Literature Review

New study finds underutilization of early palliative care for patients with advanced cancer mostly attributable to provider and organizational characteristics American Cancer Society; 5/28/24 A new study led by researchers at the American Cancer Society (ACS) shows despite considerable growth in early palliative care (PC) use, utilization among patients with advanced cancer remained low from 2010 to 2019. ... Early integration of palliative care is recommended for advanced-stage cancers, but evidence of its use and the role of provider and organizational characteristics in its uptake is limited. ... Early PC was defined as receipt of PC within 90 days post-diagnosis and before hospice admission, if any. ... Study authors stress the large variation between providers and organizations suggest important modifiable provider behaviors and organizational characteristics in early PC receipt, ...

Disparities in palliative care use for patients with blood cancer who died in the hospital The American Journal of Hospice & Palliative Care; by Tien-Chan Hsieh, Yee Hui Yeo, Guangchen Zou, Chan Zhou, Arlene Ash; 5/27/24 online ahead of printBackground: Palliative care can enhance quality of life during a terminal hospitalization. Despite advances in diagnostic and treatment tools, blood cancers lag behind solid malignancies in palliative use. It is not clear what factors affect palliative care use in blood cancer. Conclusions: This study highlights disparities in palliative care use among blood-cancer patients who died in the hospital. It seems likely that many of the 46% who did not receive palliative care could have benefitted from it. Interventions are likely needed to achieve equitable access to ideal levels of palliative care services in late-stage blood cancer.

Church group fashions 'dignity quilts' for palliative care unitCanada - Local Journalism Initiative; by Wayne Doyle; 5/22/24It’s such a simple thing. But the volume of respect it signifies is unimaginable. The impact it has on surviving family members, equally so. It’s called ‘code dove’ and it’s a special paging phrase; ... staff and residents join the family of the deceased as they gather at the front entrance to say goodbye as the resident leaves the home for the last time. “When our residents are leaving, they exit through the front lobby, the same way they came in,” said Peggy Sauve, assistant director of resident care at the IOOF on Brooks Street in Barrie. “It’s all about respect for the individual and their family. “We hold flameless candles, play their favourite music and take one last chance to say goodbye,” she added. ... As the resident leaves the home for the last time, their body is covered with a dignity quilt, designed and handmade by members of the Elmvale Presbyterian Church Craft group.

Top ten tips palliative care clinicians should know about the psychiatric manifestations of nonpsychiatric serious illness and treatments Journal of Palliative Medicine; by Gregg A Robbins-Welty, Paul A Riordan, Daniel Shalev, Danielle Chammas, Paul Noufi, Keri O Brenner, Joshua Briscoe, William E Rosa, Jason A Webb; 5/10/24... Among patients receiving palliative care (PC), psychiatric comorbidities are common and impact patient quality of life. ... This article, created collaboratively with a team of psychiatric-palliative care experts, is the second in a two-part series examining the bidirectional relationship between medical and psychiatric illness in PC. This article explores 10 prevalent psychiatric manifestations associated with severe illness and its treatment. [Additional access requires journal subscription or additional payment]

LifeBio announces partnership with New York State Office for the Aging to capture the legacies of hospice patientsKFOL/KJUN HTV10; 5/9/24 LifeBio has launched a partnership the New York State Office for the Aging (NYSOFA) and the Association on Aging in NYS (AANYS) to rollout an innovative life story project to people in hospice care. This is the first initiative of its kind in the U.S. to be supported with funding from a state-level unit on aging. Using the LifeBio Memory app to record the voices of New Yorkers, each participating hospice patient will receive back a Life Story Book containing stories, memories and favorite photos to share with loved ones. Audio files will be saved privately and securely. LifeBio will also offer the option of journals for handwriting the stories. 

Palliative patients can die peacefully at home with paramedic support, claims proposed frameworkRiotack - Australia; by James Day; 5/6/24A proposed national framework suggests paramedics could help ease pressure on emergency departments by supporting palliative care patients who wish to die at home. Published in the leading international peer reviewed journal Palliative Medicine, the framework seeks to embed palliative care into paramedics’ core business and reduce needless transports to hospital. ... Lead author and trained paramedic Dr. Madeleine Juhrmann developed the framework in consultation with paramedics, palliative care doctors, GPs, carers with lived experience and others. The expert group – representing six countries and all the states of Australia – agreed on the framework’s 32 service changes to standardise best practice for paramedics delivering palliative care in community-based settings.Pair this with a USA article in today's newsletter, "Stranded in the ER, seniors await hospital care and suffer avoidable harm." 

Georgia system reopens hospital to inpatient services Hospital CFO Report; by Mariah Taylor; 5/2/24 Piedmont Augusta (GA) is reopening the emergency department and inpatient services at its Summerville campus after converting the location into an outpatient campus over a year ago. Effective May 16, the hospital will open 15 beds in the emergency department, 12 inpatient unit beds, and new imaging services. Outpatient services will continue as normal, according to a May 1 system news release. "What we heard pretty quickly from our community is that they missed the efficiency of that campus," Lily Henson, MD, CEO of Piedmont's Augusta clinical hub, said in the release.

Nonphysical Suffering: An under-resourced and key role for hospice and palliative care social workersJournal of Social Work in End-of-Life & Palliative Care; by Maxxine Rattner & Cheryl-Anne Cait; 11/10/23... Nonphysical suffering is suffering that may be emotional, psychological, social, spiritual and/or existential in nature. The study found an absence of specialist social workers on hospice and palliative care teams or limited time for specialist social workers to address patients’ nonphysical suffering due to high caseloads and complex practical needs. While the study recognizes social workers have expertise in supporting patients’ nonphysical suffering, a competency and skill that has not been sufficiently captured in the existing literature, the systemic barriers they face in providing care may leave patients’ needs unmet. The study also highlights the unique pressure social workers may feel to relieve patients’ nonphysical suffering due to the psychosocial focus of their role.

The spectrum of end-of-life experiences: A tool for advancing death educationOmega; by Shared Crossing Research Initiative; 3/24 Abstract: Studies on end-of-life experiences (ELEs) suggest that caregivers and loved ones of dying patients also have ELEs, though these are rarely explored. This article introduces the Spectrum of End-of-Life Experiences (SELE) as a descriptive list of types of ELEs reported by all members of the care unit, including dying patients, their caregivers, and their loved ones. We applied SELE towards identifying ELEs reported by 143 caregivers and loved ones and successfully identified every experience. Interviews revealed that participants viewed their ELEs as profound communicative events, yet a substantial minority also reported struggling to name and process these experiences. We propose that SELE be included in death education to raise awareness about ELEs that can occur within the care unit, and we suggest that SELE has additional applications, including use as a prognostic aid in end-of-life care and as a therapeutic aid for bereavement support.

More legislation in Illinois deals with ending a person’s life The Center Square - Illinois; by Kevin Bessler; 5/1/24 Another bill has been introduced in Springfield dealing with end of life options for the terminally ill. Illinois state Sen. Julie Morrison’s Senate Bill 2644 would establish a statewide electronic registry that would contain Physician Orders for Life Sustaining Treatment (POLST) forms, which detail what type of medical treatment a critically ill patient does and does not want. “How much or how little treatment a person receives at the end of their life should be up to each individual instead of the one-size-fits-all approach,” said Morrison, D-Lake Forest, during a news conference Wednesday. “This measure will enable physicians to access forms detailing patients wishes in a single, accessible location.” 

A hospice doctor on deathbed visions #shorts #tedx Tedx Talks; by Dr. Christopher Kerr; 4/29/24"When it comes to end-of-life experiences, most of the reports were based on anecdotal reporting. In other words, nobody had asked patients directly or attempted to quantify or measure. So that's what we've done. What we found is that the vast majority, over 80%, reported at least one pre-death dream and vision, described as more real than real and distinct from normal dreaming. 

Cleveland Clinic eHospital expands to monitor 300,000 patients Becker's Health IT; by Naomi Diaz; 4/24/24 Cleveland Clinic's eHospital program has expanded and now monitors 248 patient beds in ICUs and other units across the organization's network. The eHospital program launched in 2014 as a pilot in one intensive care unit. ... The program has enabled more patients to receive care at community hospitals, reducing the need for transfers to the main campus, according to Cleveland Clinic. It has also helped decrease ICU lengths of stay and minimize the volume of calls received at night. 

Hospice nurse reveals the most common deathbed regretsUnilad; by Niamh Shackleton; 4/24/24Bronnie Ware, a nurse who has spent a large majority of her career working in palliative care, found that there were five common things that people regretted about their lives upon reflection as they approached death.