Literature Review

10% of people with dementia may actually have different disease, research suggestsBecker's Clinical Leadership, by Ashleigh Hollowell; 2/1/24Certain cases of dementia — potentially up to 10% — could instead be undiagnosed liver disease and related neurological issues, according to a study published Jan. 31 in JAMA. Additionally, researchers believe that the 10% of undiagnosed liver disease and brain dysfunction could possibly be resolved with treatment. For the study, researchers analyzed a decade of data — spanning 2009 to 2019 — from 177,422 veterans who had a diagnosis of dementia, and looked for a high Fibrosis-4 score, which is a sign of advanced liver fibrosis that can lead to cirrhosis.

A pathophysiological approach for selecting medications to treat nociceptive and neuropathic pain in servicemembersMil Med, by Khan Thi Nguyen, Daniel W Beauchamp, Reginald B O'Hara; 1/31/24The prevalence of chronic pain of service members (SMs) in the U.S. is estimated to be higher (roughly 31-44%) compared to that of civilian population (26%). This higher prevalence is likely due to the high physical demands related combat and training injuries that are not immediately resolved and worsen over time. Mental Health America reports that chronic pain can lead to other mental health conditions such as severe anxiety, depression, bipolar disorder, and post-traumatic stress disorder.

These sisters help families donate brains to scienceBrain&Life; 2/2/24Tish Hevel, 65, talks about the Brain Donor Project, a nonprofit group she and her sister, Annie McManis, 54, established after their father died of Lewy body dementia. ... "Our father was diagnosed with Lewy body dementia in 2014. In researching the disease, we kept reading about brain donation. Our father had always wanted to donate his body, so we knew he would want to donate his brain as well. And we knew scientists needed tissue. But the process of donating was complicated."

Nurses' encounters with patients having end-of-life dreams and visions in an acute care setting - A cross-sectional survey studyJ Adv Nurse, by Alison Hession, Tim Luckett, David Currow, Michael Barbato; 1/31/24Results: Fifty-seven nurses participated from a workforce of 169 (34% response rate), of whom 35 (61%) reported they had encountered end-of-life dreams and visions. The nature of end-of-life dreams and visions encountered was similar to those reported in previous studies by patients and clinicians. Nurses generally held positive attitudes towards end-of-life dreams and visions but identified an unmet need for education and training on this aspect of end-of-life care.Editor's Note: This research was in Australia, yet has global applications. For U.S. leaders, call on your chaplains, many of whom are trained pastoral counselors to sensitively support and explore patient's "dreams and visions," in non-manipulative ways.

Alternative therapies for pain management in senior careMedCity News, by Bent Philipson; by 1/30/24Chronic pain, an enduring concern for many older adults, is no longer confined to the traditional realm of pharmaceuticals. While traditional pain management methods like medication were once the go-to approach, alternative therapies are emerging as a viable and holistic approach to addressing this issue.

Hospices struggle to balance costs, patient needs in medication deprescribingHospice News, by Jim Parker; 1/30/24When deprescribing medications for hospice patients, providers have to navigate a complex web of factors. But according to some clinicians, the prospect of cost savings often takes precedence over clinical outcomes. Medication costs are among hospices’ biggest expenses, and deprescribing some medications deemed “curative” or “unrelated” to the patient’s terminal diagnosis is a standard practice. However, even in the context of providing comfort care at the end of life, many patients do not receive medications that could benefit them, including those for pain management.

The healing power of remembering and recordingLocalTownPages - Franklin; 1/30/24Every person on this earth holds space in the lives of those around them. We fill that space with our voices, talents, wisdom, laughter, touch, beliefs, innovations, style, and even occasionally with our struggles. Each human experience is unique and varied, complex and beautiful.

Psychedelic therapy debate returns to Missouri General AssemblyMissouri Independent, by Rebecca Rivas; 1/30/24Numerous clinical studies nationwide have shown positive results from using psilocybin to treat PTSD, depressiona and substance use. Republican lawmakers are once again pushing legislation that would require Missouri to conduct a clinical study on using psilocybin, more commonly referred to as “magic mushrooms,” to treat depression, substance use or as part end-of-life care. ... In the House Veterans Committee on Tuesday, Republican Rep. Aaron McMullen of Independence plans to present an amended version of the bill that would limit its scope to only veterans. The suicide rate among veterans in Missouri is nearly double the state rate and one of the highest in the country. ... McMullen, a veteran who served in a combat unit in Afghanistan, told The Independent, “While psilocybin is not a panacea for every issue, it represents a first true scientifically-validated hope that we have to address this crisis.”

Effectiveness of an Advance Care Planning intervention in adults receiving dialysis and their families: A cluster randomized clinical trialJAMA Network, by Mi-Kyung Song, PhD, RN; Amita Manatunga, PhD; Laura Plantinga, PhD; 1/29/24In this randomized clinical trial, the [Advanced Care Planning] ACP intervention implemented by health care workers at dialysis centers improved preparation for EOL decision-making but showed mixed effectiveness on bereavement outcomes. The ACP intervention implemented in dialysis centers may be an effective strategy to the dyad preparation for end-of-life care as opposed to the current focus on advance directives.

Spotlight PA court victory leads to new academic research into Pa. medical marijuana program Spotlight PA, by Ed Mahon; 1/29/24After a 15-month legal battle, Spotlight PA in 2022 won access to data showing the reasons why hundreds of thousands of patients qualify for the state’s medical marijuana program. We published a big investigation based on the records last year. ... In an article, the researchers described the work as “the first study in the U.S. of the association between dispensary locations and qualifying conditions.”

Increasing access to care: Designing a blended curriculum to educate adult hospice nurses in caring for pediatric patientsNursing Forum, by Paige L. McDonald, Samia M. Abdallah, Laurie B. Lyons, and Deborah Fisher; 1/29/24Access to care for pediatric hospice patients is inhibited by a lack of providers specifically educated to care for pediatric patients. Education that seeks to address this gap in care must develop the specific knowledge and skills required to care for pediatric patients, and this education must also be delivered in a format that enables convenient access to providers. 

In the hospital? Don't overlook the chaplainNext Avenue, by Alice Tremaine; 1/30/24Chaplains are the hospital's best-kept secret. Best-kept secret from patients, that is. Most of the hospital staff has figured out just how helpful chaplains can be, and will call the chaplain for everything that's difficult, scary or just plain weird: an unruly patient, a patient who received terrible news, a nurse who believes a hospital room is haunted, a mistress who showed up while the patient's wife is in the room.Editor's Note: Click here for "Common Qualifications and Competencies for Professional Chaplains," by the Board of Chaplaincy Certification, Inc.