Literature Review

Study shows end-of-life cancer care lacking for Medicare patients Vanderbilt University Medical Center (VUMC) News; by Tom Wilemon; 2/21/25 The study involved patients of diverse ethnic backgrounds age 66 or older who died from breast, prostate, pancreatic or lung cancers. Many Medicare patients with advanced cancer receive potentially aggressive treatment at the expense of supportive care, according to a study that analyzed Medicare records. The study, published Feb. 21 in JAMA Health Forum, examined the quality of end-of-life care among 33,744 Medicare decedents. ... Overall, claims records showed that 45% of the patients experienced potentially aggressive care (such as multiple acute care visits within days of death), while there was a low receipt of supportive care, such as palliative, hospice and advanced care planning in the last six months of life. While hospice care spiked to more than 70% during the month that death occurred, over 16% of patients spent less than 3 days in hospices. Moreover, receipt of advanced care planning and palliative care remained below 25%. Editor's note: Click here for the research article, "Contemporary Patterns of End-of-Life Care Among Medicare Beneficiaries With Advanced Cancer." Though this research was published just this past Friday February 21, 2025, multiple newsletters are posting it, highlighting different elements. 

How OU Health's Professional Practice Model is defining nursing excellence Health Leaders; by G Hatfield; 2/24/25 This model enables [Oklahoma University] OU Health to elevate nursing education, practice, and outcomes, says this CNE. ... Stefanie Beavers, DNP, RN, NEA-BC, chief nurse executive at OU Health, and HealthLeaders Exchange  ... The Concept: A professional practice model, according to Beavers, is an evidence-based practice that aligns organizational values with a framework driven by research and outcomes. The goal is to elevate nursing excellence and patient outcomes, but also to solidify the identity of the organization's teams. The OU Health Nursing Professional Practice Model was developed based on the Joanne Duffy Quality Caring Model, so that the organization could take caring behaviors and integrate them into OU Health’s values.

Improving knowledge, confidence, and skills in perinatal bereavement care through simulation in baccalaureate nursing studentsState Nurses Associations - Kansas State Nurses Association; by Shelby True, MSN, RN; Libby Rosen, PhD, RN, IBCLC; Ashley Seematter MSN, RN; Jeri Harvey & Karly Lauer, MSN, RN; 2/20/25Many baccalaureate nursing programs throughout the United States thread concepts of bereavement and end-of-life care throughout their curriculum. However, a standardized education program for nursing students that increases the knowledge, confidence level, and application of skills a nurse must possess when providing perinatal bereavement care is often absent from the curriculum (Sorce & Chamberlain, 2019).  Perinatal loss can have a profound impact on parents and their loved ones, leading to emotional, psychological, physical, and spiritual trauma that deeply affects the lives of those involved. The nursing care each parent receives at the time of the loss may be remembered for years to come and is crucial to determining the nature of the grieving process (Sorce & Chamberlain, 2019). ... To improve the knowledge, confidence, and skill level of nurses providing perinatal bereavement care, a role-play perinatal bereavement simulation was developed and implemented in two Midwestern universities’ baccalaureate nursing programs in the maternal/newborn courses. Editor's note: Having served our hospice's Pediatrics Team for four years, the grief of parents, grandparents, siblings affected me deeply. I remember vividly a young mom unable to physically leave her baby's body with the hospital's nurse. Gently, we held her baby together. Over the course of about 15 minutes, the mother gradually shifted the weight of holding her baby over to me, before the hardest task of her life--leaving the hospital without her child. (It was Christmas week. I bawled when I got home.) Visiting them at the funeral home and after in their home, I experienced horrible, disenfranchised comments and attitudes from others (especially a local preacher). Leaders: tune into your pediatric hospice and palliative team members. What specialized support and education do they need? And, we never know what personal stories of perinatal bereavement those around us continue to carry. 

New ACS research finds low uptake of supportive care at the end-of-life for patients with advanced cancer EurekAlert! - American Association for the Advancement of Science (AAAS); Peer-Reviewed Publication by American Cancer Society; 2/21/25  Despite considerable efforts to improve the quality of end-of-life care in the United States, a new retrospective study led by American Cancer Society (ACS) researchers revealed that close to half of patients with advanced cancer received potentially aggressive care at the end-of-life at the expense of supportive care. The findings are out today in the Journal of the American Medical Association (JAMA) Health Forum. ... Study results showed only one-quarter of patients diagnosed with advanced cancer received any palliative care in the last 6 months of life, and those who received it did so mainly in the month of death. Overall, 45% of decedents experienced any indicator of potentially aggressive care. There was an increase in the mean number of acute care visits (from 14.0 to 46.2 per 100 person-months), hospice use (from 6.6 to 73.9 per 100 person-months), palliative care (from 2.6 to 26.1 per 100 person-months), and advanced care planning (from 1.7 to 12.8 per 100 person-months) over the last 6 months of life. ...

Heritage Hospice’s “Scatter Hearts” project honors veterans and patients The Advocate-Messenger, Danville, KY; by Josely Labarrere; 2/19/25 Heritage Hospice volunteers are spreading love and appreciation this Valentine’s season with the “Scatter Hearts” project, a heartfelt initiative designed to bring joy to hospice patients, particularly veterans. ... “The volunteers thought it would be a good time to honor our veterans, acknowledge the sacrifices they have made for us, and bring a smile to our hospice patients,” said Wendy Hellard, Director of Volunteer Services at Heritage Hospice. ... The wooden hearts, designed to be displayed on doors, were individually painted by Heritage Hospice volunteers and community members in bright and cheerful colors. Special hearts featuring patriotic red, white, and blue designs were created for veteran patients."

How music is rewriting end-of-life care The Daily Iowan; by Madison Schuler; 2/18/25 The form of therapy relieves not only patients but also family members. Over the years, music has been used to express emotions for some while creating connections and memories for others. Listening to a certain song can take people back to a specific moment. Whether it elicits joy, pain, anger, or sadness, music has a different effect on each individual. Music stays with people throughout their lives, always bringing forth those emotions or memories. For those in end-of-life care, music can do the same. ... Today, hospitals and hospice centers are seeing an increase in the use of music therapy, specifically in end-of-life care. [Click on the title's link to learn more.] Editor's note: Click here for the national directory of CBMT board certified music therapists. Click here for my 2005 book in Routledge's Series in Death, Dying and Bereavement, Music of the Soul - Composing Life Out of Loss.

Cancer, aging, and meaning: Navigating psychosocial challenges The ASCO Post (Association for Clinical Oncology); by Ramy Sedhom, MD; 2/18/25 I’ve learned a lot about medicine over the years, but one thing I wasn’t taught was how to guide someone through the existential weight of dying. My education centered on diagnosing, curing, or at least managing disease—not on the delicate art of helping people and their loved ones cope with what cannot be cured. Now, several years into my career as an oncologist, primarily caring for older adults, I recognize that providing cancer care for the whole patient requires deep attention to their psychosocial health needs. ...

Influenza vaccination cuts deaths by up to four times Medscape Medical News; by Olga Fernandez Castro; 2/17/25 Influenza vaccination significantly reduces flu-related morbidity and mortality across all age groups, according to a large-scale Spanish study analyzing data from more than 38 countries and 6.5 million patients. ... The analysis confirms that vaccination against the influenza A (H1N1) virus and the influenza B virus (IBV) effectively reduces infection rates and flu-related complications in children aged under 5 years, individuals aged 5-65 years, and older adults aged over 65 years. However, protection against influenza A (H3N2) virus appears lower in older adults, despite being effective in younger children. Editor's note: Click here for the Centers for Disease & Prevention Control (CDC) "Weekly Influenza Surveillance Preport," with a map for flu activity levels for each state and drilled down to counties. Click on the "CBSA" button to change from the state view to the counties' view and downloadable data. 

Witnessing a living funeral Parkview Health; by Tim O'Sullivan, MA, Spiritual and Social Services Supervisor, Parkview Hospice; 2/16/25 ... Rather than planning services after they pass and miss out on a gathering of the people who are most precious to them, some are choosing to schedule a "funeral" while they are still living so they can be a part of the ceremony. These events are known as Living Funerals. As a hospice caregiver, I have seen a rise in the number of these pre-death celebrations of life. While this may not be for everyone, it can be a meaningful experience for those who have chosen to remember a life in this way. I was invited to one of these events and witnessed firsthand the power of acknowledging death while fully living in the moment. ... [Click on the title's link to continue reading.]

Americans who’ve become caregivers rose by a third in 10 years The Daily Sentinel, Grand Junction, CO; 2/14/25 A growing numbers of family members now provide care for older adults who live at home or in residential care settings, a new study shows. Their ranks increased 32%, from 18.2 million to 24.1 million, between 2011 and 2022, according to new research in the journal Health Affairs. The number of hours that these folks spent caring for older adults with dementia jumped by nearly 50%, from an average 21.4 hours per week in 2011 to 31 hours in 2022. Exactly what is driving the increase in family or unpaid caregiving is not fully understood, but researchers speculate that it may be due to a rise in the number of people who live with the folks who they assist. For the study, researchers culled data from the National Health and Aging Trends Study (NHATS) and the National Study of Caregiving (NSOC) in 2011 and 2022.  

Death Matters: The gift of presence: Tips for visiting someone who is dying Squim Gazette, Squim, WA; by Jeanette Stehr-Green, Volunteer Hospice of Clallam County; 2/12/25 We sometimes avoid visiting friends or family members who are terminally ill. We make lots of excuses. We don’t know what to say. We don’t know how to act. We don’t want to be a bother. The hard truth is that dying, the final stage of life, can be a lonely experience without the presence of family and friends. A visit during this time can bring comfort to the dying person and their family. It can also provide an opportunity to share feelings, reminisce, and say goodbye. Visiting a dying person seems difficult because most of us lack experience. It only takes a little courage and a few ideas to create a meaningful moment. ... Editor's note: These excellent guidelines empower hospice patients' families and friends--and protect patients' vulnerable energies and emotions--in multiple settings across the trajectory of dying. How might you adapt these for your own patient/caregiver support and community outreach?

Advanced cardiac care boosts symptom management, quality of life Carolina Caring, Newton, NC; by Cassidy Collins; 2/12/25 For those living with advanced heart disease or heart failure diagnoses, access to the right medical care can greatly improve their quality of life. This Heart Month, Carolina Caring is spotlighting the Advanced Cardiac Care Program, which provides treatment and clinical support to help patients with heart failure manage their symptoms from wherever they call home. It is the first program of its kind in North Carolina and one of the first established in the nation. It also recognized as a Certified Care program in Palliative/Hospice Heart Failure from the American Heart Association (AHA). Since this certification, Carolina Caring saw a drop to zero readmissions for primary congestive heart failure Hospice patients by the end of 2024. The benefits of this comprehensive, home-based cardiac care program are best illustrated through individuals such as Shirley, a hospice patient who began her journey with Carolina Caring last spring.

Rebuilding trust in medical science: How doctors and scientists can bridge the misinformation divide Association of American Medical Colleges  (AAMC); by Patrick Boyle; 2/11/25 Medical science has not fully recovered from the distrust that erupted among some segments of the public during the COVID-19 pandemic. Skepticism and misinformation about vaccines and other health matters are spreading. Can anyone help doctors and scientists build faith in medical expertise? Reed Tuckson, MD, is trying. Tuckson is cofounder and chair of the Coalition for Trust in Health & Science, a nonprofit that focuses on “ensuring that everyone is empowered to make informed and personally appropriate health decisions … based on accurate, understandable, and evidence-based information.” ...Tuckson recently spoke with AAMCNews about applying what has been learned over the past several years to responding to misinformation and distrust in medical science. ...