Literature Review

In the spirit of Ramadan: Diverse access to palliative care Medscape UK, by Dr. Mohammed Sattar; 4/4/24 St. Gemma’s Hospice hosted their first ever Ramadan community iftar in Moortown, Leeds on March 19, with almost 100 guests in attendance. For me, this was a historic moment. This iftar was about creating a sense of community. ... [I've] seen the visionary leadership that is provided by St. Gemma’s senior team, ... taking careful consideration of what hospice and palliative care services should look like in an ever-changing Leeds population. The team members ask themselves some difficult questions about how to become an inclusive service for all and no faiths. The iftar, the sunset meal when Muslims break their daily fast, was a testament to that. ...

Qualitative analysis of initial palliative care consultations in amyotrophic lateral sclerosis Journal of Pain and Symptom Management; by Christine L Watt, Ian C Smith, Jill Rice, Rebekah Murphy, Ari Breiner, Maria Duff, Danica Nogo, Shirley H Bush, Susan McNeely, Usha Buenger, Belinda Zehrt, Jocelyn Zwicker; 4/2/24, online ahead of print Background: Palliative care (PC) benefits patients with amyotrophic lateral sclerosis (ALS), however the needs of patients and caregivers and the optimal timing of PC discussions remains unclear. This study reports the analysis of PC consult notes from a larger feasibility trial. The specific aims of this analysis were to i) identify the PC needs of patients with ALS via qualitative analysis and ii) identify characteristics of patients and caregivers that could predict specific PC needs.

“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. 

14 Joint Commission patient safety goals for post-acute facilities Becker's Hospital Review, by Mariah Taylor; 3/21/24 The Joint Commission released a breakdown of patient safety goals for post-acute care facilities in 2024. The organization published an easy-to-read resource outlining goals for nine sectors of healthcare, including nursing facilities, surgery, hospitals and behavioral care. For post-acute facilities, the goals mostly revolved around identifying patients correctly, using medicines safely, and preventing infections and falls. Here are the patient safety goals for post-acute facilities: ...

Here’s what a doctor says actually happens when you die United Business Journal, by Nidhi Dhote; 3/26/24Death is the great equalizer; it’s a subject that intrigues and terrifies us in equal measure. Throughout human history, we’ve pondered what lies beyond the threshold of life, seeking answers in religion, philosophy, and science. Yet, despite all our advancements, the mystery of death remains largely intact. ... In this article, we’ll delve into what happens to our bodies when we die, as explained by medical professionals.

Hospice of Santa Barbara offers insights into family grievingSanta Barbara Independent, by Hospice of Santa Barbara; 3/26/24Grieving the loss of a family member is a deeply intricate emotional journey. Shared bonds and histories make family grief especially unique. Family grief extends beyond the individual and intertwines with the collective fabric of shared experiences, roles and responsibilities. ... It is common for death to change the family dynamic. This can be a result of several factors, including age, relationship, role, difference in coping mechanisms, heightened stress and emotions, and unresolved family issues which can lead to the resurfacing of past grievances.Editor's Note: CMS Hospice COPs §418.3 defines: "Bereavement counseling means emotional, psychosocial, and spiritual support and services provided before and after the death of the patient to assist with issues related to grief, loss, and adjustment." The interdisciplinary team needs to understand individual and family grief, within the scope of their roles and responsibilities with family members.

Meaning-making among parents of children with severe neurologic impairment in the PICU Pediatrics / PubMed; by Jori F Bogetz, Ellie Oslin, Maeve O'Donnell, Krysta S Barton, Joyce P Yi-Frazier, R Scott Watson, Abby R Rosenberg; 3/26/24 Online ahead of print Results: Parents discussed ongoing meaning-making that occurred through domains of comprehension and purpose, and themes of understanding of other people and the world around them. Subthemes focused on appreciation/acceptance, adaptability/accountability, valuing all lives, and learning/teaching about their child.

My Mother is in Hospice Care Reformed Journal, by Doug Browser; 3/25/24 My 96-year-old mother entered hospice care a few months ago. For a while, it seemed as though she would go on forever, even though we knew that was unlikely. ... [Here’s] the thing, maybe the most striking thing I’ve learned while sitting with my mom over these last few months. Loss of memory can sometimes be a gift. ... I realize that there can be a kind of grace in not remembering a few things. ... We don’t have to go back and revisit any of it. We have this time together. ... And together we are a mom and a son, present in the moment, a moment with a surprising amount of grace. I never expected to get there.

Physicians often shy away from preparing their patients to dieToday'sHospitalist, by Colleen Poggenburg, MD, MS; 3/22/24 There's beauty in death if we can tolerate looking. ... The beauty in death is the reflections that occur in the weeks, days and minutes prior to it, which together make up a summary of someone’s life. Why then do physicians view this time-honored decline as a series of clustered medical problems, when it really is just someone moving toward death? Are we so concerned about treating just one more condition, and do we actually think it will solve the growing list of medical problems that dying patients have? ... I compared dying to pregnancy to “soften” the description of this decline. Here’s how I see that comparison: ...Editor's Note: The author offers a fascinating, meaningful comparison of physician/patient conversations with someone who is pregant versus someone who is dying. I encourage you to share this article with your clinical leaders (and adapt it for staff), as this model beautifully reframes important conversations that can empower patients and their families.

Improvements in Interdisciplinary Communication Following the implementation of a standardized Handoff Curriculum: SAFETIPS (Statistics, Assessment, Focused Plan, Pertinent Exam findings, to Dos, If/Thens, Pointers/Pitfalls, and Severity of Illness) Cureus, by Shaefali Shandilya and Justen M. Aprile; 3/18/24 Handoffs between medical providers serve a crucial patient safety function. While most published literature on the topic studies the handover process among physicians, robust literature is available on interdisciplinary medical communication. Little is known about the downstream effects of effective physician handover on subsequent physician and nursing interactions. ...Results: Statistical analysis revealed significant post-intervention mean score increases of one full point in four categories, namely organization and efficiency, communication, content, and clinical judgment.

Navigating difficult conversations with patients with terminal cancer diagnoses Oncology Nursing News, by Darlene Dobkowski, MA; 3/18/24 Although oncology nurses need strong communication skills to help all of their patients navigate their cancer journeys, it is critical to have the ability to have difficult conversations with patients who received a terminal diagnosis, ... Betty Ferrell, Ph.D., M.S.N., CHPN, director and professor in the Division of Nursing Research and Education in the Department of Population Sciences at City of Hope in Duarte, California, said in an interview with Oncology Nursing News. For the past 24 years, her institution has been directing a project called the End-of-Life Nursing Education Consortium (ELNEC), which is a palliative care training program and includes a module focused on communication.  ... “One of the things that we teach nurses is … that your No. 1 job is to listen,” Ferrell said. “Another thing that we say to nurses is, it is not your job to have all the answers. Patients ask very unanswerable questions. ‘Why me?’ is not an answerable question. But when a patient says, ‘Why me,’ then we want nurses to have good communication skills to say, ‘I can imagine why you're asking that question. Because as you've shared with me, you had no idea that you might be diagnosed with cancer, or you're the first person in your family to ever have cancer.’”

Doctor with terminal cancer shares the three things everyone should consider doing to prepare for deathYour Tango, by Alexandra Blogier; 3/12/24Kim is a resident doctor who was diagnosed with metastatic sarcoma when she was 28 years old. She invites people to see what her life is like, as both a medical resident and a cancer patient, focusing on the practice of gratitude and being present. ... Kim revealed the three most important things she’s done as a cancer patient to get the administrative side of her affairs in order, which she recommends everyone do, even if they're not sick.