Literature Review
All posts tagged with “Clinical News | Social Work News.”
Being there for a loved one's final breaths
02/27/24 at 03:00 AMBeing 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.
Understanding the discordance about prognosis between clinicians and terminally ill patients and their surrogates
02/26/24 at 03:00 AMUnderstanding 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.
Advance praise for Oncology and Palliative Social Work: Psychosocial Care for People Coping with Cancer
02/26/24 at 03:00 AMAdvance 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.
Not all mourning happens after bereavement – for some, grief can start years before the death of a loved one
02/26/24 at 03:00 AMNot 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.
Mental health service integration in hospice organizations: A national survey of hospice clinicians and medical leadership
02/23/24 at 03:00 AM
Psychological issues in palliative care: Elissa Kozlov and Des Azizoddin
02/23/24 at 03:00 AMPsychological issues in palliative care: Elissa Kozlov and Des AzizoddinGeriPal podcast, by Alex Smith; 2/22/24Today we talk with two psychologists who are deeply invested in addressing psychological aspects of care for people living with serious illness. Elissa Kozlov, a geropsychologist and director of a new population aging MPH at Rutgers, surveyed AAHPM members, and found that doctors reported major shortcomings in level of comfort and knowledge caring for patients with psychological illness. She conducted a systematic review and meta-analysis of 38 palliative care trials, finding that many excluded people with serious illness, and a lack of impact on psychological outcomes. Analyzing the Health and Retirement Study, she found 60% of older adults screened positive for depression in the last year of life.
We gave palliative care patients VR therapy. More than 50% said it helped reduce pain and depression symptoms
02/23/24 at 03:00 AMWe gave palliative care patients VR therapy. More than 50% said it helped reduce pain and depression symptomsThe Conversation; 2/22/24Our study, published this week in the journal BMJ Supportive & Palliative Care, found more than 50% of patients experienced clinically meaningful reductions in symptoms such as pain and depression immediately after a 20-minute VR session. ... Personalised VR means each person experiences content that is meaningful to that individual. So rather than asking patients to choose, for example, between a rainforest and a beach VR experience, we interviewed the patients before their sessions to gauge their interests and create a VR session tailored to them.
Racial differences in hospice care outcomes among patients with advanced heart failure: Systematic review and meta-analysis
02/23/24 at 03:00 AMRacial 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.
Exploring whether a diagnosis of severe frailty prompts advance care planning and end of life care conversations
02/23/24 at 03:00 AMExploring 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.
Identity shifts throughout HCT: A holistic approach to patient, caregiver support
02/23/24 at 01:00 AMIdentity 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.
Studies conducted at University of New Mexico on Hospice and Palliative Medicine recently published (Cultural advocacy for indigenous individuals with serious illness)
02/22/24 at 03:00 AMStudies conducted at University of New Mexico on Hospice and Palliative Medicine recently published (Cultural advocacy for indigenous individuals with serious illness) American Journal of Hospice and Palliative Medicine, by Jeanna Ford, DNP, APRN, ACNS-BC, ACHPN, FPCN, FCNS, and Constance Dahlin, MSN, ANP-BC, ACHPN, FPCN, FAAN; first published 2/2/24, posted in Health & Medicine Daily 2/20/24Indigenous American (I.A.) individuals with serious illness and their families have unmet needs. Often, this group is viewed as a minority within a minority. Numerous health challenges exist within the I.A. populations resulting in dire health care situations. Historical trauma and mistrust of the healthcare system impacts access to quality palliative care by this marginalized population. ... The aim is to empower palliative care clinicians the knowledge to provide culturally sensitive and congruent care to I.A. individuals with serious illness and their community.
Barriers and facilitators to end-of-life care delivery in ICUs: A qualitative study
02/22/24 at 03:00 AMBarriers 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 care
02/21/24 at 03:05 AMEmbodied 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.
Death can be isolating and dehumanizing. But what if it didn’t have to be?
02/21/24 at 03:00 AMDeath can be isolating and dehumanizing. But what if it didn’t have to be?City Life, by Ben Seal; 2/17/24... In the three years since Elaine’s passing, I’ve longed for a world where more people could be given the chance to die as she did — with the fullness of life surrounding her, and with complete support, emphasizing the emotional and spiritual, not just the medical. In Philadelphia and beyond, a growing community of death-care workers — doulas, nurses, grief counselors, social workers, even funeral directors — is trying to build that world. They are reclaiming death and dying from the institutional model that has become the norm over the past century. Editor's Note: Has hospice now become so institutionalized and medical/regulatory focused that we have lost sight of "emphasizing the emotional and spiritual, not just the medical"? I ask the question, but do not draw judgment, as answers must be contextualized.
Is the patient dead?
02/19/24 at 03:00 AMIs 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:
Scaling palliative care requires adherence to best practices
02/16/24 at 02:15 AMScaling palliative care requires adherence to best practicesAJMC, by Tina Basenese, MA, APN, ACHPN; 2/14/24An important milestone came January 1, 2024, when a new add-on code [G2211] took effect for reimbursement for complex Medicare patient visits, including palliative care. ... Having patients map out their wishes through advance directives is an important metric, but it’s not the goal of palliative care, nor is it the only way to measure whether a program works. Rather, comprehensive palliative care must be truly patient centered. This requires building trust and training palliative care specialists in a manner similar to other subspecialties to create and scale processes that are infused with a culture of communication.
Understanding the discordance about prognosis between clinicians and terminally ill patients and their surrogates
02/16/24 at 02:00 AMUnderstanding 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.
How to support adolescents and young adults with cancer at the end of life
02/15/24 at 03:00 AMHow to support adolescents and young adults with cancer at the end of lifeThe Oncology Nursing Society Voice, by Kimberly Rivera DNP, RN-BC, OCN®, NPD-BC; 2/12/24... [Cancer] is the fourth leading cause of death in adolescents and young adults (AYAs), following accidents, suicide, and homicide. ... Appropriately defining the difference between palliative and end-of-life care can improve AYAs’ engagement with services such as advance care planning—a specific step that increases AYAs’ likelihood of receiving early palliative care. However, many palliative and hospice care services are geared toward pediatric or adult populations and may not meet AYAs’ unique needs, impeding effective care planning.
What is a good death? End-of-life doulas can help the dying have one.
02/14/24 at 03:00 AMWhat is a good death? End-of-life doulas can help the dying have one.Boston Globe, by Sherrie Dulworth; 2/9/24... Home hospice agencies offer vital services for terminally ill people who wish to die at home, assisting with, among other things, pain management and helping the terminally ill avoid needless medical procedures. ... But while it is often thought that home hospice workers are the primary caregivers for the dying, this is not so. Instead, it is loved ones who often do the heavy lifting, both physically and emotionally, that comes with tending to the dying. ... This is where a death doula comes in, and the work they do speaks to the nonmedical, more spiritual side of what it means to have a good death.
The Last Portrait: Local photo exhibition captures different takes on dying [Hospice & Palliative Care, Inc., New Hartford, NY]
02/14/24 at 03:00 AMThe Last Portrait: Local photo exhibition captures different takes on dyingUtica Observer Dispatch, by Amy Neff Roth; 2/9/24... The 26 black-and-white photos, taken by local photographer Mark DiOrio, all capture moments in the life of someone who has been diagnosed with a terminal illness. “I wanted to photograph them because they’ve been given news that nobody wants to hear,” DiOrio explained. “They’ve been given the news that it’s going to be their time soon. And when you’re given that kind of news, you have choices to make on how you handle it. I felt that these people, what they had to say and the emotions that they communicated in that moment were invaluable.”
NHPCO publishes Culturally Sensitive Communications to Enhance Care Delivery: A resource guide for healthcare professionals
02/06/24 at 04:00 AMNHPCO Publishes Culturally Sensitive Communications to Enhance Care Delivery: A resource guide for healthcare professionalsNHPCO Press Release; 1/30/24The National Hospice and Palliative Care Organization’s (NHPCO) Diversity Advisory Council (DAC) published Culturally Sensitive Communications to Enhance Care Delivery: A Resource Guide for Healthcare Professionals. ... It contains information from a multitude of NHPCO resources, such as the Hospice Through The DEI Lens report, Inclusion and Access Toolkit, Black and African American Outreach Guide, Chinese American Resource Guide, Latino Outreach Guide, and LGBTQ+ Resource Guide, as well as information from additional external research sources.
How does care coordination promote senior health & longevity?
02/06/24 at 04:00 AMHow 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:
Palliative care use trends, racial/ethnic disparities, and overall survival differences among patients with metastatic breast cancer
02/05/24 at 04:00 AMPalliative care use trends, racial/ethnic disparities, and overall survival differences among patients with metastatic breast cancerJ Palliat Med, by Jincong Q Freeman, Olasubomi J Omoleye, Fangyuan Zhao, Dezheng Huo; 2/1/24Conclusions: Palliative care utilization among MBC [Metastatic Breast Cancer] patients significantly increased but remained suboptimal. Racial/ethnic minority patients were less likely to use palliative care, and Black patients had worse survival, than White patients, suggesting the need for improving palliative care access and ameliorating disparities in MBC patients.
Nurses' encounters with patients having end-of-life dreams and visions in an acute care setting - A cross-sectional survey study
02/02/24 at 04:00 AMNurses' encounters with patients having end-of-life dreams and visions in an acute care setting - A cross-sectional survey studyJ Adv Nurse, by Alison Hession, Tim Luckett, David Currow, Michael Barbato; 1/31/24Results: Fifty-seven nurses participated from a workforce of 169 (34% response rate), of whom 35 (61%) reported they had encountered end-of-life dreams and visions. The nature of end-of-life dreams and visions encountered was similar to those reported in previous studies by patients and clinicians. Nurses generally held positive attitudes towards end-of-life dreams and visions but identified an unmet need for education and training on this aspect of end-of-life care.Editor's Note: This research was in Australia, yet has global applications. For U.S. leaders, call on your chaplains, many of whom are trained pastoral counselors to sensitively support and explore patient's "dreams and visions," in non-manipulative ways.