Literature Review

States ranked by nurse communication Becker's Hospital Review; by Mackenzie Bean; updated 12/13/24 Hospitals in Louisiana, Minnesota, North Dakota, Nebraska and South Dakota have the highest nurse communication scores, while hospitals in the District of Columbia have the lowest, CMS data shows. CMS collects and publicly reports data on nurse communication as part of its HCAHPS survey data. The nurse communication measure assesses the percentage of patients who reported that their nurses "always" communicated well. The data was collected in 2023 and published in CMS' Provider Data Catalog Oct. 30. Nationwide, 80% of patients reported nurses always communicated well, up one percentage point from the year prior, according to CMS data. [Click on the title's link for this ranked list.]

Supporting grieving kids during the holiday season: Susan Hamme Cleveland.com, Cleveland, OH; Guest columnist Susan Hamme, director of grief services for Hospice of the Western Reserve ... Childhood grief is tricky no matter the time of year, but the holidays can be a time of especially heightened emotion. The sights and sounds of the season can be triggers for children and adults alike. Combine that with an awareness that things will be very different without your special person, and you have the perfect recipe for emotional meltdowns and miscommunication all around. While it may be impossible to avoid this altogether, there are things you can do to lessen the stress and build in moments of peace and celebration.

The biggest lesson physicians learned in 2024 Becker's Physician Leadership; by Patsy Newitt; 12/10/24 Five physician leaders joined Becker's to discuss the biggest lesson they learned in 2024. ... [Summary topics include:]

Commentary: The coat my mother never wore National Public Radio - WBUR, Boston, MA; by Karen Propp; 12/11/24 Shortly before Thanksgiving 2018, I bought my 87-year-old mother a winter coat — a silvery-gray one that matched her hair. None of us could remember the last time she had left the house, spoken in full sentences or walked without assistance, but my father hoped that a new ultra-light coat might change things.  ... Having been close to others with progressive or terminal illnesses, I did not share his optimism. But it felt cruel to dash my father’s hope, so I hung the coat in the front hall closet, as if it were a talisman that could bring us a miracle. My mother died peacefully, late in the morning that December 24. By the time the men from the funeral home arrived, it was already dark outside. ...Editor's note: Click on the title's link to read how this simple coat evoked a daughter's grief, coping, and realization of her mother's qualities within herself. Non-clinical leaders: in case you're not aware, the extensive body of grief research reveals that grief does not have a last "stage" of "acceptance." Rather, mourning begins with a first step or "task" of accepting realities of the loss (Worden), with another step or "task" of establishing enduring connection (Worden)--which this daughter found within herself. These are not stages. Rather, they are ongoing cycles (mini and macro), with other identified, individualized dynamics.

Caring for emotional and spiritual needs of ICU families Medical Xpress; by Regenstrief Institute; 12/10/24 Family members of intensive care unit (ICU) patients often experience psychological and spiritual distress as they deal with serious illness and potential death. A new paper authored by a national team of experts at the intersection of health and spirituality highlights the critical role of the spiritual care provided by chaplains in supporting family members of ICU patients. ... "Our model describes three important ways that chaplain care supports ICU family members and helps them when faced with difficult decisions," said study co-author and chaplain-researcher George Fitchett, DMin, Ph.D., professor of religion, health and human values at Rush University Medical Center. "Chaplains provide family members with spiritual and emotional support. They also facilitate conversation with the medical team and help family members process the information from those conversations. Significantly, our study highlights the care provided by chaplains to ICU patient families and its impact on important outcomes." Editor's note: Click here for Improving Outcomes for for ICU Family Members: The Role of Spiritual Care, published in the Journal of Palliative Medicine, Oct 2024.

HSPN Staffing Summit: Leveraging technology for person-centered care Hospice News; by Sophie Knoelke; 12/9/24 This article is sponsored by CareXM. This article is based on a virtual discussion with Kathleen Benton, President and CEO of Hospice Savannah. ... Dr. Benton has a master’s degree in medical ethics and a doctorate in public health. She has offered and reviewed many publications relevant to the topics of palliative care, ethics, hospice, and communication. [Dr. Benton:] I was schooled in clinical ethics and really mediating ethical dilemmas in health care. Looking at, is this in the best interest of the patient? Are we truly following the patient’s wishes? Many of the dilemmas, I would say a good 90%, occur at the end of life. ... [At] the root of [really trending] cases was one missing element. That element was the lacking area of communication. What do I mean by that? I believe that health care does the worst job of probably all other areas of communicating with folks. We have really taken what it is to be human out of what it is to treat a patient and a person. [Click on the title's link to continue reading this insightful discussion.]

What adult children should know when discussing their parents’ end-of-life care StudyFinds; by StudyFindsStaff, reviewed by Christ Melore; 12/8/24 Talking about death can be difficult for anyone at any time. For adult children who need to know their parents’ final wishes, it can be excruciating. A new survey is revealing the stark disconnect between our beliefs and actions when it comes to end-of-life planning. While an overwhelming 90% of adults recognize the importance of these critical conversations, half have yet to take the first step with their closest loved ones. ... The numbers tell a revealing story. Twenty-six percent of respondents simply keep putting off the conversation, while 23% admit they don’t know how to approach the topic. Sixteen percent are outright scared to broach the subject, creating a wall of silence around a universal human experience. ... When people do open up, the conversations prove surprisingly rich and multifaceted.

Living and growing: Spiritual care at end of life Juenaeu Empire; by Claire Richardson; 12/7/24My favorite Gold Creek trail was damaged in one of the 2024 storms that swept through Juneau and altered the creek with a deluge of boulders, rocks and uprooted trees. You could only walk about 100 yards before the alders blocked the route. I didn’t venture there again until recently. Imagine my surprise when the dogs disappeared down the trail and this time, with wind blowing leaves to the ground, I could see clearly that the trail had been restored. Someone had cut off branches that impeded travel and without leaves to blur the way, I could easily find the new route. I felt a delightful sense of discovery, for here was an old, familiar trail now accessible on a frosty fall morning. Even though I knew where I was going, the newness of the path energized me. I moved forward with a smile. Spiritual care offered through hospice can be a lot like finding an old soul trail, but with new twists and turns. ...  Think of your hospice chaplain as a fellow hiker. While we can’t make the journey for you, we can listen carefully to your story of traveling through life. We can walk with you at your pace, perhaps pointing out a few game trails you could explore, but always following your lead.

Reading aloud to my friend in hospice was my long goodbye to her Thrive; by Patty Dann; 12/6/24 Reading a book aloud or being read to are constant threads in the tenderest moments of my life. When I was a child, my mother sat on my bed and read three books to me every night, so it would have been natural for me to sit on her bed and read to her during her final days. COVID-19 prevented that. Four years later, Batya, a woman in my building — the same age my mother was when she died — was in hospice at home. Each day, I read to her. ... Being with someone as they die is like taking a loved one to the airport. There’s often traffic along the way, and you never know how long it will take, but you do get the privilege of saying a final goodbye. Not being with my mother in her end days left an ache in my heart, but reading aloud to Batya helped me pass on a gift, something I was prevented from doing before.

Focusing on life rather than illness: the lived experience of children with life-threatening and life-limiting conditions-a qualitative study Palliative Care and Social Practice; by Trine Brun Kittelsen, Charlotte Castor, Anja Lee, Lisbeth Gravdal Kvarme, Anette Winger; 11/29/24 This study seeks to address gaps in existing knowledge, especially the limited inclusion of children's perspectives and the exclusion of children with communicative and cognitive disabilities. The aim of this study was to explore the lived experiences of children living with LT/LL conditions. ... The findings showed that the children's attention revolved around life rather than illness. The analysis revealed the presence of three themes: wanting to engage in life, being dependent on familiar relations, and the importance of cherished items.

No One Dies Alone: new Parker hospital program offers companionship to those at the end of life Parker Chronicle; by Haley Lena; 11/27/24 Katherine Wiley, a volunteer at AdventHealth Parker, was in the hospital’s emergency department when she saw first-hand how being alongside a stranger during their final moments of life can have a profound impact on those around them. Wiley sat with an elderly woman who was dying with no one around. The patient’s sons were trying to get to the hospital from Colorado Springs but didn’t make it in time. “When they got there, I told them that I had been with their mom so she was not alone and they were very grateful,” said Wiley. Wiley shared this story with the CEO of the hospital, Michael Goebel, at the annual volunteer luncheon last year, and the following week, the No One Dies Alone program was being set up. “We can provide companionship to patients in the dying process who are truly alone,” said Wiley. “In doing so, (it) provides a gift of respect and dignity to another human being at the end of life.” The volunteers of the program are called “compassionate companions.” They do not provide medical care, but they assist with comfort care measures – they sit beside the patient, hold their hands, play soothing music or read to the patients. For as many circumstances there are that lead a person to be hospitalized, there are also as many reasons why a patient is alone. The patient could have outlived other family members and friends, said Wiley, or are estranged from their family. It could be because the patients themselves don’t want to have their family see them die, but don’t want to be alone. Or they could be a John/Jane Doe who was in an accident. “We want to be there for them, whatever those reasons are,” said Wiley. “This sort of thing feeds my soul.”

New HFSA Consensus Statement provides practical guide for implementing palliative care with heart failure patients PR Newswire; by Heart Failure Society of America; 11/26/24 Patients with heart failure (HF) suffer from compromised quality of life, high mortality, and complex medical decision-making. Palliative care is an essential part of a comprehensive HF care plan. Integration of Palliative Care into Heart Failure Care: Consensus-Based Recommendations from the Heart Failure Society of America (HFSA), published today in the Journal of Cardiac Failure (JCF), is a practical guide for implementing palliative care as a component of overall HF care. It has been shown that palliative care interventions improve disease-specific quality of life, symptom control, and caregiver burden among patients with HF. Authors of the statement are indicating that HF clinicians should be skilled in providing primary palliative care with competence in basic domains including the management of physical and psychosocial symptoms and serious illness communication.

Education, telehealth, and access initiatives aim to improve cancer care for veteransOncLive; by Kyle Doherty; 11/26/24 Manali I. Patel, MD, MPH, MS, details several interventions developed to better serve veterans with cancer who are experiencing economic, social, and geographic barriers to care. Despite having the option of cancer care through the Veterans Affairs (VA) health network, veterans with cancer still experience economic, social, and geographic barriers to receiving high-quality care. This has prompted investigators to develop several interventions to better serve these patients. “Veterans have higher rates of lung cancer [compared with] civilian populations; prostate and bladder cancer [rates] are also pronounced [among] veterans, [and we also see] higher rates of melanoma, [all] largely due to exogenous exposure risk,” Manali I. Patel, MD, MPH, MS, said in an interview with Oncology Live. “One of the biggest barriers [to cancer care] for veterans is the lack of system level resources that can ensure veterans understand the diagnosis and treatment options, such that veterans receive care that is concordant with their goals, preferences, and values. Cancer care is quite complex and trying to not only coordinate care but explain the nuances in plain language is challenging. Having resources [available] that proactively assist veterans in their understanding and support them through cancer care is what is most needed to improve patient outcomes.”