Literature Review

Lawmakers remain committed to passing hospice workforce bill Hospice News; by Jim Parker; 6/24/24 Federal legislators plan to continue to work on passing a bill designed to bolster the hospice and palliative care workforce. The Palliative Care and Hospice Education Training Act (PCHETA) has come before Congress several times but has not yet been passed. The bill’s most recent development occurred in July 2023, when it was reintroduced by Sens. Tammy Baldwin (D-Wisc.) and Shelley Moore Capito (R-W.Va.). Capito has indicated that the senators are not giving up on the legislation as they seek to ensure that hospice and palliative care providers are able to meet growing demand. ... The legislation would establish fellowships through new palliative care and hospice education centers to provide short-term, intensive training, as well as incentivized award programs across all the relevant disciplines. It also would support programs to develop career paths within the field.

Hospice of Marion County trains first responders to care for dementia patients Hospice News; by Jim Parker; 6/18/24 Florida-based Hospice of Marion County, an affiliate of Empath Health, is training first responders in its community on how to treat dementia patients. For several years, the nonprofit hospice has been educating family caregivers and others in their community about the experiences of dementia patients and how to better interact with them. More recently, Hospice of Marion County [Ocala, Florida] has been expanding that training to include local law enforcement and fire departments, as well as medical students and staff at assisted living facilities, among others. The training uses a series of tools to simulate symptoms of dementia, related to visual, tactile, auditory senses, their ability to process information and perform certain tasks. The education helps first responders address the unique challenges associated with caring for dementia patients, according to Dr. Mery Lossada, chief medical officer of Hospice of Marion County.Editor's Note: Bravo, Hospice of Marion County!

When your parents die: Becoming an adult orphan The Montecito Journal; by Deann Zampelli; 6/18/24 Shortly after I got married, my 64-year-old mother lost her battle with breast cancer. Seven years later my father joined her. The loss isn’t any less painful just because you are a grown-up. ... Many don’t realize that grief isn’t linear. We don’t go through a neat little phase, checking off each stage as we complete it. The famous (and somewhat debunked) five stages of grief introduced by Elisabeth Kübler-Ross in the 1960s (Denial, Anger, Bargaining, Depression, Acceptance) were from a study she did on the emotional states of patients who were dying. It was their stages she was referencing, not ours. ... I came to a frightening realization. ...  It suddenly dawned on me that my siblings and I were next in line to kick it. [Click on the title's link to continue reading.]Editor's Note: While serving in your hospice leadership roles, you experience the ongoing aging, changes and likely even deaths of your own family members, friends, and mentors. Do you, your hospice communications, and/or your grief services rely on the outdated "Stages of Grief" model? These "stages" opened the door in the 1960's for talking about death and dying, but became overpopularizd for surviving and healing after the loss. These have been replaced with extensive bereavement/loss/grief research, clinical best practices, and more. For expert information, resources, and bereavement professionals, examine www.adec.org,  the Association for Death Education and Counseling. 

Hope in oncology: Where art and science collide Medscape; by Sharon Worcester, MA; 6/12/24 Carlos, a 21-year-old, laid in a hospital bed, barely clinging to life. Following a stem cell transplant for leukemia, Carlos had developed a life-threatening case of graft-vs-host disease. But Carlos' mother had faith. "I have hope things will get better," she said, via interpreter, to Richard Leiter, MD, a palliative care doctor in training at that time. "I hope they will," Leiter told her. "I should have stopped there," said Leiter, recounting an early-career lesson on hope during the ASCO Voices session at the American Society of Clinical Oncology (ASCO) 2024 annual meeting. "But in my eagerness to show my attending and myself that I could handle this conversation, I kept going, mistakenly." ... Carlos' mother looked Leiter in the eye. "You want him to die," she said. ...Editor's Note: Click on the title's link to continue reading this insightful reflection and discussion about the importance of "hope." Engage your oncology/palliative/hospice chaplains (hopefully CPE trained and Board Certified) with your medical team members to explore this core belief in "hope." Alert: AI referrals for palliative and hospice care are increasing exponentially. Clinicians must be sensitive to the human dimensions and dynamics of "hope" (which shift and change), and not be driven just by technological data.

The Aging Revolution: Growing old in America becoming more dignified, but with senior population booming, is nation’s health system prepared?BusinesssWire; 6/4/24A half-century after renowned gerontologist, psychiatrist and author Dr. Robert Butler ridiculed the nation’s medical establishment for ignoring the suffering of older Americans, Northwell Health today announced the publication of The Aging Revolution: The History of Geriatric Health Care and What Really Matters to Older Adults, which chronicles the significant advancements made in improving the physical and emotional health of the nation’s rapidly aging population. 

19 myths about dying people need to stop believing Million Dollar Sense; by Anuradha Supun; 5/29/24 

Three ways to communicate with Gen-Z—and why it’s importantForbes; by Clarissa Windham-Bradstock; 5/28/24"It’s not what you said, it’s how you said it!" ... Gen-Z (born 1996-2015) is leading the charge on this one, according to a new Gallup survey. ... They want to hear full transparency. ... How to Speak Gen-Z: ...

State-level initiatives tackle language-based barriers to worker training, testing McKnights Senior Living; by Kimberly Bonvissuto; 5/20/24Foreign-born workers account for 27% of the nation’s direct care workforce, but many states maintain strict, English-only testing and training requirements that can prevent some immigrants from entering the workforce, according to the results of a new analysis. PHI looked at five state initiatives working to address those language-based barriers to workforce training and certification with a goal of expanding opportunities for workers who do not speak English as their primary language. PHI highlighted initiatives in five states — California, Massachusetts, New York, Washington and Wisconsin — using approaches deemed innnovative to make progress in addressing language access barriers for direct care workers. [Click on the title's link for solutions these five states are using.]

Educating the future of hospice and palliative carePortage.life; by Center for Hospice Care; 5/21/24This spring students at the University of Notre Dame gained insight into the delivery of care to patients and families dealing with serious advanced illnesses. The university, in partnership with Center for Hospice Care (CHC), once again offered the course “Introduction to Hospice and Palliative Care” that was designed by Dr. Dominic Vachon, Director of Ruth M. Hillebrand Center for Compassionate Care in Medicine and Mike Wargo, COO and vice president of the Hospice Foundation. The five-week class covered a variety of topics focused on hospice and palliative care and was taught by CHC staff including physicians, social workers, chaplains, bereavement counselors and other hospice and palliative care support staff.

Cooling down the clinic: How to de-escalate angry patients and family members Oncology Nurse Advisor; by Kathleen Wolf, MBA, BSN, RN, NEA-BC; 5/17/24Handling challenging interactions with patients and families can be a source of stress for oncology nurses. Patients and caregivers could be feeling angry for any number of reasons. The key is to not take their anger personally. It’s more productive to instead understand the cause of their anger. [Read more for common causes and basic de-escalation strategies.]

When families fight over a relative with dementia, it’s time to call in the mediator The New York Times; by Paula Span; 5/13/24 Trained negotiators can help families struggling with vexing elder-care issues.  The four adult children were in agreement. Their father, William Curry, a retired electrical engineer and business executive, was sinking deeper into dementia. ... [But their mother] remained determined to continue caring for her 81-year-old husband at home, despite the increasing toll on her own health. ... As the weeks passed, “we were really at an impasse,” [a daughter] said. “Do you override your mother?” ...  [Increasingly,] families seek elder mediation privately, before disputes land in court and imperil or destroy family relationships. [Continue reading for descriptions of how mediation differs from arbitration, from family therapy, and for cautions about this being "a fairly new field with no nationwide certification or licensing requirements."]Editor's Notes: Executive leaders, what community education and resources are you providing for Advance Directives? What family systems education and and problem-solving are you providing for your interdisciplinary team members and grief counselors? Family conflicts are inherent--in some form or fashion--with almost anyone needing dementia care, especially when paired with palliative or hospice care. (If in doubt, ask your seasoned, front-line professionals.)

The Check-Up: How seniors can better take care of their mental health The Keene Sentinel; by Olivia Belanger Sentinel Staff; 5/8/24 My generation talks about mental health a lot. In our late 20s, my friends and I routinely check in to see how we’re feeling, reschedule plans because we’re in a mental funk or talk about how we can help support each other when we’re not feeling mentally healthy. ... But I know that for older generations, this can be hard to come by. ... [Older] adults are more likely to experience life changes — like coping with a serious illness or losing a loved one — which can lead to feelings of grief, social isolation or loneliness, according to the National Institute of Mental Health (NIMH). Loneliness in particular is one of the biggest threats to seniors, especially those who live in rural areas like the Monadnock Region where reliable transportation is limited. Research shows loneliness is as bad for people’s health as smoking 15 cigarettes per day, according to the U.S. Surgeon General. Signs that you may need to help your mental health, NIMH says, include: ...