Literature Review

Palliative care pharmacist discusses how building relationships with patients leads to rewarding career Drug Topics - Voice of the Pharmacist; by Killian Meara; 10/22/24 A discussion with Madison Irwin, PharmD, BCPS, clinical pharmacist specialist in palliative care at University of Michigan Health and clinical assistant professor at the University of Michigan College of Pharmacy. ... Irwin currently works as a clinical pharmacist specialist in palliative care in both inpatient and outpatient settings. She supports a palliative care consult team and outpatient palliative care clinics by seeing patients who are transitioning out of the hospital or patients who have more complex medication management needs. Although there are plenty of challenges that she faces in her practice, Irwin said that really getting to know patients through her work is extremely rewarding. ... In a conversation with Drug Topics, Irwin discussed how her career has unfolded, a program that she worked on that exemplifies the value of pharmacists in patient care, opportunities out there for pharmacists to expand their role, and how high rates of chronic pain will impact the pharmacy profession in the coming years.

Palliative care access for indigenous populations: Removing barriers and reducing disparities ECRI, Plymouth Meeting, PA; by Eileen Cornish; 10/22/24 ... Indigenous populations across North America face barriers to healthcare due to a combination of historical, social, economic, and systemic factors. Key barriers include historical trauma and distrust, remote or rural geography, economic disparities, cultural differences, systemic racism, and discrimination.  ... For this topic, ECRI librarians identified 35 studies, including six systematic reviews, that discuss barriers to palliative care for Indigenous people across North America. ...  Removing Barriers: Here are several key takeaways from the studies we identified. Other barriers are likely exist; however, these common themes emerged from the studies identified in ECRI’s review.

YoloCares: State awards nearly $3 million to YoloCares The Enterprise; by Craig Dresang; 10/19/24 In a move to expand and deepen the regional safety net for people facing a serious or life-limiting illness, Davis-based YoloCares recently applied for, and secured, a nearly $3 million commitment from the State of California to add an Enhanced Care Management component to its portfolio of offerings. By design, ECM intends to address the social determinants of health  which are the nonmedical factors that influence health outcomes. ... [As] Medi-Cal looks towards a major transformation in the structure of benefits, ECM is the Golden State’s initiative to address a lack of palliative and supportive care services.  ... According to Lisa Adams, YoloCares’ director of patient access and palliative care, “Our clinical team is adept at responding to the complex and unique needs of our patients and their families, often going above and beyond the scope of typical palliative care to help our patients find comfort and dignity during health challenges and transitions. This funding and recognition from the state simply acknowledges and supports the work we have been doing all along.”

Nonprofit endeavors to facilitate food justice Towne Post Network; by Julie Yate; 10/17/24 Bringing Justice Home [in Louisville, KY] is a nonprofit organization committed to alleviating hunger caused by food insecurity for those facing disabilities and chronic or serious illnesses. Now in its fourth year, the completely volunteer-run initiative seeks to facilitate food justice by delivering groceries and household supplies to health-compromised families and individuals who fall below the poverty line. Equally important is the relationship building that occurs as resources are shared and volunteers open their hearts to bringing justice closer to home. ... “Bringing Justice Home is a new kind of neighborhood that goes beyond zip codes, race, disabilities, health labels or status,” says Constance Merritt, who co-founded the organization along with her wife, Maria Accardi. Merritt is a published writer and a licensed social worker with a master’s degree from the University of Louisville. She has worked with older adults in low-income senior housing, patients and families in hospital palliative care, and individuals receiving HIV and AIDS services. 

Heartlinks expands hospice, palliative programs with new adult family home Hospice News; by Holly Vossel; 10/16/24 Heartlinks is opening a de novo located in Sunnyside, Washington, with an aim of providing a range of services to seniors in the area. Hospice and palliative care will be a “strong focus” of services provided at the new senior living facility, Heartlinks Adult Family Home, said Shelby Moore, the organization’s executive director. Other services available include 24/7 access to personal care, assistance with activities of daily living, medication management and respite care. The new location is designed to create a peaceful and comforting space for individuals with advanced and life-limiting illnesses in an area that lacks resources for patients and their families, Moore stated. 

Stratis Health builds framework for expanding rural community-based palliative care Hospice News; by Jim Parker; 10/16/24 The health care performance improvement company Stratis Health has developed a framework for expanding access to palliative care in rural communities. The company’s strategy convenes resources and organizations that already exist in a given community to help meet patient’s palliative care, psychosocial, spiritual and social determinants of health needs. It leverages those resources to offer a wraparound suite of services for seniors and seriously ill patients. Hospice News spoke with Karla Weng, senior program manager for Stratis Health, about how health care providers and other stakeholders serving rural communities can come together to better serve their patients and clients. ... The field has shifted in more recent years, so that community-based really means anywhere but the hospital. It might be in a clinic. It might be home care. We’re not that prescriptive. So we have sometimes shifted to using the language “community centric.” The way that we work with communities who are interested in going down this path is helping them first to do a gap analysis and assessment of the resources that are already there in their community.  ... [Click on the title's link to continue reading.]

From bedside to mountaintop, she advocates for meaningful palliative care UCLA Health; by Jennifer Karmarker; 10/14/24 In a society that places a premium on prolonging life, celebrating the end of life is sometimes overlooked. Lindsay Brant, BSN, RN, CCRN, EOLD, MFA, is on a mission to change that. Brant started her work as a critical care nurse in the cardiothoracic ICU at UCLA Health in 2013. Since then, her journey has taken her from the bedside of the critically ill to a mountain retreat in New Mexico to remote high-altitude villages in the Himalayas and back again. Along the way, she’s discovered something she is passionate about sharing: Death can be a beautiful experience, if we let it. “It’s that constant question of how can end of life be as peaceful and meaningful as possible for the patient and their loved ones,” Brant says. 

Palliative care use low in patients with heart failure in the United States Cardiology Advisor; by Ron Goldberg; 10/10/24 Palliative care (PC) use for end-of-life care in heart failure (HF) in the United States is low, with geographic and racial variations in access and application, and PC is becoming necessary for younger, healthier patients seeking a better quality of life, according to study findings published in the Journal of the American Heart Association. ... "PC for HF remains low in the United States. Racial and geographic variations in access and use of PC exist for patients with HF,” the investigators concluded. “These findings suggest that palliative care is not only an end-of-life care for older patients with HF but can be necessary for younger, healthier patients with needs for advanced therapies and for better quality of life.”

Integration of palliative care in the management of multiple chronic conditions: An expert consensus paper with policy implications George Washington University; by Kim Kuebler, DNP, ANP-BC, FAAN, Todd Monroe, PhD, RN, FAAN, Richard Ricciardi, PhD, CRNP, FAAN, Cheryl Westlake, PhD, ACNS-BC, FAAN, Matthew Sorenson, PhD, ANP-C, FAAN, Jane Pederson, MD, MS, Michael Neft, PhD, CRNA, FAAN, Sandra A. Mitchell, PhD, CRNP, FAAN, Kathryn Daniel, PhD, AGNP, FAAN, Susan De Santo-Madeya, PhD, APRN-CNS, FAAN, Susan Renda, DNP, ANP-BC, FAAN, Elizabeth Henneman, PhD, RN, FAAN, Eduardo Bruera, MD; 10/10/24 This paper was jointly developed from members of the American Academy of Nursing Expert Panels on Palliative and End of Life Care, Primary Care, Aging, Acute and Critical Care, and two expert physicians. Purpose: The overarching goal is to promote the integration of palliative care as symptom management into the primary care setting to transform care for patients living with multiple chronic conditions. ... Discussion: Earlier palliative interventions reduce disease exacerbation, prevent hospitalization, maintain physical functioning, and support health-related quality of life. Conclusion: This is a needed paradigm shift as the nation’s aging population escalates, Americans are living longer, and the healthcare costs for the nation are unprecedented. [Click on the title's link for this full description; then scroll down to "Download PDF" for the actual paper.]

Hospital-at-home care’s future still hangs in the balance Home Health Care News; by Joyce Famakinwa; 10/7/24 Even with a proven track record for clinical effectiveness and cost savings, the hospital-at-home model’s future hangs in the balance. “The data suggests that, for the populations that have been studied in multiple different places, it’s a very safe service to be done and with high-quality care, low readmission rates, low escalation rates, low infection rates,” Dr. Adam Groff, co-founder Maribel Health, told Home Health Care News. “The bottom line is people love it, patients love it and it’s a high-quality care experience.” ... In 2020, the hospital-at-home model had its breakthrough. Though the model was common internationally, it was considered niche in the U.S. This changed with the introduction of the Centers for Medicare & Medicaid Services’ (CMS) Acute Hospital Care At Home program. A recent report from CMS found that the program has been largely successful. ... Despite the momentum the model has seen in recent years, challenges still exist when it comes to operations and scalability. Specifically, less than 9% of waiver-approved hospitals accounted for more than 70% of all U.S. admissions, according to data from MedPAC’s June 2024 report to Congress. ... 

Guest column: Hopewest – Breaking the silence: Supporting suicide prevention and survivors of loss Special to the Herald Times; 10/2/24 Those left in the wake of a suicide loss sometimes aren’t sure where to turn or what to do. Uprooted by shock and overcome by the grief of losing someone to suicide can feel painful and isolating. ... The stigma surrounding suicide deaths, particularly on the Western Slope of Colorado, often hinders individuals from seeking the support they need. To address this crisis in our communities, we must not only bring awareness to suicide prevention but also collectively understand and acknowledge the challenges that survivors of suicide loss face. “Grief after the loss of a loved one to suicide is a unique and painful experience. Survivors struggle with a range of challenges, from the heavy weight of stigma surrounding the death, to judgment from others,” said Judy Eskelson, HopeWest Meeker Bereavement Counselor. “And for many in our community, they may not fully understand the ins and outs of this type of grief. Life after this kind of death can be overwhelmingly difficult, leaving families to navigate a path they never expected to walk.” ... Following the devastating loss of a loved one to suicide, the HopeWest bereavement team is here to walk alongside individuals and families needing a source of comfort and guidance through their grief journey. Editor's note: Though many hospices provide bare, minimum grief support, many others--like HopeWest--live out their mission by providing a fuller scope of bereavement counseling and support. What does your hospice provide? Throughout your service area, do bereaved persons (whether hospice deaths or not) think of your agency as the "dying, death and bereavement" expert, or not? 

Hoping to reach 100? You’re not going to like these new life expectancy projections New York Post; by Tracy Swartz; 10/7/24 Let’s keep it 100 — your chances of becoming a centenarian are slim. Medical breakthroughs, public health achievements and better diets led to steep increases in global life expectancy in the 1800s and 1900s. But startling new research finds this momentum has slowed and the biggest boosts to longevity may be in the rearview mirror. “Most people alive today at older ages are living on time that was manufactured by medicine,” said lead study author S. Jay Olshansky, a professor of epidemiology and biostatistics at the University of Illinois at Chicago. “But these medical Band-Aids are producing fewer years of life even though they’re occurring at an accelerated pace, implying that the period of rapid increases in life expectancy is now documented to be over,” Olshansky added. The analysis, conducted with researchers from the University of Hawaii, Harvard and UCLA, includes data from eight countries with the longest-living populations (Australia, France, Italy, Japan, South Korea, Spain, Sweden and Switzerland), Hong Kong and the US from 1990 to 2019.

$1.6M grant to focus on nursing home units to reduce racial disparities in dementia care McKnights Long-Term Care News; by Jessica R. Towhey; 10/3/24 Emory University will use a $1.6 million, federal grant to investigate the role Alzheimer’s special care units play in reducing racial and ethnic disparities in dementia care within nursing homes. The research team will be led by Huiwen Xu, PhD, an associate professor in the university’s Nell Hodgson Woodruff School of Nursing, who specializes in gerontology and elder health. The four-year grant from the National Institute on Aging will analyze quality of life and improved health outcomes in the specialized care units, which the school’s press release said are available in only 14% of nursing homes nationwide. Xu’s team will examine the underlying causes of racial disparities for Black and Hispanic residents, who have limited access to the memory care units, the release said.