Literature Review

Comment: Rule must change to allow dialysis as end-of-life care HeraldNet, by Matthew Rivara and Mackenzie Daniek; 4/13/24More than 1 in 7 American adults live with chronic kidney disease, making it one of the most common chronic disease conditions in the United States. ... Medicare will generally not reimburse health care providers for dialysis treatments if a patient has elected to enter hospice care, as dialysis treatments are considered by Medicare to be “curative” rather than “palliative” care. Because of this, most patients getting dialysis for ESRD must forego all dialysis treatment after entering a hospice program.

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.]

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. 

Why difficult conversations matter: How delivering bad news with clarity and empathy impacts both provider and patient Cedars Sinai, by Cassie Tomlin; 4/8/24Good physicians rely on a battery of hard-won skills to treat serious illness—they observe, predict, test, prescribe and diagnose. But many physicians haven’t been taught how to have productive, mutually beneficial conversations—such as sharing a life-changing diagnosis or informing patients about disease trajectory and symptoms, prognosis and end-of-life care. High-impact communication tools can be learned at any point in a physician’s career, says Jessica Besbris, MD, director of Neuropalliative Care and the Neurology Supportive Care Medicine Program at Cedars-Sinai. Here, Besbris shares why such careful conversations matter for everyone involved, and ways physicians can improve how they discuss serious illness.

‘We’re the telescope looking forward’: Medical ethicists ask tough questions as part of $66 million research project CU Department of Medicine, by Mark Harden; 4/5/24 In the original “Jurassic Park” movie, after the process of bringing dinosaurs back to life is explained to a team of consultants, one of them voices a warning: “Your scientists were so preoccupied with whether or not they could, they didn’t stop to think if they should.” University of Colorado Department of Medicine faculty members will be asking the “should” question years before there’s an answer to “could.” They’ve joined in a nationwide study of whether tiny, battery-powered electric devices and genetic material, swallowed in capsule form, could one day replace surgery or injections as treatments for metabolic diseases such as diabetes and obesity.

[Psychology Today] Facing Mortality Honestly Psychology today, by Patricia Prijatel; 4/6/24 Personal Perspective: Being Mortal, by Atul Gawander, explores end-of-life-care. I read Being Mortal by Atul Gawande when it was first published in 2014 and haven’t stopped talking about it. It shot to the top of my list as one of the most important books I’ve ever read. After 10 years, I read it again to see if it held up. It did. I was as entranced the second time as the first—even more so because, as it happens, I am also now 10 years older.

Study shows strong social ties may ease the way for older adults in life's final chapter Medical & Life Sciences, by Vijay Kumar Maleus; 4/4/24  Study Results: ... The analysis revealed that higher levels of loneliness were significantly associated with increased odds of experiencing anxiety, sadness, and pain in the last month of life, suggesting a pivotal link between social isolation and end-of-life symptomatology. Furthermore, marital status and the receipt of personal care were predictors of dying in a hospital, pointing to the influence of social support structures on the location of death. Interestingly, a larger social network was correlated with a higher likelihood of receiving hospice or palliative care, highlighting the potential benefits of broader social connections. 

Malnutrition, thyroid cancer result in high rates of death among home care, hospice patients, studies finds McKnights Home Care, by Adam Healy; 4/5/24 Two separate studies analyzing disparities in patients’ place of death revealed high death rates related to malnutrition and thyroid cancer among patients receiving care at home and in hospice. The first study, “Disparities in Place of Death Among Malnourished Individuals in the United States,” found that more than 31,000 malnutrition-related deaths occurred among home care and hospice patients between 1999 and 2020. ... Another study, “Disparities in the Place of Death for Patients With Malignant Neoplasms of the Thyroid Gland,” discovered that roughly half of all patients who died of thyroid cancer between 1999 and 2020 did so in home care or hospice.

Neuropsychiatric effects associated with opioid-based management for palliative care patients

Integration of palliative care across the spectrum of heart failure care and therapies: considerations, contemporary data, and challengesCurrent Opinion in Cardiology, by Sarah Chuzi and Katharine Manning; online ahead of May 1, 2024 printRecent findings: Patients with chronic heart failure [HF], as well as those who are being evaluated for or who have undergone advanced HF surgical therapies such as left ventricular assist device or heart transplantation, have a number of palliative care [PC] needs, including decision-making, symptoms and quality of life, caregiver support, and end-of-life care. ... PC skills and teams may also help address preparedness planning, adverse events, and psychosocial barriers in patients who have had HF surgeries, but more data are needed to determine association with outcomes.

ASCO Congratulates 2024 Special Awards RecipientsThe ASCO Post, by ASCO (American Society of Clinical Oncology, Inc.); 4/2/24 ASCO and Conquer Cancer, the ASCO Foundation, recognized researchers, patient advocates, philanthropists, teachers, and global oncology leaders who have reshaped cancer care around the world with the Society’s highest honors at the 2024 ASCO Annual Meeting. [Click on the title's link for ASCO's 2024 Special Award Recipients.

People in this state Googled ‘medical marijuana’ the most, study shows Forbes, by Benjamin Adams; 3/29/24 How inquisitive are people in your state about medical cannabis? A recent analysis aims to find out—ranking states according to the number of Google searches for “medical marijuana” and other related keywords. ... The original study, “Which States Are The Most Obsessed With Medical Marijuana In 2024?” illustrates the levels of curiosity in each state, and some of the findings are unexpected. 

Cancer patients often want ‘one more round.’ Should doctors say no? The Washington Post, by Mikkael A. Sekeres, MD; 3/31/24 My patient was in his early 30s and his leukemia had returned again following yet another round of treatment. He was a poster child for the recently reported rise in cancer rates in the young, and had just asked me what chemotherapy cocktail I could devise for him next, to try to rid him of his cancer. I hesitated before answering. Oncologists are notorious for always being willing to recommend to our patients one more course of treatment, even when the chances of success are negligible.