Literature Review

‘We’re the telescope looking forward’: Medical ethicists ask tough questions as part of $66 million research project CU Department of Medicine, by Mark Harden; 4/5/24 In the original “Jurassic Park” movie, after the process of bringing dinosaurs back to life is explained to a team of consultants, one of them voices a warning: “Your scientists were so preoccupied with whether or not they could, they didn’t stop to think if they should.” University of Colorado Department of Medicine faculty members will be asking the “should” question years before there’s an answer to “could.” They’ve joined in a nationwide study of whether tiny, battery-powered electric devices and genetic material, swallowed in capsule form, could one day replace surgery or injections as treatments for metabolic diseases such as diabetes and obesity.

Do end-of-life outcomes differ by assisted living memory-care designation?Journal of the American Geriatric Society, by Xiao Joyce Wang, Portia Y Cornell, Emmanuelle Belanger, Kali S Thomas; 4/24Residential care/assisted living (RC/AL) is an increasingly common place of end-of-life care for persons with Alzheimer's disease and related dementia (ADRD), who have unique care needs as their health declines. Approximately 22% of RC/ALs provide specialized memory care (memory-care RC/AL). Understanding how end-of-life outcomes differ by memory care among residents with ADRD could facilitate aging/dying in place for this population. The objective of this paper is to examine if end-of-life outcomes (i.e., mortality, hospice use, and number of days receiving hospice in the last month of life) differ between residents with ADRD who moved to memory-care RC/AL, compared with residents with ADRD who moved to RC/AL without memory care (general RC/AL).

Neuropsychiatric effects associated with opioid-based management for palliative care patientsCurrent Pain and Headache Reports, by Alan D Kaye, Kylie Dufrene, Jada Cooley, Madeline Walker, Shivam Shah, Alex Hollander, Sahar Shekoohi, Christopher L Robinson; 4/24The abundance of opioids administered in the palliative care setting that was once considered a standard of care is at present necessitating that providers evaluate patients for unintentional and deleterious symptomology related to aberrant opioid use and addiction. ... By having an increased understanding and awareness of potential opioid neuropsychiatric effects, patient quality of life can be improved, healthcare system costs can be decreased, and patient outcomes can be met and exceeded.

Bereaved Parent Support Study: Seeking Participants Sylvester Comprehensive Cancer Center/University of Miami Miller School of Medicine, Memorial Sloan Kettering Cancer Cancer, St. Jude Children's Hospital, and Children's Hospital of Philadelphia; 4/2/24This program is offered as a research study examining three types of support for bereaved parents who have lost a child to cancer. This is a National Institutes of Health-funded trial taking place at Sylvester Comprehensive Cancer Center/University of Miami Miller School of Medicine, Memorial Sloan Kettering Cancer Center, St. Jude Children's Hospital, and Children's Hospital of Philadelphia; however, families need not have received care from one of these institutions. ... For those assigned to receive counseling, services will be provided through videoconferencing, and all study activities can be completed from the participant’s home. ... There will be no charge for any support offered through the study. ... [Click on the title's link for more information.] Editor's Note: If your hospice does not have bereavement services tailored to the needs of parents who have lost a child, consider this opportunity for free support from these reputable sources. Click on the title's link for eligibility requirements and descriptions.

Fostering respect and appreciation seen as keys to retaining direct care workersMcKnights Online Forum, by Kimberly Bonvissuto; 3/27/24 Expressions of appreciation and respect can go a long way in addressing senior living’s direct care workforce crisis, according to a panel of direct workers and employers who addressed what makes employees want to stay — or go. ... Nate Hamme, president and executive director of the Ceca Foundation, ... said that the most important part of employee recognition is listening to people. ... He added that there is a science to recognition backed by research into what motivates people and implementing programs around that. ... Recognition programs, Hamme added, should focus on IMPACT: inclusive, mission-aligned, public, authentic, consistent and timely. 

Today's Heartwarming Story

Mortality, hospice use rates differ in assisted living communities depending on whether memory care is offeredMcKnights Senior Living, by Kimberly Bonvissuto; 4/4/24Assisted living communities that provide memory care services may attract residents closer to the end of life or promote hospice use at the end of life compared with assisted living communities without such services, according to the findings of a new study. ... Researchers from the Brown University School of Public Health, the University of Melbourne and the Johns Hopkins University School of Nursing examined whether end-of-life outcomes — mortality and hospice use — differed between assisted living facilities with and without memory care services among 15,152 residents who moved into larger communities between 2016 and 2018.Editor's Note: Click here for the source article, "Do end-of-life outcomes differ by assisted living memory-care designation?"

A process evaluation of a palliative care social work intervention for cancer patients in skilled nursing facilitiesJournal of Palliative Medicine, by Sarguni Singh, MD; Ashley Dafoe, MA; Dana Lahoff, LCSW; Laurel Tropeano, LCSW; Bree Owens, LCSW; Erin Nielsen, LCSW; John Cagle, MSW, PhD; Hillary D. Lum, MD, PhD; Brooke Dorsey Holliman, PhD; Stacy Fischer, MD; 4/24Assessing and Listening to Individual Goals and Needs (ALIGN) is a palliative care social work intervention that aims to improve delivery of goal-concordant care for hospitalized older adults with cancer discharged to skilled nursing facilities. ... ALIGN offers support in prognostic understanding, communication, and decision making during a pivotal time when patient and caregivers' goals have not been met and they are reassessing priorities.

Implementing a Palliative Care Junior Faculty Visiting Professor program: Pearls and pitfallsAmerican Journal of Hospice & Palliative Medicine, by Jennifer B Seaman, Teresa H Thomas, Risa L Wong, David I Lazris, Maria Belin, Yael Schenker; 4/24Palliative Care (PC) is a small, relatively young interprofessional sub-specialty; hence mentorship for early-career research faculty is widely dispersed across schools and universities. We developed the Junior Visiting Professor Program (JVPP) to provide junior faculty in PC with opportunities to meet multidisciplinary PC researchers from other institutions and to advance their research through networking and presenting their work. We describe how we designed and implemented the program, and we report on the first cohort of participants.

Saturday newsletters focus on headlines and research - enjoy!

The challenges of advance care planning for acute care registered nursesCanadian Journal of Nursing Research, by Lori L Rietze, Kelli I Stajduhar, Mary Ellen Purkis, Denise Cloutier; 4/24Nurses were challenged to meet multiple competing demands, leaving them to scramble to manage complex and critically ill acute care patients while also fulfilling organizational tasks aligned with funding metrics, accreditation, and strategic planning priorities. Such factors limited nurses' capacity to engage their patients in ACP. ... Acute care settings that align patient values and medical treatment need to foster ACP practices by revising organizational policies and processes to support this outcome, analyzing the tasks of healthcare providers to determine who might best address it, and budgeting how to support it with additional resources.

Excellence is never an accident. It is always the result of high intention, sincere effort, and intelligent execution. ~Aristotle