Literature Review

Suicide rates among cancer patients are falling U.S. News / HealthDay; by Ernie Mundell; 5/30/24 Even as suicide rates have risen among Americans generally, one group appears to be bucking that trend: People diagnosed with cancer. Experts are crediting improved access to counseling and other "psychosocial care" with easing the emotional toll of cancer and keeping more patients from making tragic decisions.

Bereavement care, often an ‘afterthought,’ should be public health priority Healio; by Jennifer Byrne; 5/26/24 Health care institutions and their staffs must take action to ensure bereavement care shifts from “an afterthought to a public health priority,” according to a position paper published in The Lancet Public Health. Bereavement support often is considered part of palliative care; however, there often is a lack of continuity of care for bereaved individuals after a person dies in palliative or end-of-life care settings, the paper’s authors contend. Healio spoke with [co-author Wendy G. Lichtenthal,PhD] about what bereavement care encompasses, why it should be prioritized and how institutions can support grieving individuals who may require assistance.

10 most common sentinel events in 2023: Joint Commission Becker's Clinical Leadership; by Mackenzie Bean; 5/15/24 In 2023, patient falls were once again the most common sentinel event reported by healthcare organizations, according to a May 15 report from The Joint Commission. The Joint Commission defines a sentinel event as a patient safety event that results in death, permanent harm, severe temporary harm or intervention required to sustain life. ...  The 10 most frequently reported sentinel events for 2023:

When families fight over a relative with dementia, it’s time to call in the mediator The New York Times; by Paula Span; 5/13/24 Trained negotiators can help families struggling with vexing elder-care issues.  The four adult children were in agreement. Their father, William Curry, a retired electrical engineer and business executive, was sinking deeper into dementia. ... [But their mother] remained determined to continue caring for her 81-year-old husband at home, despite the increasing toll on her own health. ... As the weeks passed, “we were really at an impasse,” [a daughter] said. “Do you override your mother?” ...  [Increasingly,] families seek elder mediation privately, before disputes land in court and imperil or destroy family relationships. [Continue reading for descriptions of how mediation differs from arbitration, from family therapy, and for cautions about this being "a fairly new field with no nationwide certification or licensing requirements."]Editor's Notes: Executive leaders, what community education and resources are you providing for Advance Directives? What family systems education and and problem-solving are you providing for your interdisciplinary team members and grief counselors? Family conflicts are inherent--in some form or fashion--with almost anyone needing dementia care, especially when paired with palliative or hospice care. (If in doubt, ask your seasoned, front-line professionals.)

“Mental wellbeing is as important as physical wellbeing – both are interconnected” Marie Curie Hospice; by Anne Finucane, Marie Curie Senior Research Fellow, and David Gillanders, Senior Lecturer, Clinical Psychology, The University of Edinburgh, United Kingdom; 5/13/24 At least one in every four people living with a terminal diagnosis will experience depression, anxiety, adjustment disorder or low mood. Many more will experience distress because of deteriorating health and related uncertainty. Feelings of hopelessness, discouragement and even a desire for hastened death can occur. People have reported that psychological support helps them develop better coping strategies, helps them be more open to their situation and improves communication with their families and those involved in their care.Editor's Note: Executive leaders, what value do you give to your interdisciplinary team members and their contributions to patients' mental/emotional care? What advocacy, support and recognition do you have for your social workers, chaplains, counselors? What mental wellbeing measures do your employees experiences throughout your organization--and more directly--from your leadership with them? Perhaps it's time to "take the pulse" of your culture's mental wellbeing.

Impact of implementing serious illness conversations across a comprehensive cancer center using an interdisciplinary approach The American Journal of Hospice & Palliative Care; by Karen Guo, Garrett Wasp, Maxwell Vergo, Matthew Wilson, Megan M Holthoff, Madge E Buus-Frank, James J Perry, Amelia M Cullinan; 5/10/24Objectives: (1) Increase Serious Illness Conversation (SIC) use across oncology teams via an interdisciplinary quality improvement (QI) approach and (2) assess patient reported shared decision making (SDM) experiences with clinicians engaged in SIC implementation.Results: Oncology teams screened a total of 538 patients, identified 278 eligible patients, and completed 144 SIC conversations. The teams improved the proportion of documented SIC among eligible patients from near 0% to a collective frequency of 52%.

LifeBio announces partnership with New York State Office for the Aging to capture the legacies of hospice patientsKFOL/KJUN HTV10; 5/9/24 LifeBio has launched a partnership the New York State Office for the Aging (NYSOFA) and the Association on Aging in NYS (AANYS) to rollout an innovative life story project to people in hospice care. This is the first initiative of its kind in the U.S. to be supported with funding from a state-level unit on aging. Using the LifeBio Memory app to record the voices of New Yorkers, each participating hospice patient will receive back a Life Story Book containing stories, memories and favorite photos to share with loved ones. Audio files will be saved privately and securely. LifeBio will also offer the option of journals for handwriting the stories. 

Improving inclusive palliative care for transgender patients Hospice News; by Holly Vossel; 5/7/24... Nearly a quarter (21.3%) of 865 interdisciplinary palliative professionals indicated that they had observed some form of discriminatory care delivered to a transgender patient in a recent study published in Cambridge University Press’ journal Palliative Support Care. Furthermore, 85.3% of study participants said they witnessed disrespectful care, while inadequate and abusive care was observed by 35.9% and 10.3% of palliative teams, respectively. ... [Read more for descriptions and interventions, as discussed with Zachary Fried, licensed clinical social worker and training supervisor of Optum at Home, a subsidiary of UnitedHealth Group.] 

Breaking the silence: The mounting need for trauma-informed hospice care Hospice News; by Holly Vossel; 5/3/24Traumatized and abused hospice patients and providers often experience an array of lingering physical, emotional and psychological effects that can fall into a silent abyss of unmet needs. ... Many seniors have experienced some form of trauma or abuse in their lifetime. ... More data has become available in recent years around the prevalence of different types of abuse and trauma. Roughly 10% of seniors 65 and older nationwide are victims of some type of abuse each year, the U.S. Department of Justice (DOJ) reported. Caregiver neglect represents 5.1% of these cases, with psychological and physical abuse impacting 4.6% and 1.6% of seniors, respectively. ...Editor's Note: This article highights interviews with Dr. Ashwin Kotwal, assistant professor at the University California San Francisco; Carole Fisher, president, National Partnership for Healthcare and Hospice Innovation (NPHI); Dr. Cameron Muir, chief innovation officer, NPHI; Andrea Devoti, executive vice president at the National Association for Home Care & Hospice (NAHC); Lindsey Owen, executive director of Disability Rights Vermont.

What's in the Black Box of a successful nurse and social worker team palliative telecare intervention (ADAPT)? (RP317)Journal of Pain and Symptom Management; by Lyndsay DeGroot, PhD, RN, CNE; Kevin Wells; Brianne Morgan, BSN; Michelle Upham, MSW, LICSW; David B. Bekelman, MD, MPH; 5/24Key Message: A nurse and social worker palliative telecare team provided structured symptom management, psychosocial care, and individualized medical changes to improve quality of life, depression, and anxiety for patients with COPD, HF, and ILD. Impact: A nurse and social work palliative telecare team used collaborative care to tailor recommendations to the unique needs and symptoms of each patient, thereby improving quality of life.

Shocked at end-of-life: An educational video for hospice workers about Implantable Cardioverter-Defibrillators Journal of Pain and Symptom Management; by Sarah Godfrey, MD, MPH; Christine L. Chen, MD; Melanie S. Sulistio, MD; Sharika Kumar, MD; and Kelley Newcomer, MD; 2/24 Introduction: Hundreds of thousands of patients with implantable cardioverter-defibrillators (ICDs) die yearly. Though ICD shocks can be lifesaving, they can also be severely painful. One third of ICD patients are shocked in the last day of life irrespective of DNR status. Over 97% of hospice programs admit patients with ICDs, yet only 10% have deactivation policies and less than 50% of hospice patients have their ICD deactivated. ...  Conclusion: Hospice personnel have limited knowledge about ICDs, prohibiting best care of patients with these devices at EOL. A short educational video increased knowledge and may serve as a helpful tool. Improving ICD knowledge amongst hospice personnel is essential to ensuring the unique needs of hospice patients with ICDs are met.

Understanding is better than criticism The Pike County News Watchman; by Loren Hardin; 4/26/24 The first time I met Glenn was at his brother, Kenny’s, and sister-in-law, Tressie’s wedding anniversary party. ... Glenn walked into the party with a swagger, was wearing dark tinted sunglasses, grabbed his belt, pulled up his pants, stuck out his chest and sat down at the kitchen table. I thought, “Who is this guy wearing dark sunglasses on an overcast day?” To be honest, I thought, “This guy is kind of cocky acting”. Little did I know that in the not-too-distant future, I would become Glenn’s hospice social worker, nor did he? ... [Click on the title's link to read more of this insightful, inspirational story.]

Patients tell me they've had a paranormal experience. I Believe Them — I had one too. MSN HuffPost, by Scott Janssen; 4/23/24 Tank’s life has been full of conflict and strife. Now he’s stuck in a wheelchair on his back porch with me, a hospice social worker, peppering him with questions. He’s pondering my query about why he’s feeling peace about his impending death. His eyes soften as he motions with his head toward the workshop near the back fence. “You remember me telling you about my older boy?” he asks. “The one that died by suicide?” I ask. “Yeah, I remember.” “If you count my old man, I was the second-worst father that ever lived. Most of my life I figured I’d go straight to hell when I died.” ...