Literature Review

Rise in pancreatic cancer tied to better detection, study suggests Becker's Hospital Review; by Elizabeth Gregerson; 11/19/24 The rise in pancreatic cancer diagnoses can be attributed to previously undetected disease and not a rise in cancer occurrence, according to a study published Nov. 19 in the Annals of Internal Medicine. Researchers from Boston-based Brigham and Woman's Hospital and Austin, Texas-based Dell Medical School analyzed U.S. Cancer Statistics and National Vital Statistics System data of adults aged 15-39 from between 2001 and 2019 for the study. Here are five notes from their findings:

Is your doctor using ‘never words’ that make you feel worse? Everyday Health; by Lisa Rapaport; 11/19/24 Words matter — especially when it comes to how doctors speak to patients and families facing a scary medical diagnosis. That’s because the exact words doctors use to explain complex health situations can make or break whether people feel heard and respected during appointments — and influence whether they follow doctors’ orders afterwards, according to a new survey published in Mayo Clinic Proceedings. Key Takeaways:

Mother, doctor, CEO: one woman’s journey to reshape health care [podcast] MedPage Today's KevinMD.com; podcast by KevinMD; 11/16/24 We dive into the powerful story of a physician-mother whose world changed with the onset of COVID-19. Our guest, Arian Nachat, a palliative and emergency medicine physician, shares her journey through the pandemic, balancing the demanding roles of mother and doctor. From navigating childcare crises and homeschooling to reimagining her career beyond the confines of traditional health care, she sheds light on the struggles faced by frontline workers. Listen as she reveals how these challenges inspired her to reshape her path, create a health care company addressing critical system gaps, and advocate for a patient-centered, physician-led approach to medicine.

[United Kingdom] After tragedy, NJ doctor finds renewed purpose working — and living — at a hospice My Central Jersey - NorthJersey.com; by Scott Fallon; 11/14/24 Even though she was on hospice care for terminal cancer at a New York hospital, Sandy Cattani’s last days were marred with pain and suffering. At one point, she began flailing so much in her hospital bed that her husband, Dr. Charles Vialotti, and other family members had to help hold her arms and legs down. This is not how any patient should die, Vialotti thought. He ought to know, having helped pioneer hospice care at three New Jersey hospitals. About a year after Sandy's death, Vialotti took the unusual step of moving into the Villa Marie Claire hospice in Saddle River, where he has spent 14 years attending to the terminally ill.

Educating patients and clinicians on end-of-life care and discussions CancerNetwork - home of the journal Oncology; by Kelley A. Rone, DNP, RN, AGNP-c CancerNetwork® sat down with Kelley A. Rone, DNP, RN, AGNP-c, to discuss the importance of speaking compassionately and ensuring patient awareness when leading end-of-life discussions among those with gastrointestinal (GI) cancers. The discussion also focused on combating burnout in the clinic, using opioids to help manage pain and other symptoms, and educating all members of a multidisciplinary team on initiating end-of-life conversations with their patients. ... As part of leading these end-of-life conversations, Rone emphasized the necessity of addressing the discomfort patients tend to feel when talking about the fact that they may die from their cancer. ... When working with other members of a multidisciplinary care team, Rone illustrated the challenge of having physicians understand that their treatments may fail in younger patients and helping other oncologists become more experienced in speaking about death with patients. ...

Elderly man sat with injuries for days after his mobile home burned and collapsed WCBD Charleston, South Carolina; by Tim Renaud; 11/11/24 An elderly Colleton County man sat injured in his yard for days after his mobile home burned and collapsed. Colleton County Fire Rescue said 9-1-1 received a call reporting the fire and injured man around 10 a.m. Friday. Crews arrived to find the single-wide mobile home had already collapsed with the injured man sitting in his yard. The man told firefighters that the home burned down “one or two days ago,” fire rescue said. He suffered burns to his face and hands and was not able to call for help. “He sat injured in the yard since that time,” the agency said. The man’s hospice nurse stopped by to check on him, and that’s when she discovered the fire. She provided initial aid and called 9-1-1. Emergency crews took the elderly man to the burn center at the Medical University of South Carolina for treatment. His condition is unknown. The cause of the fire is under investigation. 

Sioux City’s first Caregiver Olympics celebrates home care KCAU Sioux City; by Alyssa Tatsch; 11/7/24 November is National Care at Home Month, and to celebrate, several local healthcare organizations came together to participate in Sioux City’s first Caregiver Olympics. “I was watching the Olympics this summer and I was thinking of something fun to do with our caregiving team,” Visiting Angels owner and director Kristen Hammerstrom said. “Then I was at a meeting with some of the other [home care organizations] and I floated the idea to them and they said ‘that would be awesome.’” In honor of National Hospice and Palliative Care month, nine Sioux City caregiving teams went head-to-head competing in a relay race with specialized in-home care tasks. ... “As much as it is difficult to be a caregiver, it is also difficult for these employees too to help and take care of families, so this is just our light heartfelt fun moment to help people,” Hospice of Siouxland marketing & fund director Kim Wilson said. Despite the friendly competitive atmosphere, all nine teams shared one common goal. “While we might be competitors, at the end of the day our main goal is to care for patients and make sure that our patients and their loved ones are taken care of. That is our main goal,” Wilson said.

Pennsylvania signs home care, hospice efficiency bills into law McKnights Home Care; by Adam Healy; 11/5/24 Pennsylvania Gov. Josh Shapiro (D) signed into law two bills that will reduce operational challenges and improve recruitment efforts for home care and hospice agencies. House Bill 155 allows healthcare providers, including home care and hospice agencies, to use remote video technology for interviews with direct care workers. Meanwhile, Senate Bill 1080 allows licensed practical nurses (LPNs) to pronounce death in home-based hospice settings. These two new laws will make direct care worker recruiting processes more accessible and efficient, while improving end-of-life care for both patients and providers, according to the Pennsylvania Homecare Association. “The signing into law of HB 155 and SB 1080 helps create efficiencies in how we deliver home-based care,” Mia Haney, chief executive officer of PHA, said Friday in a statement. “With a growing demand for these services, efforts such as these allow providers to use their time effectively and focus on what’s most important — quality of care.”

Nurse burnout the root of decreased resident safety, medication errors, study shows McKnights Long-Term Care News; by Zahara Johnson; 11/6/24 A new study has found a direct link between nurse burnout and unfavorable patient and facility outcomes, including medication errors and a degraded safety culture. The meta-analysis of 85 studies and 288,581 nurses, compiling more than 30 years of research, concluded that nurses who suffer from burnout – emotional exhaustion, depersonalization and a low sense of personal accomplishment – have a negative impact on patients.

Early palliative care may curb aggressive end-of-life care Medscape; by Marilynn Larkin; 11/6/24 Increasing the uptake of palliative care may decrease the aggressiveness of end-of-life care, an analysis of ovarian cancer decedents suggested. Palliative care initiated earlier than 3 months before death was associated with lower rates of emergency department (ED) visits, hospital admissions, and intensive care unit (ICU) admissions in the last 3 months of life. It was also associated with a lower rate of death in the hospital. “When patients with advanced or incurable cancers experience aggressive end-of-life care, spending their final weeks of life in and out of the ED or admitted to acute care hospital wards or the ICU, where they undergo invasive tests or procedures that may not meaningfully prolong life or address symptoms or suffering, this can be very distressing for patients and their caregivers,” lead author Sarah J. Mah, MD, of McMaster University in Hamilton, Ontario, Canada, told Medscape Medical News.

Physician explores family's end-of-life journey in new podcast: "There were so many places that we ran into unexpected obstacles" MedPage Today; by Rachael Robertson; 11/4/24 As host of the TED Health podcastopens in a new tab or window, Shoshana Ungerleider, MD, is no stranger to podcasting. But now, the internist turned the mic on herself to explore death and mortality through the lens of her own experience losing her father to pancreatic cancer. Her eight-episode show is called "Before We Go" and is available on all podcast platforms (Spotify, Apple) with new episodes each week through early December. ... Ungerleider: My father died from pancreatic cancer in the spring of 2023. In my experience as an internist and as someone who is an expert on end-of-life through my work with End Well, there were so many things that kind of shocked me along the way. Despite the fact that I had the knowledge, the expertise, and the resources to provide him with a good end-of-life experience, there were so many places that we ran into unexpected obstacles. I wanted to share my story, really, with the goal of helping other people who might be facing the same kind of journey, and how to find the balance between being a doctor and being a daughter.  ...

Future-proofing healthcare: Upskilling the workforce to meet tomorrow’s challenges Healthcare Business Today; by Chris Trout; 11/4/24 A surgical technician recently told me, “We’re constantly helping people.” This simple yet powerful sentiment captures the essence of what healthcare workers ... focus on every day. However, the healthcare industry is undergoing profound changes that will shape its future over the next decade and beyond. These changes, driven by workforce shortages, AI and technological advancements, and shifting skill demands, have the potential to either enhance or burden healthcare systems. ... One of the most significant forces driving change is the shortage of healthcare workers, especially in critical areas like nursing. ...  The replacement cost for a nurse is estimated to be between $40,000 and $60,000, covering recruitment, temporary staffing and lost productivity. But these numbers don’t account for the consequences of staffing shortages: diminished patient care, declining morale and increasing mental health challenges among overworked staff. Despite these challenges, healthcare organizations have a remarkable opportunity to develop talent, especially in entry-level and middle-skill roles. [Click on the title's link to continue reading.]

How end-of-life dreams and visions are bringing comfort to dying patients: A conversation with Christopher W. Kerr, MD, PhD The ASCO Post (American Society of Clinical Oncology); by Jo Cavallo; 11/1/24 Just weeks or even days or hours away from death, the majority of conscious terminally ill patients often experience growth and meaning in their lives and the absence of fear through end-of-life dreams and visions, according to research by Christopher W. Kerr, MD, PhD. Dr. Kerr is Chief Executive Officer and Chief Medical Officer of Hospice and Palliative Care Buffalo, New York, and coauthor of Death Is But a Dream: Finding Hope and Meaning at Life’s End (Avery, 2020). ... In this interview with The ASCO Post, Dr. Kerr discussed how end-of-life dreams and visions bring comfort to dying patients, the difference between these experiences and hallucinations, and the importance of ensuring that patients understand the reality of their prognosis when cure is no longer attainable.