Literature Review

Being there for a loved one's final breaths NextAvenue, by Elaine Soloway; 2/26/24"I'll be downstairs," I told him one night. "And I'll be up to kiss you goodnight before I go to sleep." He smiled and squeezed my hand. I had barely settled on the couch when the hospice worker appeared at the top of the stairs. "He's gone," she said. I learned this pause is not unusual. Hospice workers report that some people who are dying wait to be alone for their final breaths.

Vancouver hospital asked wrong family whether to pull the plug on patientKGW8 NBC News; 2/21/24In a terrible case of mistaken identity that has never been publicly disclosed, KGW found PeaceHealth Southwest Medical Center in Vancouver allowed a family to pull the plug on the wrong man. “We made life-ending decisions for a person we don’t even know,” said Danielson’s husband, Gary.

Not all mourning happens after bereavement – for some, grief can start years before the death of a loved one The Conversation, by Beth Daley; 2/22/24For many people, grief starts not at the point of death, but from the moment a loved one is diagnosed with a life-limiting illness. Whether it’s the diagnosis of an advanced cancer or a non-malignant condition such as dementia, heart failure or Parkinson’s disease, the psychological and emotional process of grief can begin many months or even years before the person dies. This experience of mourning a future loss is known as anticipatory grief.Editor's Note: All clinical team members need to be equipped to tune into and validate grief that is already underway. Social workers and chaplains--especially--need to be trained to tend grief in the present, and to know how to make high-acuity referrals to bereavement counselors.  

Exploring whether a diagnosis of severe frailty prompts advance care planning and end of life care conversationsNurs Older People, by Stacey Dodson; 2/21/24Findings: Frailty appeared to be complex, multifaceted and at times difficult to identify. A diagnosis of severe frailty did not necessarily prompt advance care planning and end of life care conversations. Such conversations were more likely to happen if the person had comorbidities, for example cancer. Prognostication appeared to be challenging, partly due to the gradual and uncertain trajectory in frailty and a lack of understanding, on the part of healthcare professionals, of the condition and its effects.

Psychological issues in palliative care: Elissa Kozlov and Des AzizoddinGeriPal podcast, by Alex Smith; 2/22/24Today we talk with two psychologists who are deeply invested in addressing psychological aspects of care for people living with serious illness. Elissa Kozlov, a geropsychologist and director of a new population aging MPH at Rutgers, surveyed AAHPM members, and found that doctors reported major shortcomings in level of comfort and knowledge caring for patients with psychological illness. She conducted a systematic review and meta-analysis of 38 palliative care trials, finding that many excluded people with serious illness, and a lack of impact on psychological outcomes.  Analyzing the Health and Retirement Study, she found 60% of older adults screened positive for depression in the last year of life.

What are death doulas?SwiftTelecast, by Shawn Butlere; 2/21/24... That’s why some people turn to end-of-life doulas. They are among the professionals who can help someone prepare for their death and reflect on their life: their greatest joys and regrets, any fears or worries on their mind, and how they want to be remembered. ... Unlike hospice, the cost of a doula is not covered by Medicare. ... Doulas may charge an hourly rate, from $45 to $100, or on a sliding scale. Or you may be quoted a flat fee from $500 to $5,000. 

Studies conducted at University of New Mexico on Hospice and Palliative Medicine recently published (Cultural advocacy for indigenous individuals with serious illness) American Journal of Hospice and Palliative Medicine, by Jeanna Ford, DNP, APRN, ACNS-BC, ACHPN, FPCN, FCNS, and Constance Dahlin, MSN, ANP-BC, ACHPN, FPCN, FAAN; first published 2/2/24, posted in Health & Medicine Daily 2/20/24Indigenous American (I.A.) individuals with serious illness and their families have unmet needs. Often, this group is viewed as a minority within a minority. Numerous health challenges exist within the I.A. populations resulting in dire health care situations. Historical trauma and mistrust of the healthcare system impacts access to quality palliative care by this marginalized population. ... The aim is to empower palliative care clinicians the knowledge to provide culturally sensitive and congruent care to I.A. individuals with serious illness and their community.

Funerals becoming a thing of the past as end-of-life rituals change County Life, by Sharon Harrison; 2/16/24As times are changing, more and more people don’t want a traditional, religious funeral and instead are seeking alternatives to align with present day values. 

The role of bioethics services in paediatric intensive care units: A qualitative descriptive studyBMC Medical Ethics, by Denise Alexander, Mary Quirke, Jo Greene, Lorna Cassidy, Carol Hilliard, and Maria Brenner; 2/19/24Results: From 33 interviews, we identified four themes that described the functionality of bioethics services when a child requires technology to sustain life: striving for consensus; the importance of guidelines; a structure that facilitates a time-sensitive and relevant response; and strong leadership and teamwork.

Reimagining end-of-life care: Balancing polypharmacy, treatment modification, and quality of life in advanced cancer patientsBNN, by Mahnoor Jehangir; 2/15/24In a recent groundbreaking study, researchers have illuminated the complexities surrounding polypharmacy and the prescription of potentially inappropriate medications (PIMs) to patients at the end of their lives, particularly those battling advanced cancer. This investigation, involving a cohort of 265 older adults, sheds light on the nuanced challenges and critical decisions faced by healthcare providers in managing the delicate balance between treatment efficacy and quality of life for terminally ill patients. 

A race against time: Cancer patient's touching keepsake for his familyBNN; 2/15/24When time was running out, 44-year-old cancer patient Yiu created a heartfelt keepsake for his family. With the help of an art therapist, he cast a realistic mold of his intertwined hands with his wife's symbolizing their love and unity. This touching story highlights the power of love and hope in the face of adversity.

This hospice volunteer program is transforming end-of-life care for inmates in MaineYouTube - News Center Maine, video news; 2/16/24The prisoner hospice volunteer program started in 2001 as a partnership among the Maine Hospice Council, Maine State Prison, and Maine Department of Corrections.

Palliative care’s psychedelic futuretruthdig, by Jane C. Hu; 2/14/24In Oregon, hospice doctors are expanding the menu of treatments for end-of-life anxiety and depression.