Literature Review

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.

Palliative care may improve quality of life for stroke survivors and their family members American Heart Association - Stroke News & Brain Health; by Newsroom; 12/16/24 Palliative care ... can help improve quality of life for stroke survivors as well as their family members, according to “Palliative and End-of-Life Care in Stroke,” a new scientific statement published today in the Association’s peer-reviewed scientific journal Stroke. ... The new statement complements the Association’s 2014 Scientific Statement on Palliative and End-of-Life Care in Stroke, which covered core palliative care competencies and skills for health care professionals who treat stroke patients. The statement includes strategies to improve communication about prognosis and goals-of-care, address psychosocial needs such as coping with loss, navigate complex health care systems and prepare for death with end-of-life care when necessary. It also highlights the substantial inequities that exist in palliative care after stroke across sociodemographic and regional characteristics and the need to reduce those disparities.

Northern Colorado cancer palliative care nurse leans on patients as she battles her own diagnosis ABC KJCT News 8, Fort Collins, CO; by Dillon Thomas; 12/11/24 A Northern Colorado woman who has spent years of her career helping patients navigate their cancer diagnosis says she leaned on her own patients for encouragement as she battled cancer herself. Riley Mulligan, a palliative care nurse navigator for UCHealth in Fort Collins, said she was able to battle her diagnosis of breast cancer by leaning into the courage of her patients while also taking lessons from herself. Mulligan’s journey battling cancer started nearly a decade ago, but the cancer she was helping battle wasn’t her own at the time. As a palliative care nurse, her job was to help some of the most ill patients that UCHealth treats. ... “I’m trying to take my own advice, I am trying to remember how to live. On the days I felt the worst, the most nauseous and tired, I still tried to get out and do things because I knew it would help me feel better,” Mulligan said.

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.

A healthcare system’s moral bankruptcy goes viral MedCity News; by Neal K. Shah; 12/5/24 Brian Thompson's murder was chilling, but the social media response of this tragedy was equally shocking, if eye-opening. It shows a massive collapse of public trust in our healthcare system, a system so broken that it bankrupts families, denies life-saving care, and treats death as an acceptable cost of doing business. When UnitedHealthcare CEO Brian Thompson was gunned down outside a Manhattan hotel ..., something chilling happened: thousands of Americans responded not with horror, but with dark jokes and scathing comments about the health insurance industry. People shared stories of being denied coverage by the company and drew parallels comparing the CEO’s death to the ways they’ve been mistreated by America’s healthcare system. ... The tragedy of Thompson’s death is compounded by a cruel irony: He was rushed to Mount Sinai  — a healthcare system whose hospitals UnitedHealth removed from its network only a few months ago, leaving thousands of patients scrambling. Even in death, he couldn’t escape the byzantine system his company helped create.

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.

Key differences between palliative and hospice care in California Psychology Today; by Bob Uslander, MD; 12/3/24 ... Key Difference Between Palliative and Hospice Care in California: Whether you’re looking for support early in an illness or need end-of-life care, Californians have resources available to help. California also has some unique programs and resources, such as palliative care programs for people covered by Medi-Cal, California’s Medicaid program. Additionally, California has strict laws to protect patients’ rights, ensuring that people are fully informed about your care options and can make choices that align with your personal values and cultural beliefs. Below are some of the key differences highlighted to help you make the best choice possible for you and your family when the time comes. [Click on the title's link for more information.]Editor's note: Through recent years, too many hospice agencies have eliminated references to end-of-life care, a life-expectancy of six months or less, and references to dying, death, or grief. Various fraud and abuse cases have described that persons/caregivers did not even realize they had signed up for "hospice" care. Ethically, this is untenable. Key differences between palliative and hospice care--with applications to the person--are significant.

Bloom Healthcare CEO: Integrating palliative care into every decision Hospice News; by Jim Parker; 12/3/24 The house call provider Bloom Healthcare has leveraged its integrated palliative-primary care model to achieve substantial reductions in hospitalizations and health care costs. The U.S. Centers for Medicare & Medicaid Services recently recognized Bloom as a top performing High-Needs Accountable Care Organization under the agency’s Realizing Equity, Access and Community Health (ACO REACH) model. Through its ACO REACH program, Bloom reduced unplanned hospital readmissions by 25% and realized a gross cost savings rate of 24.6%. The company’s patients averaged 326.7 days at home during  2023. Bloom Healthcare cares for about 10,000 high-needs patients with a comprehensive primary care and care management model that incorporates palliative care. The company currently operates in Colorado and Texas. ... Palliative Care News sat down with Bloom CEO Dr. Thomas Lally to discuss the strategies the company used to garner these results and how palliative care factored in. [Click on the title's link to continue reading.]

[New Zealand] Palliative care podcast’s win a ‘complete surprise’ Otago Daily Times, New Zealand; by Matthew Littlewood; 12/2/24 A Dunedin carer’s attempts to bring conversations about palliative care to a wider audience has been acknowledged at the New Zealand podcasting awards. Otago Hospice care nurse Denise van Aalst told the Otago Daily Times that winning the bronze medal in the Best Interview Podcast category for her podcast Ending Life Well came as a "complete surprise". The 29-episode series was launched about two years ago, and covered subjects such as self-care, legal matters, funeral planning and whānau manaaki (families who provide care to a kaumātua at end of life). "We knew that our podcast was helpful for people. "We don’t talk about death and dying in polite society, and people are often now going in and helping to care for somebody at the end of life with little experience or knowledge, and they don’t know where to go to get that."

Homebound seniors living alone often slip through health system’s cracks KFF Health News; by Judith Graham; 12/2/24 Carolyn Dickens, 76, was sitting at her dining room table, struggling to catch her breath as her physician looked on with concern. “What’s going on with your breathing?” asked Peter Gliatto, director of Mount Sinai’s Visiting Doctors Program. “I don’t know,” she answered, so softly it was hard to hear. “Going from here to the bathroom or the door, I get really winded. I don’t know when it’s going to be my last breath.” Dickens, a lung cancer survivor, lives in central Harlem, barely getting by. She has serious lung disease and high blood pressure and suffers regular fainting spells. In the past year, she’s fallen several times and dropped to 85 pounds, a dangerously low weight. And she lives alone, without any help — a highly perilous situation. Across the country, about 2 million adults 65 and older are completely or mostly homebound, while an additional 5.5 million seniors can get out only with significant difficulty or assistance. ... It’s a population whose numbers far exceed those living in nursing homes — about 1.2 million — and yet it receives much less attention from policymakers, legislators, and academics who study aging.