Literature Review

Palliative care improves quality of life for bone marrow transplant patients Duke Health News & Media, by Alexis Porter; 3/25/24 ... Researchers tested the effectiveness of an integrated palliative care intervention across diverse settings. They enrolled 360 adults undergoing bone marrow transplants at three academic medical centers, including Duke University Hospital, Massachusetts General Hospital and the Fred Hutch Cancer Center at the University of Washington. ... Patients receiving the palliative care intervention reported better quality of life, defined by the degree to which an individual is healthy, comfortable, and able to participate in life events. They also had lower depression, PTSD and fatigue symptoms compared to those receiving usual care. 

‘You can become a husband again’ National Association of Federal Retirees (Canada); by Jennifer Campbell; 3/25/24When his wife got a much-needed bed in palliative care, a perceptive nurse told Brian Hills he could concentrate on being a husband again, instead of a caregiver. 

4 things nobody tells you about watching a loved one die of cancer The New York Post; by Jessica Ariel Wendroff; 3/23/24 ... “The surgery was successful. However, tests after the operation found cancer had been present,” the Princess of Wales, 42, revealed in a bombshell videotaped statement Friday. ... While the royal insisted she is “well and getting stronger every day,” other patients’ real pain begins when the cancer has spread too far and chemotherapy and radiation no longer work, so doctors stop treatment. As the daughter of a Stage 4 bladder cancer patient, I’ve empirically learned four realities that people usually don’t talk about ...

Incurable but not hopeless: How hope shapes patients’ awareness of their advanced cancer prognosis The Conversation, by Jean Mathews and Michael Brundage; 3/24/24Hope is defined as the expectation of achieving a future good. Patients with cancer, whether it is curable or not, prioritize cure as their highest hope. ... Previous research indicates that less than half of patients with incurable cancer are aware of their prognosis. This is often attributed to a failure of communication. ... In the context of advanced cancer, the relationship between hope and hopelessness is balanced by acceptance, which can re-direct hope to new goals beyond cure, such as hope for connection with others and enjoyment of daily pleasures. 

Racial/ethnic differences in care intensity at the end of life for patients with lung cancer The ASCO Post, by Matthew Stenger; 3/21/24 The study used data from the California Cancer Registry linked to patient discharge data abstracts. The primary outcome measure was intensity of care in the last 14 days before death, with greater intensity defined as any hospital admission or emergency department visit, intensive care unit (ICU) admission, intubation, cardiopulmonary resuscitation (CPR), hemodialysis, and death in an acute care setting. ... The authors concluded: “Compared with [non-Hispanic White] patients, [Asian/Pacific Islander], Black, and Hispanic patients who died with lung cancer experienced higher intensity of [end-of-life] care. Future studies should develop approaches to eliminate such racial and ethnic disparities in care delivery at the [end of life].”

Physicians often shy away from preparing their patients to dieToday'sHospitalist, by Colleen Poggenburg, MD, MS; 3/22/24 There's beauty in death if we can tolerate looking. ... The beauty in death is the reflections that occur in the weeks, days and minutes prior to it, which together make up a summary of someone’s life. Why then do physicians view this time-honored decline as a series of clustered medical problems, when it really is just someone moving toward death? Are we so concerned about treating just one more condition, and do we actually think it will solve the growing list of medical problems that dying patients have? ... I compared dying to pregnancy to “soften” the description of this decline. Here’s how I see that comparison: ...Editor's Note: The author offers a fascinating, meaningful comparison of physician/patient conversations with someone who is pregant versus someone who is dying. I encourage you to share this article with your clinical leaders (and adapt it for staff), as this model beautifully reframes important conversations that can empower patients and their families.

Multinational Association of Supportive Care in Cancer (MASCC) expert opinion/guidance on the use of clinically assisted hydration in patients with advanced cancer

Music Therapy intervention to reduce symptom burden in hospice patients: A descriptive study American Journal of Hospice & Palliative Care; by Madison H Estell, Kevin J Whitford, Angela M Ulrich, Brianna E Larsen, Christina Wood, Maureen L Bigelow, Travis J Dockter, Kimberly L Schoonover, Amy J Stelpflug, Jacob J Strand, Monica P Walton, Maria I Lapid; 3/19/24 online ahead of printResults: Patients reported a reduction in symptom severity and emotional distress and an increase in QOL. All patients endorsed satisfaction with music therapy, describing it as particularly beneficial for stress relief, relaxation, spiritual support, emotional support, and well-being. Scores on overall QOL and stress were worse for caregivers. 

Signs of end-stage Parkinson's disease Medical News Today; Medically reviewed by Heidi Moawad, MD, by Meara Withe; 3/18/24... Understanding the signs of end-stage Parkinson’s disease is crucial for patients, caregivers, and healthcare professionals alike. This article explores the physical health, mental health, and emotional dimensions of end-stage Parkinson’s, shedding light on what to expect and how to provide compassionate care during this demanding phase. Editor's Note: Hospice and palliative non-medical interdisciplinary team members need to understand disease-specific factors related to the patient's experience and the family caregiver's challenges. These include social workers, chaplains, counselors, and caregiver-oriented volunteers.  

Creating a community-led telehealth approach for supportive cancer care mHealthIntelligence, by Anuja Vaidya; 3/18/24 Tennessee Oncology is joining forces with rural patients to explore strategies for expanding telehealth access to supportive cancer care services. ... The NEST program aims to expand access to palliative care, psychology, and integrative oncology and nutrition services among rural cancer patients in seven Middle Tennessee counties: Robertson, Dickson, Putnam, Dekalb, Warren, Bedford, and Coffee counties.

Improvements in Interdisciplinary Communication Following the implementation of a standardized Handoff Curriculum: SAFETIPS (Statistics, Assessment, Focused Plan, Pertinent Exam findings, to Dos, If/Thens, Pointers/Pitfalls, and Severity of Illness) Cureus, by Shaefali Shandilya and Justen M. Aprile; 3/18/24 Handoffs between medical providers serve a crucial patient safety function. While most published literature on the topic studies the handover process among physicians, robust literature is available on interdisciplinary medical communication. Little is known about the downstream effects of effective physician handover on subsequent physician and nursing interactions. ...Results: Statistical analysis revealed significant post-intervention mean score increases of one full point in four categories, namely organization and efficiency, communication, content, and clinical judgment.

Navigating difficult conversations with patients with terminal cancer diagnoses Oncology Nursing News, by Darlene Dobkowski, MA; 3/18/24 Although oncology nurses need strong communication skills to help all of their patients navigate their cancer journeys, it is critical to have the ability to have difficult conversations with patients who received a terminal diagnosis, ... Betty Ferrell, Ph.D., M.S.N., CHPN, director and professor in the Division of Nursing Research and Education in the Department of Population Sciences at City of Hope in Duarte, California, said in an interview with Oncology Nursing News. For the past 24 years, her institution has been directing a project called the End-of-Life Nursing Education Consortium (ELNEC), which is a palliative care training program and includes a module focused on communication.  ... “One of the things that we teach nurses is … that your No. 1 job is to listen,” Ferrell said. “Another thing that we say to nurses is, it is not your job to have all the answers. Patients ask very unanswerable questions. ‘Why me?’ is not an answerable question. But when a patient says, ‘Why me,’ then we want nurses to have good communication skills to say, ‘I can imagine why you're asking that question. Because as you've shared with me, you had no idea that you might be diagnosed with cancer, or you're the first person in your family to ever have cancer.’”

Hines VA introduces new monitoring system for hospice and nursing home Veterans VA Press Release; 3/15/24 Edward Hines Jr. VA Hospital has begun integrating a new patient monitoring system to improve Veteran health and assist medical staff. The AvaSure© Continuous Video Monitoring System places portable cameras in patients’ rooms who may need closer monitoring. Staff can observe up to 15 patients simultaneously through a virtual interface to monitor for issues such as a patient out of bed or patient-caused medical device interference. ... The monitoring system will be used in Hines VA’s Community Living Center (CLC), which includes short- and long-term nursing home care and hospice.