Literature Review

Top ten tips palliative care clinicians should know about the psychiatric manifestations of nonpsychiatric serious illness and treatmentsJournal of Palliative Medicine; Gregg A. Robbins-Welty, Paul A. Riordan, Daniel Shalev, Danielle Chammas, Paul Noufi, Keri O. Brenner, Joshua Briscoe, William E. Rosa, Jason A. Webb; 5/24Mental health issues are widespread and significant among individuals with serious illness. Among patients receiving palliative care, psychiatric comorbidities are common and impact patient quality of life. Despite their prevalence, PC clinicians face challenges in effectively addressing the intricate relationship between medical and psychiatric disorders due to their complex, intertwined and bidirectionally influential nature.

End-of-life care of persons with Alzheimer’s Disease and other dementiasAmerican Journal of Hospice and Palliative Medicine; by Darlon Jan, Kye Y. Kim; 5/24End-of-life (EOL) care has been a common option for patients with terminal medical conditions such as cancers. However, the utilization of EOL care in Alzheimer disease and other dementing conditions have become available relatively recently. As the end-stage dementia approaches, the clinicians and caregivers become faced with numerous clinical challenges—delirium, neuropbehavioral symptoms, the patient’s inability to communicate pain and associated discomfort, food refusal, and so on. In addition to providing quality clinical care to the EOL patients, clinicians should pay special attention to their families, assuring that their loved ones will receive supportive measures to improve quality of life (QOL).

When doctors withhold futile treatments, that isn’t ‘assisted dying’ The Guardian; by Dr. James Haslam; 5/15/24 [Commentary / Letter] I write in response to Dr Jagat Aulakh’s letter (A form of assisted dying already happens in hospitals, 8 May). It must be made clear that withholding or withdrawing futile treatments is not and never has been assisted dying. Stopping – or not starting – treatments that are not wanted, are not working or are not worthwhile is good medicine and the law of the land. Whereas “assisted dying” is the modern euphemism for physician-assisted suicide and euthanasia, both forms of medicalised killing [the author's choice of words]. ... Intentions are important. ...Editor's Note: This thoughtful response puts forth ethical support against Medical Aid in Dying (MAiD), also known as "physican assisted suicide." Likely, different opinions can be inflammatory among your hospice and palliative employees, board, community, and more personally among your family and friends. As hospice and palliative leaders, we must address this issue with respectful dialogue, critical thinking, case studies, personal beliefs and values, empathy, and humanity.

Other Business Headlines of Interest, updated 5/16/24 per nasdaq.com

A Review of "Heartwood: The Art of Living with the End in Mind" by Barbara Becker CU Anschutz; by Darcy Campbell, AGNP-D, ACHPN; 5/14/24 This year, one of our [small group] readings was the book, Heartwood; The Art of Living with the End in Mind, by interfaith pastor Barbara Becker. The book is composed of small vignettes from her life that explore death and dying. Many of her experiences as a hospice volunteer are captured as well. Her book was to be about death, but she learned that in writing about death she really explored what it means to live. Heartwood is the inner core of a tree. While dead it does not decay as it is supported by the outer living rings of the tree. Becker, describes Heartwood as the ideal metaphor for our life, “where life and death cannot exist separately from each other.” ... Working in palliative care, we too are forced to look at our own mortality.

PACE program officially launches in Greater Peoria area OSF HelathCare, Peoria, IL; by Nathan Pritzker; 5/14/24 It’s a new and exciting day for older adults receiving health care services in the Greater Peoria area. After months of preparation, the state of Illinois and the Centers for Medicare and Medicaid Services (CMS) have awarded OSF HealthCare a contract to be one of the first in the state to offer Program of All-Inclusive Care for the Elderly (PACE). Enrollment for the program, known as OSF PACE, is currently underway with services officially beginning June 1.“OSF PACE will really help the people in the Tri-County area stay in their home and community,” says Nathan Pritzker, executive director of OSF PACE.

Psychological trauma can worsen symptom burden at end-of-life Hospice News; by Holly Vossel; 5/15/24 Recent research has found that traumatic experiences can lead to increased pain and symptom burden at the end of life, along with a greater likelihood of emotional suffering and isolation. Collective trauma experiences have been associated with higher instances of pain and dyspnea among more than half of seniors nationwide, a recent study found, published in the Journal of Pain and Symptom Management. Traumatized seniors are also more likely to experience loneliness, dissatisfaction with their life and depression. ... Hospices need a greater understanding of both the depth of these patients’ suffering and the scope of their unique needs to improve trauma-informed care delivery, [Dr. Ashwin] Kotwal said, assistant professor of medicine at the University of California San Francisco’s (UCSF) Division of Geriatrics.

Vitas’ acquisition pipeline likely growing Hospice News; by Jim Parker; 5/15/24 Vitas Healthcare, a subsidiary of Chemed Corp. is gearing up for potential acquisitions. ... VITAS is targeting its home state of Florida and other Certificate of Need (CON) states for potential deals, Michael Witzeman, vice president, CFO and controller at Chemed said during the Bank of America Securities Health Care Conference. “We certainly think that there’s a pipeline growing, and we have the resources on our balance sheet with cash and no debt to be able to really be a player in any of these,” Witzeman said. “We would like to be in states that have CON restrictions much more than an unrestricted state, but we certainly have the interesting inability when things come available to be able to jump on them.” ...

Emerging leaders in hospice and palliative care AAHPM - American Academy of Hospice and Palliative Medicine; webpage source for various press releeases of individuals; 5/24AAHPM developed the Emerging Leaders in Hospice and Palliative Care program to recognize the exceptional work accomplished by the next generation of leaders and bring increased exposure to the specialty of hospice and palliative medicine. In 2014, the first class of Emerging Leaders was named. AAHPM seeks to recognize accomplished early career professionals and the next generation of hospice and palliative care leaders. This award recognizes new Emerging Leaders in recognition of their career accomplishments, involvement in the Academy, mentoring of residents and students, and participation in charitable work. [Click on the title's link for the list of 36 honorees.]Editor's Note: Do you work with or know any of these honorees? If so, please share this with them and your colleagues, along with congratulations from Hospice & Palliative Care Today! (Invite them to register for free--no strings attached--to our daily newsletter.)

10 most common sentinel events in 2023: Joint Commission Becker's Clinical Leadership; by Mackenzie Bean; 5/15/24 In 2023, patient falls were once again the most common sentinel event reported by healthcare organizations, according to a May 15 report from The Joint Commission. The Joint Commission defines a sentinel event as a patient safety event that results in death, permanent harm, severe temporary harm or intervention required to sustain life. ...  The 10 most frequently reported sentinel events for 2023:

Golf tournament raises more than $16k for hospice The Villages Daily Sun (FL); by James Dinan; 5/13/24 The Women’s Guild at St. George Episcopal Church in The Villages was determined to raise lots of money for Cornerstone Hospice on May 2 through its annual Peg Busch Ladies Golf Scramble. By the time all was said and done, the guild went beyond even what its leaders expected. “We were hoping to crack the $10,000 mark for the first time,” said Dale Dreps, who helped organize this year’s tournament. “But we managed to raise $16,150 for Cornerstone Hospice this year. We couldn’t believe it.”

Early palliative care perceptions by patients with cancer and primary caregivers: metaphorical languageBMJ Supportive & Palliative Care; by Elena Bandieri, Sarah Bigi, Melissa Nava, Eleonora Borelli, Carlo Adolfo Porro, Erio Castellucci, Fabio Efficace, Eduardo Bruera, Oreofe Odejide, Camilla Zimmermann, Leonardo Potenza, Mario Luppi; 5/13/24Methods: Data were collected through a pen-and-paper questionnaire on respondents’ perceptions of the disease, its treatment and their idea of death, before and after receiving EPC [early palliative care]. The data were analysed by identifying all metaphorical uses of language, following the ‘metaphor identification procedure’ proposed by the Praggjelaz Group.Results: Metaphors were used from a variety of semantic fields. EPC was described using spiritual terms, to indicate that this approach was instrumental in ‘restoring life’, ‘producing hope’ and making patients feel ‘accompanied’. The most recurrent metaphors were those referring to light and salvation; spatial metaphors were used to describe the treatment and the hospital as a ‘safe haven’ and ‘an oasis of peace’. 

End-of-life doulas’ growing value proposition in hospice Hospice News; by Holly Vossel; 5/14/24 Hospices and other health care providers are increasingly recognizing the value proposition of end-of-life doulas. Organizations are taking varied routes to leverage doula’s skills to improve quality. End-of-life doulas support patients and their families in a number of broad and diverse ways, according to Erin Collins, program director of The Peaceful Presence Project. Collins is also a certified hospice and palliative care nurse and end-of-life doula. She serves as vice-chair of the National Hospice and Palliative Care Organization’s (NHPCO) End-of-Life Doula Advisory Council. Editor's Note: Caution. What training, professional experience, credentials, referrals, and other qualifications does the individual, end-of-life care doula bring? Not bring? What gaps in your services (for which a doula might be called) indicate that your organization needs to "step up" your community education, caregiver/family resources, psychosocial support, and volunteer presence?