Literature Review

Use of palliative care for ICU patients, familiesReview of Doherty, C., Feder, S., Gillespie-Heyman, S., & Akgün, K. M. (2023). Easing Suffering for ICU Patients and Their Families: Evidence and Opportunities for Primary and Specialty Palliative Care in the ICU. Journal of Intensive Care Medicine. Yale School of Medicine, review by Chigoziri Knokwo; 1/8/24... The authors identify the most commonly worrisome symptoms affecting ICU patients as the inability to communicate, pain, difficulty breathing, and thirst. They also highlight distressing experiences for families and caregivers of patients in the ICU, particularly depression and complicated grief. They recommend the continued incorporation of humanistic palliative care principles, considering perspectives from a more diverse representation of countries and cultures, particularly more resource-limited settings.

CDC map shows dramatic increase in illness nationwide: See where it’s worstNexstar Media Wire News / The Hill, by Alix Martichoux; 1/5/24What a difference a week can make. New data released by the Centers for Disease Control and Prevention Friday shows an 18% jump in people testing positive for influenza last week. The number of people going to the doctor with symptoms of respiratory illness — whether it be the flu, COVID, RSV, or none of the above — also continues to trend upward. Now, according to the CDC, 21 states and New York City are experiencing “very high” levels of sickness.

Home health agencies grapple with 'acuity creep' as patient needs become more complexHome Health Care News, by Patrick Filbin; 1/5/24As the demand for home-based care continues to rise, so does the need for more intensive care plans as patients continue to be sicker and more complex. Home health agencies are feeling this “acuity creep,” and they’re adjusting. But at times, it’s hard to keep up. “When I’m talking about acuity creep, I’m thinking about how much need do the patients in our care models require?” Michael Johnson, president of home health and hospice at Bayada Home Health Care, said. “It’s not just medical needs, either — there’s a social need as well."

Financial hardship drives unhappiness in people living with dementia, study findsMcKnights Long-Term Care News, by Kristen Fischer; 1/4/24A new study is uncovering just how tough it can be financially to live with dementia. The report, published Dec. 29 in the Journal of the American Geriatrics Society, found that nearly 56% of people with dementia face financial hardships. Those financial challenges are linked with worse reported satisfaction with life and healthcare. ... The study examined data from 534 participants with dementia who shared details on satisfaction with their lives and their healthcare. The researchers compared that data to information from questionnaires from 576 people who were newly diagnosed with cancer and receiving treatment.

Palliative care providers can enhance care coordination Hospice News, by Rachel Edwards; 1/2/24Fragmented health care has significant ties to adverse outcomes in patients with chronic or serious illnesses. Palliative care providers’ ability to navigate the health care system, coordinate the delivery of care, interact regularly with patients and facilitate communication between providers can reduce this fragmentation. This type of coordination can improve outcomes, decrease costs and offer patients a better quality of life.

How to live: What the dying tell usPsychology Today, by Tasha Seiter; 1/2/24Subtitle: The top regrets of the dying and how we can use them to better our lives.Bronnie Ware, a hospice nurse, asked the dying what they regretted most. While it may have been too late for her patients, their answers can tell us about how we should be living while we still have the chance. Here are the top five regrets of the dying, according to her research (both qualitative and quantitative):

Should patients be allowed to die from anorexia?DNYUZ; 1/3/24The doctors told Naomi that she could not leave the hospital. She was lying in a narrow bed at Denver Health Medical Center. Someone said something about a judge and a court order. Someone used the phrase “gravely disabled.” Naomi did not think she was gravely disabled. Still, she decided not to fight it. She could deny that she was mentally incompetent — but this would probably just be taken as proof of her mental incompetence. Of her lack of insight. She would, instead, “succumb to it.” [Read more of Naomi's story, followed by this examination of palliative care.]The field of palliative care was developed in the 1960s and ’70s, as a way to minister to dying cancer patients. Palliative care offered “comfort measures,” like symptom management and spiritual guidance, as opposed to curative treatment, for people who were in pain and would never get better. Later, the field expanded beyond oncology and end-of-life care — to reach patients with serious medical illnesses like heart disease, H.I.V. and AIDS, kidney failure, A.L.S. and dementia. Some people who receive palliative care are still fighting their diseases; in these cases, the treatment works to mitigate their suffering. [Read more of this discussion of emerging issue.]

Biased AI models in healthcare may lead caregivers and clinicians astray, new study warnsMcKnights' Tech Daily News, by Aaron Dorman; 1/2/24Over the past year, studies have highlighted how artificial intelligence models in healthcare sometimes can increase bias. Now, a new study warns that clinicians could follow AI down the wrong path. When reviewing data for respiratory failure, a common problem for older adults, clinicians were 11% less accurate in their diagnoses when using a biased AI model than if they didn’t use AI at all, the study found. Disturbingly, this fact was true even when given explanations about how the AI came to a diagnostic conclusion. 

Social determinants of health predict outcomes in hematologic cancersHematologyAdvisor, by Jonathan Goodman, MPhil; 12/27/23A systematic review published in Blood Advances suggested that several social determinants of health (SDHs) may affect survival disparities among patients with hematological conditions. Notably, insurance status, household income, education attained, and marital status all appear to affect survival likelihood in this patient population.

Brisas Health Unveils New Supportive Care ServicePalliative Care NewsDecember 20, 2023Puerto Rico-based Brisas Health has launched a new supportive care service in conjunction with the 20th anniversary of the organization’s founding. The program, branded as Brisas Supportive, will provide palliative care services for patients suffering from chronic illnesses, including services that not universally covered by health insurance plans. 

Can AI Help You Die? Doctors in New Jersey are experimenting with software to prompt discussions with patients about palliative or hospice care.BloombergDecember 18, 2023Doctors can be slow to talk about the end of the traditional medical road. When they’ve been trying to manage a life-threatening illness or keep a terminal patient alive, bringing up palliative or hospice care can feel like giving up. But these options can radically improve quality of life, or the end of life, when traditional medicine hasn’t helped enough—if patients and their doctors figure it out in time. ... “When someone is actively declining, you can see it, but being able to predict before that happens is hard.” Can artificial intelligence software do a better job than humans of picking that moment? That’s the idea behind Serious Illness Care Connect, a software tool that about 150 doctors are testing in a pilot program in New Jersey’s largest health-care network, Hackensack Meridian Health. ... The Hackensack Meridian team stresses that the tool isn’t making decisions. “Think of this as a ‘check engine’ light,” says Lauren Koniaris, the chief medical informatics officer at Hackensack Meridian.

Memory Care Gap—GAO Report Shows Less than 2.5% of Medicare Beneficiaries with Alzheimer’s Receive Cognitive AssessmentSenior Housing NewsDecember 13, 2023Between 2018 and last year, use of cognitive assessment and care plan services tripled, but few Medicare beneficiaries who qualify received the service, according to a recent study by the Government Accountability Office. The GAO study found that, at most, 2.4% of Medicare beneficiaries with a diagnosis of Alzheimer’s disease or a related disorder received this service. 

Contessa’s Lessons Learned on Risk-Based Palliative CarePalliative Care NewsDecember 13, 2023As Contessa Health pioneers a growing value-based palliative care-at-home program, they’ve encountered some learning curves when it comes to operating within a new payment system. Contessa is a subsidiary of Amedisys, which the home health and hospice provider acquired in 2021 for $250 million.