Literature Review

[Turkey] Actual roles of Occupational Therapists in palliative and hospice care: A scoping reviewAmerican Journal of Hospice and Palliative Medicine; Güleser Güney Yılmaz, PhD, OT; Hülya Yücel, PT, PhD; Milda Gintiliene, MD; 1/25 Occupational therapists play a crucial role in coordinating and facilitating safe transitions from the hospital to home, aiming to improve the overall quality of life and reduce hospital stays. Various roles of occupational therapists have been defined in palliative care: discovering occupational meaning in the last periods of life and supporting occupational participation, management of persistent physical and psychological symptoms, especially pain and fatigue, improving or supporting the quality of life for individuals under palliative care, supporting mental well-being, supporting social participation, use of adaptive technologies, providing individuals with confidence and comfort. Occupational therapists also have various duties in maintaining palliative-hospice care at home include evaluating the individual at home and supporting home care and rehabilitation after discharge. Interventions for caregivers or supporting caregivers who have lost their roles, occupations or jobs in the care process are also among the roles of occupational therapists.

How music is rewriting end-of-life care The Daily Iowan; by Madison Schuler; 2/18/25 The form of therapy relieves not only patients but also family members. Over the years, music has been used to express emotions for some while creating connections and memories for others. Listening to a certain song can take people back to a specific moment. Whether it elicits joy, pain, anger, or sadness, music has a different effect on each individual. Music stays with people throughout their lives, always bringing forth those emotions or memories. For those in end-of-life care, music can do the same. ... Today, hospitals and hospice centers are seeing an increase in the use of music therapy, specifically in end-of-life care. [Click on the title's link to learn more.] Editor's note: Click here for the national directory of CBMT board certified music therapists. Click here for my 2005 book in Routledge's Series in Death, Dying and Bereavement, Music of the Soul - Composing Life Out of Loss.

Addressing overtreatment in end-of-life cancer care Medscape; by David J. Kerr, CBE, MD, DSc; 2/19/25 ... What do we mean by overtreatment? This means that many patients who are approaching the end of life receive treatments, like directed anticancer therapies, that are unlikely to provide clinically meaningful benefits and may do more harm than good. This is an expression that I use often in the clinic when I'm explaining to patients that we have reached the end of the road in active interventions, such as chemotherapeutic drugs, that will do more harm than good. It doesn't stop us from doing our very best to look after patients. We focus on improving the quality of life and maintaining that for as long as we can, while continuing to care and look after the patients. ... Overtreatment may even, one would argue, accelerate death when you consider those 1% or 2% mortality rates that can be associated with some treatments that we offer. ...

New insights into older hearts  The New York Times; by Paula Span; 2/15/25 It turns out that the Isley Brothers, who sang that 1966 Motown hit “This Old Heart of Mine (Is Weak for You),” were onto something when they linked age to an aching and flagging heart. Heart disease, the nation’s leading cause of death and disability, has been diagnosed in about 6 percent of Americans ages 45 to 64, but in more than 18 percent of those over 65, according to the Centers for Disease Control and Prevention. ... [In] recent years, dramatic improvements in treatments for many kinds of cardiovascular conditions have helped reduce both heart attacks and cardiac deaths. ... That can complicate decision-making for heart patients in their 70s and beyond, however. Certain procedures or regimens may not markedly extend the lives of older patients or improve the quality of their remaining years, especially if they have already suffered heart attacks and are contending with other illnesses as well. “We don’t need to open an artery just because there’s an artery to be opened,” said Dr. Alexander, referring to inserting a stent. “We need to think of the whole person.” ...

Death Matters: The gift of presence: Tips for visiting someone who is dying Squim Gazette, Squim, WA; by Jeanette Stehr-Green, Volunteer Hospice of Clallam County; 2/12/25 We sometimes avoid visiting friends or family members who are terminally ill. We make lots of excuses. We don’t know what to say. We don’t know how to act. We don’t want to be a bother. The hard truth is that dying, the final stage of life, can be a lonely experience without the presence of family and friends. A visit during this time can bring comfort to the dying person and their family. It can also provide an opportunity to share feelings, reminisce, and say goodbye. Visiting a dying person seems difficult because most of us lack experience. It only takes a little courage and a few ideas to create a meaningful moment. ... Editor's note: These excellent guidelines empower hospice patients' families and friends--and protect patients' vulnerable energies and emotions--in multiple settings across the trajectory of dying. How might you adapt these for your own patient/caregiver support and community outreach?

How to help caregivers of patients with dementia Physician's Weekly; by Linda Girgis, MD, FAAP; 2/13/25 Dr. Linda Girgis discusses how physicians can assist caregivers of patients with dementia, helping these critical caretakers avoid experiencing burnout. ... As doctors, we all have witnessed caregiver burnout. Often, it was a family member who bore the brunt of the responsibility, one for whom there were no vacation days or sick time available. Whatever specialty we practice, we know patients with dementia can present a significant problem. ... How can we assist caregivers of patients with dementia?

HealthcareBusinessToday.com series on hospice careEditor's note: The following articles were posted on 2/10/25 by HealthcareBusinessToday.com.

What we talk about, or not, when talking about death Enumclaw Courier-Herald; by Wire Service; 2/9/25 Death is a guarantee for everyone, so why do people shy away from talking about it and using words like death and dying? ... As a death doula and grief coach, Kathleen Putnam hopes that providing care to those who are grieving can help change the language surrounding death. ... Putnam explains that in present society, people want to avoid grief and pain. With medical advancements and industries and marketing systems focusing on keeping people alive, the rhetoric surrounding dying has become negative. Putnam also pointed out that instead of using phrases like “they died” or “they’re dying,” other phrases like “pass away” and “they went to sleep” have become popular when talking about a loss.

4 phrases successful leaders intentionally use to motivate their teams Forbes; by Dr. Cheryl Robinson; 2/1/25 ... Great leaders understand that their words can shape company culture, influence behavior and impact employee engagement; it’s about delivering messages with clarity and intent. The tone, phrasing and timing of communication can energize a team or deflate morale. A well-placed word of encouragement can spark motivation, while careless criticism can hinder progress. Whether providing constructive feedback or navigating tough conversations, leaders who speak with intention create a culture where employees feel valued and driven to contribute their best. ... 4 Phrases Successful Leaders Use:

Well-being and choosing the best job for youJAMA Internal Medicine; Jamile A. Ashmore, PhD; J. Michael DiMaio, MD; 1/25Well-being is emerging as the catch-all term describing the field dedicated to understanding and addressing the way in which the health care system, work environment, and individual interact to influence the fulfillment and meaning that health care workers derive from their work. Clinician well-being is often led by a chief wellness officer (CWO) or other executive leader who is compensated to focus on well-being. In addition to strategic planning and oversight, the CWO’s role is to ensure that well-being is considered in administrative and operational decisions including in those related to governance, rewards systems, and culture. Health care systems’ moving from the triple to the quadruple aim are signaling that they are committed to taking care of those that care for the patients. Indeed, health care systems cannot have optimal patient care without a healthy and fulfilled workforce. 

What can we learn from the dying? Newscastle's News Letter Journal (NLJ), Newcastle, WY; by Kelly Evans-Hullinger, MD; 1/26/25 For the last five years, I have had the great privilege of serving my local health system as Medical Director for Home Hospice. Every week I sit in a meeting with the multidisciplinary caretakers on this team ... Patients facing their own deaths want to talk about their lives. Our staff frequently tries to facilitate what they call a “life review” in which a patient can openly talk about their childhood, family, career, service, and sometimes their regrets. This is therapeutic for the dying patient and their loved ones.  ... I have recently thought about this particular human need – to reflect and remember one’s life. I take this as a reminder to both seek those stories from my own loved ones (I wish I had asked my grandmother more questions about her life) and, perhaps, to tell and write about the things in my own life I would want to be remembered after I am gone. For if there is another thing I’ve learned serving patients on hospice, it is that my death is also inevitable; but, I think, life’s finality is what gives it beauty and meaning. 

Palliative care is essential for seriously ill patients—at any ageAMA (American Medical Association); by Kevin B. O'Reilly; 1/27/25 The AMA House of Delegates has adopted new policies outlining physicians’ ethical obligation to provide or seek optimal palliative care for patients with serious illnesses who can benefit from comprehensive management of pain and other distressing symptoms—not only those with terminal illnesses or on the precipice of death. “Physicians have clinical ethical responsibilities to address the pain and suffering occasioned by illness and injury and to respect their patients as whole persons,” says one of the new policies adopted at the latest AMA Interim Meeting, held in Lake Buena Vista, Florida. “These duties require physicians to assure the provision of effective palliative care whenever a patient is experiencing serious, chronic, complex or critical illness, regardless of prognosis.” 

Some wary of Providence home health joint venture with for-profit company Herald Net, Everett, WA; by Jenna Peterson; 1/23/25 Some nurses in the state say an upcoming joint venture between Providence Home and Community Care and Compassus, a for-profit company with private equity ownership, could have an adverse effect on health care. The deal, expected to be finalized in Washington early this year, ... impacts locations in five U.S. states. ... Boyle and Compassus spokesperson Dana Coleman said there will be no changes in care or staffing under the joint venture. But some nursing advocates, like Ian Mikusko, worry that a for-profit, private equity influence could be harmful for health care.“Private equity is somewhat more extractive because there’s a pressure to provide large dividend payments to investors,” said Mikusko, strategic researcher with the Washington State Nurses Association. Mikusko cited research that shows quality of care diminishes when private equity companies become involved in health care, such as a 2023 study from the Center for Economic and Policy Research.