Literature Review

Integration of palliative care across the spectrum of heart failure care and therapies: considerations, contemporary data, and challengesCurrent Opinion in Cardiology, by Sarah Chuzi and Katharine Manning; online ahead of May 1, 2024 printRecent findings: Patients with chronic heart failure [HF], as well as those who are being evaluated for or who have undergone advanced HF surgical therapies such as left ventricular assist device or heart transplantation, have a number of palliative care [PC] needs, including decision-making, symptoms and quality of life, caregiver support, and end-of-life care. ... PC skills and teams may also help address preparedness planning, adverse events, and psychosocial barriers in patients who have had HF surgeries, but more data are needed to determine association with outcomes.

Should we be using palliative care for scleroderma? The Medical Republic, by Karina Bray; 4/2/24Almost three-quarters of systemic sclerosis patients could benefit from specialist palliative care, according to Australian research. The first-of-a-kind study, published in Arthritis Care & Research, set out to examine and quantify the need for palliative care to address high symptom burden as an integrated part of systemic sclerosis management. ... “Almost 75% of SSc patients may benefit from specialist palliative care input to manage specific severe symptoms, and the overlapping nature of such symptoms highlights the complex symptom management needs of SSc patients,” the authors wrote. 

Hospice care for those with dementia falls far short of meeting people’s needs at the end of life ArcaMax, Maria J Silveira, University of Michigan; 4/1/24... Strikingly, only 12% of Americans with dementia ever enroll in hospice. Among those who do, one-third are near death. This is in stark contrast to the cancer population: Patients over 60 with cancer enroll in hospice 70% of the time. In my experience caring for dementia patients, the underuse of hospice by dementia patients has more to do with how hospice is structured and paid for in the U.S. than it does patient preference or differences between cancer and dementia.

High intensity of end-of-life care for minority patients with lung cancerU.S. Medicine; 3/27/24While disparities in lung cancer mortality among racial and ethnic minorities are well documented, not as much is understood about how racial and ethnic minority patients with lung cancer are treated at the end of life. A study led by researchers from the Indiana University School of Medicine and the Richard L. Roudebush VAMC, both in Indianapolis, sought to determine if those patients experience higher rates of intensity of care at the end of life (EOL) compared with non-Hispanic white (NHW) patients.

Alzheimer’s deaths expected to grow and industry not prepared with workers, report show Journal-News, by Samantha Wildow; 3/26/24The number of Alzheimer’s deaths in the U.S. more than doubled between 2000 and 2021, the Alzheimer’s Association says in its latest report, which details how about half of health care workers say their industry is not fully equipped to handle the growing population of people with dementia. ... Multiple factors play into why deaths to Alzheimer’s disease and other forms of dementia are increasing, including how the health care system is getting better at treating other things like heart disease and cancer, one local doctor said.

What is the FAST scale for Alzheimer's?MedicalNewsToday, by Charlotte Lillis and medically reviewed by Shilpa Amin, MD, CAQ, FAAFP; 3/25/24The Reisberg Functional Assessment Screening Tool (FAST) is a scale that doctors use to diagnose and evaluate aspects of Alzheimer’s disease. ... This article provides an overview of the FAST tool, including a breakdown of its individual stages. It also outlines what to expect from the FAST evaluation, what the scale means for hospice care, and more.

"A strong reason why I enjoy coming to work": Clinician acceptability of a palliative and supportive care intervention (PACT) for older adults with acute myeloid leukemia and their care partners Journal of Geriatric Oncology; by Ayomide Okanlawon Bankole, Natasha Renee Burse, Victoria Crowder, Ya-Ning Chan, Rachel Hirschey, Ahrang Jung, Kelly R Tan, Susan Coppola, Mackenzi Pergolotti, Daniel R Richardson, Ashley Leak Bryant; 3/20/24 Introduction: ... In this study, we examined clinician acceptability of a NIH-funded interdisciplinary PAlliative and Supportive Care inTervention (PACT) for older adults with acute myeloid leukemia (AML) and their care partners that transcends both inpatient and outpatient settings. Results: ... Five themes were identified in the thematic analysis: (1) Emotions and affect towards the intervention, (2) Intervention coherence and self-efficacy, (3) Barriers, burden, and opportunity costs of delivering the intervention, (4) Usefulness and effectiveness of the intervention, and (5) Recommendations to improve intervention delivery.

Report: Alzheimer's and dementia caregivers total 840K in Florida, bear heavy burden NPR WMFE, by Joe Byrnes; 3/22/24The number of Floridians serving as caregivers for people with Alzheimer's and other dementias is an estimated 840,000, an increase of 13,000 in just one year, according to an annual report from the Alzheimer's Association. Caregiving takes a toll on families hit by the degenerative brain disease, but a new program from the Centers for Medicare and Medicaid Services could lessen that burden. ... [This] promising resource in the works is the Guiding an Improved Dementia Experience Model, an approach that includes the patient and caregiver. The GUIDE Model -- through the Centers for Medicare & Medicaid Services -- starts in July. 

Signs of end-stage Parkinson's disease Medical News Today; Medically reviewed by Heidi Moawad, MD, by Meara Withe; 3/18/24... Understanding the signs of end-stage Parkinson’s disease is crucial for patients, caregivers, and healthcare professionals alike. This article explores the physical health, mental health, and emotional dimensions of end-stage Parkinson’s, shedding light on what to expect and how to provide compassionate care during this demanding phase. Editor's Note: Hospice and palliative non-medical interdisciplinary team members need to understand disease-specific factors related to the patient's experience and the family caregiver's challenges. These include social workers, chaplains, counselors, and caregiver-oriented volunteers.  

Clinician perspectives on integrating neuro-oncology and palliative care for patients with high-grade glioma  Oxford Academic Neuro-Oncology Practice; by Rita C Crooms, MD MPH; Jeannys F Nnemnbeng, MD MS RRT; Jennie W Taylor, MD MPH; Nathan E Goldstein, MD; Ksenia Gorbenko, PhD; Barbara G Vickrey, MD MPH; 3/14/24  Background/objectives: Patients with high-grade glioma have high palliative care needs, yet few receive palliative care consultation. This study aims to explore themes on 1) benefits of primary (delivered by neuro-oncologists) and specialty (SPC) palliative care and 2) barriers to SPC referral, according to a diverse sample of clinicians.

Palliative and end-of-life care in hematologic malignancies: Progress and opportunities JCO Oncology Practice, by Mazie Tsang, MD, MAS, MS and Thomas W. LeBlanc, MD, MA, MHS, FAAHPM, FASC; 3/13/24 ... An important finding from this study was the qualitative data from narratives of volunteer caregivers and hospice staff that described daily patient care, changes in patient status, perceived symptom burden, and indications for medication administration. The authors identified skin integrity concerns, bleeding, pathologic fractures, and delirium as unique issues for patients with hematologic malignancies enrolled on hospice. ... These findings provide further evidence that hospice care can and does work well for some patients with hematologic malignancies. 

[ALS] Controlling what can be controlled: Palliative Care ALS Association [Amyotrophic Lateral Sclerosis, commonly known as "Lou Gehrig's Disease]; 3/13/24 “Palliative care specialists can help people determine and define what are the ‘everyday things’ that matter to them. Some people may already know what these are but may not have had an opportunity to share this information with their health care team,” Dr. Mehta says. “Others may not know they can share this with their health care team. They may not know where to find help with these ‘everyday things.’ [Dr. Ambereen K. Mehta, MD, MPH, FAAHPM, associate professor of palliative care in the Departments of Medicine and Neurology at the Johns Hopkins School of Medicine]Editor's Note: Are your palliative care services connected with your local ALS Association? This page on the ALS website describes beautifully the benefits of palliative care as soon as the diagnosis occurs.