Literature Review

Palliative and end-of-life care in hematologic malignancies: Progress and opportunities JCO Oncology Practice, by Mazie Tsang, MD, MAS, MS and Thomas W. LeBlanc, MD, MA, MHS, FAAHPM, FASC; 3/13/24 ... An important finding from this study was the qualitative data from narratives of volunteer caregivers and hospice staff that described daily patient care, changes in patient status, perceived symptom burden, and indications for medication administration. The authors identified skin integrity concerns, bleeding, pathologic fractures, and delirium as unique issues for patients with hematologic malignancies enrolled on hospice. ... These findings provide further evidence that hospice care can and does work well for some patients with hematologic malignancies. 

Doctor with terminal cancer shares the three things everyone should consider doing to prepare for deathYour Tango, by Alexandra Blogier; 3/12/24Kim is a resident doctor who was diagnosed with metastatic sarcoma when she was 28 years old. She invites people to see what her life is like, as both a medical resident and a cancer patient, focusing on the practice of gratitude and being present. ... Kim revealed the three most important things she’s done as a cancer patient to get the administrative side of her affairs in order, which she recommends everyone do, even if they're not sick.

What are ageing and death from a biological point of view? Polytchnique insights, by Alexis Gautreau and Clemence Guillermain; 3/12/24 Linking philosophy and biology may seem strange. Yet there are many subjects where the two disciplines come into play and are, in turn, essential to understanding them. Death is a perfect example. This biological reality remains an abstract concept until we experience it in our own lives. But, however abstract it may be, death is based on a biological reality. 

Can we make more accurate prognoses during last days of life?Journal of Palliative Medicine; by Sylvie Bouchard, Andreea Paula Iancu, Elena Neamt, François Collette, Sylvie Dufresne, Patricia Maureen Guercin, Suganthiny Jeyaganth, Desanka Kovacina, Taliá Malagón, Laurie Musgrave, Marilisa Romano, Jenny Wong, Sybil Skinner-Robertson; 3/8/24Background: ... Established methods (Palliative Performance Scale [PPS], Palliative Prognostic Index [PPI]) have been validated for intermediate- to long-term prognoses, but last-weeks-of-life prognosis has not been well studied. Patients admitted to a palliative care facility often have a life expectancy of less than three weeks. Reliable last-weeks-of-life prognostic tools are needed. Conclusions: ... Using SPS [Short-Term Prognosis Signs] along with PPS and PPI during the last weeks of life could enable a more precise short-term survival prediction across various end-of-life diagnoses. The translation of this research into clinical practice could lead to a better adapted treatment, the identification of a most appropriate care setting for patients, and improved communication of prognosis with patients and families.

Facing dementia: clarifying end-of-life choices, supporting better lives EurekAlert!, by The Hastings Center; 3/11/24A new Hastings Center special report considers how America’s aging society responds to the needs and concerns of people facing dementia. ... Three essays reconsider familiar ways of thinking and talking about decision-making and care concerning people nearing the end of life to better reflect the needs and concerns of people facing dementia. For example, “Too Soon or Too Late: Rethinking the Significance of Six Months When Dementia Is a Primary Diagnosis” takes a critical look at the “six-month rule.”

Is extending life by weeks worth the toll some cancer drugs take? Doctors push for 'common-sense oncology' CBC News, by Amina Zafar and Christine Birak; 3/11/24 People may celebrate a 2-week improvement in survival without acknowledging costs. When a treatment buys a few weeks or months but comes with with a lot of side-effects, then the perspectives of people with cancer may differ, says Dr. Christopher Booth. ... The goal of what they call "common-sense oncology" is to prioritize treatments that meaningfully improve survival and quality of life. They aim to address what they see as problems in the field, such as a lack of critical thinking in oncology training, falling standards for drug approvals and avoidance of end-of-life discussions.

Whistleblower cases on the rise nationwide; Sarbanes-Oxley, Dodd-Frank laws open door for more to speak out PressReader, Herald-Tribune; by Esteban Parra and Xerxes Wilson; 3/10/24A former medical director specializing in neurosurgery at southern Delaware's largest health care provider claims in a lawsuit that Bayhealth Medical Center misclassified "brain-dead" patients in order to overbill for services. 

When health care is woven in our family fabric, we find support in unexpected places Oncology Nursing Society (ONS) Voice, by Suzanne M. Mahon, DNS, RN, AOCN®, AGN-BC, FAAN; 3/7/24... We have a built-in support system in our family. We understand all of those feelings and stressors in each other. We just get it. ... Where is your dinner table of support? Who is your go-to person who just gets it and listens? My husband and daughters support me, and I also have friends from nursing school, the workplace, and ONS who support me. They make all the difference in the world. Today, take time to thank your own support team.

Palliative care: A compassionate approach for mesothelioma patientsSurviving Mesothelioma, by Holly Zink; 3/10/24Mesothelioma is a rare and aggressive cancer linked to asbestos exposure. It poses significant challenges to those diagnosed and their loved ones. The disease affects the lining of the lungs (pleura). But it can also occur in the lining of the abdomen (peritoneum) and other organs. Mesothelioma has an average survival rate ranging from 8 to 14 months post-diagnosis. Managing the physical, emotional, and practical aspects of this condition is important.

Programmatic palliative care consultations in pediatric heart transplant evaluations Pediatr Cardiol, by Erika J Mejia, Rui Xiao, Jennifer K Walter, Chris Feudtner, Kimberly Y Lin, Aaron G DeWitt, Meeta Prasad Kerlin; 3/8/24 Guidelines advocate for integrating palliative care into the management of heart failure (HF) and of children with life-limiting disease. The potential impact of palliative care integration into pediatric HF on patient-centered outcomes is poorly understood. The present study sought to assess the association of programmatic implementation of palliative care into the heart transplant evaluation process with hospital-free days (HFD) and end of life (EOL) treatment choices. 

Compassionate extubation and beyond: Is there a need for more guidance in managing end-of-life in the intensive care unit? Chest Physician, by Angela L. Birdwell, DO, MA; Nehan Sher, MD  Approximately 20% of deaths in the United States occur during or shortly after a stay in the ICU and approximately 40% of ICU deaths involve withdrawal of artificial life support (WOALS) or compassionate extubation. ... How the team approaches WOALS can make a difference to both patients and decision-makers. Unfortunately, there is striking variation in practice and lack of guidance in navigating issues that arise at end-of-life in the ICU. 

Palliative care across the spectrum of heart failure JACC Heart Fail;  y Laura P Gelfman, Moritz Blum, Modele O Ogunniyi, Colleen K McIlvennan, Dio Kavalieratos , Larry A Allen; online ahead of print 2/27/24; print 3/8/24 Persons with heart failure (HF) often suffer from poor symptom control, decreased quality of life, and poor communication with their health care providers. ... New models are required that are better informed by high-quality data, engage a range of health care providers in primary palliative care principles, and have clear triggers for specialty palliative care engagement, with specific palliative interventions tailored to patient's illness trajectory and changing needs.