Literature Review

4 Benefits of palliative care at home: Personalized and coordinated medical care at home increases quality of life Psychology Today; by Bob Uslander, MD; 12/20/24 ... More than six million people in the U.S. could benefit from palliative care, and, according to the Center to Advance Palliative Care, thousands received it at home last year. Research shows that being cared for at home enhances quality of life because it is usually consistent with one’s life goals. ... 4 Benefits Palliative Care at Home Provides: ...

Mobile app–facilitated collaborative palliative care intervention for critically ill older adults-A randomized clinical trialJAMA Internal Medicine; Christopher E. Cox, MD, MPH; Deepshikha C. Ashana, MD, MBA, MS; Katelyn Dempsey, MPH; Maren K. Olsen, PhD; Alice Parish, MSPH; David Casarett, MD; Kimberly S. Johnson, MD; Krista L. Haines, DO; Colleen Naglee, MD; Jason N. Katz, MD, MHS; Mashael Al-Hegelan, MD, MBA; Isaretta L. Riley, MD, MPH; Sharron L. Docherty, RN, PNP, PhD; 12/24An automated electronic health record–integrated, mobile application–based communication platform that displayed family-reported needs over 7 days, coached ICU attending physicians on addressing needs, and prompted palliative care consultation if needs were not reduced within 3 study days. In this randomized clinical trial, a collaborative, person-centered, ICU-based palliative care intervention had no effect on palliative care needs or psychological distress compared to usual care despite a higher frequency of palliative care consultations and family meetings among intervention participants.

Impact of transition to home palliative care on patient support and prescriptions Physician's Weekly; 12/19/24 The following is a summary of “Evaluating the Benefits of Transition to Home Palliative Care: Pharmacological Prescriptions, Social, and Psychological Support Post-Referral,” published in the November 2024 issue of Primary Care by Ribeiro et al. Community palliative care teams provide at-home care based on referral criteria that prioritize functional status and clinical complexity. They focus on patients with limited benefit from continued hospital care. Researchers conducted a retrospective study to assess the quality of referrals and the transition to community palliative care teams. ... They concluded that most complex patients were successfully monitored and died at home, with hospital deaths reserved for exceptional cases. There was no significant difference in the biopsychosocial approach between patients followed by various palliative care teams, indicating varying approaches. 

Torrie Fields on palliative care and serious illness innovations Teleios Collaborative Network (TCN); podcast hosted by Chris Comeaux; 12/18/24 In this episode of TCNtalks, host Chris Comeaux interviews Torrie Fields, Founder & Chief Executive Officer, TFA Analytics, about her journey in the field of palliative care.  Torrie shares her insights on the importance of palliative care, innovations in reimbursement models, and the lessons learned from implementing palliative care programs in California and Hawaii. The conversation highlights the urgency for hospice organizations to adapt to changing healthcare landscapes by innovating in the serious illness and palliative care space and the need for effective partnerships with payers. Torrie emphasizes the importance of articulating the unique value propositions of palliative care services and offers strategies for hospice leaders to thrive in the future.

Greater education needed to bring palliative care to cancer patients Hospice News; by Jim Parker; 12/18/24 Cancer patients generally need palliative care, but widespread misperceptions often stand in their way, both among the public and many clinicians themselves. This is according to Nadine Barrett, president of the Association of Cancer Care Centers (ACCC). The organization has been holding a series of webinars designed to better educate the oncology community about palliative care. The association is also in the process of studying racial and ethnic gaps in advance care planning, among other projects funded by its research arm, the ACCC Community Oncology Research Institute. Palliative Care News sat down with Barrett to discuss the barriers that cancer patients often experience when it comes to accessing palliative care. [Click on the title's link to read more.]

Palliative medicine for the community paramedic Journal of Emergency Medical Services (JEMS) - The Conscience of EMS; by Maurice Paquette; 12/17/24 The role of the paramedic is evolving. ... EMS has become a catch-all, a gateway into a somewhat—if not totally—fractured healthcare system. ... The landscape of healthcare is shifting as well. The pandemic, coupled with the realization of self-care, well-being, and mental health struggles has caused drastic reduction in the number of healthcare workers, and the amount of experience in skills that those healthcare workers carried with them. ... Over the past many years, we’ve seen a push for the idea of the community paramedic, as well as mobile healthcare. The establishment of a community paramedic program, especially in rural areas of the United States, would provide non-emergent care, under expanded scope and under the direction of a physician in the patient’s home.  According to a literature review in the International Journal of Paramedicine, the most common community paramedic program goals are to “aid patients in chronic disease management, reduce emergency department visits, reduce hospital admissions/readmissions, and reduce Healthcare costs.” Editor's note: Pair this with the article we posted yesterday, Characteristics of patients enrolled in hospice presenting to the emergency department.

Health gap at end of life is now wider in US than any other country Science Alert - Health; by Carly Cassella; 12/16/24 A data-crunching survey covering 183 member nations of the World Health Organization has now confirmed what some scientists feared: while years are being added to most people's lives, healthy life is not being added to most people's year. Researchers at the Mayo Clinic found that people around the world in 2019 were living 9.6 years of life burdened by disability or disease – an increase of 13 percent from 2000. In that same time frame, global life expectancy has increased 6.5 years, and yet health-adjusted life expectancy has only increased 5.4 years. In the US, the gap between lifespan and 'healthspan' is growing particularly wide. Between 2000 and 2019, life expectancy in the US increased from 79.2 to 80.7 years for women, and from 74.1 to 76.3 years for men. When adjusting for healthy years of added life, however, the span only increased by 0.6 years among men. And among women, while health-adjusted life expectancy fluctuated slightly over time, in 2019 it matched the figure seen in 2000. The expanding gap means if an American woman lived to the expected 80.7 years of age, the last 12.4 years of her life would on average be impacted by disease or disability.

Families value flexibility and compassion in end-of-life care for children with cancer Hematology Advisor; by Megan Garlapow, PhD; 12/12/24 Bereaved families of children who died of cancer expressed a strong desire for high-quality end-of-life care that balanced comfort with continued treatment efforts, particularly chemotherapy, according to results from a study published in Cancer. Families did not perceive a conflict between comfort care and the pursuit of chemotherapy, seeking both as integral parts of their child’s final days. Despite variations in race and location, there was no clear preference for home or hospital deaths, ... Instead, decisions surrounding the location of death were often driven by the child’s preferences, medical needs, the impact on other family members, and prior experiences with death. ... Family decision-making was centered on maintaining hope, avoiding harm, and doing what was best for their child and themselves, with religious beliefs playing a significant role.

Two states lead the pack on palliative care access, many lag behind Hospice News; by Jim Parker; 12/10/24 Two states — Massachusetts and Oregon — rise above the rest when it comes to access to palliative care. This is according to the new rankings from the Center to Advance Palliative Care, America’s Readiness to Meet the Needs of People with Serious Illness Scorecard. The scorecard ranks each state’s capacity to deliver high-quality care to people facing serious illness on a five-star scale by evaluating five domains, according to Stacie Sinclair, the associate director for policy and care transformation at the Center to Advance Palliative Care (CAPC). To develop the scorecard, CAPC applied an updated methodology that considers metrics beyond those used in previous reports, which only examined the availability of palliative care in hospitals with 50 beds or more. 

What adult children should know when discussing their parents’ end-of-life care StudyFinds; by StudyFindsStaff, reviewed by Christ Melore; 12/8/24 Talking about death can be difficult for anyone at any time. For adult children who need to know their parents’ final wishes, it can be excruciating. A new survey is revealing the stark disconnect between our beliefs and actions when it comes to end-of-life planning. While an overwhelming 90% of adults recognize the importance of these critical conversations, half have yet to take the first step with their closest loved ones. ... The numbers tell a revealing story. Twenty-six percent of respondents simply keep putting off the conversation, while 23% admit they don’t know how to approach the topic. Sixteen percent are outright scared to broach the subject, creating a wall of silence around a universal human experience. ... When people do open up, the conversations prove surprisingly rich and multifaceted.

Forcura and Axxess announce palliative care software integration Bluefield Daily Telegraph, Jacksonville, FL; Business Wire; 12/9/24 Forcura, a healthcare workflow management company, announced a strategic partnership enhancement with Axxess, the leading global technology platform for healthcare at home, by expanding connectivity to Axxess’ palliative care platform. Consequently, Axxess’ palliative care client organizations now can manage the workflow associated with onboarding and coordinating care for patients through a bi-directional API integration with Forcura. Together, Forcura and Axxess can provide shared home health, hospice, home care and palliative care clients a seamless interoperable experience.

Embracing well-being at the end of life Phaneuf Funeral Homes & Crematorium; by Phaneuf; 12/5/24At the 29th Annual Fall Hospice & Palliative Care Conference, Dr. Ira Byock delivered a thought-provoking keynote challenging the misconceptions surrounding hospice and palliative care and illuminating a brighter path forward for individuals, families, and caregivers. ... Far too often, hospice and palliative care services are seen as a last resort or equated with “giving up.” Dr. Byock pushed back against this notion, emphasizing that hospice and palliative care are not about death but about life. “Hospice and palliative care are about living as fully and as well as possible through the end of human life,” Dr. Byock said. Rather than signifying the end of healthcare options, palliative care provides comfort, dignity, and even joy for individuals facing life-limiting conditions. Dr. Byock shared that families often express relief and gratitude after beginning hospice care, lamenting that they hadn’t learned about it sooner. These experiences highlight a common issue: Hospice care is often introduced too late, preventing families and patients from reaping its full benefits. 

The ISNP opportunity for hospice providers  Hospice News; by Jim Parker; 12/5/24 Hospice providers can collaborate with institutional special needs Medicare Advantage plans (ISNP) to reach patients who reside in long-term care facilities. ISNPs restrict enrollment to MA eligible individuals who, for 90 days or longer, have had or are expected to need the level of services provided in a long-term care (LTC), skilled nursing facility, a LTC nursing facility, intermediate care facility for individuals with intellectual disabilities (ICF/IDD), or an inpatient psychiatric facility. The nonprofit senior services organization Empath Health, which operates several hospices, recently partnered with the MA organization American Health Plans to bring their services to ISNP-enrolled patients.