Literature Review

From classroom to clinic: End-of-life conversations — there’s empathy in foresightThe Tufts Daily, by Deeksha Bathini; 2/21/24Palliative care physicians have conversations with families to identify patient wishes, particularly when they are facing death. These physicians are equipped with training that emphasizes empathy, comfort and patient autonomy. Freedom of choice during the dying process gives patients the power to reclaim their agency amidst a process rife with uncertainty.

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.

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.

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. 

Redefining end-of-life care: Stories of compassion and innovationBNN, by Waqas Arain; 2/18/24In the heart of compassionate care and the challenging journey of end-of-life situations, two remarkable healthcare professionals stand out for their dedication and innovative approaches to palliative support. Teresa Hovatter, a Community Liaison with Grane Hospice, and Kirsty Lazenby, an organ donation nurse at Royal Stoke's Critical Care Unit, have each been recognized for their exceptional efforts in providing comfort, dignity, and support to terminally ill patients and their families. Their stories, though distinct, converge on a singular mission: to transform the end-of-life experience into one of peace, understanding, and meaningful closure.

Causes and ways of death in patients with head and neck cancerJAMA Otolaryngol Head Neck Surg; by Boyd N. van den Besselaar, MD; Aniel Sewnaik, PhD; Arta Hoesseini, MD; et al; 2/15/24 The results of this study potentially illuminate causes and ways of death in patients with HNC and support health care professionals in providing more patient-centered care, particularly for those in the palliative phase.

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.

Bristol Hospice’s quest to help patients sleepHospice News, by Jim Parker; 2/14/24Salt Lake City-based Bristol Hospice has developed a branded program designed to help their patients get better sleep, which can significantly impact quality of life.

Understanding the discordance about prognosis between clinicians and terminally ill patients and their surrogatesThe ASCO Post, by Jo Cavallo; 2/14/24A Conversation with Douglas B. White, MD, MASResearch shows that about half of adults near the end of life in the United States are too ill to participate in decisions about whether to accept life-prolonging treatment, requiring family members and other proxies to serve as surrogate decision-makers for their critically ill loved ones. However, research also shows that surrogates of patients with advanced illness often have optimistic expectations about prognosis, which often lead to the increased use of invasive treatment (including life support) in dying patients and delays in the integration of palliative care.

These 8 traits make great doctors, and residents can develop themAMA, by Brendan Murphy; 2/5/24