Literature Review

"The great escape": How an incident of elopement gave rise to trauma informed palliative care for a patient experiencing multiple disadvantage BMC Palliat Care, by Sam Quinn, Libby Ferguson, Derek Read, and Naomi Richards; 2/28/24Background: This case report ... illustrates how unresolved traumatic experiences across the life course can affect a patient's engagement with palliative care and offers insights into the flexibility and adaptations necessary for taking a trauma informed approach to care for an individual experiencing multiple disadvantage. 

Are we consulting, sharing care, or taking over? A conceptual frameworkPalliat Med Rep, by José Pereira, Christopher Klinger, Hsien Seow, Denise Marshall, Leonie Herx; 2/23/24Background: Primary- and specialist-level palliative care services are needed. They should work collaboratively and synergistically. Although several service models have been described, these remain open to different interpretations and deployment.Aim: This article describes a conceptual framework, the Consultation-Shared Care-Takeover (C-S-T) Framework, its evolution and its applications.

Right-sizing interprofessional team training for serious-illness communication: A strength-based approach PEC Innvov, by Liana Eskola, Ethan Silverman, Sarah Rogers, Amy Zelenski; distributed 2/28/24Objective: Palliative care communication skills help tailor care to patients' goals. With a palliative care physician shortage, non-physicians must gain these serious illness communication skills. Historically, trainings have targeted physician-only groups; our goal was to train interprofessional teams.

Subcutaneous patient-controlled analgesia in home-based palliative care: "It's as straightforward as pushing a button, right at my fingertips" J Pain Palliat Care Pharmacother, by Miguel Julião, Patrícia Calaveiras, Eduardo Bruera, Paulo Faria de Sousa; 2/26/24Subcutaneous patient-controlled analgesia (SCPCA) in home-based palliative care is a potentially valuable option for providing effective pain relief to some patients, particularly when conventional analgesic approaches prove ineffective or are refused.

Communicating with patients with hearing loss or deafness—Can you hear me? JAMA Intern Med, by Dianne P. O'Leary, PhD and Timothy J. O'Leary, PhD, MD... Virtually all health care professionals want to provide the best possible care and to communicate as effectively as possible. However, ... frequent communication failures are leading to inferior care for the hearing impaired. Effective communication might require some or all of the approaches listed in [this article].

Being there for a loved one's final breaths NextAvenue, by Elaine Soloway; 2/26/24"I'll be downstairs," I told him one night. "And I'll be up to kiss you goodnight before I go to sleep." He smiled and squeezed my hand. I had barely settled on the couch when the hospice worker appeared at the top of the stairs. "He's gone," she said. I learned this pause is not unusual. Hospice workers report that some people who are dying wait to be alone for their final breaths.

From classroom to clinic: End-of-life conversations — there’s empathy in foresightThe Tufts Daily, by Deeksha Bathini; 2/21/24Palliative care physicians have conversations with families to identify patient wishes, particularly when they are facing death. These physicians are equipped with training that emphasizes empathy, comfort and patient autonomy. Freedom of choice during the dying process gives patients the power to reclaim their agency amidst a process rife with uncertainty.

Advance praise for Oncology and Palliative Social Work: Psychosocial Care for People coping with Cancer Oxford Academic - Oxford University Press; 2/23/24Oncology and Palliative Social Work: Psychosocial Care for People Coping With Cancer (OPSW) fills an important gap in the serious illness literature. The book illustrates the need for integrating palliative care early in the lives of patients with cancer and illuminates the important role that social workers have in providing psychosocial support services across the cancer trajectory. 

Why long-term hospice care might be goodNBC KPRC TV, interview with Joseph Rotella, MD MBA HMDC FAAHPM, Chief Medical Director American Academy of Hospice and Palliative Medicine; 2/21/24Most people receiving hospice care don't live for more than a few weeks. Doctor explains why receiving hospice care earlier can be beneficial.

Exploring whether a diagnosis of severe frailty prompts advance care planning and end of life care conversationsNurs Older People, by Stacey Dodson; 2/21/24Findings: Frailty appeared to be complex, multifaceted and at times difficult to identify. A diagnosis of severe frailty did not necessarily prompt advance care planning and end of life care conversations. Such conversations were more likely to happen if the person had comorbidities, for example cancer. Prognostication appeared to be challenging, partly due to the gradual and uncertain trajectory in frailty and a lack of understanding, on the part of healthcare professionals, of the condition and its effects.

Racial differences in hospice care outcomes among patients with advanced heart failure: Systematic review and meta-analysisAm J Cardiol, by Diego Chambergo-Michilot, Victor G Becerra-Gonzales, Veraprapas Kittipibul, Rosario Colombo, Katia Bravo-Jaimes; 2/19/24There remains a paucity of investigational data about disparities in hospice services among people with non-cancer diagnoses, specifically in heart failure. Black patients with advanced heart failure have been disproportionally affected by health care services inequities but their outcomes after hospice enrollment are not well studied. We aimed to describe race-specific outcomes in patients with advanced heart failure who were enrolled in hospice services.

Identity shifts throughout HCT: A holistic approach to patient, caregiver supportHematology Advisor; by Katie Schoeppner, MSW, LICSW; Leah Christianson, OPN-CG; Hailey Hassel, MSW, LICSW; Cortney Alleyne, MPH; 2/20/24Patients undergoing hematopoietic cell transplant (HCT), their caregivers, and family members often experience dramatic shifts in their identity during and after the transplant process. These shifts can cause significant disruption in their lives, even among the most stable family and friend units. With holistic guidance and informed, empathetic care from professionals on healthcare teams, these patients and their support persons can better cope with the identity-related challenges they face.Editor's Note: See the patients you serve as persons. While this article focuses on person undergoing hematopoietic cell transplant, its rich insights about the patient/person's "tangible and intangible identity shifts" apply to the persons you serve, whatever the diagnosis. Read this article to develop your empathy and its practical applications throughout the services your organizations provide.

AI-generated clinical summaries require more than accuracyJAMA Network; by Katherine E. Goodman, JD, PhD; Paul H. Yi, MD; and Daniel J. Morgan, MD, MS; Originally published 1/29/24, redistributed 2/20/24 ... Currently, there are no comprehensive standards for LLM-generated [Large Language Model] clinical summaries beyond the general recognition that summaries should be consistently accurate and concise. Yet there are many ways to accurately summarize clinical information. Variations in summary length, organization, and tone could all nudge clinician interpretations and subsequent decisions either intentionally or unintentionally. To illustrate these challenges concretely, we prompted ChatGPT-4 to summarize a small sample of deidentified clinical documents. [Click on the title's link to view the example.]