Literature Review

Social isolation changes and long-term outcomes among older adultsJAMA Network Open; by Chen Lyu, Katherine Siu, Ian Xu, Iman Osman, Judy Zhong; 7/24Is social isolation change associated with long-term outcomes in older adults? In this cohort study using a national longitudinal health survey of 13 649 adults aged 50 years or older in the US, data revealed that increased isolation was associated with an increased risk of mortality, disability, and dementia. Decreased isolation was associated with a lower risk of mortality only among individuals who were non-isolated at baseline. These results underscore the importance of interventions targeting the prevention of increased isolation among older adults to mitigate its adverse effects on mortality, as well as physical and cognitive function decline.

Start of the COVID-19 pandemic and palliative care unit utilization: a retrospective cohort studyJournal of Pain and Symptom Management; by Michael Bonares, Kalli Stilos, Madison Peters, Lise Huynh, Debbie Selby; 7/24Despite historically poor palliative care units (PCU)/hospice access, the COVID-19 pandemic created circumstances that may have enabled unprecedented utilization in individuals with non-cancer diagnoses in our cohort. This substantiates that so long as it is concordant with their goals, individuals with non-cancer diagnoses can have enhanced PCU/hospice utilization.

Familial loss of a loved one and biological aging: NIMHD Social Epigenomics Program JAMA Network Open; by Allison E. Aiello, PhD, MS; Aura Ankita Mishra, PhD; Chantel L. Martin, PhD; Brandt Levitt, PhD; Lauren Gaydosh, PhD; Daniel W. Belsky, PhD; Robert A. Hummer, PhD; Debra J. Umberson, PhD; Kathleen Mullan Harris, PhD; 7/29/24Is the experience of losing a loved one associated with accelerated biological aging? In a cohort study of 3963 participants from the National Longitudinal Study of Adolescent to Adult Health, nearly 40% experienced the loss of a close relation by adulthood. Participants who had experienced a greater number of losses exhibited significantly older biological ages compared with those who had not experienced such losses. These findings suggest that loss can accelerate biological aging even before midlife and that frequency of losses may compound this, potentially leading to earlier chronic diseases and mortality.

Adapting an intervention to address barriers to pain management in hospice: formative research to inform EMPOWER-D for dementia caregiversPalliative Medicine Reports; by Karla T. Washington, Morgan L. Van Vleck, Todd D. Becker, George Demiris, Debra Parker Oliver, Paul E. Tatum, Jacquelyn J. Benson, John G. Cagle; 7/24Pain management is a priority for hospice patients, including those with ADRD [Alzheimer’s disease or a related dementia], most (63%) of whom experience bothersome pain. One such intervention, EMPOWER (Effective Management of Pain: Overcoming Worries to Enable Relief), has been shown to improve hospice pain management by training hospice staff on barriers to pain management, incorporating screening for pain concerns into routine hospice care, delivering tailored pain education to hospice patients and their family caregivers, and facilitating needed follow-up services. Participants indicated that the EMPOWER-D materials addressed common pain concerns that were both family-centered and relevant to clinical dementia care. 

Nursing strategies to mitigate separation between hospitalized acute and critical care patients and families: A scoping review Intensive Critical Care Nurse; Sonja Meiers, Véronique de Goumoëns, Lorraine Thirsk, Kristen Abbott-Anderson, Petra Brysiewicz, Sandra Eggenberger, Mary Heitschmidt, Blanche Kiszio, Natalie S Mcandrew, Aspen Morman, Sandra Richardson; 7/26/24 Implications for clinical practice: Permanent policy changes are needed across acute and critical care settings to provide support for nurses in mitigating patient and family separation. We recommend that family members be considered as caregivers and care receivers, not visitors in patient and family-centered care in acute and critical care settings. 

Patient outcomes of a virtual reality-based music therapy pilot in palliative care Palliative Medicine Reports; by Adreanne Brungardt, Angela Wibben, Prajakta Shanbhag, Debra Boeldt, Jeanie Youngwerth, Amanda Tompkins, Abigail J Rolbiecki, Heather Coats, A Blythe LaGasse, Jean S Kutner, Hillary D Lum; 7/19/24 Hospitalized patients with palliative care needs often have high levels of physical and psychological symptom distress. Virtual reality (VR) with a music therapy intervention may improve physical and psychological symptoms. Results: Seventeen patients completed VR-MT (range 20-79 years of age, 59% women). Moderate clinical improvements were observed for total ESAS-r score (Cohen's d effect size, 0.68), physical distress subscale (0.52), and psychological distress subscale (0.60); small improvements were observed in total MQOL-r score (0.26) and the existential subscale (0.27). Health care team members described the value of VR-MT as facilitating meaningful conversations.

Pain Management at the End of LifeJournal of Hospice and Palliative Nursing; HPNA position statement; 8/24.Pain management is essential from the time of diagnosis of a serious illness and throughout the disease trajectory. Unfortunately, the prevalence of pain in those with serious illness remains unacceptably high. In most cases, pain experienced by people with advanced disease can be prevented or relieved through optimal care, yet studies reveal that patients continue to experience uncontrolled pain in the final weeks, days, and hours of their lives...

The Uniform Determination of Death Act is not changing. Will physicians continue to misdiagnose brain death?The American Journal of  Bioethics; Michael Nair-Collins; 7/24Efforts to revise the Uniform Determination of Death Act [UDDA] in order to align law with medical practice have failed. It has long been common practice to declare some patients dead by neurologic criteria even though they do not meet the legal standard for death. Thus, legally living people will continue to be declared dead, not because of a mistake, but because of a choice. The decision to continue misdiagnosing death according to the law will create routine violations of civil rights, will continue to violate the DDR [dead donor rule] that allegedly is such an important red line for organ transplantation, and will contribute to a well-deserved mistrust in the determination of death.

The home-based experiences of palliative and hospice care for children and caregivers (EXPERIENCE) Measure: evaluation of psychometric propertiesJournal of Pain and Symptom Management; by Jackelyn Y Boyden, Mary Ersek, Kimberley A Widger, Judy A Shea, Chris Feudtner; 6/24Home-based pediatric palliative and hospice care (PPHC) supports the hundreds of thousands of children with serious illness and complex care needs and their families in the home setting. The EXPERIENCE Measure is a tool with evidence for reliable and valid scores to evaluate family-reported home-based PPHC experiences at the time care is being received.

Further psychometric evaluation of the eight-item Hospice Philosophy Scale: Results from a national sample of interdisciplinary hospice clinicians Journal of Applied Gerontology; by Todd D Becker, Sarah E Clem, Paul Sacco, John G Cagle, Joan K Davitt, Nancy Kusmaul; 7/20/24 online ahead of print This study examined the psychometric properties of the eight-item Hospice Philosophy Scale (HPS-8) through confirmatory factor analysis; differential item functioning by age, gender, race, and professional discipline; and internal consistency reliability. ... Our results support the HPS-8 as a valid and reliable measure of attitudes toward the hospice philosophy of care in hospice clinicians.

Omega - Journal of Death and Dying - June 2024 Sage Journals - Omega - Journal of Death and Dying; June 2024 issue Omega - Journal of Death and Dying, a peer-reviewed journal that says it brings insight into terminal illness, the process of dying, bereavement, mourning, funeral customs and suicide, published research articles on the following topics in its June 2024 edition (Vol. 89, Issue 2). [A few sample topics include the following:]

[Australia] Methadone versus other opioids for refractory malignant bone pain: a pilot randomised controlled studySupportive Care in Cancer; Merlina Sulistio, Alexandra Gorelik, Hoong Jiun Tee, Robert Wojnar, David Kissane, Natasha Michael; 7/24Refractory cancer-induced bone pain (CIBP) affects a patient's functional capacity and quality of life, but there is limited evidence to guide opioid choice. We assessed the feasibility, tolerability and possible efficacy of methadone rotation (MR) compared to other opioid rotations (OOR) in this cohort. Of 51 eligible participants...both groups displayed significant reduction in average...and worst pain...and total pain interference score. Oral morphine equivalent daily dose was reduced significantly in MR compared to the OOR group (d = - 0.8, p = 0.05). The incidence of opioid-related adverse events following MR was unchanged but lower in the OOR group. There were no within-group or between-group differences in satisfaction with analgesia at the end of the study.

Assessing pediatric resident needs in grief and bereavement educationJournal of Pain and Symptom Management; Hannah Reuman, Scott H Maurer, Kelly Harris, Amanda W Brown; July 2024Pediatric [medical] residents care for dying children during training. Few educational efforts focus on helping trainees better understand their own grief process and the supports available to them and their patients' families. This work aims to assess pediatric residents' needs and preferences for content included in a curriculum on grief and bereavement. Conclusion: Pediatric residents indicate a strong desire for structured curricula on grief and bereavement focusing on resources that exist for families, approaches to grieving as a healthcare professional, and better understanding the experiences of bereaved families. These data may inform educators on priorities in training and support of pediatric residents on grief and bereavement.