Literature Review

Music Therapy intervention to reduce symptom burden in hospice patients: A descriptive study American Journal of Hospice & Palliative Care; by Madison H Estell, Kevin J Whitford, Angela M Ulrich, Brianna E Larsen, Christina Wood, Maureen L Bigelow, Travis J Dockter, Kimberly L Schoonover, Amy J Stelpflug, Jacob J Strand, Monica P Walton, Maria I Lapid; 3/19/24 online ahead of printResults: Patients reported a reduction in symptom severity and emotional distress and an increase in QOL. All patients endorsed satisfaction with music therapy, describing it as particularly beneficial for stress relief, relaxation, spiritual support, emotional support, and well-being. Scores on overall QOL and stress were worse for caregivers. 

Creating a community-led telehealth approach for supportive cancer care mHealthIntelligence, by Anuja Vaidya; 3/18/24 Tennessee Oncology is joining forces with rural patients to explore strategies for expanding telehealth access to supportive cancer care services. ... The NEST program aims to expand access to palliative care, psychology, and integrative oncology and nutrition services among rural cancer patients in seven Middle Tennessee counties: Robertson, Dickson, Putnam, Dekalb, Warren, Bedford, and Coffee counties.

Signs of end-stage Parkinson's disease Medical News Today; Medically reviewed by Heidi Moawad, MD, by Meara Withe; 3/18/24... Understanding the signs of end-stage Parkinson’s disease is crucial for patients, caregivers, and healthcare professionals alike. This article explores the physical health, mental health, and emotional dimensions of end-stage Parkinson’s, shedding light on what to expect and how to provide compassionate care during this demanding phase. Editor's Note: Hospice and palliative non-medical interdisciplinary team members need to understand disease-specific factors related to the patient's experience and the family caregiver's challenges. These include social workers, chaplains, counselors, and caregiver-oriented volunteers.  

Palliative Care as ‘Personalized Medicine’Hospice News, by Jim Parker; 3/18/24The term “personalized medicine” is often used to describe health needs based on a patient’s genetics. However, more stakeholders are applying the term to palliative care. Personalized medicine is a step away from a “one-size-fits-all” approach to health care. The model uses information gathered from a patient’s genome to plan for care, treatment and services, and to some extent, predict a likely health trajectory, according to the National Human Genome Research Institute, part of the National Institutes of Health.

Hospices stepping up performance on visits-in-last-days-of-life measure Hospice News, by Jim Parker; 3/14/24 Hospices, in aggregate, are showing improvement on the quality measure for visits in the last days of life. The number of registered nurse and social worker visits during a patient’s final week is one of the seven quality measures that CMS uses to evaluate providers. In Calendar Year 2021, the share of hospice care days with nurse visits in the last seven days of life rose to 63%, up from 62% year over year, according to the National Hospice and Palliative Care Organization (NHPCO). 

Preventing adverse drug events in hospice care Hospice News, by Holly Vossel; 3/15/24 Documentation errors and a fragmented health system pose the greatest risks for adverse drug events among hospices. ... Evaluating these risks involves having solid medication reconciliation processes in place — both at the time of a patient’s admission and throughout their end-of life care experience, according to Mary Lynn McPherson, professor and executive program director of advanced post-graduate education in palliative care at the University of Maryland’s School of Pharmacy. McPherson also serves on the board of the American Academy of Hospice and Palliative Medicine (AAHPM).

Breast cancer palliative care and metastatic disease: Looking beyond end of life MedPage Today, by Shalmali Pal; 3/15/24 ... It is important to inform patients that they can receive palliative care at any timeopens in a new tab or window during their treatment, from the time of diagnosis to end of life. ... At some juncture, the options for metastatic breast cancer treatment become limited. Progression can be classified into four general types: 

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. 

Heart failure staging and indications for advanced therapies in adults with Congenital Heart DiseaseHeart Failure Clinics / Elsevier, by Alexander C Egbe and Heidi M Connolly; pre-publish 4/24 via onlineSummary: Heart Failure (HF) is common in adults with Congenital Heart Disease (CHD), United States, and it is the leading cause of death in this population. Adults with CHD presenting with stage D HF have a poor prognosis, and early recognition of signs of advanced HF, and referral for advanced therapies for HF offer the best survival as compared with other therapies. The indications for advanced therapies for HF outlined in this article should serve as a guide for clinicians to determine the optimal time for referral. Palliative care should be part of the multidisciplinary care model for HF in patients with CHD.

In the resuscitation discussion, do words matter between doctors and patients? Rutgers, by Patti Zielinski; 3/12/24Rutgers Health researchers seek to reduce barriers to physicians having code status conversations with older adults. ... The study, published in the Journal of the American Geriatrics Society, sought to determine the best language doctors could use when discussing a patient’s code status to reduce the barrier to having these conversations. It found that it takes less than five minutes on average for doctors to have discussions going over what CPR is, what a patient’s preference might be and making a decision that patients felt comfortable with regarding whether they want to be resuscitated, according to the study.Editor's Note: Click on the title above for the summary description; click here for the detailed research article, "Aligning patient values and code status: Choice of Diction's Effect (CODE) study.

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.

Oncology hospitalists improve hospice transitions for patients with advanced cancers Yale School of Medicine, by Osman Moneer; 3/11/24Unplanned hospitalizations for patients with advanced cancer often trigger discussions about care goals and transitions to hospice. Late referrals to hospice, particularly near the end of life, have been associated with reduced quality of life and increased healthcare costs. A new research study published in Cancer investigates the impact of oncology hospitalists on the timing of hospice transitions for patients with advanced cancers. 

Palliative care cuts costs for metastatic cancer