Literature Review

Ethics roundtable state-erected barriers to end-of-life careAmerican Journal of Hospice and Palliative Medicine; by Saima Rashid, Scott P Broyles, Andrew Wampler, Matthew Stolick, Steven J Baumrucker; 10/24[An interesting ethics case study discussed from physician, spiritual care, legal, and ethics perspectives. Discussion focused on conflicts between healthcare ethics and state law.]

"Grief explodes all relationships": Experiences of grief and coping among parents and siblings following the death of a childOmega (Westport); by Katy A Tenhulzen, Amy M Claridge, Abigail McCarthy, Meredith Craven, Libby Faith McClendon; 10/24The death of a child is an intense loss for families, which impacts the wellbeing of parents, surviving siblings, and the family as a whole. This study expanded on existing literature by collecting qualitative accounts from bereaved parents and siblings about their experiences before, during, and after the death of a child in their family... Findings highlighted three periods of the grieving process, which were not linear but rather ongoing and often happening simultaneously: (1) Crisis; (2) Learning to cope; and (3) Establishment of a new equilibrium... Findings have implications for palliative care and bereavement professionals in terms of supporting parent, sibling, and family coping before, during, and after the death of a child.

Beyond infection: Mortality and end-of-life care associated with infectious disease consultation in an academic health systemClinical Infectious Diseases; by Alison G. C. Smith, Michael E. Yarrington, Rasha Raslan, Wil L. Santivasi, Arthur W. Baker, Nicholas A. Turner, Gary M. Cox, Kristen V. Dicks, John J. Engemann, Patricia Kohler, Ahmad Mourad, Rebekah H. Wrenn, Sofia Zavala, Jason E. Stout; 10/24Infectious diseases (ID) physicians are increasingly faced with the challenge of caring for patients with terminal illnesses or incurable infections. This was a retrospective cohort of all patients with an ID consult within an academic health system from 1 January 2014 through 31 December 2023, including community, general, and transplant ID consult services. There were 60,820 inpatient ID consults involving 37,848 unique patients... In total, [2898] 7.5% of patients receiving an ID consult died during admission and 1006 (2.6%) of patients were discharged to hospice... In total 2866 (7.6%) of all patients receiving ID consultation also received palliative care consultation during the same hospitalization... Patients receiving ID consultation were increasingly complex and more likely to die soon after consultation. These results provide a framework for ID clinicians to consider their role in end-of-life care.Publisher's note: How often does your hospice work with infectious disease physicians and patients?

A comprehensive perspective on educational and economic barriers for utilization of palliative radiation therapy in hospice: A narrative reviewAdvances in Radiation Oncology; by Sarah J Hendee, Kareem Fakhoury, Sana D Karam; 10/24Despite the agreed-on efficacy and benefits of palliative radiation therapy (PRT) to alleviate end-of-life complications related to cancer progression, PRT remains an underused treatment in the hospice-care setting. Common barriers for hospice patient use of PRT include educational and economic limitations. This paper discussed these barriers and ways to eliminate them based on previously published interventions.

Mortality and function after widowhood among older adults with dementia, cancer, or organ failureJAMA Network Open; Rebecca Rodin, MD, MSc; Alexander K. Smith, MD, MS, MPH; Edie Espejo, MPH; Siqi Gan, MPH; W. John Boscardin, PhD; Lauren J. Hunt, PhD, RN; Katherine A. Ornstein, PhD, MPH; R. Sean Morrison, MD; 9/24In this cohort study including 13,824 participants in the Health and Retirement Study, widowhood was associated with functional decline and increased 1-year mortality in functionally impaired older adults with dementia and cancer. The study findings suggest that older adults with functional impairment and cancer or dementia are at risk of adverse outcomes following widowhood, including functional decline and a marked elevation in the risk of death, in the year after widowhood.

[UK] Symptom management for people with advanced dementia who are receiving end of life careCurrent Opinion in Supportive and Palliative Care; Maria Drummond , Bridget Johnston; 10/24Recent studies indicate that people with advanced dementia often experience significant unmet palliative care needs, particularly regarding symptom management. Palliative care for people with advanced dementia is currently inadequate due to a lack of tailored interventions, poor symptom management, and disjointed care systems. Enhancing training for caregivers, fostering interdisciplinary collaboration, and focusing on integrated care approaches across home and institutional settings are crucial to improving quality of life and symptom control for people with advanced dementia.

Serenity House Garden receives colorful makeover in honor of patients and families The Oskaloosa Herald, Oskaloosa, IA; 10/23/24 Mahaska Health announced recent enhancements to the Serenity House Garden, made possible by the generosity of Bob and Roxanne Denner. The updated garden now features a vibrant array of new plants and a beautifully revitalized rock landscape, offering a serene and uplifting environment for patients and their families. Roxanne Denner, a member of the Serenity Hospice Auxiliary Board, has been involved in supporting the Serenity House mission for several years. As an avid gardener, she saw this opportunity to enhance the garden as a way to contribute to the well-being of guests and their families. Editor's note: We celebrate the countless hospice and palliative care volunteers who give their time and talents to create more meaningful, compassionate environments and experiences for patients and families. Whom might you thank and recognize?

Louisiana partners with Elizabeth Dole Foundation's Hidden Heroes Campaign Audacy.com; by Laine Griffin; 10/24/24 Louisiana Gov. Jeff Landry announced last week his support for the more than 100,000 military and veteran caregivers in the state by joining the Elizabeth Dole Foundation’s Hidden Heroes Campaign. The campaign’s goal is to raise awareness and bring critical resources to military and veteran caregivers, who are referred to as hidden heroes and care for wounded, ill or injured service members and veterans. ... Currently, there are 2.3 military and veteran caregiver children and 14.3 million military and veteran caregivers who care for America’s wounded, ill, or injured veterans or service members, according to the foundation’s website. ... The 14.3 million military and veteran caregivers provide care valued at a minimum of $119 billion.

Anxiety grows over telemedicine flexibility extension The Hill; by Joseph Choi; 10/24/24 Lawmakers and physicians are growing anxious for COVID-era telemedicine flexibility measures to be extended for a third time, as federal regulators signal a potential tightening of the rules ahead of a deadline at the end of the year. Since 2020, the Department of Health and Human Services and the Drug Enforcement Administration (DEA) have allowed physicians to prescribe schedule II to V controlled substances without in-person medical evaluations. ... Last year, the two agencies extended these flexibility measures through the end of 2024. With December fast approaching, a bipartisan group of lawmakers in both the House and Senate want another round of extensions secured. 

A meal, a smile and a prayer: volunteers venture into the heart of flood-affected areaThe Mountaineer, Waynesville, NC; by Brionna Dallara; 10/23/24 Luke Ross and Louisa Koehring peer out their car window as they snaked down Old Clyde Road, muddy piles of flood debris strewn along the shoulders. With a trunk full of hot meals, they scan for flood-stricken homes, looking for people in their yards or signs of anyone home. Their arrival at homes has been a sure sign of hope. Relief sweeps across the flood victims' faces as Luke and Louisa approach their doorsteps with hot meals or a new pack of under garments. The first stop along their route this day is Ronnie Hall, who was stranded for eight days post-Helene, alone with nothing but his two cats — Famous Amos and Snowflake — to keep him company. Not only do the young couple feed him, but offer him friendship. ... Without power and alone for eight days following the flood, with no one but hospice to check on him, Hall said he persevered with the help of his faith.

Michigan HHS to pay $13M after unannounced shooter drill at psych hospital Becker's Hospital Review; by Mariah Taylor; 10/18/24The Michigan Department of Health and Human Services agreed to pay $13 million to settle allegations that it caused psychological damage after conducting a surprise active shooter drill at a children's psychiatric hospital, The Washington Post reported Oct. 17. The Hawthorn Center, based in Northville Township, Mich., is a state-run psychiatric hospital for children with emotional, mood and thought disorders. On Dec. 21, two laborers were instructed by their supervisor to act as armed intruders in an unannounced drill. The two were told to walk around the facility and ensure every room was locked and the people inside were hidden. The receptionist was instructed to announce that there were active shooters in the building and that shots were fired. Neither the staff nor the police were notified a drill was occurring. 911 calls reported the active shooter and 22 police officers rushed to the scene. The two laborers exited the building and were detained while the police sorted out the situation. Employees filed a class action lawsuit in April 2023 against the health department-run facility alleging that the unannounced drill gave them post-traumatic stress and emotional harm. According to the lawsuit, patients acted aggressively toward themselves and others in the subsequent weeks, and staff members experienced increased anxiety and sleep struggles, and some quit their jobs.

Patient, staff satisfaction biggest ROIs of trauma-informed hospice care Hospice News; by Holly Vossel; 10/23/24 Improved patient and staff satisfaction are among the most significant returns on investment for hospices that are pouring greater resources into trauma-informed training. The ability to build a trusting relationship with patients and their families is a key skill set for any hospice professional to possess, but one that takes on a profoundly different meaning when caring for survivors of abuse, violence and trauma. This is according to Amber Ash, pediatric hospice and palliative care social worker at Ohio-based Hospice of the Western Reserve. Trauma-informed education should be a normalized part of hospice’s interdisciplinary training to help staff recognize and respond to a range of experiences, Ash indicated. This type of training can help provide opportunities for improved goal-concordant care while also aligning with staff’s professional goals and personal values, she stated.