Literature Review

Viral moment: Hospice worker reunites with former mentor for touching bedside serenade FaithIt, by Kelsey Straeter; 4/23/24In Austinburg, Ohio, at the Austinburg Nursing & Rehab Center, a video capturing a deeply moving moment has gone viral, striking a chord with over half a million viewers. The footage shows hospice worker Joshua Woodard singing a heartfelt rendition of “How Great Thou Art” to his former mentor, Mary Redmond, just days before her peaceful passing. ... Decades ago, Mary Redmond was not only a cherished voice and piano teacher in her community but also a vibrant member of the local arts scene, starring in productions such as “Hello, Dolly!” and “The Music Man.” ... One of those lives was a young Joshua Woodard ... She became his first voice coach, leaving a lasting impression that endured through the years.

Hospice nurse plays instrumental role in patient’s joy Scottsdale Progress, by Lin Sue Flood; 4/20/24 You see it at every symphony performance. People so enraptured by the music — their eyes close and their fingers dance in the air. Stuart Brown is one of those people. But as illness began to limit his mobility, the 81-year-old Scottsdale man relinquished the thought of ever attending a live concert again. That’s when his Hospice of the Valley nurse secretly reached out to the Phoenix Symphony with a request to hold a small private concert in his Scottsdale home.

[Unique Grief Program] Stillwater Hospice offers grief hikesTimes Union Online, Fort Wayne, IN; by Stillwater Hospice; 4/18/24 Time spent in nature has been associated with improved mental health and overall well-being. Walking and movement can be helpful in processing emotions that are a part of the grieving process. Grief hikes are designed to combine these benefits through mindful movement and immersion in nature. The Peggy F. Murphy Community Grief Center in collaboration with ACRES Land Trust will be hosting Grief Hikes on the third Friday every month from May through September. ... Each hike will be held at a different ACRES location, accessible within the Stillwater Hospice service area.

Clinician burnout and effectiveness of guideline-recommended psychotherapies JAMA Network - Psychiatry; by Nina A. Sayer, PhD; Adam Kaplan, PhD; David B. Nelson, PhD; et al; 4/17/24 Importance: Clinician burnout has been associated with clinician outcomes, but the association with patient outcomes remains unclear. Conclusions: This prospective cohort study suggests that clinician burnout was negatively associated with patient outcomes from evidence-based psychotherapies. Findings support research to test the hypothesis that interventions to reduce burnout may improve outcomes from guideline-recommended psychotherapies for PTSD. Future work should determine when and how burnout is associated with intervention delivery and patient outcomes.Editor's Note: Most research on hospice and palliative clinician burnout focuses on physicians and nurses. Examine this in light of your psychosocial/spiritual professionals, i.e. social workers, chaplains/spiritual care, and bereavement counselors. 

Defining metrics for assessing end-of-life care quality in children with cancer Physician's Weekly; 4/16/24 In this study, the researchers sought to define the target population for applying newly developed quality measures in end-of-life (EOL) care for children with cancer. Through a series of nominal groups, panelists addressed the question: “Which children, diagnoses, conditions, or prognoses should be included when examining the quality of EOL care for children with cancer?” ... A team of pediatric oncology and palliative care clinician-scientists developed a coding structure to analyze responses and identify associated themes and subthemes. 

Health care system eats away at the doctor-patient relationship The Boston Globe; updated 4/17/24... The system economically rewards throughput (the number of patients seen per unit time) and procedures rather than the time needed to develop an open and communicative doctor-patient relationship. While a good physician might understand the tests and evaluations that are indicated by a presenting medical problem, the excellent clinician knows which tests and evaluations should not be done. This is primarily ascertained by delving into details of the patient’s physical, psychological, social, family, and economic history. This process, as James highlights, can lead to collaborative and more effective care. ...Editor's Note: This article highlights "Dr. Thea James’s remarkable work at Boston Medical Center in addressing structural inequity in medical care as a means of enhancing outcomes brings up an underlying structural problem across the entire medical care system (“Her health equity message being heard,” April 13, 2024.)

Shared decision-making between nephrologists, patients key to conservative kidney management Healio, by Mark E. Neumann; 4/15/24 ... Conservative kidney management: Patients who decline dialysis treatment do so for many reasons, Fahad Saeed, MB, BS, and colleagues wrote in a paper published in the American Journal of Nephrology. Patients told researchers that quality of life; fewer symptoms caused by dialysis; more personal time; avoiding the burden of dialysis, including for family and friends; witnessing a family member or friend on dialysis and wanting to have a peaceful death were reasons to select conservative kidney management.

Comment: Rule must change to allow dialysis as end-of-life care HeraldNet, by Matthew Rivara and Mackenzie Daniek; 4/13/24More than 1 in 7 American adults live with chronic kidney disease, making it one of the most common chronic disease conditions in the United States. ... Medicare will generally not reimburse health care providers for dialysis treatments if a patient has elected to enter hospice care, as dialysis treatments are considered by Medicare to be “curative” rather than “palliative” care. Because of this, most patients getting dialysis for ESRD must forego all dialysis treatment after entering a hospice program.

Physician coaching by professionally trained peers for burnout and well-being: A randomized clinical trial JAMA Network; by Stephanie B. Kiser, MD, MPH; J. David Sterns, MD, MPH; Po Ying Lai, MS; et al; 4/12/24Findings: In this randomized clinical trial of 138 physicians, participants who received 3 months of coaching by professionally trained physician peers had a statistically significant reduction in interpersonal disengagement and burnout, with improvement in professional fulfillment and work engagement.

Medical marijuana program enrollments up 500% from 2016 to 2022 Green Market Report, by John Schroyer; 4/11/24The increase was partially due to a rise in mainstream "cultural acceptance of cannabis" and corresponding interest in medical uses. A new federally funded report that tallied medical marijuana patient statistics from across the country found a dramatic increase of registered cannabis patients over a seven-year period, from roughly 678,000 in 2016 to more than 4.1 million at the end of 2022.

3 ways advance care planning empowers people TCPalm, Visiting Nurse Association, by Lauren Gruber; 4/10/24 ... National Healthcare Decisions Day on April 16th, which seeks to inspire, educate and empower the public and providers on the importance of health planning, is a prime opportunity to consider enrolling in an advance care plan. Identifying the right caregiving plans may seem daunting at first, but it’s important that patients solidify an advance care plan for the security and peace of mind of themselves and their loved ones. ... Here are three ways why choosing an advance care plan through the VNA can empower patients to ensure the best care possible during their health care journey:

Readers share stories of their loved ones’ deathbed visions DNYUZ; 4/10/24 When I started reporting “What Deathbed Visions Teach Us About Living,” about the visions, often of loved ones, that some people have in the final stretches of their lives, I had no idea just how universal the experience was. But within minutes of the story’s publication, readers took to the comments section to post their own memories of having witnessed the phenomenon. The stories were rich, deeply personal, and seemed to confirm something that the researcher featured in my story, Dr. Chris Kerr, knew in his years of studying such visions: they bring peace to the dying and solace to the living. Family members wrote in with stories of watching loved ones have visions, as did health care workers, who had years of experience witnessing them. [Click on the article's title to read more stories.]

A wish to remember: Penn Medicine program fulfills patients’ last requests Penn Medicine News, by Meredith Mann; 4/9/24 The patient was dying of cancer. All options for saving or prolonging their life had been exhausted. Now, the patient most wanted to spend one more carefree, joyous day with their grandchild. ... This is just one example of the last requests granted through Princeton Health’s Three Wishes Project. On paper, it’s about performing small gestures that bring comfort and meaning to patients at the end of their lives. In practice, it’s about so much more—providing a sense of hope and closure, not only to these patients and their families, but also to staff.