Literature Review

Alzheimer’s prognosis models should expand data sources McKnights Senior Living; by Kristen Fischer; 8/12/24 Integrating data from nursing home electronic health records and claims in addition to the minimum data set — data required for nursing home residents — could be better than just relying on the MDS sources to produce an accurate prognosis for nursing home residents with Alzheimer’s disease and related dementias, according to a report published Thursday in the Journal of the American Geriatrics Society. ... The authors of the report noted that a recent review of prognostic models for late-stage ADRD found that assessments commonly used to evaluate prognosis-based eligibility for hospice weren’t reliable. ... Only 15% of people enrolled in hospice have a primary diagnosis of ADRD. That’s because it’s challenging to estimate the six-month prognosis required to be eligible for hospice, and dementias have a prognosis of 12 to 18 months when they are in the late stage, the authors pointed out.

Ten-Minute VR Therapy Provides Sustained Pain Relief for Patients With CancerPhysician's Weekly; 8/7/24A new study suggests virtual reality pain relief interventions may be effective at reducing pain in hospitalized populations with cancer. Virtual reality (VR) provides pain relief in various health settings, but few studies investigate its impact on hospitalized patients with cancer. A recent study in Cancer intends to fill that gap. The researchers completed a randomized control trial in which patients received a VR pain relief intervention or a 2D alternative. While both provided pain relief, the VR intervention was more effective. The researchers also found that pain relief lasted up to 24 hours after the intervention. “Virtual reality is a relatively new, rapidly developing technology that has capabilities to influence the patient experience in innovative ways,” said Hunter Groninger, MD, in an interview. Dr. Groninger is the director of Palliative Care at MedStar Washington Hospital Center, where the study was conducted, and a professor of medicine at Georgetown University.

‘Restored faith in humanity:’ What’s it like to volunteer at Mercy Health Hospice of the Valley?[OH] Mahoning Matters; by Kelcey Norris; 8/5/24Jennifer Burgoyne, Hospice of the Valley’s volunteer coordinator, described the volunteering experience as getting “a paycheck of the heart.”

Kids’ hospice offers hope-of-life care in Las Vegas Valley homesReview Journal; by Jeff Burbank; 8/5/24Known for palliative care for kids and young adults ending at age 21, the program (1Care) is called a “hospice” in the newer sense of the word, said Courtney Kaplan, director of community affairs for 1Care. The program is 100 percent covered by government-funded Medicaid. “Hospice is provided for a person with a terminal illness whose doctor believes he or she has six months or less to live if the illness runs its natural course,” the institute states. But in 1Care’s juvenile hospice, palliative care is provided for children with severe conditions but who don’t necessarily have terminal illnesses and can receive treatment while living with their parents and siblings, Kaplan said.

The Last 30 Days: How Oncologists' Choices Affect End-of-Life Cancer CareMedscape; by Katie Lennon; 8/2/24Oncologists show significant variability in prescribing systemic cancer therapies in the last 30 days of life. Patients treated by oncologists in the top quartile for end-of-life prescribing behavior were almost four and a half times more likely to receive end-of-life therapy than those treated by these specialists in the bottom quartile... "Given calls to rein in overutilization of end-of-life six to eight cancer therapies, our findings highlight an underappreciated area for further research: How treatment discontinuation before death is shaped by oncologists' unique treatment propensities. Elucidating the reasons for this remarkable variability in oncologist treatment behavior could inform efforts to reduce end-of-life cancer treatment overutilization," wrote the authors of the study. [Free subscription may be required.]

Preventing the prescribing cascade: Lessons from hospice and palliative careMcKnight's Home Care; by Caren McHenry Martin; 7/24/24More than 2 in 5 seniors experience polypharmacy, meaning they are prescribed five or more drugs. Polypharmacy is a persistent issue in elder care, particularly for patients with chronic or advanced disease. The medication burden increases as patients near the end of life, with an average of more than 10 drugs per patient. As a pharmacist serving the hospice community, I often find myself asking a simple question: Is this medication treating a symptom or a side effect?

Veteran in hospice care completes bucket list with tattoos designed by family WNEM/Gray News, Saginaw, MI; by WNEM Digital and Gray News Staff; 7/28/24 A Michigan veteran with ALS crossed off the final item on her bucket list by getting tattoos designed by family members, including her teenage daughter. Beth Bedore, a 47-year-old veteran, served in Iraq and Kuwait before retiring after 23 years. Last year, she was diagnosed with amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease. She is currently receiving care while on hospice at the Aleda E. Lutz VA Medical Center in Saginaw, WNEM reports. Bedore’s recreational therapist, Heidi Nadobny, says the last wish on the veteran’s bucket list was crossed off Friday. She received two tattoos, one designed by her 14-year-old daughter and the other designed by her daughter’s father. 

Signs that cognitive changes are worrisome —and what you can do about it CU Anschutz (Colorado University) Department of Medicine; by Tayler Shaw; 7/26/24 ... As a geriatrician and palliative medicine physician, Hillary Lum, MD, PhD, has spent her career working to better the lives of older adults and their families, often raising awareness about what cognitive decline can look like and when it is concerning. She is currently involved in the Colorado Alzheimer’s Disease and Related Dementias State Plan, a state initiative to improve awareness and actions to address dementia in Colorado, specifically looking at how to build a competent workforce related to Alzheimer’s disease and related dementias.  We recently sat down with Lum ... to talk about what cognitive decline is, symptoms to look out for, and how people can best protect their brain health.  

Proactive fall prevention: Elevating patient safety and healthcare excellenceHealthCare Business News; by Amy Hester; 7/26/24... The significance of fall prevention cannot be overstated, as it directly impacts patient outcomes and overall healthcare quality. With the patient safety solutions market growing at an expected rate of 11.2%, the importance of proactive fall prevention strategies becomes even more evident. ... In the United States, preventable medical errors, including falls, are the third leading cause of death. The impact of falls on patient health and recovery is profound, often leading to longer hospital stays, delayed recovery and increased risk of subsequent falls.Editor's Note: Proactive fall prevention is especially important for persons needing palliative or hospice care. As the person's health and mobility declines, they have to adjust to these changes mentally, emotionally, physically, and relationally. Recognizing decline can feel like defeat. Asking for help can be tough. Family members can expect the person to move more independently more than possible, leading to falls.

Loss of a loved one early in life may accelerate aging: StudyThe Hill - Health Care; by Miranda Nazzaro; 7/29/24 The experience of losing a loved one early in life could make a person age faster, according to a new study published Monday in the Journal of the American Medical Association. ... Losing a parent or sibling early in life can often be traumatic, causing mental health or cognitive issues, higher risks of heart disease and earlier mortality, researchers noted, adding repeated losses can increase the likelihood of heart disease, dementia or mortality. ... “Future research should focus on finding ways to reduce disproportionate losses among vulnerable groups. For those who experience loss, providing resources for coping and addressing the trauma is essential.”Editor's Note: Click here for the study, "Familial Loss of a Loved One and Biological Again: NIMHD Social Epigenomics Program." Calling all executive leaders who decide staffing and resources for your hospice's bereavement services: examine the long-term mission of your bereavement services for (1) children and teens, (2) young adults, (3) persons with racial and ethnic disparities. 

The bereavement care crisis in hospice facilities MedCity News; by Cara McCarty Abbott; 7/28/24 Bereavement care is an essential part of the hospice experience, designed to support those coping with loss. Bereavement care is not just a compassionate gesture; it is a critical component of the hospice care continuum. So why is it so underserved in the U.S.? ... Instead of pushing harder on hospice providers to find more ways to deliver comprehensive bereavement care with less, it's key to address the systemic forces hampering their ability to deliver quality care at the scale required and address these challenges. Editor's Note: Additionally, does your hospice still rely on the misnamed, overused "5 Stages of Grief"? These were determined from 1960's persons who were dying, not from bereaved persons who live on--surviving--the death. Extensive fresh, contemporary, hospice-designed grief resources to support bereavement counselors and the persons they serve are provided by Composing Life Out of Loss, a sponsor for our newsletter.

AMA Advocacy issue briefsAmerican Medical Association; 7/24/24 Issue briefs summarize key health policy issues by providing concise and easily digestible content targeting both relevant stakeholders and those who may know little about the topic. Contents: Medicare & Medicaid; Telehealth; Scope of practice; Prior authorization; Reducing physician burnout; Practice management; Overdose and mental health/substance use disorder parity; Access to affordable, high-value care; Health care costs & price transparency; Drug costs & pricing; Hospitals & health systems; State medical liability reform; LGBTQ+ health; The business of medicine; Public health improvement; Essential Tools & Resources.

‘My sibling died and my parents never talked about her again’ The Telegraph; by Steph Clarkson; 7/20/24 Julia Martin has few memories of her sister Karen, but remembers the last time she saw her. “She was five years old. I was seven. We were playing on the swing in the park. Then she went off to the hospital with Mum and Dad for a scheduled operation. “She never came home.” Losing a sibling is tragic enough, but for Julia the death of her sister following an operation to repair a hole in the heart was just the start of years of trauma. “I remember my father telling me Karen had died,” says Julia, ... “But that was it. There were no hugs, no comforting words. “Mum barely came near me. She tucked herself away. I had no other siblings to talk to. I was alone.” Things got worse as Julia’s parents built a wall of silence around their loss: ‘‘I wasn’t taken to see Karen in the hospital, I was kept away from the funeral, so there was no closure,” she says.