Literature Review

End-of-life care can be more aggressive for cancer patients with defibrillators Medical Xpress; by UT Southwestern Medical Center; 1/8/25 Patients with advanced cancer who also had cardiac defibrillators were more likely than those without these implants to receive aggressive end-of-life care, a team led by UT Southwestern Medical Center researchers found in a new study. The findings, published in Cancer, could help physicians guide patients in this growing population toward care that better matches their goals. ... The findings showed that about 6% of patients with advanced cancer also had [implantable cardioverter defibrillators] ICDs. However, significantly more of the ICD patients received aggressive care during the last month of their lives compared to those without these devices.

Hospice workers share the foods that bring patients comfort till the end: Plus, they reveal how families can support their loved ones with scents, small bites and shared memories HuffPost; by Julie Kendrick; 12/30/24... We all live, we all die and we all enjoy food along the way. The memory and meaning of food, along with the bliss of being able to savor a cherished flavor, are still present in our lives, even as we head toward a last meal, a soothing sip of water or a final bit of sustenance. “Food often plays an emotional role in the last stages of life,” said Dr. Kurt Merkelz, the chief medical officer at Compassus, a home-based care company. “Some patients may reminisce about favorite meals or foods that connect them to fond memories and loved ones. There are instances where patients crave a specific dish that reminds them of their family or heritage, even if they can’t eat much.” ... People often ask for things like mashed potatoes, ice cream and chicken soup, according to Gail Inderwies, the founder and president of KeystoneCare, a hospice and home health provider in Pennsylvania. ... Sometimes, those comforts are part of a culinary heritage.

Behavioral symptoms and treatment challenges for patients living with dementia: Hospice clinician and caregiver perspectivesJournal of the American Geriatrics Society; Karolina Sadowska BA; Molly Turnwald BA; Thomas O'Neil MD; Donovan T. Maust MD, MS; Lauren B. Gerlach DO, MS; 12/24Dementia affects one in three older adults over age 85 and individuals with dementia constitute the fastest growing population of patients entering hospice care. While cognitive impairment is the hallmark of dementia, behavioral symptoms are reported in nearly all patients with advanced dementia, contributing to both the complexity of end-of-life care and caregiver burden. Behavioral symptoms of dementia are highly prevalent among the US hospice population and are often managed with psychotropic medications prescribed off-label. There are limited treatment guidelines in this population, so the appropriate risk and benefit balance may be highly individual. This qualitative study can help to inform the decision-making of hospice clinicians and caregivers regarding anticipated behavioral changes and limitations of treatment options in dementia end-of-life care. 

4 Benefits of palliative care at home: Personalized and coordinated medical care at home increases quality of life Psychology Today; by Bob Uslander, MD; 12/20/24 ... More than six million people in the U.S. could benefit from palliative care, and, according to the Center to Advance Palliative Care, thousands received it at home last year. Research shows that being cared for at home enhances quality of life because it is usually consistent with one’s life goals. ... 4 Benefits Palliative Care at Home Provides: ...

Mobile app–facilitated collaborative palliative care intervention for critically ill older adults-A randomized clinical trialJAMA Internal Medicine; Christopher E. Cox, MD, MPH; Deepshikha C. Ashana, MD, MBA, MS; Katelyn Dempsey, MPH; Maren K. Olsen, PhD; Alice Parish, MSPH; David Casarett, MD; Kimberly S. Johnson, MD; Krista L. Haines, DO; Colleen Naglee, MD; Jason N. Katz, MD, MHS; Mashael Al-Hegelan, MD, MBA; Isaretta L. Riley, MD, MPH; Sharron L. Docherty, RN, PNP, PhD; 12/24An automated electronic health record–integrated, mobile application–based communication platform that displayed family-reported needs over 7 days, coached ICU attending physicians on addressing needs, and prompted palliative care consultation if needs were not reduced within 3 study days. In this randomized clinical trial, a collaborative, person-centered, ICU-based palliative care intervention had no effect on palliative care needs or psychological distress compared to usual care despite a higher frequency of palliative care consultations and family meetings among intervention participants.

Mom, 26, dies days after choosing to enter hospice following 13 years of living with kidney failure (exclusive) People; by Zoey Lyttle; 12/18/24 Though she left behind a 4-year-old daughter, Sara Long told PEOPLE her feelings about death were "more certain" than they'd ever been when she started end-of-life care. “I think a lot of people spend a lot of time thinking about what it means to have a good life. And don't get me wrong, I did that too,” Sara Long, 26, told PEOPLE over the phone just shy of a week before she died at the hospice facility into which she had just recently moved. ... Long said she’s spent “the last two or three years” deliberating about her idea of a “good death.” She decided that it wasn’t just about how she would experience these last expected few weeks of her life in hospice. What Long really wanted was to be surrounded by her most precious loved ones — including her husband Justin, 32, and their 4-year-old daughter Riley Jean — but she didn't want them to watch her die while intubated and attached to hospital equipment as she was half of her life. “I just feel like if I pushed it any harder, then I was going to get to a place where it was going to be outside of my control,” said the mom of one. “I was going to wind up dying in a hospital alone, afraid, full of tubes, scared. My daughter wouldn't be able to be part of the process, and it would just be really lonely, and that's really not the goal.” Detached from the familiar yet foreign medical equipment, Long told PEOPLE she was freed from fear knowing she would only survive another couple of weeks in hospice. (She died with a week less than anticipated.) Editor's note: This another follow-up post to this profound young woman's story that we post on 

[Canada] First reading: Hundreds seeking death due to loneliness — inside Canada’s new MAID figures National Post, Toronto, Ontario, Canada; by Tristin Hopper; 12/13/24 [Health Canada has] released the official figures on medical assistance in dying (MAID) deaths in 2023. The Fifth Annual Report on Medical Assistance in Dying in Canada, published on Wednesday, reveals that one in every 20 Canadian deaths is now due to assisted suicide. There were 15,343 total MAID deaths in 2023, the median age ... was 77.7 years, and 622 people received MAID for a non-terminal illness. ... The growth rate [in Canada] remains higher than anywhere else. ... Half of non-terminally ill people applying for MAID report being lonely. When applying for MAID, patients are asked to detail all the types of suffering they’re experiencing in order to determine if their condition qualifies as something “grievous and irremediable” — and thus eligible for death. Health Canada’s report reveals that 47.1 per cent of non-terminally ill Canadians who applied for MAID reported “isolation or loneliness” as one of the causes of their suffering. This was significantly higher than the number of terminally ill applicants who said the same (21.1 per cent).

Weekly US Map: Influenza summary updateCDC - U.S. Centers for Disease Control and Prevention; ongoing, retrieved from the internet 12/16/24A Weekly Influenza Surveillance Report Prepared by the Influenza Division Editor's note: Bookmark this page to your web browser to monitor flu activity in your service areas through these more vulnerable winter months. Click on the map's "State" button for macro data at the state level. Click on the map's "CBSA" to drill down to counties.

UConn John Dempsey Hospital joins National Age-Friendly Health System Movement UConn Today; by Jennifer Walker; 12/12/24 UConn John Dempsey Hospital was recently accepted for participation in the national Age-Friendly Healthy Systems Movement to improve health care for older adults. The Age-Friendly Health Systems Movement, sponsored by The John A. Hartford Foundation and the Institute for Healthcare Improvement in partnership with the American Hospital Association and the Catholic Health Association of the United States​, is a national collaboration of hospitals and health systems implementing a set of evidence-based interventions to make the care of all older adults equitable and age-friendly. This initiative addresses the reality that a growing proportion of the US population is elderly and has complex healthcare needs which challenge many institutions. This movement is built upon a framework of a set of four best practice interventions known as the 4Ms.

The politics of loss: What grief reveals Psychology Today; by Daniela E. Miranda, PhD; 12/10/24 It has been a bit over two years since my 27-year-old brother unexpectedly passed away, exactly two weeks before my 64-year-old father, quickly and expectedly, died from cancer. What followed was a series of “secondary losses”. For my family, secondary losses included the shifting dynamics of caregiving and the emotional labor required to rebuild a daily life after multiple losses, while permanently uprooting to a different country. This article is not about my grief but about how the experience of loss can illuminate the fractures and possibilities within our systems of care. ... Key points:

What adult children should know when discussing their parents’ end-of-life care StudyFinds; by StudyFindsStaff, reviewed by Christ Melore; 12/8/24 Talking about death can be difficult for anyone at any time. For adult children who need to know their parents’ final wishes, it can be excruciating. A new survey is revealing the stark disconnect between our beliefs and actions when it comes to end-of-life planning. While an overwhelming 90% of adults recognize the importance of these critical conversations, half have yet to take the first step with their closest loved ones. ... The numbers tell a revealing story. Twenty-six percent of respondents simply keep putting off the conversation, while 23% admit they don’t know how to approach the topic. Sixteen percent are outright scared to broach the subject, creating a wall of silence around a universal human experience. ... When people do open up, the conversations prove surprisingly rich and multifaceted.

HomeCare & Hospice seeking blanket donations to comfort hospice patients The Batavian, Batavia, NY; 12/5/24 HomeCare & Hospice is inviting the community to help bring warmth and solace to individuals in their final stages of life by donating new lap blankets. As the colder months approach, these blankets not only provide physical warmth but also deliver emotional comfort, offering a small but meaningful way for the community to support those in need. ... Blankets can be newly handmade or purchased from retail stores, offering flexibility for those who wish to contribute. Both options are deeply appreciated, as they provide comfort and care to hospice patients who need it most. Editor's note: This simple, practical request can be replicated easily, with meaningful outcomes. 

'I've already had my miracle': 26-year-old Savannah mom enters hospice care with only weeks to live ABC WJCL 22 News, Savannah, GA; by Savannah Younger; 12/4/24 As the holiday season begins, Sara Long, a 26-year-old Savannah woman, is entering hospice care after a prolonged battle with kidney failure. Now the wife and mother is preparing to say her final goodbyes to family and friends. "I wanted to make sure that everything's kind of ready to go for when family visits and all that kind of stuff," Long said. "So, I just want to make things as easy as possible for everybody." Long has been told she has two to three weeks left to live and is now preparing her family for her passing. ... Their daughter, Riley, 4, is too young to understand what is happening, but Long is creating a hope chest so Riley can always remember her. "There are probably dozens, if not hundreds, of letters at this point, to open at different various points in her life. So, like her first day of school all through, or a graduate degree, potentially," Long said. "I feel like I've already had my miracle," Sara said. "I feel like Riley is my miracle. ..."Editor's note: See our "Today's Encouragement" for today, with a beautiful quote from Sara Long, in this article.