Literature Review

Terminally ill pediatric patients and the grieving therapist Psychotherapy.net, by Sara Loftin, LPC-S, RPT-S; 4/18/24 A pediatric clinician shares the rewards and challenges of working with terminally ill children and their families. When asked about the favorite aspect of my (dream) job, I could talk for hours. I feel passionate about working in a pediatric hospital setting with chronically ill children and their families. Each day brings new challenges. ... Experiencing the death of a child is the most painful part of my job, and it will never make sense to me although logically, I know this happens. On the other hand, I feel honored to be a small part of the most vulnerable time in a family’s life, and to walk alongside them in their journey of grief and loss. ... It has been impossible for me to not be deeply impacted working in this arena. [This article includes:]

Hospice handoffs may lower odds of Medicare denials Medscape, by Lara Salahi; 4/29/24Clearer communication between primary care clinicians and hospice providers may decrease the number of denied Medicare approvals for end-of-life treatment, according to a small study presented on April 18 at the American College of Physicians Internal Medicine Meeting 2024. Tyler Haussler, MD, acting medical director at  Brookestone Home Health & Hospice in Carney, Nebraska, said he conducted the study. ... CMS requires a "face-to-face encounter" between a physician and hospice caregiver to communicate clinical findings and determine the patient's terminal status. Missing or incomplete documentation of a patient's medical condition remains one of the main reasons the agency denies hospice coverage. 

AACN spotlights innovative tool for palliative care consultations

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.

Implementing spiritual care education into the teaching of palliative medicine: An outcome evaluation BMC Medical Education; by Yann-Nicolas Batzler, Nicola Stricker, Simone Bakus, Manuela Schallenburger, Jacqueline Schwartz, and Martin Neukirchen; 4/15/24 Objective: This is a novel, interprofessional approach in teaching undergraduate medical students about spiritual care in the format of a seminar. The aim of this study is to assess if an increase in knowledge about spiritual care in the clinical context is achievable with this format. ... Conclusions: We conclude that implementing spiritual care education following an interprofessional approach into existing medical curricula, e.g. palliative medicine, is feasible and well perceived among medical students. ...

Goals of care among patients with advanced cancer and their family caregivers in the last years of life JAMA Network; by Semra Ozdemir, PhD; Isha Chaudhry, MSc, Chetna Malhotra, MD; et al; 4/11/24 Conclusions and Relevance: In this cohort study of patient-caregiver dyads, findings suggested the importance of interventions aimed at reducing discordance in goals of care between patients and caregivers and helping them develop realistic expectations to avoid costly, futile treatments.

Expanding perinatal palliative care, hospice Hospice News, by Holly Vossel, 4/10/24A lack of trained staff and evolving health laws are among the leading barriers to expanding perinatal palliative and hospice care among underserved populations. ... Mistrust and fear of discrimination are among the common barriers, along with social determinants of health such as insurance coverage, socioeconomic status and transportation, according to recent analysis from researchers at the Morehouse School of Medicine’s Department of Obstetrics and Gynecology.

How to become a nurse later in life Board Vitals; 4/11/24 Embarking on a career in the nursing field later in life is an inspiring journey that many individuals choose to undertake. Whether it’s a personal passion or a long-held dream, it’s never too late to pursue a fulfilling career in healthcare. In this guide, we will answer the most common questions asked by those starting a nursing career later in life. Editor's Note: Does your hospice or palliative care organization partner with a nursing school? Or with any other type of university, community college, etc. that educates professionals for roles used in your organization? Explore opportunities to instill information and interest in end-of-life care.

PeaceHealth nurses announce plan to picket outside hospital April 18 The Columbian, by Chrissy Booker; 4/10/24 Nurses at PeaceHealth Southwest Medical Center in Vancouver will picket outside the hospital April 18. ... The bargaining unit, which includes 1,465 nurses, is negotiating with the hospital for a new three-year contract. According to a news release from the union, “management has not agreed to the association’s proposed workplace protections, staffing commitments or market-rate wages.” PeaceHealth countered that its proposals have been “highly competitive.”

HopeHealth’s expanding scope of pediatric hospice, palliative services Hospice News, by Holly Vossel; 4/8/24 HopeHealth has been growing its pediatric hospice and supportive care service lines in recent years to address a range of unmet needs among seriously ill children and their families. The nonprofit health system serves Rhode Island and southeastern Massachusetts. ... Hospice News recently sat down with pediatrician Dr. Rebecca MacDonell-Yilmaz, medical director of HopeHealth’s pediatric supportive services. 

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.]