Literature Review

Perspectives on artificial intelligence–generated responses to patient messagesJAMA Network Open; Jiyeong Kim, PhD, MPH; Michael L. Chen, BA; Shawheen J. Rezaei, MPhil; April S. Liang, MD; Susan M. Seav, MD; Sonia Onyeka, MD; Julie J. Lee, MD, MPH; Shivam C. Vedak, MD, MBA; David Mui, MD, MBA; Rayhan A. Lal, MD; Michael A. Pfeffer, MD; Christopher Sharp, MD; Natalie M. Pageler, MD, MEd; Steven M. Asch, MD, MPH; Eleni Linos, MD, DrPH; 10/24Generative artificial intelligence (AI) has the potential to assist clinicians in responding to patients’ messages. Satisfaction was consistently higher with AI-generated responses than with clinicians overall and by specialty. However, satisfaction was not necessarily concordant with the clinician-determined information quality and empathy. For example, satisfaction was highest with AI responses to cardiology questions while information quality and empathy were highest in endocrinology questions. Interestingly, clinicians’ response length was associated with satisfaction while AI’s response length was not. The findings suggest that the extreme brevity of responses could be a factor that lowers satisfaction in patient-clinician communication in EHR.

Virtual reality videos for symptom management in hospice and palliative careMayo Clinic Proceedings - Digital Health; by James R Deming, Kassie J Dunbar, Joshua F Lueck, Yoonsin Oh; 8/24Nature scenes significantly improved total symptom scores, as well as scores for drowsiness, tiredness, depression, anxiety, well-being, and dyspnea. The improved scores were not sustained 2 days later. Overall, bucket-list videos did not significantly improve symptoms. Neither previous experience with an activity nor a strong connection correlated with significant improvement; however, when patients rated video quality as outstanding, scores improved. Patients with lower functional status tended to have more symptoms beforehand and improve the most.

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.

Patterns of migration following dementia diagnosisJAMA Network Open; Momotazur Rahman, PhD; Bishnu Bahadur Thapa, PhD; Christopher Santostefano, MPH, RN; Pedro Gozalo, PhD; Ulrike Muench, RN, PhD; Cyrus M. Kosar, PhD; Hyesung Oh, PhD; Elizabeth White, APRN, PhD; Vincent Mor, PhD; 10/24In this cohort study of more than 1 million Medicare fee-for-service beneficiaries, individuals with a diagnosis of dementia were almost twice as likely to migrate to another county or state compared with those with diagnoses of myocardial infarction, chronic obstructive pulmonary disease, or colon cancer. Of the excess migrations resulting from dementia diagnosis, 55% occurred in community settings, and 45% occurred in institutional settings. The marked increase in migration among patients following a dementia diagnosis highlights a distinctive need for policy and support interventions tailored to their unique migration patterns and care requirements.

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.

New FTC regulations could create obstacles for hospice M&A Hospice News; by Jim Parker; 10/24/24 Changes to federal rules governing mergers and acquisitions could have sweeping effects on hospice and other health care transactions. The Federal Trade Commission (FTC) recently finalized a rule that will implement changes to required pre-merger notification forms. Pursuant to the Hart-Scott-Rodino Act, parties to certain transactions must submit these documents to the FTC and other regulatory agencies to help identify and address potential antitrust concerns. The law requires that transactions exceeding $120 million must submit the form, which agencies will use to conduct a 30-day premerger assessment, according to Luke Smith, member at the law firm Bass, Berry and Sims. The final rule will likely complicate the closing of some hospice acquisitions.

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.