Literature Review

Palliative care initiated in the Emergency Department-A cluster randomized clinical trialJAMA; Corita R. Grudzen, MD, MSHS; Nina Siman, MA, MSEd; Allison M. Cuthel, MPH; Oluwaseun Adeyemi, MBBS, PhD; Rebecca Liddicoat Yamarik, MD; Keith S. Goldfeld, DrPH, MS, MPA; PRIM-ER Investigators; 1/25Question-What is the effect of a multicomponent intervention to initiate palliative care in the emergency department on hospital admission in older adults with serious, life-limiting illness? In this cluster randomized clinical trial, which was conducted at 29 US emergency departments and included 98,922 initial visits, there was no difference in the rate of hospital admission in older adults with serious, life-limiting illness receiving care before (64.4%) vs after (61.3%) emergency department clinical staff receipt of a multicomponent primary palliative care intervention. Relevance-This multicomponent intervention to initiate palliative care in the ED did not have an effect on hospital admission, subsequent health care use, or short-term mortality in older adults with serious, life-limiting illness.

Arkansas Hospice names Brian Bell new President and CEO Arkansas Money & Politics (AMP); by AMP Staff; 2/7/25 Arkansas Hospice announced Thursday that Dr. Brian W. Bell, M.D., FAAHPM, will take over as president and CEO for Arkansas Hospice’s Family of Care on March 10.  He joined the company in 2016 and is currently the chief medical officer. He will replace Judith Wooten, who announced her retirement last year. Wooten will stay on through April to ensure a smooth transition. Bell has worked in hospice care since 2006 and is board-certified in family medicine and hospice and palliative medicine. He is one of only people in the state with the designation fellow of the Academy of Hospice and Palliative Medicine. 

Flu cases continue to rise across the countryABC 6 News, Rochester, MN; by KAALTV; 2/10/25Flu cases are continuing to rise across the country as doctor visits for flu-like symptoms are now reaching their highest point in 15 years. The CDC estimates at least 24 million illnesses this flu season alone, with 13,000 turning deadly. Right now, about 31% of flu tests are coming back positive, nearly double the peak from last season. Doctors say your best line of defense is vaccination. Editor's note: We see this surge across news media sources, and compiled this state-specific list for you. 

New report details financial, emotional toll of Parkinson’s on family caregivers McKnights Home Care; by Foster Stubbs; 2/4/25 A new report sheds a light on the unique challenges faced by family caregivers who care for loved ones with Parkinson’s disease (PD). The report, Parkinson’s Disease Caregiving in the US, features insights from secondary analysis and supplementary interviews with 10 PD caregivers. These caregivers average 31 hours of unpaid care per week; half of interviewed caregivers exceed 100 hours each week, according to the report. The National Alliance for Caregiving (NAC), with support from The Michael J. Fox Foundation for Parkinson’s Research (MJFF) and Arcadia University, released the report.  

Keep your face always toward the sunshine—and shadows will fall behind you. ~Walt Whitman

Compassion in the justification of physician-assisted dying: Gandhi’s non-violence vs. Aristotle’s virtues and vicesMedicine, Health Care and Philosophy; Ercan Avci; 1/25Compassion is an essential phenomenon in the therapeutic relationship, and some use it to justify physician-assisted dying practices. However, different approaches to its definition and scope can lead to distinct conclusions about the role of compassion in end-of-life interventions. In this context, the paper aims to compare Mahatma Gandhi’s and Aristotle’s views on compassion to explore whether it can be utilized to justify physician-assisted dying. Gandhi’s thoughts on compassion and Aristotle’s standpoint on virtues and vices demonstrate that Gandhi evaluates this concept as a moral duty to relieve intractable suffering, whereas Aristotle relies on balancing all virtues through relevant deficiencies and excesses. Therefore, even though Gandhi’s opinion on compassion can for allow assisted dying interventions, Aristotle’s idea of virtues and vices restricts compassion to a scope that alleviates suffering through available means without causing death.

Brain biomarkers for pain sensitivityJAMA Neurology; Prasad Shirvalkar, MD, PhD; Christopher J. Rozell, PhD; 1/25Identifying objective biomarkers that track individual pain severity has been dubbed “the holy grail” of pain neuroscience. Chronic pain affects up to one-fifth of US adults, and its complexity is attributed to a confluence of physical, emotional, and cognitive factors that contribute to suffering and disability. The epidemic of chronic pain initially contributed to the rise of the opioid epidemic and continues to plague nearly all fields of clinical medicine. Identifying and validating biomarkers to predict individual risk for chronic pain facilitate a precision medicine approach to pain medicine. Despite the unknown provenance of the proposed biomarkers, the results of the present study have the potential to aid in the practical development of personalized pain management strategies.

Reimagining care and research for Amyotrophic Lateral SclerosisJAMA Neurology; Suma Babu, MBBS, MPH; Joshua M. Sharfstein, MD; Eva L. Feldman, MD, PhD; 1/25Amyotrophic lateral sclerosis (ALS) is a fatal neurological disease involving progressive motor neuron degeneration. In 2022, US Congress and the National Institutes of Health (NIH) commissioned the National Academies of Science, Engineering and Medicine (NASEM) to identify priorities to make ALS a livable disease within a decade. After extensive deliberations and input from the public, researchers, and persons with lived experience, the committee released its report, Living With ALS. To accelerate progress in patient care and therapeutics, one of the report’s major recommendations was for the National Institute of Neurological Disorders and Stroke (NINDS) to fund a clinical trials network dedicated to ALS that is distributed across diverse geographic regions and integrated within a novel hub-and-spoke system of care and research for ALS. The hubs are ALS Centers of Excellence that provide patient care and research, both basic and clinical, while the spokes represent a large number of community and regional ALS clinics that provide care and link to hubs for research. By integrating ALS clinical trials within this structure, we have the potential to transform ALS care, drive innovation in ALS therapeutic development, and pave the way for breakthroughs in other neurodegenerative diseases. 

Impact of inpatient palliative care on end-of-life care among patients with early-onset colorectal cancerJournal of Clinical Oncology; Suriya Baskar, Bohae R Lee, Rajiv Midha, Udhayvir Singh Grewal; 1/25Palliative care has proven benefits in elderly patients with advanced cancer; however, the objective benefits of palliative care in younger patients with cancer remain under-studied. We sought to examine the impact of inpatient palliative care consultation on end-of-life (EOL) care among hospitalized patients with early-onset colorectal cancer (EO-CRC). Inpatient palliative care consultation at EOL among patients with EOCRC was associated with lesser use of aggressive interventions and higher rates of DNR code status. We also noted significantly lower costs of hospitalization among patients receiving inpatient palliative care consultation at EOL. These results underscore the importance of integration of inpatient palliative care consultation among patients with EOCRC at EOL. 

Hospice - The time is now for additional integrity oversightJAMA Forum; by Joan M. Teno; 4/23...Leading hospice organizations are calling for more oversight. The National Partnership for Healthcare and Hospice Innovation, LeadingAge, the National Association for Home Care & Hospice, and the National Hospice and Palliative Care Organization provided a comprehensive set of recommendations to preserve the integrity of hospice. These organizations are returning to the historic mission of hospice: to improve care for dying persons and support for their family members... The recommendations put forth by the 4 hospice organizations are important. Further reforms also are needed.

St. Croix Hospice opens new location in La Crosse News 8 Now, La Crosse, WI; by Corey Peters; 2/12/25 St. Croix Hospice held a ribbon cutting for their new location in La Crosse on Wednesday. St. Croix Hospice originated back in 2009 in Oakdale, Minnesota, and have now expanded to 18 locations around Wisconsin. St. Croix Hospice held a ribbon cutting for their new location in La Crosse on Wednesday. St. Croix Hospice originated back in 2009 in Oakdale, Minnesota, and have now expanded to 18 locations around Wisconsin.

Aging for Amateurs: Valentine's Day brings out the poetry of aging in love The Post and Courier, Charleston, SC ; by Bert Keller; 2/10/2 The week of Valentine’s Day breathes love. Many elders have lived through love’s changing seasons consciously, experiencing what an alive, evolving, hazardous and soul-satisfying thing love is. ... In every long love, the emotional part undergoes a change as the stages of life are lived through. Marriage begins like a bonfire that melts and merges us: our togetherness wants no separation. Then it eases into a practical fire for cooking meals and washing dishes — those years of getting up with the baby, balancing the books, taking out the garbage. ... And then in old age ... love is less a feeling alongside other feelings, and more a shared sense of being with the other. My wife calls it “with-ness.” ... What was transactional in an earlier stage has become grace. After retirement I volunteered to do chaplaincy with a local hospice. I recall a moment sitting at the bedside of a 93-year-old man whose memory was erased by Alzheimer’s disease. He was now dying ... His wife, who also had Alzheimer’s and was no longer capable of much conversation, sat in a wheelchair by his bed and held his hand. She kept repeating to me, tears flowing, “We’ve been married for 73 years, you know.” It was a kind of mantra. How could I know what it’s like to be at the deathbed of a partner with whom you’ve intimately shared 73 years of life? All the stories, all the peaks and valleys, of such a lifetime? ... Editor's note: May we listen and learn.