentially burdensome and facility-based care near the EOL. Greater use of home-based care may improve quality of care but may also leave patients without adequate assistance after hospitalization.

Saturday newsletters focus on headlines and research - enjoy!

Omega - Journal of Death and Dying - June 2024 Sage Journals - Omega - Journal of Death and Dying; June 2024 issue Omega - Journal of Death and Dying, a peer-reviewed journal that says it brings insight into terminal illness, the process of dying, bereavement, mourning, funeral customs and suicide, published research articles on the following topics in its June 2024 edition (Vol. 89, Issue 2). [A few sample topics include the following:]

Hospice House of Williamsburg halts admissions for 3 months during renovations WHRO; by Nick McNamara; 7/18/24 Hospice House of Williamsburg is pausing admissions while the facility enters the final phase of renovations. Hospice House has provided end-of-life care and support for upwards of 150 guests annually since its facility opened in 2002. More than 3,000 people have stepped through its Powhatan Parkway doors in that time. And it did it all free of charge, according to Executive Director Brandon Randall. ... To meet that mission, the nonprofit relies on community donations to the tune of $1 million per year. Donations are also what made Hospice House’s renovations possible. ... The final phase of renovations starts in July and is expected to be complete in 12 weeks. During that time, staff will continue offering bereavement support services.