Literature Review

Fall prevention for the elderly: 13 strategies to keep them safe U.S. News & World Report, by Claire Wolters, ed. by Christine Comizion, MPH; 3/26/24Falls are the leading cause of injury in adults 65 and older – with reports showing about 14 million adults fall each year, according to the Centers for Disease Control and Prevention. ... According to the CDC, falls are also the leading cause of injury-related death in the 65-and-older population – and the fall death rate is growing.Here's what to know about what increases risk for falls in older adults, and get familiar with fall prevention tips and safety measures that can help reduce the risk.Editor's Note: This U.S. News article primes the pump. Preventing falls matters especially for vulnerable hospice patients as their disease progresses, and as they and/or family want the person to be as mobile as possible. What do your Incident Reports tell you about falls? What falls-specific education do you provide for your interdisciplinary teams? On-call staff? Family caregivers? Volunteers? What QAPI programs have addressed falls? 

Tele-palliative care benefits veterans with cardiac, pulmonary diseases Hospice News, by Jim Parker; 3/26/24 Patients with cardiac and pulmonary conditions see improvements in their quality of life after receiving palliative care via telehealth. A randomized clinical trial with 306 participants who suffered from chronic obstructive pulmonary disease (COPD), heart failure (HF), and interstitial lung disease (ILD) found that palliative telehealth resulted in significant improvements. The results were published in the Journal of the American Medical Association.

A nurse practitioner-driven palliative and supportive care service in nursing homes: Evaluation of a quality improvement projectJournal of Hospice & Palliative Nursing; by Joan G Carpenter, Julianne Murthi, Molly Langford, Ruth Palan Lopez; 3/26/24, online ahead of print This article describes a quality improvement project implemented by a national postacute long-term care organization aimed at enhancing the provision of palliative care to nursing home residents. ... Most common symptoms that were managed included pain, delirium, and dyspnea; most common diagnoses cared for were dementia and chronic organ failure (eg, cardiac, lung, renal, and neurological diseases).

Hospice of Santa Barbara offers insights into family grievingSanta Barbara Independent, by Hospice of Santa Barbara; 3/26/24Grieving the loss of a family member is a deeply intricate emotional journey. Shared bonds and histories make family grief especially unique. Family grief extends beyond the individual and intertwines with the collective fabric of shared experiences, roles and responsibilities. ... It is common for death to change the family dynamic. This can be a result of several factors, including age, relationship, role, difference in coping mechanisms, heightened stress and emotions, and unresolved family issues which can lead to the resurfacing of past grievances.Editor's Note: CMS Hospice COPs §418.3 defines: "Bereavement counseling means emotional, psychosocial, and spiritual support and services provided before and after the death of the patient to assist with issues related to grief, loss, and adjustment." The interdisciplinary team needs to understand individual and family grief, within the scope of their roles and responsibilities with family members.

Alzheimer’s deaths expected to grow and industry not prepared with workers, report show Journal-News, by Samantha Wildow; 3/26/24The number of Alzheimer’s deaths in the U.S. more than doubled between 2000 and 2021, the Alzheimer’s Association says in its latest report, which details how about half of health care workers say their industry is not fully equipped to handle the growing population of people with dementia. ... Multiple factors play into why deaths to Alzheimer’s disease and other forms of dementia are increasing, including how the health care system is getting better at treating other things like heart disease and cancer, one local doctor said.

Meaning-making among parents of children with severe neurologic impairment in the PICU Pediatrics / PubMed; by Jori F Bogetz, Ellie Oslin, Maeve O'Donnell, Krysta S Barton, Joyce P Yi-Frazier, R Scott Watson, Abby R Rosenberg; 3/26/24 Online ahead of print Results: Parents discussed ongoing meaning-making that occurred through domains of comprehension and purpose, and themes of understanding of other people and the world around them. Subthemes focused on appreciation/acceptance, adaptability/accountability, valuing all lives, and learning/teaching about their child.

What is the FAST scale for Alzheimer's?MedicalNewsToday, by Charlotte Lillis and medically reviewed by Shilpa Amin, MD, CAQ, FAAFP; 3/25/24The Reisberg Functional Assessment Screening Tool (FAST) is a scale that doctors use to diagnose and evaluate aspects of Alzheimer’s disease. ... This article provides an overview of the FAST tool, including a breakdown of its individual stages. It also outlines what to expect from the FAST evaluation, what the scale means for hospice care, and more.

Digital avatars and personalized voices—How AI is helping to restore speech to patients JAMA Network, by Samantha Anderer and Yulin Hswen, ScD, MHP; 3/22/24 This conversation is part of a series of interviews in which JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS, and expert guests explore issues surrounding the rapidly evolving intersection of artificial intelligence (AI) and medicine.  As a specialist in advanced brain mapping methods, Edward Chang, MD, set out to understand the mechanisms that turn our thoughts into words. Now, with the help of AI, his team at the University of California, San Francisco (UCSF) Weill Institute for Neurosciences has demonstrated that the brain signals associated with speech-related sensory and motor processes could grant a new voice to patients who have lost the ability to speak.

Researchers advocate for more home-based options for end-of-life care McKnights Home Care, by Adam Healy; 3/25/24 As older adults increasingly prefer to receive end-of-life care in their homes, new, community-based options will be critical to help patients achieve a home death, according to a new research review published in Palliative Care and Social Practice. ... The researchers analyzed 28 studies conducted between 2002 and 2023 related to factors that affect patients’ abilities to achieve a home death. One persistent issue, they found, was a lack of available home palliative care services. 

End-of-life care in heart failure MedPageToday; by Crystal Phend, reviewed by Andrew Perry, MD; 3/22/24 Palliative care has a perception problem. It's often associated with end of life or advanced cancer. However, cardiovascular disease actually accounts for a higher proportion of adults in need of palliative care than does cancer (38.5% vs 34%), according to the World Health Organization. Patients with heart failure (HF) have a median survival of about 5 years -- on par with many types of cancer, yet patients with cancer are much more likely to be referred to palliative care. 

Palliative care in the older adult with cancer and the role of the geriatrician: a narrative review Annals of Palliative Medicine, by Bibban Bant Deol, Lisa Binns-Emerick, MOhammad Kang, Pragnesh Patel; 3/15/24 online ahead of print Conclusions: Embedding primary care geriatrics in the palliative care arena helps to provide more access to this care. This integration helps providers address basic symptom management, advance care planning and work with individuals on goals of care to assure the care being provided is congruent individual's priorities. Older adults respond to symptoms different than their younger counterparts. Management of these symptoms has to be addressed in a manner commiserate with their age.

Frailty needs to be a factor in drug development, proposed guidelines suggest McKnights Long-Term Care News, by Kristen Fischer; 3/20/24A new report on strategies for geriatric drug development and assessment determined that drugs need to consider age as well as other factors that older adults face such as cognitive impairment, frailty and polypharmacy. This is according to the International Union of Basic and Clinical Pharmacology (IUPHAR) Geriatric Committee, which published the report. The strategies specifically focused on integrating frailty as a factor in drug development. The report, published in the Journal of the American Geriatrics Society earlier this month, includes 12 principles pertaining to frailty in reference to drug development. The recommendations include measuring frailty at the start of when a person goes on a drug they’ll likely take regularly.