Literature Review

Free Death Cafés provide a venue for difficult conversations The Northern Virginia Daily. Stephens City, VA; by Brian Brehm; 1/20/25... Blue Ridge Hospice, in partnership with Bowman Library, wants to spark the death-related conversations that many people want to have but are comfortable initiating. Starting this month, the two organizations will be hosting a Death Café on the fourth Thursday of every other month. ... According to a media release from Blue Ridge Hospice, “Death Café is not a grief support group or a counseling session, but rather a casual and welcoming space for people to reflect on death-related topics, with the aim of helping us live life more fully. Whether you’re curious, thoughtful or seeking meaningful conversation, come as you are and engage in this judgment-free, agenda-free discussion.”

Hospice centers: Balancing comfort and controversy Crossroads Today, Victoria, TX; by Amaya Norman; 1/9/25 Hospice centers play a critical role in providing care for patients with terminal illnesses, focusing on comfort, dignity, and peace during life's most challenging moments. These centers are designed to support both patients and their families, but public opinions about their services often vary. ... While many see hospice centers as an essential support system offering much-needed relief and care, others express concerns about the quality of services or the emotional toll they can bring to families. These differing perspectives have sparked ongoing discussions about the role and perception of hospice care in society.

Daughter arrested for neglect after elderly mother found stuck to mattress The Augusta Press; by Greg Rickabaugh; 1/6/25 An elderly woman from Augusta was found in a state of severe neglect last week, prompting her daughter’s arrest. The 82-year-old was discovered incoherent and physically stuck to her mattress during a medical emergency on Dec. 30 at the home they shared on Rollingwood Drive, authorities said. When paramedics arrived at the family’s home, they found the woman non-responsive, with her skin literally adhered to the mattress due to untreated bedsores. She was rushed to Wellstar MCG Health, where she was stabilized. Authorities later arrested 54-year-old Tyrossale Peak, the woman’s daughter, charging her with neglect of a disabled or elderly adult. ... Investigators revealed that Peak had discontinued hospice care for her mother in June but failed to provide adequate care or maintain a safe living environment. 

UnitedHealthcare taught us ways to deny claims: Former employee NBC News Channel 8, Tampa, FL; by Damita Menezes; 12/30/24A former UnitedHealthcare claims representative says employees were systematically trained to deny medical claims and rush distressed customers off phone lines, revealing internal practices at the nation’s largest health insurer amid growing scrutiny of the industry. Natalie Collins, who worked for UnitedHealthcare for nine months, said Saturday on “NewsNation Prime” that staff received “so many different ways to deny” claims during their two to three months of training, with supervisors often standing behind representatives instructing them on denial methods. “We weren’t given proper instruction to actually pay the claim, and there wasn’t enough monies in certain files in certain companies to pay medical claims,” Collins said. “We would have to just get the client off the phone as fast as we could.” Collins described crying at her desk while handling calls from desperate patients, as supervisors laughed.

'We do more than just pray': Chaplains take active role at Milwaukee VA and in community U.S. Government Veterans Administration; by David Walter; 12/23/24 If you think hospital chaplains just pray at bedsides, think again. At the Milwaukee VA Medical Center, chaplains are much more than comfort providers. They are fully integrated into the everyday workings of the hospital, serving on committees, participating in numerous events and consulting with other subject matter experts. Their work also goes beyond the walls of the hospital, interfacing with the community to help better reach those Veterans who may not venture into the hospital. And while they continue to meet one-on-one with patients on a daily basis, they also extend their services to hospital staff, providing solace and support for those dealing with the emotional toll that caregiving can sometimes take on health care professionals. “There’s been a really big shift here,” said Chaplain Robert Allen, chief of the Milwaukee VA’s Chaplain Services, adding that for too long chaplains were “put in this corner, thinking that we only just pray.” Editor's note: To strengthen your understanding of chaplaincy roles, standards, training, and certification, examine the national Association of Professional Chaplains.

31 Photos and stories that show how expensive it is to die in America

How innovative designs can help ease ethical tension in good dementia caregiving and decision-makingAMA Journal of Ethics; Emily Roberts, PhD; 12/24The European dementia village is a pioneering health care site: 4 acres of integrated housing and amenities that include large exterior walkways around gardens, restaurants, and shops. A US-based conceptual model is the dementia friendly city center [DFCC], which integrates health care service delivery into adaptive reuse and urban revitalization. Separately and together, we can work to deliver new interventions that can make a difference for those living with dementia and their families. Further exploration of the DFCC model is required to address possible financial and regulatory constraints that accompany the development of necessary public health infrastructure.

Palliative care bypasses Black heart disease patients The St. Louis American; by Alvin A. Reid; 11/30/24 A study by Saint Louis University researchers paints a grim picture for many heart failure patients in America – and the outlook is worse for African Americans. The study, published in the Journal of the American Heart Association, found that only one in eight patients with heart failure nationwide receive palliative care consultations within five years of diagnosis. Alarmingly, Black people were 15% less likely to receive palliative care compared to white patients with similar heart health illness. Other recent respective studies illustrate the higher risk and mortality rates for cardiovascular disease in the Black population – further demonstrating that the missing palliative care options have a greater negative impact on African American health. New statistics from a medical team at EHproject show African American women are at a greater risk for cardiovascular disease than their white counterparts. It found that 47.3% of Black women have heart disease. If they do not have it currently, they are 2.4 times more likely to develop heart disease. ... A March 2023 study published in JAMA Cardiology showed that Black men remain at the highest risk of dying from cardiovascular disease. ... 

World Medical Association Declaration of Helsinki-Ethical principles for medical research involving human participantsJAMA; World Medical Association; 10/24Preamble: The World Medical Association (WMA) has developed the Declaration of Helsinki as a statement of ethical principles for medical research involving human participants, including research using identifiable human material or data. The Declaration is intended to be read as a whole, and each of its constituent paragraphs should be applied with consideration of all other relevant paragraphs. While the Declaration is adopted by physicians, the WMA holds that these principles should be upheld by all individuals, teams, and organizations involved in medical research, as these principles are fundamental to respect for and protection of all research participants, including both patients and healthy volunteers.

Guidelines vary when surrogates with power of attorney disagree with advance directives  Healio, Boston, MA; by Richard Gawel; 10/30/24 Inconsistent guidelines can lead to conflicts when surrogates with powers of attorney disagree with what may be described in a patient’s advance directive, according to a poster presented at the CHEST Annual Meeting. ... Key takeaways:

[Scotland] Palliative care-based arguments against assisted dyingBioethics; Ben Colburn; 10/24Opponents of legalised assisted dying often assert that palliative care is worse in countries where assisted dying has been legalised, and imply that legalised assisted dying makes palliative care worse. This study considers five versions of this claim: that it is difficulty to access expert palliative care in countries where assisted dying has been legalised, that those countries rank low in their quality of end-of-life care; that legalising assisted dying doesn't expand patient choice in respect of palliative care; that growth in palliative care services has stalled in countries where assisted dying has been legalised; and that legalised assisted dying impedes the growth of palliative care or causes it to decline. In each case, it concludes that neither argumentation nor evidence supports these claims.

Allowing patients to die: Louise Aronson and Bill AndereckGeriPal podcast; by Alex Smith, Eric Widera, Louise Aronson, Bill Andereck; 9/5/24In today’s podcast we set the stage with the story of Dax Cowart, who in 1973 was a 25 year old man horribly burned in a freak accident. Two thirds of his body was burned, most of his fingers were amputated, and he lost vision in both eyes. During his 14 month recovery Dax repeatedly demanded that he be allowed to die. The requests were ignored. After, he said he was both glad to be alive, and that the doctors should have respected his wish to be allowed to die. But that was 1973, you might say. We don’t have such issues today, do we? Louise Aronson’s recent perspective about her mother in the NEJM, titled, “Beyond Code Status” suggests no, we still struggle with this issue. And Bill Andereck is still haunted by the decision he made to have the police break down the door to rescue his patient who attempted suicide in the 1980s, as detailed in this essay in the Cambridge Quarterly of HealthCare Ethics.

The Hastings Center awarded $1.5 million by PCORI to study organizational trustworthiness and community-engaged research  EurekAlert! AAAS; Susan Gilbert, The Hastings Center; 8/13/24 A research team at The Hastings Center has been approved for $1.5 million in funding by the Patient-Centered Outcomes Research Institute (PCORI) to study organizational trustworthiness as it relates to community-engaged research. Led by Virginia A. Brown, PhD, a research scholar at The Hastings Center, the study will be the first to investigate the role of organizational trustworthiness in shaping research engagement processes and outcomes.