Literature Review

Barriers and facilitators to end-of-life care delivery in ICUs: A qualitative studyCrit Care Med; by Lauren M Janczewski, Adithya Chandrasekaran, Egide Abahuje, Bona Ko, John D Slocum, Kaithlyn Tesorero, My L T Nguyen, Sohae Yang, Erin A Strong, Kunjan Bhakta, Jeffrey P Huml, Jacqueline M Kruser, Julie K Johnson, Anne M Stey; 2/19/24Objectives: To understand frontline ICU clinician's perceptions of end-of-life care delivery in the ICU.Setting: Seven ICUs across three hospitals in an integrated academic health system.Subjects: ICU clinicians (physicians [critical care, palliative care], advanced practice providers, nurses, social workers, chaplains).Conclusions: Standardized work system communication tasks may improve end-of life discussion processes between clinicians and families.

Embodied decisions unfolding over time: a meta-ethnography systematic review of people with cancer's reasons for delaying or declining end-of-life careBMC Palliat Care, by Jessica Young, Antonia Lyons, Richard Egan, and Kevin Dew; 2/19/24Conclusions: Decisions about when (and for some, whether at all) to accept end-of-life care are made in a complex system with preferences shifting over time, in relation to the embodied experience of life-limiting cancer. Time is central to patients' end-of-life care decision-making. ... The integration of palliative care across the cancer care trajectory and earlier introduction of end-of-life care highlight the importance of these findings for improving access whilst recognising that accessing end-of-life care will not be desired by all patients.

Redefining end-of-life care: Stories of compassion and innovationBNN, by Waqas Arain; 2/18/24In the heart of compassionate care and the challenging journey of end-of-life situations, two remarkable healthcare professionals stand out for their dedication and innovative approaches to palliative support. Teresa Hovatter, a Community Liaison with Grane Hospice, and Kirsty Lazenby, an organ donation nurse at Royal Stoke's Critical Care Unit, have each been recognized for their exceptional efforts in providing comfort, dignity, and support to terminally ill patients and their families. Their stories, though distinct, converge on a singular mission: to transform the end-of-life experience into one of peace, understanding, and meaningful closure.

Is the patient dead?AMA Journal of Ethics; email 2/14/24Debate over the criteria by which doctors declare brain death has some bioethicists concerned. The AMA Journal of Ethics offers the following educational resources:

A race against time: Cancer patient's touching keepsake for his familyBNN; 2/15/24When time was running out, 44-year-old cancer patient Yiu created a heartfelt keepsake for his family. With the help of an art therapist, he cast a realistic mold of his intertwined hands with his wife's symbolizing their love and unity. This touching story highlights the power of love and hope in the face of adversity.

Bristol Hospice’s quest to help patients sleepHospice News, by Jim Parker; 2/14/24Salt Lake City-based Bristol Hospice has developed a branded program designed to help their patients get better sleep, which can significantly impact quality of life.

Advance planning values and end-of-life care among patients on dialysisdocwirenews, by Victoria Socha; 2/12/24... Patients treated with dialysis are also more likely to die in the hospital and less likely to receive hospice care. [Researchers] conducted a survey designed to examine the association between patients’ health care values and engagement in advance care planning and end-of-life care. Analyses of survey responses were reported in JAMA Internal Medicine.

Understanding the discordance about prognosis between clinicians and terminally ill patients and their surrogatesThe ASCO Post, by Jo Cavallo; 2/14/24A Conversation with Douglas B. White, MD, MASResearch shows that about half of adults near the end of life in the United States are too ill to participate in decisions about whether to accept life-prolonging treatment, requiring family members and other proxies to serve as surrogate decision-makers for their critically ill loved ones. However, research also shows that surrogates of patients with advanced illness often have optimistic expectations about prognosis, which often lead to the increased use of invasive treatment (including life support) in dying patients and delays in the integration of palliative care.

Changes in hospice care experiences during the COVID-19 pandemicRand, Journal of the American Geriatrics Society; by Maria DeYoreo, Rebecca Anhang Price, Ann C. Haas, Anagha Alka Tolpadi, Joan M. Teno, Marc N. Elliott; 2/12/24Demand for hospice and palliative care services increased during the COVID-19 pandemic. Hospices strove to meet this demand despite staffing shortages and visitation restrictions that sometimes prevented family members and hospice staff from visiting patients in institutional settings such as nursing homes, assisted living facilities, and hospitals. We examine how the COVID-19 pandemic may have influenced the characteristics of patients receiving hospice care, the settings in which they received care, and their care experiences using national data from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey. The survey is completed by bereaved family caregivers following the death of the hospice patient, and is the national standard for assessing patient- and family-centeredness of hospice care.

Patient navigator intervention to improve palliative care outcomes for Hispanic patients with serious non-cancer illness a randomized clinical trial JAMA Intern. Med, by Stacy M. Fischer, MD; Sung-Joon Min, PhD; Danielle M. Kline, MS; et al; 2/212/24Importance: Disparities persist across the trajectory of serious illness, including at the end of life. Patient navigation has been shown to reduce disparities and improve outcomes for underserved populations.Objective: To determine the effectiveness of a lay patient navigator intervention, Apoyo con Cariño, in improving palliative care outcomes among Hispanic patients.

Alzheimer's: Watch for signs it's time to start hospice careThe Advocate, by Dana Territo; 2/5/24When is someone with dementia ready for hospice care? ... Some of the characteristics the affected individual may be exhibiting include the lack of ability to ambulate without assistance, incontinence of bowel and bladder, inability to dress and bathe properly, and speech limited to approximately a half dozen or fewer intelligible and different words. There are also intercurrent illnesses associated with advanced dementia in which hospice services would be a benefit. 

Clinicians and caregivers must keep pace with new pacemaker tech available for seniors: studyMcKnight's Senior Living, by Aaron Dorman; 2/6/24As new pacemaker and implantable heart technology becomes available, it has become increasingly important for caregivers to keep track of the different models. A new survey classifies cardiac implantable electronic devices, or CIEDs, according to both their function and where in the heart their components are placed. The various categories also overlap, the study indicates, as CIEDs can be leadless — that is, have no wires connecting heart implants to the battery — and can include defibrillator shock capabilities.Editor's Note: Dying with an defibrillator can be traumatic for the patient and the family if the implanted defibrillator attempts to shock the person back to life, even after the heart has given out. Examine this with your Medical Director, physicians and nurses, and Policies and Procedures.

How does care coordination promote senior health & longevity?MediaFeed.org, by Kara Lewis; 2/2/24... Care coordination offers several fundamental benefits to seniors, according to an American Nurses Association report: