Literature Review

Industry professionals reflect on five years of medical marijuana in Arkansas Arkansas Advocate; by Mary Hennigan; 5/13/24Since the launch of medical marijuana in Arkansas in 2019, more than three dozen storefronts have opened, at least 102,000 residents have registered for patient cards and revenue has topped $1.1 billion. The latest card count exceeds 102,000, and there’s no indication of a letup in new applications,  ... As of June 2023, one in three Arkansans with a patient card listed post-traumatic stress disorder as their qualifying condition, ... The next highest qualifying condition was intractable pain, or pain that has not responded to ordinary medications for more than six months, at nearly 30%. 

Utah man angry: "Why am I still alive?" Cat Country 107.3/94.9; by Andy Griffin; 5/10/24 George Ball (not his real name) is angry. He's dying soon, he knows that. But what he's really mad about is that he's still alive. "I signed the paper. I made the request," he said. "So, why am I still alive?" ... The 72-year-old Utahn recently had a heart attack (cardiac arrest), and was essentially dead for a few minutes before being resuscitated at a Utah hospital. Life-saving measures were taken, including shooting adrenaline into his heart. He was gone, but they brought him back. Happy ending, right? The only problem was, Ball had signed and certified a DNR -- a do not resuscitate order -- so that if he, well, died, heroic measures would not be taken to bring him back to life. ...

Nurse Practitioner care, scope of practice, and end-of-life outcomes for nursing home residents with dementia JAMA Health Forum - JAMA Network; by Cyrus M. Kosar, PhD; Bishnu B. Thapa, MPA, PhD; Ulrike Muench, RN, PhD; Christopher Santostefano, RN, MPH; Emily A. Gadbois, PhD; Hyesung Oh, MA, MBA; Pedro L. Gozalo, PhD; Momotazur Rahman, PhD; Elizabeth M. White, APRN, PhD; 5/10/24 Question: Is nurse practitioner (NP) care associated with end-of-life outcomes for nursing home residents with Alzheimer disease and related dementias (ADRD), and do these associations differ between states with full vs restrictive NP scope of practice regulations? Findings: The results of this cohort study including 334 ,618 US nursing home residents with ADRD indicated that decedents with greater NP involvement at end of life had fewer hospitalizations and higher hospice use. The adjusted differences in outcomes between decedents with extensive vs minimal NP care were larger in states with full scope of practice regulations than in states with restrictive regulations.

Care Synergy appoints Dr. Pradeep Rai as Chief Medical Officer Care Synergy Network; 5/13/24  Care Synergy announced the selection of Dr. Pradeep Rai, MD, as the company’s chief medical officer. Additionally, Dr. Rai will serve as The Denver Hospice’s (TDH) medical director as well. As Chief Medical Officer, Dr. Rai will lead clinical operations across all of Care Synergy’s hospice, palliative care, and home health affiliates. These affiliates include The Denver Hospice, Pikes Peak Hospice & Palliative Care in Colorado Springs, Pathways Hospice in Fort Collins, and the Colorado Visting Nurses Association (CVNA) which serves patients across the Front Range. He will also spearhead medical operations for Colorado PACE upon its anticipated Q4 2024 launch.

I am no longer accepting the things I cannot change. I am changing the things I cannot accept. ~ Angela Davis

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.

A survey of Jewish attitudes and experiences relating to end-of-life care and the “right to die”American Journal of Hospice and Palliative Medicine; by Christopher M. Moreman, Ayona Chatterjee; 3/24We conducted a survey of Jewish attitudes towards, and experiences with, end-of-life care. Questions fell into three areas: (1) Expectations for Jewish end-of-life care; (2) Experiences with such care; and (3) Attitudes toward the “right to die.” Examining denominational differences in belief in, and adherence to, Halakha (Jewish law), we confirm many expectations described in the literature. We find notable nuances in specific areas of need across Jewish denomination, and in terms of acceptance of the withdrawal of life support vs assisted suicide. Care for the nuances of Jewish belief is indicated for effective and satisfying Jewish end-of-life care.

Association between physician age and patterns of end-of-life care among older AmericansJournal of the American Geriatrics Society; by Hiroshi Gotanda, Ryo Ikesu, Anne M. Walling, Jessica J. Zhang, Haiyong Xu, David B. Reuben, Neil S. Wenger, Cheryl L. Damberg, David S. Zingmond, Anupam B. Jena, Nate Gross, Yusuke Tsugawa; 4/15We found that differences in patterns of EOL care between ben-eficiaries cared for by younger and older physicians were small, and thus, notclinically meaningful. Future research is warranted to understand the factorsthat can influence patterns of EOL care provided by physicians, including ini-tial and continuing medical education.

Developing, implementing, and evaluating the visiting Neighbors’ program in rural Appalachia: A quality improvement protocolPLoS One; by Ubolrat Piamjariyakul, Susan R. McKenrick, Angel Smothers, Angelo Giolzetti, Helen Melnick, Molly Beaver, Saima Shafique, Kesheng Wang, Kerri J. Carte, Brad Grimes, Marc W. Haut, R. Osvaldo Navia, Julie Hicks Patrick, Kirk Wilhelmsen; 1/24Older adults living alone in rural areas frequently experience health declines, social isolation, and limited access to services. To address these challenges, our medical academic university supported a quality improvement project for developing and evaluating the Visiting Neighbors program in two rural Appalachian counties. Our Visiting Neighbors program trained local volunteers to visit and guide rural older adults in healthy activities. These age-appropriate activities (Mingle, Manage, and Move- 3M's) were designed to improve the functional health of older adults. The program includes four in-home visits and four follow-up telephone calls across three months.

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).

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:

Purpose. Benefit. Check. ~Peter Benjamin, quoted at the Homecare & Hospice Association of Colorado Annual Conference