Literature Review

[UK] End-of-life care demand for dementia patients set to surge, study warns Jersey Evening Post, United Kingdom; by UK News; 9/16/24 The number of people living with dementia who require end-of-life care is set to “substantially increase” in the coming years, according to a study. ... Researchers said: “Previous projections of the number of people with dementia who will have palliative care needs in England and Wales were based only on the number of people who died with dementia, and did not take into account people living with dementia. Thus, it is likely that the prevalence of palliative care needs among people with dementia in England and Wales has been considerably underestimated. Our analysis shows that even if dementia incidence declines between 2018 and 2040, the number of people living with dementia in England and Wales who have palliative care needs will increase substantially by 2040, reaching levels far greater than previous estimates based on mortality data.”Editor's note: How do these projection processes in the UK compare or contrast with the USA data you use? For more immediate information about current resources, click here for the Alzheimer's Assocation "Support for People Living With Dementia" and click here for 

Improving access to palliative care for patients with cancer JAMA - JN Learning; podcast by Eduardo Bruera, MD; 9/11/24 Palliative care is an essential component to high-quality care for patients with cancer. How can access to palliative care be expanded? Eduardo Bruera, MD, from MD Anderson Cancer Center speaks with JAMA Editor in Chief Kirsten Bibbins-Domingo about 2 new trials in JAMA that address access to care and what more it will take for executives, insurers, and regulators to support palliative care programs. [Podcast: 11 minutes 53 seconds] 

A dying wish: Longtime hospice volunteer has a challenge for GV Green Valley News, Green Valley, AZ; by Dan Shearer; 9/10/24 ... The woman who walked alongside dying patients as a hospice volunteer for more than 20 years is now herself in hospice. She smiles but says the glistening in her eyes are sad tears. But cancer hasn't taken her joy, and she’s emotionally strong enough to meet with a reporter in her final weeks to make a request of Green Valley: Please consider taking up just the kind of work she’s been doing for two decades. It’s tough, but it comes with lessons and blessings that last a lifetime. ...

Too Much, Too Little, Just Right: Optimizing cancer care for older adults The ASCO Post, American Society of Clinical Oncology; by Ramy Sedhom, MD; Bobby Green, MD; and Julia  Frydman, MD, MS; 9/10/24 Imagine walking into a fancy restaurant only to find a menu consisting mostly of kids’ dishes. It would make no sense. Just 25% of restaurant diners are younger than age 12, and they rarely write Yelp reviews. But when it comes to cancer treatment, this is not very far from what we do. The median age for a new cancer diagnosis is 67, and among those who die of cancer each year, 73% are older adults. Yet just one in four clinical trial participants is aged 70 or older. Consequently, guidelines for most new cancer therapies are based on a median age that is significantly younger than the patient population who actually receives these therapies. That’s quite a conundrum. More than half of patients older than age 65 experience toxicity of grade 3 or worse while undergoing standard chemotherapy. ... Palliative Care—For a 40-year-old mother of two young children, the goal of cancer treatment is usually clear: complete remission and long-term survival. But when you ask older patients with cancer about their priorities, a majority regard symptom control, emotional coping, and other quality-of-life measures at least as much as longevity and sometimes more.

CHCF unveils palliative care mural California Department of Corrections and Rehabilitation (CHCF); by Lt. M. Orozco; 9/9/24 California Health Care Facility (CHCF) staff joined the incarcerated population and outside stakeholders to unveil the palliative care mural Aug. 23. Warden Gena Jones had a vision to normalize CHCF’s environment, making it more appealing for the incarcerated population and staff to enjoy while working. The vision consists of murals being painted throughout the institution with this mural setting the path for many more to come. In April 2024, incarcerated artists Issac Sinsun, Antiono Garcia, Loreto Arizpe, and Francsico Olivares started the palliative care mural. Little did they know it was the start to a new beginning. With the combined efforts of the four artists, the mural took 81 days and about 2,268 hours to complete. The ideas for the artwork were a combined effort from custody and medical staff as well incarcerated population within the housing unit. [Click on the title's link to see photos.]

Blue Ridge Hospice expanding mission to serve people better, sooner The Winchester Star, Winchester, VA; by Brian Brehm; 9/9/24 “We’re calling this a year of transformation,” said Jason Parsons, who was named CEO of the Winchester-based nonprofit in December. “Blue Ridge has been around for 43 years and this year, 2024, we’re transforming ourselves into Blue Ridge Care, which includes Blue Ridge Hospice, Blue Ridge Independence at Home — which is our PACE (Program of All-Inclusive Care for the Elderly) program — Blue Ridge Palliative Care Services and our eight thrift shops.” It’s a sweeping change for an organization that most people only associate with end-of-life care. Parsons ... said Blue Ridge Care will continue to provide graceful exits for patients in the final chapter of their lives, but it will also expand its focus to improve the quality of life for seniors who still have a lot of stories to tell.

Palliative care for dialysis-dependent pediatric patients: A survey of providers, nurses, and caregiversKidney360; Joshua Lipsitz, Mark Stockton Beveridge, Katherine Maddox; 8/24Dialysis-dependent pediatric patients and their families face significant biopsychosocial burdens and low health-related quality of life. Palliative care consultations can alleviate some degree of suffering for patients and families but remain underutilized within pediatric nephrology. 90% of providers and all nurses desired more palliative care education. Of the 22% of caregivers whose child had already received palliative care services, all found the consultation to be helpful. These data support further palliative care education for pediatric nephrology providers and nurses and more robust and systematic involvement of subspecialty palliative care for dialysis-dependent pediatric patients.

ASCO palliative care expert panel provides recommendations to integrate health equity into guideline development OncLive, Cranbury, NJ; by Kyle Doherty; 9/4/24 The ASCO Palliative Care Expert Panel [American Society of Clinical Oncology], in collaboration with ASCO’s Health Equity and Outcomes Committee, has published recommendations for integrating health equity measures into future guideline updates. Recommendations advocated for partnerships with increased representation from historically marginalized groups and patient and community-based advocates; a reinforcement of implicit bias training for Expert Panel members as a component of guideline preparation; stratified recommendations and/or guidelines for additional groups; and the review and appraisal of future recommendations by the Expert Panel, patient as well as community advocates, and ASCO reviewers for the inclusion of proper health equity measures before publication.

“What I wish I knew about hospice”: A Cleveland Clinic palliative care physician’s insights The Healthy; by Dr. Patricia Varacall, DO; 9/3/24 End-of-life care is deeply personal and incredibly complex. An expert MD shares essential insights on hospice: "At its core, is about human connection." … Laura Hoeksema, MD, MPH, FAAHPM, medical director of Cleveland Clinic Hospice and staff physician in the department of palliative and supportive care, explains the importance of hospice: “Death is a part of life just as much as birth is. When time becomes limited, patients need to be able to spend time in a way that’s meaningful to them.” ... Dr. Hoeksema emphasizes that choosing hospice care is exactly that—a choice. The team offers additional support, guiding patients and their families through the last months of life. ... “When a patient has a serious illness, it’s common for their illness to become the primary focus,” reflects Dr. Hoeksema. The constant anticipation of how the disease might progress can create overwhelming anxiety. With hospice, the illness recedes into the background, allowing the emphasis to be on caring for the person as a whole. ... “The most profound healing I’ve witnessed as a physician has been in patients receiving hospice care,” Dr. Hoeksema adds. She recalls seeing families reconcile after years of tension and others coming together after long periods of distance. The joy on a patient’s face when surrounded by loved ones, laughing and reminiscing, is what it’s all about. “Hospice care, at its core, is about human connection.”

CareXM and Enhabit increase clinician capacity by 250% using virtual visits amid staffing shortages GlobeNewswire; by CareXM; 8/27/24 CareXM ... is proud to announce  some of the exciting results with Enhabit in their quick connect Virtual Visits platform. ... “We saw an increase in clinician capacity, allowing us to do more with less,” says Vice President of Care Management Shelley Baker of Enhabit, which provides care annually to 228,000 patients. “Completing visits virtually, when appropriate, has freed up our clinicians to better manage their schedules so they can be with patients who need hands-on care.” "While virtual visits do not replace the need for in-home visits, they do offer the ability to connect with patients more frequently, supplementing the visits that do need to be in-person,” said Si Luo, CEO at CareXM, “We see a growing need not just for visit utilization but for visit prioritization- let’s save our field nurses for those visits that truly do need to be in-person. ..."

New ASCO Guidelines stress importance of early palliative care Hospice News; by Jim Parker; 8/26/24 The 2024 update to the American Society of Clinical Oncology’s (ASCO) clinical practice guidelines place renewed emphasis on palliative care. The guidelines are updated periodically by a multidisciplinary team, including a patient representative and experts in medical and radiation oncology, hematology and palliative care. For the 2024 revisions, this panel reviewed 52 randomized controlled trials that evaluated outcomes among cancer patients who received palliative care, ASCO reported. “This is a pivotal time,” the panel’s co-chair Betty Ferrell of City of Hope Cancer Care told the ASCO Post. “This guideline is a call to action for everyone to think about how they are integrating palliative care for all patients with cancer. There are great advances in cancer care, but none of these will be fully effective unless we fully integrate palliative care.”

Improving post-hospital care of older cancer patients Cancer Health; by University of Colorado Cancer Center and Greg Glasgow; 8/26/24 A few years ago, University of Colorado Cancer Center member and hospitalist Sarguni Singh, MD, began to notice a troubling trend: Older adults with cancer who were leaving the hospital for skilled nursing facilities after treatment were being readmitted to the hospital or having worse outcomes while in rehabilitation. ... Singh knew of an intervention called Assessing and Listening to Individual Goals and Needs (ALIGN) — a palliative care social worker-led protocol aimed at improving quality of life, aligning goals of care, and providing support to patients and caregivers — and she began using it for cancer care. ... The results were overwhelmingly positive, and patients and caregivers told us, ‘This was so helpful,’” says Singh, associate professor of hospital medicine in the CU School of Medicine.