Literature Review

Patients with metastatic cancer state more accurate prognosis when in poor healthMedscape / YouTube, Dr. Maurie Markman; 3/7/24Dr. Maurie Markman discusses a paper focused on the controversial oncology topic of prognosis beliefs among patients with metastatic cancer.Editor's Note: For the transcript, click on the link beneath the YouTube's description that has the text "medscape.com/viewarticle." 

Programmatic palliative care consultations in pediatric heart transplant evaluations Pediatr Cardiol, by Erika J Mejia, Rui Xiao, Jennifer K Walter, Chris Feudtner, Kimberly Y Lin, Aaron G DeWitt, Meeta Prasad Kerlin; 3/8/24 Guidelines advocate for integrating palliative care into the management of heart failure (HF) and of children with life-limiting disease. The potential impact of palliative care integration into pediatric HF on patient-centered outcomes is poorly understood. The present study sought to assess the association of programmatic implementation of palliative care into the heart transplant evaluation process with hospital-free days (HFD) and end of life (EOL) treatment choices. 

Rising suicide risk among seniors due to loneliness, mobility, financial insecurity, study finds McKnights Home Care, by Adam Healy; 3/5/24As the number of adults over 65 continues to grow, suicide rates among older adults have also been rising, according to data from the National Center for Health Statistics. Between 2008 and 2017, the share of suicide-related emergency department visits among adults 65 years and older more than doubled. These older adults face age-related stressors that can negatively affect mental health, such as declining physical health, reduced mental sharpness, or the loss of friends or loved ones, which can heighten the risk of suicide. 

What is the appropriate response when a colleague is not following an aid-in-dying law? American Clinicians Academy on Medical Aid in Dying - Ethics Consultation Service; posted by Jean Abbott, MD, MH; originally posted 2/2/24 and emailed 3/4/24 Outline of Ethics Question: A resource practitioner for aid-in-dying care has encountered practitioners who have not followed the requirements of the laws in that state, including eligibility, documentation, and other standard legal or medical elements of aid-in-dying care. The resource practitioner wonders what ethical responsibilities should guide their response to these concerns. Definition of “resource practitioner”: An experienced prescriber who acts as a source of information or a mentor for others prescribing or consulting for patients considering aid in dying. Their role is to advise the provider on aid-in-dying best medical practices and the process required to comply with the law.

Writing condolence cards supports nurses as well as deceased patients’ families ONS Voice, by Casey S. Kennedy; 2/29/24During extended treatment and end-of-life care, patients, their family and caregivers, and the healthcare team can form close bonds and relationships. Those ties are abruptly severed when a patient dies, leaving each party to grieve alone. For healthcare professionals, sending a condolence card can provide closure for themselves and support for a deceased patient’s family, a team of nurses reported in an article published in the December 2023 issue of the Clinical Journal of Oncology Nursing.

Debate intensifies over palliative care's reach: Wootton vs. Finlay's divergent viewsThe Wall Street Journal, by Getta Pillai; 2/29/24Discover the differing perspectives of Sarah Wootton and Dr. Ilora Finlay on the effectiveness of palliative care. Gain insights into the challenges and potential solutions in end-of-life care.

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.

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].

Racial differences in shared decision-making about critical illnessJAMA Intern Med, by Deepshikha C. Ashana, MD, MBA, MS; Whitney Welsh, PhD; Doreet Preiss, PhD; et al; published online 2/26/24Question: How do critical care clinicians approach shared decision-making with Black compared with White caregivers of critically ill patients?Findings: In a thematic analysis of 39 audio-recorded clinician-caregiver meetings, racial differences were most evident in the following clinician behaviors: providing emotional support to caregivers, acknowledging trust and gratitude expressed by caregivers, disclosing medical information, and validating caregivers' treatment preferences.

Not all mourning happens after bereavement – for some, grief can start years before the death of a loved one The Conversation, by Beth Daley; 2/22/24For many people, grief starts not at the point of death, but from the moment a loved one is diagnosed with a life-limiting illness. Whether it’s the diagnosis of an advanced cancer or a non-malignant condition such as dementia, heart failure or Parkinson’s disease, the psychological and emotional process of grief can begin many months or even years before the person dies. This experience of mourning a future loss is known as anticipatory grief.Editor's Note: All clinical team members need to be equipped to tune into and validate grief that is already underway. Social workers and chaplains--especially--need to be trained to tend grief in the present, and to know how to make high-acuity referrals to bereavement counselors.  

Understanding the discordance about prognosis between clinicians and terminally ill patients and their surrogates: A conversation with Douglas B. White, MD, MASThe ASCO Post, by Jo Cavallo; 2/25/24Research 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.

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.