Literature Review

Compassionate extubation and beyond: Is there a need for more guidance in managing end-of-life in the intensive care unit? Chest Physician, by Angela L. Birdwell, DO, MA; Nehan Sher, MD  Approximately 20% of deaths in the United States occur during or shortly after a stay in the ICU and approximately 40% of ICU deaths involve withdrawal of artificial life support (WOALS) or compassionate extubation. ... How the team approaches WOALS can make a difference to both patients and decision-makers. Unfortunately, there is striking variation in practice and lack of guidance in navigating issues that arise at end-of-life in the ICU. 

Programmatic palliative care consultations in pediatric heart transplant evaluations Pediatr Cardiol, by Erika J Mejia, Rui Xiao, Jennifer K Walter, Chris Feudtner, Kimberly Y Lin, Aaron G DeWitt, Meeta Prasad Kerlin; 3/8/24 Guidelines advocate for integrating palliative care into the management of heart failure (HF) and of children with life-limiting disease. The potential impact of palliative care integration into pediatric HF on patient-centered outcomes is poorly understood. The present study sought to assess the association of programmatic implementation of palliative care into the heart transplant evaluation process with hospital-free days (HFD) and end of life (EOL) treatment choices. 

Palliative care across the spectrum of heart failure JACC Heart Fail;  y Laura P Gelfman, Moritz Blum, Modele O Ogunniyi, Colleen K McIlvennan, Dio Kavalieratos , Larry A Allen; online ahead of print 2/27/24; print 3/8/24 Persons with heart failure (HF) often suffer from poor symptom control, decreased quality of life, and poor communication with their health care providers. ... New models are required that are better informed by high-quality data, engage a range of health care providers in primary palliative care principles, and have clear triggers for specialty palliative care engagement, with specific palliative interventions tailored to patient's illness trajectory and changing needs.

Healthcare access dimensions and racial disparities in end-of-life care quality among ovarian cancer patients Cancer Research Communications; by Shama Karanth, Oyomoare L. Osazuwa-Peters; Lauren E. Wilson, Rebecca A. Previs, Fariha Rahman, Bin Huang, Maria Pisu, Margaret Liang, Kevin C. Ward, Maria J. Schymura, Andrew Berchuck, and Tomi F. Akinyemiju; 3/5/24 This study investigated the association between healthcare access (HCA) dimensions and racial disparities in end-of-life (EOL) care quality among Non-Hispanic Black (NHB), Non-Hispanic White (NHW), and Hispanic patients with ovarian cancer (OC).

UChicago Medicine nurses plan 1-day strike Becker's Hospital Review, by Kelly Gooch; 3/5/24Members of the National Nurses Organizing Committee, an affiliate of National Nurses United, are set to hold a one-day strike March 14 at UChicago Medicine. The union represents 2,800 nurses at UChicago Medicine, according to a union news release. UChicago Medicine, which includes the flagship 811-bed University of Chicago Medical Center, has roughly 13,000 employees total.Editor's Note: The University of Chicago Medical Center provides palliative and hospice care services. At the time of this publication, we do not know if or how these services will be impacted. 

Why I chose palliative care: A nurse's personal journey to providing comfort careAnschutz, by Lauren Carter; 3/5/24My interest in palliative care started with my grandma’s use of hospice services seventeen years ago. She suffered with multiple sclerosis for over forty years. ... What may have been a terrible experience for most people was actually made very positive for me. ... Unfortunately, I had another opportunity fifteen years later, to once again be there for my family in this way. ... It takes empathy and specialized training to assist in end-of-life care. It may be something that we are called to. I care deeply about these patients and their families. I am able to have difficult conversations when necessary. I try to create space for family members to talk about who the person in the hospital bed is, when that person can no longer talk for themselves. ...

Understanding the role algorithms play in our lives and navigating palliative careListen - Life Matters, by Hilary Harper, presenter podcast; 3/4/24Every day, we interact with dozens of algorithms as we go about our lives, but many of us don't understand how they work. How do we get the the best out of these tools while keeping the potential dangers in check?Editor's Note: From palliative care experts Australia; information about algorithms and Artificial Intelligence (AI) transfers to our USA palliative care (of course, without applications to CMS systems).

Editorial: Illness trajectories in the age of big data The BMJ; by Peter Tanuseputro, Colleen Webber, and James Downar; 3/1/24For decades, healthcare providers have understood that patients follow typical trajectories of health decline as they approach the end of life, and they have used this understanding to help patients and families anticipate the dying process. Traditional trajectories focus on function or overall health status and include sudden death, terminal illness ..., organ failure ..., and frailty ... Two Education articles in the BMJ add novel dimensions to our understanding of health decline. Murray et al explain how declines in function do not always mirror declines in social, psychological, and spiritual dimensions. They also add a new trajectory, multimorbidity, to describe a person with conditions from multiple trajectories (such as heart disease from organ failure and cognitive impairment from frailty).

Creating comfort through communication: Strategies for supporting mental wellbeing in palliative careWorldHealth.net; 3/4/24... To provide comprehensive and compassionate care, this article explores the various strategies for communicating and supporting mental well-being in palliative care. 

Medicare’s new Dementia GUIDE Model: How can physicians, hospices, and home health agencies participate? Morgan Lewis Blog Post; 3/1/24If you have had a loved one suffer from dementia, you know the emotional, physical, and financial toll of this terrible disease. With advancements in dementia treatment, however, there is renewed hope on addressing this disease and increasing emphasis on fostering innovative care models. A central pillar of this effort is the Guiding an Improved Dementia Experience (GUIDE) model, announced by the US Department of Health and Human Service’s Centers for Medicare & Medicaid Services (CMS) in July 2023. This initiative—a new voluntary, nationwide alternative payment model—is designed to support Medicare beneficiaries with dementia, as well as their caregivers.

Opinion: How death can be the chance to serve others WAtoday, by Annie Whitlock; 3/3/24 I see my death as an opportunity to serve others ... . A few years ago, I offered my corpse to the department of anatomy and physiology at the University of Melbourne. The university co-ordinates a body donor program for the purposes of anatomical examination and the precious teaching and study of anatomy to its medical students. ... To the medical students who will be learning from my body I gave the department the following letter: I give you my body. ... Learn from me this one last time. So my organs, flesh and scars tell of times and outcomes that in death I cannot utter any more. ...

APRNs, home health / personal care aides top healthcare careers in 2024 McKnights Senior Living, by Kathleen Steele Gaivin; 2/28/24Advanced practice registered nurses and home health and personal care aides lead the list of top healthcare careers in 2024, according to a study from digital healthcare platform Tebra. The researchers compared 46 healthcare industry jobs by median pay, 10-year outlook and expected job growth, employment per 10,000 workers and web search volume, using data from the Bureau of Labor Statistics and the Census Bureau. ... Among all healthcare occupations included in the study, ones in home care had the highest employment rate. 

Podcast: Dr. Robert Carolla’s reflections on life and mortality Springfield Daily Citizen; 2/28/24 Dr. Carolla, a pioneer in his field, sheds light on the delicate balance between life and mortality that oncologists navigate daily.  Through his work with the Hospice Foundation of the Ozarks and national recognition from StoryCorps broadcasts, he and his wife, Peg, have touched countless lives with their compassion and dedication. Dr. Carolla’s journey offers a profound perspective shift on life, death, grief and the human experience.