Literature Review

Chesapeake Life Center offers monthly LGBTQIA+ drop-in grief support group Southern Maryland News Net; 5/6/24 Chesapeake Life Center will host a monthly drop-in grief support group for members of the LGBTQIA+ community. ... Grief is a hard and vulnerable time, and it is important to have safe spaces to process what we are going through. This group is intended for adult members of the LGBTQIA+ community who are grieving a past or approaching death. The group will be facilitated by a licensed queer therapist but will be loosely structured to offer an opportunity for participants to share their feelings and grieve with community.Editor's Note: Hospice & Palliative Care Today does not post upcoming, local hospice events, grief support groups, volunteer trainings, etc. However, we're posting this LGBTQIA+ grief support ("past or approaching death") due to its profound need and support, with opportunities for replication by other hospices. Pair this support with the article we posted on 4/21/24: LGBTQ+ individuals have higher rates of cancer because of disparities in modifiable risk factors, ACS says. 

Patients, caregivers more willing to spend extra for home-based care, study finds McKnights Home Care; by Adam Healy; 4/30/24 [According to a new study published in JAMA Network Open:] ... On average, respondents were willing to spend an extra $51.81 for care that takes place in the home, compared to facility-based care such such as that in a skilled nursing facility. They were also more willing to pay more for care that can reduce their recovery time or reduce caregivers’ burden. Caregivers, meanwhile, also prioritized higher-quality care, even if it came with a heftier price tag. 

Updated guidance on workplace harassment covers misgendering pronouns, bias over bathroom use, more McKnights Senior Living; by Kathleen Steele Gaivin; 5/2/24 Final guidance published last week by the Equal Opportunity Employment Commission aims to clarify for employers, employees and others their obligations related to harassment in the workplace. ... This is the first update to the guidance in 25 years, aimed at enforcing more recent changes in federal law. EEOC clarified that harassment by any person — including employers, coworkers, customers and clients — can violate federal law. ... According to the EEOC, the new guidance “updates, consolidates and replaces the agency’s five guidance documents issued between 1987 and 1999 and serves as a single, unified agency resource on EEOC-enforced workplace harassment law.” Among other guidance, the EEOC calls out asking intrusive questions about a person’s sexual orientation, gender identity, gender transition or intimate body parts as forms of harassment.

[Australia] Palliative patients can die peacefully at home with paramedic support, claims proposed frameworkRiotack - Australia; by James Day; 5/6/24A proposed national framework suggests paramedics could help ease pressure on emergency departments by supporting palliative care patients who wish to die at home. Published in the leading international peer reviewed journal Palliative Medicine, the framework seeks to embed palliative care into paramedics’ core business and reduce needless transports to hospital. ... Lead author and trained paramedic Dr. Madeleine Juhrmann developed the framework in consultation with paramedics, palliative care doctors, GPs, carers with lived experience and others. The expert group – representing six countries and all the states of Australia – agreed on the framework’s 32 service changes to standardise best practice for paramedics delivering palliative care in community-based settings.Editor's Note: Pair this solution with related articles in today's newsletter, "Stranded in the ER, seniors await hospital care and suffer avoidable harm" and "How Mass General Brigham provides emergency care at home" (both are in our "Post-Acute" section). 

How to become a great bossBy Jeffrey J. Fox; 2002The Great Boss Simple Success Formula:

TCN News Stories of the Month, April 2024TCN Talks; by Chris Comeaux and Mark Cohen; 5/1/24In this podcast Chris and Mark discuss our newsletter's top news stories for the month of April as reported in Hospice and Palliative Care Today. You can subscribe for free here: https://www.hospicepalliativecaretoday.com/registration.

Retraumatization when an adult child cares for the parent who harmed them through serious illness or the end of lifeJournal of Pain and Symptom Management; by Jaime Goldberg, Jooyoung Kong; 5/24Adult children caring for a parent who harmed them through the parent's serious illness or the end of life are at high risk for experiencing retraumatization. This session will offer trauma-informed, culturally responsive, person-centered tools and techniques hospice and palliative care professionals can use to effectively identify, assess, and intervene with this often-overlooked population of caregivers.Publisher's note: This current article summary is for an upcoming AAHPM conference workshop. The study was previously published in JPSM 5/24 here.

The value of screening for a history of incarceration in the palliative care settingAmerican Journal of Hospice and Palliative Medicine; by Joseph Michael Schnitter, Joshua Hauser; 5/24In this article, we explore existing literature that highlights the unique physical, cognitive, and psychosocial challenges that formerly incarcerated patients face. We proceed to argue that palliative care providers should screen for a history of incarceration to identify and address the needs of this patient population. We also offer strategies to create a safe, welcoming environment to discuss past traumas related to these patients’ time in prison.

The role of mindfulness and resilience in Navy SEAL trainingMilitary Psychology; by Andrew Ledford, Celeste Raver Luning, Deirdre P. Dixon, Patti Miles, Scott M. Lynch; 5/24Mindfulness and resilience are thought to be essential qualities of the military’s special operations community. Both are tested daily in Special Operations Forces (SOF) assessment and selection efforts to prepare candidates to persist through grueling training and complex combat situations; but these qualities are rarely measured. While military leadership places value on the concepts of mindfulness and resilience, there is minimal empirical research examining the role that they play in the completion of training. This longitudinal study followed three classes of SEAL candidates at Basic Underwater Demolition/SEAL (BUD/S) training over their six-month selection program. We estimated logit models predicting successful completion of BUD/S and specific types of failure in that training environment with indexes of mindfulness and resilience at the start of the program as predictors of completion. The results indicate that mindfulness is generally unrelated to completion, while resilience generally predicts completion.Publisher's note: A leadership-oriented article from another field (the military) that can be applied to healthcare.

Reflective learning: A new leadership development framework driving engineering innovationReflective Practice; by Jeremy Wei; 2/18/24Innovation is an organizational learning process that demands a reflexive perspective to take on uncertainties and question deeply held assumptions, propelling leadership and organizational structures forward. ... A reflexive-learning-based leadership development program is a set of collective actions comprising four fundamental steps: acknowledging problems, reassessing assumptions, thinking of alternatives, and developing new perspectives. This study demonstrates its effectiveness in developing collective reflexivity within an engineering organization by repurposing the After-Action Review (AAR) as reflexive learning training.Publisher's note: A leadership model applied in the engineering field that could be translated to healthcare.

Inpatient palliative care and healthcare utilization among older patients with Alzheimer's Disease and Related Dementia (ADRD) and high risk of mortality in U.S. hospitalsAmerican Journal of Hospice and Palliative Care; by Zhigang Xie, Guanming Chen, Oluwadamilola T Oladeru, Hanadi Y Hamadi, Lucinda Montgomery, Maisha T Robinson, Young-Rock Hong; 5/24PC substantially reduced hospital expenditures for older patients with ADRD-HRM, but the prevalence remained low at 14.6% in the study period. Future studies should explore the unmet needs of patients with lower sociodemographic status and those in rural hospitals to further increase their PC consultation utilization.

Oregon Death with Dignity Act access: 25 year analysisBMJ Supportive & Palliative Care; by Claud Regnard, Ana Worthington, Ilora Finlay; 5/24[UK] The number of assisted deaths in Oregon increased from 16 in 1998 to 278 in 2022. Over this time, patients’ health funding status changed from predominantly private (65%) to predominantly government support (79.5%), and there was an increase in patients feeling a burden and describing financial concerns as reasons for choosing an assisted death. There has been a reduction in the length of the physician–patient relationship from 18 weeks in 2010 to 5 weeks in 2022, and the proportion referred for psychiatric assessment remains low (1%). Data are frequently missing, particularly around complications.

[Honoring Nurses Week] Too many nurses are being assaulted. Some say they are being blamed for the attacks. Chief Healthcare Executive; by Ron Southwick; 5/9/24 With disturbing regularity, nurses in hospitals and other healthcare settings are being physically assaulted and verbally harassed. More than half of emergency nurses say they’ve been assaulted or threatened within the past 30 days, according to the Emergency Nurses Association. In a separate study, researchers found that healthcare workers faced at least one violent or aggressive incident for every 40 hours worked, according to findings published by The Joint Commission Journal on Quality and Patient Safety. With the observance of National Nursing Week, the increased violence in healthcare can’t be ignored. Nursing leaders say the regular exposure to violence or threatening behavior is one factor adding to stress and burnout of nurses and, in some cases, spurring them to seek new jobs.