Literature Review

The daily balancing act of value-based cancer care The American Journal of Managed Care (AJMC); by Laura Joszt, MA; 10/14/24 In value-based care, there’s a daily balancing act to achieve quality outcomes, cost reduction, and patient care improvements, explained Stuart Staggs, vice president of transformation, quality, and shared services for The US Oncology Network (Network). At the Institute for Value-Based Medicine event, cohosted by The American Journal of Managed Care (AJMC) and Minnesota Oncology, Staggs kicked it off with what he called a “practical look at value-based care.” He highlighted 4 main areas: quality, improvement, adoption, and cost. ... The area of improvement that the Network wanted to focus on was advanced care planning and better supporting and engaging patients and their families around hospice and life support. During the OCM, the Network better engaged patients and families around hospice care and encouraged practices to have difficult conversations. Not only does this improve patient experience by providing them the end-of-life care that they want, but there is also a cost factor. Patients who don’t receive hospice care spend significantly more in the last 30 to 60 days, Staggs said.

‘It’s more like hope’: New hospice patient’s Halloween wish come true WTOC 11, Pooler, GA; by Jasmine Butler; 10/14/24 Tons of candy, a bunch of costumes and hundreds of people. That is what a neighborhood in Pooler looked like as people gathered for a Layla Alacan, who recently entered Hospice Care. “She is so sweet when she wants to be and she’ll cuddle up and give kisses, she’s the definition of a sour patch kid. She’s super sour and then super sweet after,” said Layla’s mother, Courtney Alacan. She has a big personality, but she’s fighting a big battle. Layla has a rare terminal disorder called 4H Leukodystrophy. ... It’s an experience her parents Courtney and Nick Alacan know all too well. “Our first child Jamie also had the condition. And she unfortunately passed in April of 2023,” said Alacan. So, they’re vowing to make her wildest dreams come true. ... “[We]  asked her what her favorite holiday was and she said Halloween," said Alacan. “Thinking we would have 40 or 50 kids come through and just you know, have a nice little night. Then, it blew up and now we’re here and we couldn’t be more grateful," said Alacan. An entire community, celebrating Halloween a little early but also rooting on the six-year-old with enough spunk, for them all. 

A compassionate guide to caring for someone with dementia: 5 essential tips NBC-4 Washington, DC; 10/14/24 According to the World Health Organization, more than 55 million people worldwide are living with dementia, with over 10 million new cases each year. Dementia encompasses a range of brain conditions that lead to a decline in cognitive function, affecting a person's ability to manage everyday tasks. While the disease can present unique challenges for both medical professionals and caregivers, there is hope in the growing understanding of how to best support those affected. ...

Clinical scenario: Patient care through POLST  The Hospitalist; by Mihir Patel, MD, MPH, FACP, CLHM, SFHM; 10/10/24 Physician orders for life-sustaining treatment (POLST) forms are crucial tools in ensuring that patient treatment preferences are respected and followed, particularly during medical emergencies. As hospitalists, integrating POLST into patient care can significantly enhance decision-making processes, aligning treatments with the patient’s wishes. Here, we present a clinical scenario demonstrating the application of POLST in a hospital setting, emphasizing the importance of electronic documentation in the patient’s medical record. ... [Click on the title's link for this Case Study, which includes the Case, Hospitalist Actions,Outcome, and Conclusion.]

The death issue: Austin’s Children’s hospice professionals advocate for honesty The Austin Chronicle; by Maggie Quinlan; 10/11/24 Sometimes parents wait too long to tell their sick children that they will die. Sometimes, by the point of disclosure, their child can no longer speak. ... She said often the dying child will become an “emotional caretaker” in the hospital room where they’ve just learned that their illness will kill them. “Even though it’s happening to them, they tend to really want to protect their family.” It doesn’t have to be that way. Cosby says a lot of the job is beautiful, even fun. Families make memories, and child life specialists help make it happen. They go to see the ocean. They throw private proms and graduation ceremonies. They finger paint. They crack jokes. They decide to make the most of precious little time. ... “Grief is the price of love, and there’s so much love in there,” says Heather Eppelheimer, another Dell Children’s child life specialist. “We have to be able to love fully in order to also grieve fully.” Child life specialists respect family wishes and also advocate for honest, clear language about death. They say to use that word – death, dying, die – and avoid “passing away” (“To where?” Cosby asks). That kind of straightforward communication isn’t part of our cultural hardwiring, Cosby says, but it makes everything easier. In her life, when people aren’t comfortable talking about death, she asks why. What are they afraid of? ...

Couple who volunteers together, shares the same joy Envision - Greater Fond du Lac, WI; contact Betty Wallerser; 10/7/24 For the past nine years, Matthew Davis, a Green Lake resident, has been spending a good amount of his days volunteering with SSM Health at Home Hospice – Green Lake. “A friend of mine mentioned volunteering for hospice telling me that it was the most rewarding thing he had ever done, so I thought I’d give it a try,” according to Matthew. A handful of stories and memories later, Matthew is still volunteering for SSM Health at Home Hospice – Green Lake. ... In 2023, Matthew’s wife, Becky, also started volunteering for SSM Hospice at Home Hospice in Green Lake.  “I always wanted to be a hospice volunteer,” Becky shares. “I worked in physical therapy for 25 years and had a comfort level with patients I knew some people didn’t have. When a close friend of mine passed away on hospice, I knew it was my time to sign up.” Matthew and Becky are one of several couples who volunteer in hospice and are a great asset to the Volunteer Services team, as they both visit with several hospice patients a week.

Guest column: Hopewest – Breaking the silence: Supporting suicide prevention and survivors of loss Special to the Herald Times; 10/2/24 Those left in the wake of a suicide loss sometimes aren’t sure where to turn or what to do. Uprooted by shock and overcome by the grief of losing someone to suicide can feel painful and isolating. ... The stigma surrounding suicide deaths, particularly on the Western Slope of Colorado, often hinders individuals from seeking the support they need. To address this crisis in our communities, we must not only bring awareness to suicide prevention but also collectively understand and acknowledge the challenges that survivors of suicide loss face. “Grief after the loss of a loved one to suicide is a unique and painful experience. Survivors struggle with a range of challenges, from the heavy weight of stigma surrounding the death, to judgment from others,” said Judy Eskelson, HopeWest Meeker Bereavement Counselor. “And for many in our community, they may not fully understand the ins and outs of this type of grief. Life after this kind of death can be overwhelmingly difficult, leaving families to navigate a path they never expected to walk.” ... Following the devastating loss of a loved one to suicide, the HopeWest bereavement team is here to walk alongside individuals and families needing a source of comfort and guidance through their grief journey. Editor's note: Though many hospices provide bare, minimum grief support, many others--like HopeWest--live out their mission by providing a fuller scope of bereavement counseling and support. What does your hospice provide? Throughout your service area, do bereaved persons (whether hospice deaths or not) think of your agency as the "dying, death and bereavement" expert, or not? 

Caring for Hindu patients at the end-of-life: A narrative review Cambridge University Press; by Brinda Raval Raniga, MD, Savannah Kumar, MD, Rebecca McAteer Martin, MD, and Craig D. Blinderman, MD; 10/3/24  This paper reviews the existing literature to identify specific challenges that may arise in the context of providing palliative and end-of-life (EOL) care for Hindu patients in the physical, psychological, and spiritual domains. We offer practical strategies where appropriate to mitigate some of these challenges. We review how the Hindu faith impacts EOL decision-making, including the role of the family in decision-making, completion of advance directives, pain management, and decisions around artificial nutrition and hydration (ANH) and cardiopulmonary resuscitation (CPR). 

Data points to need for trauma-centered care at end of lifeMcKnight's Long-Term Care News; by Kristen Fischer; 10/2/24A new study has found that early life and cumulative trauma are linked to poorer physical and psychosocial health at the end of life. The report was published Tuesday in the Journal of the American Geriatrics Society. Among participants, 19% reported no trauma, while 47% experienced one to two traumatic events and 25% had three to four traumatic events. A total of 9% of people reported more than five traumatic events in their lives. “Findings highlight the need for clinicians caring for seriously ill older adults to ensure interdisciplinary care for trauma symptoms and potentially adopting a trauma-informed approach to end-of-life care,” the authors wrote.

$1.6M grant to focus on nursing home units to reduce racial disparities in dementia care McKnights Long-Term Care News; by Jessica R. Towhey; 10/3/24 Emory University will use a $1.6 million, federal grant to investigate the role Alzheimer’s special care units play in reducing racial and ethnic disparities in dementia care within nursing homes. The research team will be led by Huiwen Xu, PhD, an associate professor in the university’s Nell Hodgson Woodruff School of Nursing, who specializes in gerontology and elder health. The four-year grant from the National Institute on Aging will analyze quality of life and improved health outcomes in the specialized care units, which the school’s press release said are available in only 14% of nursing homes nationwide. Xu’s team will examine the underlying causes of racial disparities for Black and Hispanic residents, who have limited access to the memory care units, the release said. 

Breast cancer rising among younger women and Asian Americans, report findsNBC News; by Kaitlin Sullivan; 10/1/24Even as death rates from breast cancer have fallen, rates of new diagnoses continue to tick upwards, according to an American Cancer Society report. Americans have benefited from huge leaps in breast cancer treatment over the last two decades, but diagnoses are becoming more common, especially among younger women, according to a report published Tuesday by the American Cancer Society. The new report shows that breast cancer mortality has decreased by 44% since the late 1980s. Rates of breast cancer, however, have increased by 1% every year since 2012. In younger women, rates have increased at a faster clip — by about 1.4% every year since 2021.

How 300 terminally ill couples had their ‘perfect’ weddings thanks to this nonprofit (Exclusive) People Magazine; by Johnny Dodd; 9/28/24 "We're in the business of hope," says Wish Upon a Wedding's executive director, Lacey Wicksall. On any given day, Lacey Wicksall can be found fielding phone calls from couples across the nation who are deeply in love but are running out of time. And that’s exactly why Wicksall is talking to them. As the executive director with the Chicago-based nonprofit Wish Upon a Wedding, the 43-year-old mother of two helps provide free weddings and vow renewals to couples who are facing a terminal illness or a life-altering health circumstance. “I just got off the phone with a couple a few hours ago and I still have tears in my eyes,” says Wicksall of a recent phone call, vetting a couple who were in the process of applying for one of the nonprofit’s weddings. “We were all in tears. It’s hard.” ... Since 2009, the organization has provided nearly 300 ceremonies by working with wedding industry professionals who donate everything from catered food and wedding attire to a venue, videographers and DJs. ... Before being selected for an interview by Wicksall and “wish coordinator” Megan Biehl, they verify the applicant’s health status through their physician or hospice worker, then go to work learning more about the couple and what they envision for their special day. ...

Palliative care in kidney cancer more than just relieving symptoms Cure; by Ashley Chan; 9/26/24 Patients with kidney cancer who want more support during treatment can consider palliative care, whether it’s for symptoms or discussing goals and values. ... For patients with kidney cancer, understanding how palliative care can help is essential throughout the treatment process. Palliative care, according to the Mayo Clinic, is medical care that specializes in relieving pain and symptoms associated with an illness. This type of care can also help patients cope with treatment-related side effects. However, there’s more to palliative care than just relieving symptoms. It also “aims to help patients and families in one of three major categories,” Dr. Pallavi Kumar explained during an interview with CURE®. Kumar is the director of Oncology Palliative Care and assistant professor of Clinical Medicine in the hematology-oncology division at the University of Pennsylvania. She noted that the three categories of palliative care include: