Literature Review

Psychological issues in palliative care: Elissa Kozlov and Des AzizoddinGeriPal podcast, by Alex Smith; 2/22/24Today we talk with two psychologists who are deeply invested in addressing psychological aspects of care for people living with serious illness. Elissa Kozlov, a geropsychologist and director of a new population aging MPH at Rutgers, surveyed AAHPM members, and found that doctors reported major shortcomings in level of comfort and knowledge caring for patients with psychological illness. She conducted a systematic review and meta-analysis of 38 palliative care trials, finding that many excluded people with serious illness, and a lack of impact on psychological outcomes.  Analyzing the Health and Retirement Study, she found 60% of older adults screened positive for depression in the last year of life.

Hospice vs. Palliative Care in Tucson: Which One Is Right for You and Your Loved Ones?AzFoothills.com, 2/20/24  ... Choosing between hospice and palliative care can seem overwhelming, especially when you're trying to make the best decision for someone you love. There are some distinctions between these two types of care. Here, we discuss some of those differences to guide you in choosing the proper care for a loved one. 

Studies conducted at University of New Mexico on Hospice and Palliative Medicine recently published (Cultural advocacy for indigenous individuals with serious illness) American Journal of Hospice and Palliative Medicine, by Jeanna Ford, DNP, APRN, ACNS-BC, ACHPN, FPCN, FCNS, and Constance Dahlin, MSN, ANP-BC, ACHPN, FPCN, FAAN; first published 2/2/24, posted in Health & Medicine Daily 2/20/24Indigenous American (I.A.) individuals with serious illness and their families have unmet needs. Often, this group is viewed as a minority within a minority. Numerous health challenges exist within the I.A. populations resulting in dire health care situations. Historical trauma and mistrust of the healthcare system impacts access to quality palliative care by this marginalized population. ... The aim is to empower palliative care clinicians the knowledge to provide culturally sensitive and congruent care to I.A. individuals with serious illness and their community.

Embodied decisions unfolding over time: a meta-ethnography systematic review of people with cancer's reasons for delaying or declining end-of-life careBMC Palliat Care, by Jessica Young, Antonia Lyons, Richard Egan, and Kevin Dew; 2/19/24Conclusions: Decisions about when (and for some, whether at all) to accept end-of-life care are made in a complex system with preferences shifting over time, in relation to the embodied experience of life-limiting cancer. Time is central to patients' end-of-life care decision-making. ... The integration of palliative care across the cancer care trajectory and earlier introduction of end-of-life care highlight the importance of these findings for improving access whilst recognising that accessing end-of-life care will not be desired by all patients.

Redefining end-of-life care: Stories of compassion and innovationBNN, by Waqas Arain; 2/18/24In the heart of compassionate care and the challenging journey of end-of-life situations, two remarkable healthcare professionals stand out for their dedication and innovative approaches to palliative support. Teresa Hovatter, a Community Liaison with Grane Hospice, and Kirsty Lazenby, an organ donation nurse at Royal Stoke's Critical Care Unit, have each been recognized for their exceptional efforts in providing comfort, dignity, and support to terminally ill patients and their families. Their stories, though distinct, converge on a singular mission: to transform the end-of-life experience into one of peace, understanding, and meaningful closure.

Causes and ways of death in patients with head and neck cancerJAMA Otolaryngol Head Neck Surg; by Boyd N. van den Besselaar, MD; Aniel Sewnaik, PhD; Arta Hoesseini, MD; et al; 2/15/24 The results of this study potentially illuminate causes and ways of death in patients with HNC and support health care professionals in providing more patient-centered care, particularly for those in the palliative phase.

A race against time: Cancer patient's touching keepsake for his familyBNN; 2/15/24When time was running out, 44-year-old cancer patient Yiu created a heartfelt keepsake for his family. With the help of an art therapist, he cast a realistic mold of his intertwined hands with his wife's symbolizing their love and unity. This touching story highlights the power of love and hope in the face of adversity.

Bristol Hospice’s quest to help patients sleepHospice News, by Jim Parker; 2/14/24Salt Lake City-based Bristol Hospice has developed a branded program designed to help their patients get better sleep, which can significantly impact quality of life.

Tier - Palliative Care: A population-based care delivery model to match evolving patient needs to palliative care services for community-based patients with heart failure or cancer [This link goes to the more detailed National Institutes of Health (NIH) description of this clinical trial.]Genomics & Genetics Daily, by a news reporter-staff news editor; 2/14/24Staff editors report on the newly launched clinical trial, NCT06228209, which has the following summary description: "TIER-PC is an adaptive model of delivering palliative care that provides the right level of care to the right patients at the right time. It represents an adaption of the Mount Sinai PALLIATIVE CARE AT HOME (PC@H) program, which delivers home-based palliative care. TIER-PC increases the number and intensity of disciplines added to the patient's care team as their symptoms worsen and function declines."

Understanding the discordance about prognosis between clinicians and terminally ill patients and their surrogatesThe ASCO Post, by Jo Cavallo; 2/14/24A Conversation with Douglas B. White, MD, MASResearch shows that about half of adults near the end of life in the United States are too ill to participate in decisions about whether to accept life-prolonging treatment, requiring family members and other proxies to serve as surrogate decision-makers for their critically ill loved ones. However, research also shows that surrogates of patients with advanced illness often have optimistic expectations about prognosis, which often lead to the increased use of invasive treatment (including life support) in dying patients and delays in the integration of palliative care.

Changes in hospice care experiences during the COVID-19 pandemicRand, Journal of the American Geriatrics Society; by Maria DeYoreo, Rebecca Anhang Price, Ann C. Haas, Anagha Alka Tolpadi, Joan M. Teno, Marc N. Elliott; 2/12/24Demand for hospice and palliative care services increased during the COVID-19 pandemic. Hospices strove to meet this demand despite staffing shortages and visitation restrictions that sometimes prevented family members and hospice staff from visiting patients in institutional settings such as nursing homes, assisted living facilities, and hospitals. We examine how the COVID-19 pandemic may have influenced the characteristics of patients receiving hospice care, the settings in which they received care, and their care experiences using national data from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey. The survey is completed by bereaved family caregivers following the death of the hospice patient, and is the national standard for assessing patient- and family-centeredness of hospice care.

Patient navigator intervention to improve palliative care outcomes for Hispanic patients with serious non-cancer illness a randomized clinical trial JAMA Intern. Med, by Stacy M. Fischer, MD; Sung-Joon Min, PhD; Danielle M. Kline, MS; et al; 2/212/24Importance: Disparities persist across the trajectory of serious illness, including at the end of life. Patient navigation has been shown to reduce disparities and improve outcomes for underserved populations.Objective: To determine the effectiveness of a lay patient navigator intervention, Apoyo con Cariño, in improving palliative care outcomes among Hispanic patients.