Literature Review

A guide to making end-of-life decisions easier for your loved ones The Detroit Jewish News; by Shari Cohen; 7/1/24 It’s not a pleasant prospect, but each of us will eventually die. For family members, the death of a loved one brings sadness and a sense of loss but also a need to deal with practical matters. ... A new guidebook, Two Envelopes: What You Want Your Loved Ones To Know When You Die, by Rusty Rosman offers practical advice to help families with the death of a relative. ... While Rosman’s book is written from a Jewish perspective, as part of her research, she spoke with funeral directors and clergy from many religious and ethnic groups. ... Rabbi Joseph Krakoff, CEO of Jewish Hospice and Chaplaincy Network (JHCN), who wrote a preface for the book, describes it as “a great motivation to help people to think about these things. I encourage everyone to talk about it when they’re healthy,” he adds.

Palliative care nurses see us in our final hours — these are the life lessons they've learnt ABC News; by Iskhandar Razak; 6/29/24 Anne Myers was once confused and shaken by death. After more than a decade as a nurse, including in hospital ICUs, her mother died. "I'd seen a lot of deaths in my nursing life, but it was the closest human to me that had died," she said. "It kind of sent me down a 'oh my god, I don't know what's happening to me', this grief I'm experiencing." Soon afterwards, she became a palliative care nurse. "I ended up just going down the path of 'what is death, what is death and dying all about?'" she recalled. More than 15 years later, here's what she and other palliative care nurses have discovered on how to die well and live well.

[American Heart Association] Palliative care beneficial to manage symptoms, improve quality of life for people with CVD [cardiovascular disease] American Heart Association; by NewMediaWire; 7/1/24 Implementing patient-centered palliative care therapies, including prescribing, adjusting or discontinuing medications as needed, may help control symptoms and improve quality of life for people with heart disease, according to “Palliative Pharmacotherapy for Cardiovascular Disease,” a new scientific statement from the American Heart Association, published today in the Association’s journal, Circulation: Cardiovascular Quality and Outcomes. The new scientific statement reviews current evidence on the benefits and risks of cardiovascular and essential palliative medications. The statement provides guidance for health care professionals to incorporate palliative methods as part of holistic medication management at all stages of a patient’s health conditions, emphasizing the importance of shared decision-making and goal-oriented care.

Evaluating palliative care impact: Insights from Tennessee Oncology's OCM participation The American Journal of Managed Care (AJMC); by Mary Caffrey and Pearl Steinzor; 6/27/24 A study finds limited changes in hospice utilization, highlighting challenges in real-world implementation. In an interview at the 2024 American Society of Clinical Oncology annual meeting, Ravi Parikh, MD, MPP, assistant professor of medicine and health policy, Perelman School of Medicine, University of Pennsylvania, discussed the outcomes of a palliative care study at Tennessee Oncology, providing insights into the challenges and limitations of evaluating hospice utilization and quality-of-life improvements in the real-world setting. 

Patient experiences of specialty palliative care in the perioperative period for cancer surgery Journal of Pain and Symptom Management; by Laura M Holdsworth, Rachel Siden, Anna Sophia Lessios, Mae Verano, Elizabeth Rickerson, Bridget Fahy, Fabian M Johnston, Brittany Waterman, Rebecca Aslakson; 6/19/24 online ahead of print  Context: Though patients undergoing treatment for upper gastrointestinal (GI) cancers frequently experience a range of sequelae and disease recurrence, patients often do not receive specialty palliative care soon after diagnosis and it is unknown in what ways they may benefit.  Results: We found five themes that characterized patient experiences and perceptions of specialty palliative care. Patients typically had limited prior awareness of palliative care (theme 1), but during the study, came to understand it as a "talking" intervention (theme 2). Patients whose concerns aligned with palliative care described it as being impactful on their care (theme 3). However, most patients expressed a focus on cure from their cancer and less perceived relevance for integration of palliative care (theme 4). Integrating specialist palliative care practitioners with surgical teams made it difficult for some patients to identify how palliative care practitioners differed from other members of their care team (theme 5).

Chronic loneliness can raise stroke risk in older adults, findings show McKnights Long-Term Care News; by Kristen Fischer; 6/24/24 A new study links loneliness to stroke risk, showing that those who are regularly lonesome have a 56% higher risk for stroke than those who are more socially connected. Situational loneliness wasn’t linked to a higher risk for stroke, which indicates that the stroke risk stems from chronic loneliness. Investigators led by a team from Harvard T.H. Chan School of Public Health published their report Monday in eClinicalMedicine. Research has already linked loneliness to an increased risk for cardiovascular disease. The new report is one of the first to evaluate the association between loneliness and stroke risk.

Project ECHO: 5 years of fostering learning in your community Dartmouth Health; by Connections Magazine and modified for the web; 6/25/24 Teach, teach, learn, learn. That is the model Project ECHO® at Dartmouth Health uses to connect people and their communities in a virtual setting, sharing knowledge between participants and subject matter experts. The program is especially helpful for rural communities seeking expertise on a broad range of health and medical issues. ... ECHO is an acronym for Extension for Community Healthcare Outcomes. ... The past three cohorts of the Palliative Care ECHO have been very successful, and the program content has continued to evolve over time. The sessions have had an average of 70 participants and have received high scores on feedback metrics. Fifty percent of participants were repeat attendees. “Our mission is to improve palliative care throughout our region, and our leadership is committed to the model,” Kathleen Broglio, DNP says. “This was the culmination of what I hoped to do in my career.” Editor's Note: Memorable quote from this article, "“Everyone is a teacher, and everyone is a learner,” says Kathleen Broglio, DNP, associate professor of medicine and a nurse practitioner of palliative medicine. Broglio has co-led the Palliative Care ECHO with Robin Larson, MD, MPH through three courses (cohorts) and with the support of the Project ECHO team at Dartmouth Health.

Dementia decisions: Making tough choices about hospice, palliative care Being Patient; by Katy Koop; 6/25/24 In the later stages of Alzheimer's, palliative and hospice care can be necessary. But how do you find a facility designed for dementia patients? ... Dr. Maribeth Gallagher, director of Arizona’s Hospice of the Valley dementia program, joins Being Patient video reporter Mark Niu to discuss how to make these difficult decisions and what makes a palliative or hospice care program “dementia-capable.” Gallagher’s work directing the Hospice of the Valley’s dementia program has received national and international awards for its innovative approaches. Her focus on dementia care was initially inspired by her personal experiences as a family caregiver, sharing the journey with her loved one from diagnosis to death. [Click on the title's link for the full conversation, in both audio and text.]

Improving advanced care planning for late-stage cancer Medical Xpress; by Melissa Rohman; 6/24/24 Multilevel care interventions improved clinician–documented advanced care planning (ACP) compared with a clinician-level intervention alone for patients with genitourinary cancer, according to findings published in JAMA Oncology. "Clinicians often have limited time to assist patients in fully understanding ACP. This intervention is one approach to improve ACP and care delivery among patients with advanced stages of genitourinary cancer," said Gladys M. Rodriguez, MD, MS, assistant professor of Medicine in the Division of Hematology and Oncology and lead author of the study. For patients diagnosed with late-stage cancer, ACP can help reduce unnecessary acute care, increase palliative care and improve quality of life. However, previous reports have found that less than 20% of patients will engage in ACP with their health care providers. ... The primary outcome was ACP documentation in the electronic health record by the patient's oncology clinician within 12 months. Secondary outcomes included shared decision-making, palliative care use, hospice use, emergency department visits and hospitalizations within 12 months.

Strong palliative care presence at this year’s World Health Assembly Worldwide Hospice Palliative Care Alliance - WHPCA; by Stephen Connor, Executive Director, WHPCA; 6/18/24 Palliative care was well represented at the World Health Assembly (WHA) this year! All together there were twelve delegates from the organisations attending in official relations with WHO (6 from WHPCA and 6 from IAHPC). All attendees covered their expenses. This year is the 10th anniversary of the passage of the Palliative Care Resolution (67.19) “Strengthening of Palliative Care as a Component of Comprehensive Care Throughout the Life Course.” ... To use this fact as an opportunity WHPCA organised a side event on the margins of this year’s WHA titled: Ten Years Since the WHA Resolution on Palliative Care: Access is Increasing Slowly in LMICs, How Can We Expedite it? The event was co-sponsored by four countries (Australia, Belgium, Chile, and Panama) along with nine NGOs (UICC, ICPCN, IAHPC, NCDA, C/Can, APCA, APHN, UNTF NCDs, and Team Humanity). ... WHPCA is working to create a coalition of countries to advocate for palliative care at upcoming UN meetings.

Mercy Medical Center unveils Andy Yee Memorial Palliative Care Unit WWLP 22 News, Springfield, MA; 6/18/24 Springfield city officials joined Mercy Medical Center for a tour of the upcoming Andy Yee Memorial Palliative Care Unit. Patients who are severely sick or coming to their last days will now have another space to get the care that they need. The work for the Andy Yee Memorial Palliative Care Unit is underway at Mercy Medical Center. This new space on the 5th floor of the facility will help to enhance patient care. ... In the next phase comes the renovation and remodeling of eight patient rooms. This new unit will help Mercy Medical providers care for about 300 patients a year. 

Top oncologists say everyone with advanced cancer needs early palliative care. Here are 6 things to know ABC News, New York; by Lindsey Ulin, MD; 6/20/24This year, the American Society of Clinical Oncology — the world’s leading oncology organization — recommended palliative care for everyone with advanced cancer at the time of diagnosis and while receiving treatment. ... By next year, 693,000 people in the United States will have advanced breast, prostate, lung, colorectal, bladder, or skin cancer. ... “What I’m really excited to see is that these guidelines are taking a step back and thinking about [palliative care] from the time of diagnosis,” Dr. Arif Kamal, chief patient officer for the American Cancer Society and an associate professor at Duke University specializing in oncology and palliative care, told ABC News. “It should particularly be used in areas to help people stay on treatment, such as in clinical trials or hematologic malignancies.” Here are six things to know about palliative care:

CMS - Roadmap to Better Care: Tribal Version CMS; 6/17/24This version of the Roadmap has been updated to help members of the American Indian and Alaskan Native community connect to their health care, including benefits provided through the Indian Health Service (IHS), Medicare, Medicaid, Marketplaces, or private insurance. Unlike Medicare, Medicaid, the IHS is not an insurance program or an established benefits package. IHS cannot guarantee funds are available each year, and as a result sometimes needs to prioritize patients of greatest need. The preservation of legacy, heritage, and traditions is vital. This roadmap is designed to help sustain cultural richness and strengthen the well-being of present and future American Indian and Alaska Natives for generations. To learn more about enrollment in Marketplace, Medicare, or Medicaid see pages 4 and 5 or visit ihs.gov/forpatients.