Literature Review

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.

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.

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.

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. 

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.”

Viewpoint: Care fragmentation, care continuity, and care coordination—How they differ and why it mattersJAMA Intern Med., by Lisa M. Kern, MD, MPH; Julie P. W. Bynum, MD, MPH; Harold Alan Pincus, MD; 1/29/24Health care in the US is characterized by fragmentation, with many patients seeing multiple physicians. Indeed, 35% of Medicare beneficiaries saw 5 or more physicians in 2019.1 Having multiple physicians may be appropriate, but it may also lead to medical errors, unnecessary visits, avoidable hospitalizations, and suboptimal care if all of the physicians do not have complete information about the patient and each other’s care plans.

Your 2024 guide to Joint Commission changes - Becker's Hospital ReviewBecker's Hospital Review, by Ashleigh Hollowell; 1/26/24The Joint Commission is cutting more than 200 standards across its accreditation programs, many of which will take effect July 1. The organization initially announced its plans to scale back standards at this scale in July 2023, describing it as the "second tranche of major standards' reduction" following a first round of cuts in December 2022. ... [Among these], Home Care will receive a 15% reduction in performance elements.

Use of complementary health approaches overall and for pain management by US adultsJAMA, by Richard L. Nahin, MPH, PhD; Amber Rhee, MHS; Barbara Stussman, BA; 1/25/24Millions of US adults use complementary health approaches (CHAs) each year; ... Previously, the safety and efficacy of many of these approaches lacked rigorous clinical trials. Over the past 2 decades, increasing evidence has supported the safety and efficacy of selected approaches for pain management. We examined trends in CHA use among US adults at 3 time points: 2002, 2012, and 2022.

Defining key elements of a clinical experience in hospice and palliative medicine for medical residents in the United StatesJ Med Educ Curric Dev, by Carolyn E. Kezar and Andrew J. Lawton; 1/23/24The ACGME [Accreditation Council for Graduate Medical Education] has ... recognized the importance of HPM [hospice and palliative medicine] training for medical residents, establishing in its 2022 Common Program Requirements for Internal Medicine a new expectation that all residents have a clinical experience in HPM. ... However, internal residencies vary significantly. ... In this perspective, we draw from the available literature and our experience as educators to propose 5 core elements for creating an optimal HPM experience for medical residents.Editor's Note: Does your hospice support nearby medical schools? Rich opportunities abound.

Craft a memorial pillow for your loved one at this DeKalb workshopShaw Local News Network; 1/22/24The DeKalb Public Library will partner with Northern Illinois Hospice to host a workshop for patrons to create pillows out of a loved one’s shirt. ... Attendees can create up to two pillows out of a T-shirt or button-down shirt. Sewers will be available to assist. Participants should not bring denim, jackets or thick fabrics. Bereavement information and support will be provided.Editor's Note: Explore this lovely, meaningful activity for your hospice's bereavement care, volunteer services, and community outreach.