Literature Review

Cancer caregiver anxiety over time: The influence of palliative careJournal of Palliative Care; Laura A Siminoff, PhD; Maureen Wilson-Genderson, PhD; Marcin Chwistek, MD, FAAHPM; Maria D Thomson; 10/24Our analysis detected 3 distinct cancer caregiver groups reporting low, elevated, and very high levels of anxiety. Caregivers with elevated or high anxiety also demonstrated increasing anxiety overtime; however increases were attenuated with patient receipt of palliative care. For cancer caregivers with elevated and high levels of anxiety, palliative care buffers further deterioration of their mental health. Caregivers with the lowest level of anxiety were more likely to be Black, report fewer symptoms of depression or caregiver burden and higher self-rated physical health. Caregivers who were younger reported higher anxiety.

Alzheimer Disease—What’s in a name?JAMA Neurology; Ronald C. Petersen, PhD, MD; Elizabeth Mormino, PhD; Julie A. Schneider, MD, MS; 11/24Back in 2018, the National Institute on Aging (NIA)–AA [Alzheimer Association] group proposed a biological definition of AD [Alzheimer Disease] stating that if a person had the biomarker evidence of brain amyloid (A) and tau (T), the pathologic hallmarks of the disease, the patient had AD irrespective of the person’s clinical state. In their recent 2024 revision, they maintain a biological definition but have extended it to incorporate more recent biomarkers for AD; ... positivity on core 1 biomarkers that indicate the crossing of a specific amyloid threshold on amyloid positron emission tomography (PET), cerebrospinal fluid, and foreseeably, plasma biomarkers. A major question pertains to the requirement for tau in the definition [as] the AA group argues that the vast majority of individuals who have amyloid-positive PET scans have some tau pathology. Furthermore, the AA group proposes a clinical staging scheme that provides a framework to define the frequent mismatch between AD biomarker positivity (and underlying neuropathology) and the clinical expression of the disease, often an indicator of mixed pathologies or resilience. Importantly, although the AA group does base the AD diagnosis on biomarker positivity, they do not currently advise testing in asymptomatic persons in a clinical setting.

[UK] Multiple points of system failure underpin continuous subcutaneous infusion safety incidents in palliative care: A mixed methods analysisPalliative Medicine; Amy Brown, Sarah Yardley, Ben Bowers, Sally-Anne Francis, Lucy Bemand-Qureshi, Stuart Hellard, Antony Chuter, Andrew Carson-Stevens; 10/24 About 25% of palliative medication incidents involve continuous subcutaneous infusions. Complex structural and human factor issues make these risk-prone interventions. Primary incidents (most proximal to patient outcomes) leading to inappropriate medication use (including not using medication when it was needed) were underpinned by breakdowns in three major medication processes: monitoring and supply ... administration ... and prescribing ... Recurring contributory factors included discontinuity of care within and between settings, inadequate time, inadequate staffing and unfamiliarity with protocols. Psychological harms for patients and families were identified. System infrastructure is needed to enable timely supply of medication and equipment, effective coordinated use of continuous subcutaneous infusions, communication and continuity of care.

Solo but not alone: An examination of social and help networks among community-dwelling older adults without close familyJournal of Applied Gerontology (J Appl Gerontol); by Jane Lowers, Duzhi Zhao, Evan Bollens-Lund, Dio Kavalieratos, Katherine A Ornstein; 11/31/2022... Nearly one in four adults is at high risk for aging without a spouse or children ... Previous descriptions of adults aging solo have focused on social isolation (Chamberlain et al., 2018; Roofeh et al., 2020), yet diverse, non-kin social networks can provide robust emotional and instrumental (task-oriented) support and such networks are becoming more common over time (Suanet & Antonucci, 2016; Verdery et al., 2019), although the type and intensity of support may vary by the type of relationship (e.g., kin vs non-kin) and factors including frequency of interaction (Wellman 1990). ... Therefore, as a first step, we sought to define the population of adults aging solo and compare its social networks and sources of help to adults with close family nearby. Editor's note: Though this article is from 2022, we are posting it due to our post on 11/13/24, Older Americans living alone often rely on neighbors or others willing to help, and our readers' frequent "most read" articles about seniors' challenges with isolation, depression, and caregiving challenges. 

Use of hospice and end-of-life care quality among medical centers with high versus lower specialist palliative care reach among people with heart failure: An observational studyJournal of Palliative Medicine; by Shelli L Feder, Ling Han, Yan Zhan, Erica A Abel, Kathleen M Akgün, Terri Fried, Mary Ersek, Nancy S Redeker; 11/24Rates of specialist palliative care (SPC) vary among Veterans Affairs Medical Centers (VAMCs) for people with advanced heart failure (aHF). We evaluated the associations between facility rates of SPC reach and the quality of end of life (EOL) care received among this population. Families of patients with aHF who die in VAMCs with higher SPC reach report better EOL care quality regardless of whether or not they receive SPC. Research is needed to investigate factors beyond receiving SPC associated with these EOL outcomes.

Unity Hospice to open East Side Resale Shoppe on November 18th The Chamber, Manitowoc County, De Pere, WI; Press Release; 11/13/24 Unity, Northeast Wisconsin’s pioneering nonprofit healthcare provider, is excited to announce the expansion into a second Resale Shoppe location at 1302 S. Broadway in De Pere. This east side location, scheduled to open 10:00 am Monday, November 18, 2024, will provide a meaningful place for the community to donate or purchase cherished household goods and clothing. This new location will allow even greater convenience for customers and donors located on the east side of De Pere. 

CMS to surveyors: Keep eyes open for hospice fraud Hospice News; by Jim Parker; 11/14/24 The U.S. Centers for Medicare & Medicaid Services (CMS) has issued a memo to accreditation bodies and state agencies advising surveyors to watch out for potential hospice fraud. The memo directs surveyors to refer issues to CMS if they suspect fraudulent activity. These actions were spurred by a rash of fraudulent hospices that have emerged primarily in California, Texas, Nevada and Arizona. “While the primary purpose of [state agencies and accreditation organization] surveys is to determine compliance with the Medicare Hospice CoPs, there are several elements of the survey process that can uncover concerns that would necessitate a referral to CMS for potential fraud,” CMS indicated in the memo. 

HomeCare & Hospice receives Renodin Grant Olean Times Herald, Allegany, NY; 11/14/24 HomeCare & Hospice announces it has received a generous grant from the Dr. Lyle F. Renodin Foundation to support its comfort care basket initiative for hospice patients. This funding will enable HomeCare & Hospice to provide comfort care baskets filled with thoughtfully selected items that promote relaxation, comfort and dignity for those facing end-of-life care. Each basket is designed to offer a bit of respite, bringing a sense of warmth and care to patients during a vulnerable time. The Dr. Lyle F. Renodin Foundation, affiliated with the Franciscan Sisters of Allegany, is committed to supporting projects that uplift individuals experiencing poverty, homelessness, food insecurity and other vulnerabilities. “We are deeply grateful to the Dr. Lyle F. Renodin Foundation for their support,” said Melissa Sullivan, CEO of HomeCare & Hospice. “This grant will allow us to provide meaningful and comforting items to our hospice patients, helping to ease their journey and providing support that reflects the compassion and respect at the heart of our mission.”

It's not just pumpkin spice time--it's time for the family conversation! Dunlap Bennet & Ludwig; by George Reilly; 11/13/24 “Quality family time” is a phrase often heard in the period from Thanksgiving to New Year’s, sometimes even with air quotes, to describe what many people believe to be a necessary, but not necessarily enjoyable, time of family togetherness. ... Whatever your perspective on this “quality family time,” chances are that for most of you, it was/will be a missed opportunity to discuss very important matters with your loved ones—namely what happens in the event of disability or death; who takes care of what; a parent’s (or grandparents, or your own) wishes on the end of life medical care and funeral/burial/cremation choices; your wishes on guardians for minor children; and other critical, but admittedly sensitive and gloomy topics. ...  Consider these statistics from surveys conducted by the Conversation Project: ... 92% of Americans say it’s important to discuss their wishes for end-of-life care, but only 32% have had such a conversation! [Click on the title's link to continue reading.]

Growing palliative care team expands access into ambulatory setting UConn Today; by Jennifer Walker; 11/13/24 Palliative care is a medical subspecialty focused on providing relief from the symptoms and stress of serious illness. The goal is to improve the quality of life for both the patient and the family. Palliative care is appropriate at any age and stage of illness and can be provided along with all other medical treatments. Eight years ago, UConn Health began outpatient palliative care at the Carole and Ray Neag Comprehensive Cancer Center with a cancer center supportive care clinic.  The supportive care clinic includes two full-time nurse practitioners and support from an interdisciplinary team. The service has continued to grow since it was started with volumes increasing 250%. As the Cancer Center grows, volume and need for palliative care is also anticipated to increase.

Carolina Caring celebrates fourth graduating class of CNA Training and Job Placement Program Focus, Newton, NC; 11/13/24 On the evening of Thursday, October 24th, Carolina Caring recognized the seven graduates of its latest Certified Nurse Aide (CNA) Training and Job Placement Program. ... This state-approved CNA Training Program runs for eight weeks at Carolina Caring’s Newton campus on 3975 Robinson Road. Led by licensed nursing instructors, these courses provide expert hands-on education which prepares students to pass the intensive North Carolina Nurse Aide certification exam. Students receive financial aid throughout the program, and all graduates who successfully complete their certifications are offered positions with Carolina Caring. ... “Carolina Caring blessed me by selecting me for this program and providing me with an opportunity that I otherwise would not have been able to financially invest in at this current moment,” said Allison Ackley, class valedictorian. “They poured into me, and so I’m going to be pouring back into them.”Editor's note from Carolina Caring's website: "In 1979, Carolina Caring was established as one of North Carolina’s original three hospice providers. We were a small group of grassroots volunteers with a mission: to help our parents, grandparents and neighbors walk through their final moments with dignity and respect." We congratulate you on this innovative, mission-driven educational and staffing initiative.

Mom of 4 is placed in hospice care 2 weeks before son's wedding. On his big day, she's on the dance floor with a smile (exclusive) People; by Jordan Greene; 11/14/24 ... In October, before entering hospice care, Liv recalls how her mom was in the hospital, and all she could talk about was attending the wedding. With Olivia's health deteriorating, Liv says her brother Salvatore and his fiancée Kelsey had even considered holding the wedding ceremony in the hospital room if necessary. But that contingency plan quickly became unnecessary. On Nov. 2, their mom defied expectations and arrived at Basilica Hudson in Hudson, New York, alongside the other 105 guests to watch her son walk down the aisle — turning the hopes of her kids and everyone else in attendance into a reality. In fact, Liv says her mom exceeded even the best-case scenario the family had imagined. ...