Literature Review

"A wholeness that grows out of that which is lacking": Providing palliative care to patients with anorexia nervosaPsychiatric Times; by Rabbanit Allissa Thomas-Newborn, BCC; 6/13/24Sitting with the patient, I brought in a nesting doll, separating each doll and lifting the layers of self that surrounded the smallest version of herself within. We spoke about layers. Layers and walls we put up to protect ourselves. Layers that hide the things we are afraid for anyone—worst of all, ourselves—to see. Layers that embrace and comfort and hold us together. ... With the fullness of the nesting doll displayed, we gave witness to her story together. ... To see ourselves as stories of wholeness growing out of that which is lacking requires that we accept what is lacking without judgment. We do not need to fix or fill whatever is lacking, or to pretend it is not there. It is there and may always be there. And there is a wholeness that can still grow. Editor's Note: Rabbanit Thomas-Newborn is a board-certified chaplain at New York-Presbyterian Columbia University Irving Medical Center and Morgan Stanley Children’s Hospital. She specializes in Behavioral Health, Palliative Care, and Critical Care chaplaincy. She is the president of Neshama: Association of Jewish Chaplains. 

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.

WorldView announces Referral AI, the most accurate referral classification platform to increase home health and hospice revenue Investors Observer; by PR Newswire; 6/10/24 WorldView , a leading provider of integrated healthcare technology to the top home health and hospice EHR/EMR platforms, today announced the upcoming launch of Referral AI, an enhancement to automate intake referrals using a custom AI/ML model built specific for the healthcare industry. ... Home health and hospice agencies receive many forms of electronic documents in their inbox, including referrals for new patient service. Referrals must be acted on quickly, but with documents being dozens of pages, they often sit unread or, worse, are missed or overlooked. Over time, the referral can become invalid, resulting in lost revenue for the agency and posing a risk of delayed service for patients.

Governor on hand for PACE openingNews-ExpressKy, Pikeville, KY; by Terry L. May; 6/7/24Mountain View PACE (Program of All-Inclusive Care for the Elderly) was created to help adults 55 years old and older with complex care needs to avoid nursing homes and to receive care and services necessary to help them be safe, comfortable, and healthy while maintaining a more independent lifestyle, Mountain View PACE Medical Director Dr. James Rummel Jr. said. ... “For those of us who have aging parents, we see this cycle of people who are having a hard time living well at home so they tend to do this circle of home to the ER to the hospital to the nursing home for rehab then back home and it keeps repeating.” ... “We are not trying to replace anybody,” Rummel said. “We are trying to augment the system to fill the gaps. We are a niche type of healthcare system.” ... “What a great day in Pikeville and Pike County,” Governor Beshear said. “How we treat our seniors says something about us and our values as a people." 

Design, creation, and 13-month performance of a novel, web-based activity for education in primary cardiology palliative care Journal of Pain and Symptom Management; by Jill M Steiner, Caroline L Doherty, Jill A Patton, Jadry Gruen, Sarah Godfrey, John Mulrow, Richard A Josephson, Sarah J Goodlin; 6/5/24 online ahead of print Cardiovascular disease (CVD) clinicians who care for seriously ill patients frequently report that they do not feel confident nor adequately prepared to manage patients' palliative care (PC) needs. With the goal, therefore, of increasing PC knowledge and skills amongst interprofessional clinicians providing CVD care, the ACC's PC Workgroup designed, developed, and implemented a comprehensive PC online educational activity. This paper describes the process and 13-month performance of this free, online activity for clinicians across disciplines and levels of training, "Palliative Care for the Cardiovascular Clinician" (PCCVC).Editor's Note: Reiterating, this "free, online activity [is] for clinicians across disciplines and levels of training." The trajectories for cardiovascular diseases can elicit enormous anxiety--due to their roller-coaster changes that can result in sudden death--in contrast to the more predictable trajectories for cancer. Whether you use this resource or another, educate your interdisciplinary clinical managers and team members to the all-important disease and care factors for cardiology palliative care, relevant to the scope of professionals' different roles. 

Palliative care in the intensive care unit: The standard of care AACN - American Association of Critical-Care Nurses; by Clareen Wiencek, PhD, RN, ACNP, FAAN; 6/7/24Intensive care unit–based palliative care has evolved over the past 30 years due to the efforts of clinicians, researchers, and advocates for patient-centered care. ... This article provides an overview of the current state of intensive care unit–based palliative care, examines how the barriers to such care have shifted, reviews primary and specialist palliative care, addresses the impact of COVID-19, and presents resources to help nurses and intensive care unit teams achieve optimal outcomes. [Access to the full article requires subscription or purchase of the individual article.]

Telehealth delivers early palliative care as effectively as in-person careAJMC, American Society of Clinical Oncology; by Laura Joszt, MA; 6/2/24 Early palliative care can be delivered via telehealth with equivalent quality-of-life effects as palliative care delivered in person to patients with advanced non–small cell lung cancer (NSCLC), according to late-breaking results presented during [a] plenary session at the 2024 American Society of Clinical Oncology (ASCO) annual meeting. Whether the palliative care was delivered in person or via telehealth, the most common topics discussed during the visit were similar and included building and establishing rapport to create a relationship with the patient and their family, identifying symptoms and grading symptom management, and coping with serious illness, explained Joseph Greer, PhD, codirector of the Cancer Outcomes Research & Education Program at Massachusetts General Hospital Cancer Center and associate professor of psychology in the Department of Psychiatry at Harvard Medical School ...

ASCO updates Guidelines on Palliative Care Hematology Adviosor; by Jen Smith; 5/30/24 The American Society of Clinical Oncology (ASCO) has released an update to its guidelines on palliative care for cancer patients. The guidelines and related information were published in the Journal of Clinical Oncology and JCO Oncology Practice. To develop updated recommendations for integrating palliative care into cancer care, an expert panel reviewed randomized controlled trials, systematic reviews, and meta-analyses published during 2015-2023. Based on their findings, the experts recommend that patients with advanced cancer be referred to specialized interdisciplinary palliative care teams soon after diagnosis, while the patients are still receiving active cancer treatment.

New study finds underutilization of early palliative care for patients with advanced cancer mostly attributable to provider and organizational characteristics American Cancer Society; 5/28/24 A new study led by researchers at the American Cancer Society (ACS) shows despite considerable growth in early palliative care (PC) use, utilization among patients with advanced cancer remained low from 2010 to 2019. ... Early integration of palliative care is recommended for advanced-stage cancers, but evidence of its use and the role of provider and organizational characteristics in its uptake is limited. ... Early PC was defined as receipt of PC within 90 days post-diagnosis and before hospice admission, if any. ... Study authors stress the large variation between providers and organizations suggest important modifiable provider behaviors and organizational characteristics in early PC receipt, ...

How palliative care is changing in today’s health care environment Hospice News; by Molly Bookner; 5/29/24 As the palliative care field continues to grow and transform, understanding the current trends, outlook, relevant challenges and necessary skills for future leaders is critical. Two significant trends impacting the field of palliative care currently, according to experts, are the expansion of services and the integration of technology, particularly artificial intelligence (AI). Dr. Vicki Jackson, board president of the American Academy of Hospice and Palliative Medicine (AAHPM), noted that palliative care has demonstrated a positive impact on patient-reported outcomes across various illnesses, including cancer, heart, liver, kidney disease and dementia. 

Disparities in palliative care use for patients with blood cancer who died in the hospital The American Journal of Hospice & Palliative Care; by Tien-Chan Hsieh, Yee Hui Yeo, Guangchen Zou, Chan Zhou, Arlene Ash; 5/27/24 online ahead of printBackground: Palliative care can enhance quality of life during a terminal hospitalization. Despite advances in diagnostic and treatment tools, blood cancers lag behind solid malignancies in palliative use. It is not clear what factors affect palliative care use in blood cancer. Conclusions: This study highlights disparities in palliative care use among blood-cancer patients who died in the hospital. It seems likely that many of the 46% who did not receive palliative care could have benefitted from it. Interventions are likely needed to achieve equitable access to ideal levels of palliative care services in late-stage blood cancer.