Literature Review

Home-based pediatric hospice and palliative care provider visits: Effects on healthcare utilization The Journal of Pediatrics; by Steven M. Smith, MD; Daniel H. Grossoehme, DMin; Kate Cicozi, MD; Audrey Hiltunen, MD; Catherine Roth, MPH, CCRP; Gwendolyn Richner, BA; Stephani S. Kim, PhD, MPH; Nguyen K. Tram, PhD; Sarah Friebert, MD; May 2024 journal issue Objective: This hypothesis-generating study sought to assess the impact of home-based hospice and palliative care (HBHPC) provider home visits (HV) on healthcare use.  Conclusion: HBHPC provider HVs were associated with fewer inpatient admissions, hospital days, and intensive care unit days, and increased clinically relevant phone calls and phone calls before emergency department visit. These findings indicate that HBHPC HV may contribute to decreased inpatient use and increased use of the HBHPC team.

Chesapeake Life Center offers monthly LGBTQIA+ drop-in grief support group Southern Maryland News Net; 5/6/24 Chesapeake Life Center will host a monthly drop-in grief support group for members of the LGBTQIA+ community. ... Grief is a hard and vulnerable time, and it is important to have safe spaces to process what we are going through. This group is intended for adult members of the LGBTQIA+ community who are grieving a past or approaching death. The group will be facilitated by a licensed queer therapist but will be loosely structured to offer an opportunity for participants to share their feelings and grieve with community.Editor's Note: Hospice & Palliative Care Today does not post upcoming, local hospice events, grief support groups, volunteer trainings, etc. However, we're posting this LGBTQIA+ grief support due to its unique need, with opportunities for replication in other hospices. 

Empathy exhaustion in nursing Psychiatry Advisor; by Elizabeth Quaye; 5/5/24 This article looks at the role of empathy in nursing, the causes and symptoms of empathy exhaustion, and steps nurses can take to address it. ...

Breaking the silence: The mounting need for trauma-informed hospice care Hospice News; by Holly Vossel; 5/3/24Traumatized and abused hospice patients and providers often experience an array of lingering physical, emotional and psychological effects that can fall into a silent abyss of unmet needs. ... Many seniors have experienced some form of trauma or abuse in their lifetime. ... More data has become available in recent years around the prevalence of different types of abuse and trauma. Roughly 10% of seniors 65 and older nationwide are victims of some type of abuse each year, the U.S. Department of Justice (DOJ) reported. Caregiver neglect represents 5.1% of these cases, with psychological and physical abuse impacting 4.6% and 1.6% of seniors, respectively. ...Editor's Note: This article highights interviews with Dr. Ashwin Kotwal, assistant professor at the University California San Francisco; Carole Fisher, president, National Partnership for Healthcare and Hospice Innovation (NPHI); Dr. Cameron Muir, chief innovation officer, NPHI; Andrea Devoti, executive vice president at the National Association for Home Care & Hospice (NAHC); Lindsey Owen, executive director of Disability Rights Vermont.

Substance use disorders in hospice palliative care: A narrative review of challenges and a case for physician interventionCambridge University Press; by Lauren Rudy and Emilie Lacroix; 2/29/24Objectives: Substance use disorders (SUDs) are frequently encountered in hospice palliative care (HPC) and pose substantial quality-of-life issues for patients. However, most HPC physicians do not directly treat their patients’ SUDs due to several institutional and personal barriers. ...Results: ... Recommendations for physicians and training environments to address these challenges include developing familiarity with standardized SUD assessment tools and pain management practice guidelines, creating and disseminating visual campaigns to combat stigma, including SUD assessment and intervention as fellowship competencies, and obtaining additional training in psychosocial interventions.

When a parent dies: A scoping review of protective and risk processes for childhood bereavementDeath Studies; by Rebecca Hoppe, Marcia A. Winter, Chelsea D. William, and Irwin Sandler; 4/15/24Abstract: The death of a parent can have profound effects on child development. ... A scoping review was conducted in samples of parentally bereaved children to identify key processes, synthesize results, and determine research gaps. This scoping review identified 23 studies (mainly from the United States), published between 1990 and 2023, that reported child (ages 3–22 years) individual and/or environmental protective and/or risk processes that contributed to bereavement outcomes. Findings can be used to apprise clinicians, families, and policymakers of the unique nature of childhood bereavement and to identify malleable processes to target in interventions designed to prevent problematic outcomes in bereaved children.Funding: This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development through the Ruth L. Kirschstein National Research Service Award [F31HD110247].

What's in the Black Box of a successful nurse and social worker team palliative telecare intervention (ADAPT)? (RP317)Journal of Pain and Symptom Management; by Lyndsay DeGroot, PhD, RN, CNE; Kevin Wells; Brianne Morgan, BSN; Michelle Upham, MSW, LICSW; David B. Bekelman, MD, MPH; 5/24Key Message: A nurse and social worker palliative telecare team provided structured symptom management, psychosocial care, and individualized medical changes to improve quality of life, depression, and anxiety for patients with COPD, HF, and ILD. Impact: A nurse and social work palliative telecare team used collaborative care to tailor recommendations to the unique needs and symptoms of each patient, thereby improving quality of life.

Home care clinicians' perspectives on Advance Care Planning for patients at risk for becoming incapacitated with no evident advance directives or surrogates Journal of Hospice & Palliative Nursing; by Landau, Aviv Y. PhD, MSW; Venkatram, Chinmayi BA; Song, Jiyoun PhD, AGACNP-BC, APRN; Topaz, Maxim PhD; Klitzman, Robert MD; Shang, Jingjing PhD; Stone, Patricia PhD; McDonald, Margaret MSW; Cohen, Bevin PhD; 4/24 Abstract: ... This qualitative descriptive study elicited perspectives of home health nurses and social workers regarding barriers and facilitators to creating advance care plans in home health settings, with particular attention to patients with few familial or social contacts who can serve as surrogate decision-makers. ...  Participants reported a multitude of barriers to supporting patients with advance care planning at the provider level ... Participants noted that greater socialization and connection to existing educational resources regarding the intended purpose, scope, and applicability of advance directives could benefit home care patients.

Shocked at end-of-life: An educational video for hospice workers about Implantable Cardioverter-Defibrillators Journal of Pain and Symptom Management; by Sarah Godfrey, MD, MPH; Christine L. Chen, MD; Melanie S. Sulistio, MD; Sharika Kumar, MD; and Kelley Newcomer, MD; 2/24 Introduction: Hundreds of thousands of patients with implantable cardioverter-defibrillators (ICDs) die yearly. Though ICD shocks can be lifesaving, they can also be severely painful. One third of ICD patients are shocked in the last day of life irrespective of DNR status. Over 97% of hospice programs admit patients with ICDs, yet only 10% have deactivation policies and less than 50% of hospice patients have their ICD deactivated. ...  Conclusion: Hospice personnel have limited knowledge about ICDs, prohibiting best care of patients with these devices at EOL. A short educational video increased knowledge and may serve as a helpful tool. Improving ICD knowledge amongst hospice personnel is essential to ensuring the unique needs of hospice patients with ICDs are met.

More legislation in Illinois deals with ending a person’s life The Center Square - Illinois; by Kevin Bessler; 5/1/24 Another bill has been introduced in Springfield dealing with end of life options for the terminally ill. Illinois state Sen. Julie Morrison’s Senate Bill 2644 would establish a statewide electronic registry that would contain Physician Orders for Life Sustaining Treatment (POLST) forms, which detail what type of medical treatment a critically ill patient does and does not want. “How much or how little treatment a person receives at the end of their life should be up to each individual instead of the one-size-fits-all approach,” said Morrison, D-Lake Forest, during a news conference Wednesday. “This measure will enable physicians to access forms detailing patients wishes in a single, accessible location.” 

DEA tells court that Right to Try law doesn’t supersede CSA in psilocybin case PsychedelicNewsWire; 4/30/24The U.S. Drug Enforcement Administration (DEA) is claiming that a federal law that affords severely ill individuals the right to try investigational medications doesn’t apply to drugs classified under the Controlled Substances Act. This is in response to a lawsuit filed by a doctor in Washington state who sought permission to legally administer psilocybin as treatment for patients in end-of-life care with cancer. The agency argues that because drugs classified under Schedule I are said to have no accepted medical use, the law prevents them from being dispensed, even by professionals. 

Postpandemic, telehealth preferred in outpatient palliative care setting Rheumatology Advisor; by Lisa Kuhns, PhD; 5/1/24 Even after the SARS-CoV-2 vaccine against COVID-19 became available, patients preferred outpatient palliative care visits via video rather than in person, according to study results published in the Journal of Pain and Symptom Management. ... The researchers ... added, “Although telehealth may be preferable for reasons beyond social distancing, this survey found that COVID-19 transmission was still a [postpandemic] concern for some patients, where telehealth can be advantageous. These concerns reflect [an] ongoing sentiment [that] patients with advanced cancer, who are often immune-compromised, have with regards to the pandemic even after widespread vaccine availability and end of COVID-19 restrictions. 

Understanding is better than criticism The Pike County News Watchman; by Loren Hardin; 4/26/24 The first time I met Glenn was at his brother, Kenny’s, and sister-in-law, Tressie’s wedding anniversary party. ... Glenn walked into the party with a swagger, was wearing dark tinted sunglasses, grabbed his belt, pulled up his pants, stuck out his chest and sat down at the kitchen table. I thought, “Who is this guy wearing dark sunglasses on an overcast day?” To be honest, I thought, “This guy is kind of cocky acting”. Little did I know that in the not-too-distant future, I would become Glenn’s hospice social worker, nor did he? ... [Click on the title's link to read more of this insightful, inspirational story.]