Literature Review

Exploring unmet concerns in home hospice cancer care: Perspectives of patients, informal caregivers, palliative care providers, and family physicians Cambridge University Press; by Eran Ben-Arye, Noah Samuels, Yael Keshet, Miri Golan, Erez Baruch, and Jama Dagash; 4/8/24 Objectives: The study examines perspectives of patients in home hospice care; their informal caregivers; palliative health-care providers (HCPs); and family physicians, all regarding patients’ unmet needs and quality of life (QoL)-related concerns.Conclusions: While the 4 groups were similar in their scoring of patient QoL-related concerns, there were discrepancies for some concerns (e.g., patient fatigue) and expectations regarding the need to discuss emotional and spiritual concerns, including on death and dying. Educational initiatives with programs providing training to all 4 groups may help bridge this gap, creating a more open and collaborative hospice care environment.

A hospice doctor on deathbed visions #shorts #tedx Tedx Talks; by Dr. Christopher Kerr; 4/29/24"When it comes to end-of-life experiences, most of the reports were based on anecdotal reporting. In other words, nobody had asked patients directly or attempted to quantify or measure. So that's what we've done. What we found is that the vast majority, over 80%, reported at least one pre-death dream and vision, described as more real than real and distinct from normal dreaming. 

Oncology social workers' involvement in palliative care: Secondary data analysis from nationwide oncology social workers surveyPalliative & Supportive Care; by Ting Guan, Karlynn BrintzenhofeSzoc, Alyssa Middleton, Shirley Otis-Green, Tara Schapmire, Makeeta Rayton, Krista Nelson, Michael L Grignon, Brad ZebrackResults: Responses from a secondary data set of 243 oncology social workers involved in palliative care results in a 6-factor solution comprising 34 tasks. These factors were identified as: Therapeutic Interventions for Individuals, Couples, and Families; Facilitate Patient Care Decision-making; Care Coordination; Assessment and Emotional Support; Organization and Community Service; and Equity and Justice.Significance of results: The findings can be used to develop job descriptions and education for social workers employed in palliative cancer care. The clear role descriptions also make social work visible to other professionals in palliative oncology. By clarifying the roles of oncology social workers, this study contributes to the improvement of palliative care delivery and enhances interprofessional collaboration within cancer care teams.

Psychosocial distress screening among interprofessional palliative care teams: A narrative review Journal of Social Work in End-of-Life & Palliative Care, by Chelsea K Brown and Cara L Wallace; 4/23/24With increased need for palliative care and limited staffing resources, non-social workers are increasingly responsible for screening for urgent psychosocial distress. The National Consensus Project guidelines call for all palliative care team members to be competent in screening across domains. ... Although an abundance of validated screening tools exists for outpatient oncology-specific settings, there is minimal guidance on psychosocial screening tools intended for specialty palliative care. The most oft-cited tools have been met with concern for validity across diverse palliative care populations and settings. ...  

Clinician burnout and effectiveness of guideline-recommended psychotherapies JAMA Network - Psychiatry; by Nina A. Sayer, PhD; Adam Kaplan, PhD; David B. Nelson, PhD; et al; 4/17/24 Importance: Clinician burnout has been associated with clinician outcomes, but the association with patient outcomes remains unclear. Conclusions: This prospective cohort study suggests that clinician burnout was negatively associated with patient outcomes from evidence-based psychotherapies. Findings support research to test the hypothesis that interventions to reduce burnout may improve outcomes from guideline-recommended psychotherapies for PTSD. Future work should determine when and how burnout is associated with intervention delivery and patient outcomes.Editor's Note: Most research on hospice and palliative clinician burnout focuses on physicians and nurses. Examine this in light of your psychosocial/spiritual professionals, i.e. social workers, chaplains/spiritual care, and bereavement counselors. 

Health Talk: Getting into a health care career The Barre Montpelier Times Argus Online, by Peg Bolgioni; 4/13/24According to the American Hospital Association, there will be a shortage of up to 3.2 million health care workers by 2026. America will face a shortage of up to 124,000 physicians by 2033 and will need to hire at least 200,000 nurses per year to meet increased demand, and to replace retiring nurses. ... The mission of Southern Vermont Area Health Education Center is to enhance community efforts to grow and sustain the health workforce in southern Vermont. One of the ways we do this is by delivering pathway programs that connect students to health careers. [Click the title's link to read about this event.]Editor's Note: How might your organization create similar career engagement and education in your community? 

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:

Readers share stories of their loved ones’ deathbed visions DNYUZ; 4/10/24 When I started reporting “What Deathbed Visions Teach Us About Living,” about the visions, often of loved ones, that some people have in the final stretches of their lives, I had no idea just how universal the experience was. But within minutes of the story’s publication, readers took to the comments section to post their own memories of having witnessed the phenomenon. The stories were rich, deeply personal, and seemed to confirm something that the researcher featured in my story, Dr. Chris Kerr, knew in his years of studying such visions: they bring peace to the dying and solace to the living. Family members wrote in with stories of watching loved ones have visions, as did health care workers, who had years of experience witnessing them. [Click on the article's title to read more stories.]

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.

The Sunday Read: 'What deathbed visions teach us about living' New York Times Podcasts, 4/7/24 Chris Kerr was 12 when he first observed a deathbed vision. His memory of that summer in 1974 is blurred, but not the sense of mystery he felt at the bedside of his dying father. ... Kerr now calls what he witnessed an end-of-life vision. His father wasn’t delusional, he believes. ... Kerr followed his father into medicine, and in the last 10 years he has hired a permanent research team that expanded studies on deathbed visions to include interviews with patients receiving hospice care at home and with their families, deepening researchers’ understanding of the variety and profundity of these visions.

How to talk about death Maine Public Radio, by Jennifer Rooks and Cindy Han; 4/5/24 Talking about death is not easy. We'll discuss why stigma and discomfort can impede end-of-life conversations, for the person who may be nearing death as well as for friends and family members. We'll find out how to address the emotional and spiritual aspects of dying. And we'll discuss the more practical legal, financial and medical matters to handle before and after someone has died.Panelists: Julie Weiss, social worker, Hospice of Southern Maine; Dr. Paul Segal, nephrologist, assistant professor of medicine; helped create curriculum for end-of-life doula students, University of New England; Dr. Fernando Moreno, palliative care specialist; medical director, Hospice of Southern Maine