Literature Review

Association between opioid use disorder and palliative care: a cohort study using linked health administrative data in Ontario, CanadaCMAJ; by Jenny Lau, Mary M. Scott, Karl Everett, Tara Gomes, Peter Tanuseputro, Sheila Jennings, Rebecca Bagnarol, Camilla Zimmermann and Sarina R. Isenbergl; 4/29/24Background: People with opioid use disorder (OUD) are at risk of premature death and can benefit from palliative care. We sought to compare palliative care provision for decedents with and without OUD.Conclusion: We identified important differences in palliative care provided at the end of life between people with and without OUD. People with OUD were less likely to receive palliative care despite accessing palliative care earlier, which may reflect their end-of-life illness trajectories and underlying structural vulnerability that may prompt them to receive palliative care primarily in acute care. Health care providers should receive training in palliative care and addiction medicine to support people with OUD. 

An exploration of managing emotional labour and maintaining professional integrity in children's hospice nursing International Journal of Palliative Nursing; by Mandy J Brimble, Sally Anstey, Jane Davies, Catherine Dunn; 4/17/24Aim: To investigate how children's hospice nurses manage emotional labour and professional integrity in their long-term relationships with parents. Findings: Three overarching, cross-cutting themes were identified—purposeful positioning; balancing personability and professionalism; coping with and counterbalancing emotional labour. All themes were indicative of and/or built upon emotional intelligence constructs, such as self-awareness, self-regulation, appropriate (managed) empathy, social skills and intrinsic motivation. Innate features of children's hospice work were important for perpetuating intrinsic motivation and satisfaction.

Nonphysical Suffering: An under-resourced and key role for hospice and palliative care social workersJournal of Social Work in End-of-Life & Palliative Care; by Maxxine Rattner & Cheryl-Anne Cait; 11/10/23... Nonphysical suffering is suffering that may be emotional, psychological, social, spiritual and/or existential in nature. The study found an absence of specialist social workers on hospice and palliative care teams or limited time for specialist social workers to address patients’ nonphysical suffering due to high caseloads and complex practical needs. While the study recognizes social workers have expertise in supporting patients’ nonphysical suffering, a competency and skill that has not been sufficiently captured in the existing literature, the systemic barriers they face in providing care may leave patients’ needs unmet. The study also highlights the unique pressure social workers may feel to relieve patients’ nonphysical suffering due to the psychosocial focus of their role.

Exploring unmet concerns in home hospice cancer care: Perspectives of patients, informal caregivers, palliative care providers, and family physicians Cambridge University Press; by Eran Ben-Arye, Noah Samuels, Yael Keshet, Miri Golan, Erez Baruch, and Jama Dagash; 4/8/24 Objectives: The study examines perspectives of patients in home hospice care; their informal caregivers; palliative health-care providers (HCPs); and family physicians, all regarding patients’ unmet needs and quality of life (QoL)-related concerns.Conclusions: While the 4 groups were similar in their scoring of patient QoL-related concerns, there were discrepancies for some concerns (e.g., patient fatigue) and expectations regarding the need to discuss emotional and spiritual concerns, including on death and dying. Educational initiatives with programs providing training to all 4 groups may help bridge this gap, creating a more open and collaborative hospice care environment.

The spectrum of end-of-life experiences: A tool for advancing death educationOmega; by Shared Crossing Research Initiative; 3/24 Abstract: Studies on end-of-life experiences (ELEs) suggest that caregivers and loved ones of dying patients also have ELEs, though these are rarely explored. This article introduces the Spectrum of End-of-Life Experiences (SELE) as a descriptive list of types of ELEs reported by all members of the care unit, including dying patients, their caregivers, and their loved ones. We applied SELE towards identifying ELEs reported by 143 caregivers and loved ones and successfully identified every experience. Interviews revealed that participants viewed their ELEs as profound communicative events, yet a substantial minority also reported struggling to name and process these experiences. We propose that SELE be included in death education to raise awareness about ELEs that can occur within the care unit, and we suggest that SELE has additional applications, including use as a prognostic aid in end-of-life care and as a therapeutic aid for bereavement support.

America’s favorite, weed, comes with big health risks: Pyschosis is an increasing risk of today's strong marijuana.Psychology Today; by Mark S. Gold, MD; 4/30/24Key Points:

Assessing caregiver burnout for hospice, palliative patients Hospice News, by Jim Parker; 4/30/24 Burnout is a state of complete mental, physical and emotional exhaustion. Symptoms of burnout can include depression, compassion fatigue, stress and anxiety, and apathy, both in general life and towards work tasks, according to the Mayo Clinic. To help address these issues — and to help ensure that caregiving remained sustainable — a team of researchers from the Ann & Robert Lurie Children’s Hospital of Chicago and the University of Pittsburgh launched a project to improve assessment of caregiver burnout.

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. 

OSF launches new tools to help make end-of-life planning easier News25, Peoria, IL; by Liz Lape; 4/26/24 OSF Healthcare reports that thousands of patients are dying in medical facilities without end-of-life care plans. ... Sarah Overton, Chief Officer of Nursing, describes that studies show that over 70% of patients would prefer a setting other than a hospital to spend their last moments, like at home hospice or palliative care. OSF has launched self-service resources such as an Advanced Careplanning page and Patient Questionnaire on their app MyChart. Overton says the goal is to make end-of-life care planning more available to the public.

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.]

Attitudes and beliefs regarding Pain Medicine: results of a national palliative physician survey Journal of Pain and Symptom Management; by Daniel K Partain, Wil L Santivasi, Mihir M Kamdar, Susan M Moeschler, Jon C Tilburt, Karen M Fischer, Jacob J Strand; 4/25/24 online ahead of print Objectives: To evaluate referral rates, co-management strategies, and beliefs of palliative physicians about the value of Pain Medicine specialists in patients with serious illness. Conclusion: This study shows that Palliative Care physicians have highly positive attitudes toward Pain Medicine specialists, but referrals remain low. Facilitating professional collaboration via joint educational/clinical sessions is one possible solution to drive ongoing interprofessional care in patients with complex pain.

Employing telehealth to ease the hospice transition for kids with cancer mHelathIntelligence, by Anuja Vaidya; 4/23/24 ... In a study published in the Journal of Pain and Symptom Management last month, Children's Healthcare of Atlanta researchers detailed a telehealth-based intervention the hospital has employed to ease the transition to hospice for young cancer patients and their families. ... The intervention includes a series of coordinated telehealth visits during the first month of hospice enrollment for children or young adults, 29 or younger, with cancer. ... Hospice nurses participating in the pilot received a tablet equipped with mobile WiFi cellular service that they would take to the family's home, which enabled the [hospital/pediatric specialty] nurses and families to join the call. ... The most important finding of the study was that coordinated telehealth visits between the hospital, hospice, and the families during the first month of hospice enrollment were feasible and acceptable to all participants.

Psychosocial distress screening among interprofessional palliative care teams: A narrative review Journal of Social Work in End-of-Life & Palliative Care, by Chelsea K Brown and Cara L Wallace; 4/23/24With increased need for palliative care and limited staffing resources, non-social workers are increasingly responsible for screening for urgent psychosocial distress. The National Consensus Project guidelines call for all palliative care team members to be competent in screening across domains. ... Although an abundance of validated screening tools exists for outpatient oncology-specific settings, there is minimal guidance on psychosocial screening tools intended for specialty palliative care. The most oft-cited tools have been met with concern for validity across diverse palliative care populations and settings. ...