Literature Review

Goals of care among patients with advanced cancer and their family caregivers in the last years of life JAMA Network; by Semra Ozdemir, PhD; Isha Chaudhry, MSc, Chetna Malhotra, MD; et al; 4/11/24 Conclusions and Relevance: In this cohort study of patient-caregiver dyads, findings suggested the importance of interventions aimed at reducing discordance in goals of care between patients and caregivers and helping them develop realistic expectations to avoid costly, futile treatments.

Iowa River Hospice arranges unique celebration of life for Marshalltown woman with cancer Times Republican, by Robert Maharry; 4/13/24 Sandy Messer ... has been battling cancer for the last two years and is currently receiving in-home hospice care. On March 23, a Celebration of Life was arranged by Iowa River Hospice at Mama DiGrado’s so that her family members could share their love with Messer while she is still alive.

3 ways advance care planning empowers people TCPalm, Visiting Nurse Association, by Lauren Gruber; 4/10/24 ... National Healthcare Decisions Day on April 16th, which seeks to inspire, educate and empower the public and providers on the importance of health planning, is a prime opportunity to consider enrolling in an advance care plan. Identifying the right caregiving plans may seem daunting at first, but it’s important that patients solidify an advance care plan for the security and peace of mind of themselves and their loved ones. ... Here are three ways why choosing an advance care plan through the VNA can empower patients to ensure the best care possible during their health care journey:

Angela Hospice opening a hospice residence at Lourdes Senior Community in Waterford Detroit Regional Chamber, by Angela Hospice; 4/10/24 Angela Hospice will expand its caring services to the Waterford community and beyond, when it begins operating a 15-bed hospice residence at Lourdes Senior Community this summer and providing additional home hospice services in the area. The non-profit will extend its geographic reach further into north Oakland County, offering additional outreach to benefit all in the community, not just those on hospice care, through transformational grief support groups, educational outreach, and their Good Samaritan program, which serves those who are without insurance or the ability to pay for hospice.

A wish to remember: Penn Medicine program fulfills patients’ last requests Penn Medicine News, by Meredith Mann; 4/9/24 The patient was dying of cancer. All options for saving or prolonging their life had been exhausted. Now, the patient most wanted to spend one more carefree, joyous day with their grandchild. ... This is just one example of the last requests granted through Princeton Health’s Three Wishes Project. On paper, it’s about performing small gestures that bring comfort and meaning to patients at the end of their lives. In practice, it’s about so much more—providing a sense of hope and closure, not only to these patients and their families, but also to staff.

Lost for words? Research shows art therapy brings benefits for mental health The Conversation; 4/8/24 Creating art for healing purposes dates back tens of thousands of years, to the practices of First Nations people around the world. ... When people face significant physical or mental ill-health, it can be challenging to put their experiences into words. Art therapists support people to explore and process overwhelming thoughts, feelings and experiences through a reflective art-making process. This is distinct from art classes, which often focus on technical aspects of the artwork, or the aesthetics of the final product.

I work with dying Trump supporters. It's...confusingDaily Kos, by Scott Janssen; 4/6/24Publisher's note: There weren't a couple sentences to summarize this opinion piece. In our advocacy, we often say "death and hospice are bipartisan". This article challenges us to ethically wrestle with our biases (political or otherwise) to professionally provide excellent end-of-life care.

[Psychology Today] Facing Mortality Honestly Psychology today, by Patricia Prijatel; 4/6/24 Personal Perspective: Being Mortal, by Atul Gawander, explores end-of-life-care. I read Being Mortal by Atul Gawande when it was first published in 2014 and haven’t stopped talking about it. It shot to the top of my list as one of the most important books I’ve ever read. After 10 years, I read it again to see if it held up. It did. I was as entranced the second time as the first—even more so because, as it happens, I am also now 10 years older.

Study shows strong social ties may ease the way for older adults in life's final chapter Medical & Life Sciences, by Vijay Kumar Maleus; 4/4/24  Study Results: ... The analysis revealed that higher levels of loneliness were significantly associated with increased odds of experiencing anxiety, sadness, and pain in the last month of life, suggesting a pivotal link between social isolation and end-of-life symptomatology. Furthermore, marital status and the receipt of personal care were predictors of dying in a hospital, pointing to the influence of social support structures on the location of death. Interestingly, a larger social network was correlated with a higher likelihood of receiving hospice or palliative care, highlighting the potential benefits of broader social connections. 

Palliative care could be a game changer for public health Harvard Public Health, by Meredith Lidard Kleeman; 4/4/24California and Hawaii are pioneering ways to expand access. ... California is one of the first states in the country to require insurance companies that administer Medicaid benefits to fully cover palliative care services for eligible residents. ... Palliative care is poised to be a game changer for public health. Nearly 50 percent of states now include palliative care services for eligible Medicaid recipients, according to C-TAC. And in California and Hawaii, two paths are being forged toward wider palliative care access. ... 

“Personhood,” not “Patienthood”:  Tips on dignity-conserving practice in palliative careIAHPC, by Kim Adzich, MD; 4/1/24 One of Dame Cicely Saunders’ foundational tenets of palliative care is embodied in her words, “You matter because you are you, and you matter until the last moment of your life.” Dignity is the inherent worthiness of being human, of mattering until that last breath. But how do we ensure that we reflect that inherent dignity back to those in our care? Dr. Harvey Max Chochinov, having dedicated decades to researching and teaching dignity-conserving care, ... [offers] a few thoughts on how we can foster that sense of dignity and uniqueness in those we care for as they near the end of life. 

How’s Your Soul? JAMA Network, by Daivd Vermette, MD, MBA, MHS; 3/28/24 "Brother David, how’s your soul?” The question took me by surprise. It was time for my first advisement meeting with my residency program director. In medicine, the machine runs on competence and achievement of “milestones.” Yet, as I braced for a meeting to trudge through performance evaluations and in-training exam scores, I awoke to humanity. ... Medical education has numerous models for coaching, advising, and mentoring. While these models helped develop my professional life, they missed the fundamental core of who I am: a human being. Perhaps instead we could embrace a model in medical education built on the tenets of pastoral care. ...

Hospice & Palliative Care Handbook: Quality, Compliance, and Reimbursement, 4th Edition McGraw Hill - Access APN; textbook by Tina M. Marrelli and Jennifer Kennedy; 3/28/24 “Hospice & Palliative Care Handbook, Fourth Edition, is an invaluable resource for timely hospice regulatory and compliance information, documentation, care planning, and case management. It provides clear guidance for hospice managers, clinicians, and interdisciplinary group members. I have utilized Tina Marrelli’s home health and hospice handbooks to support training new clinical staff and students for decades and consider these resources to be the gold standard.” – Kimberly Skehan, MSN, RN, HCS-D, COS-C, Vice President of Accreditation - Community Health Accreditation Partner