Literature Review

Palliative care, mental health services underutilized in pancreatic cancer Healio; by Jennifer Byrne; 12/19/24 Individuals with pancreatic cancer underutilized palliative care and mental health services, according to a retrospective analysis. ... Researchers from Saint Louis University used electronic health record data from Optum’s Integrated Claims-Clinical Data set to identify 4,029 patients with newly diagnosed pancreatic cancer. The investigators then used ICD-9/10 codes to identify subsequent diagnoses of anxiety and depression, as well as palliative care consultations. ... Results showed higher prevalence of anxiety (33.9% vs. 22.8%) and depression (36.2% vs. 23.2%) among patients who had palliative care consultations than those who did not have documented consultations. ... Healio: Did any of your findings surprise you? Divya S. Subramaniam, PhD, MPH: It was unexpected to see that palliative care consultations, despite identifying higher levels of anxiety and depression, did not increase treatment rates for these mental health conditions. This suggests mental health might not yet be a central focus in palliative consultations, which often concentrate on managing physical symptoms.

December challenge: Gift ideas part two ActiveRain; by Kat Palmiotti; 12/17/24 ... My mother dealt with cancer the last four years of her life with an upbeat attitude, ...  So what did she do with the time she had left? The same as always. It was late November 2011 at this point. So what she decided to do was to make a point of purchasing us all our last Christmas present. ... So for me, she purchased me a coffee cup with a lid which is pictured in the feature photo. ... But my mom didn't stop there. She also wrote each of her family members a handwritten letter. Her letter to me talked about me being her first born, and about what I was like during my childhood, and how she felt about my life as an adult. It was a beautiful letter that makes me smile and cry every time I read it. I treasure it. ... So why am I sharing this? Because when I think back on all the gifts I've ever received, it's not jewelry or clothing or anything else that pops into my mind first. It's a $5 cup and a piece of paper with writing on it. And both of those were my mom giving me love. So, when giving gifts to those you care about, give them love. Perhaps grab a piece of paper and a pen and let them know how much you care about them. Or buy them a small carefully selected item that they might use on a daily basis, smiling because it's from you. Because really, it truly is the thought that counts. Let that thought be love.

Palliative care may improve quality of life for stroke survivors and their family members American Heart Association - Stroke News & Brain Health; by Newsroom; 12/16/24 Palliative care ... can help improve quality of life for stroke survivors as well as their family members, according to “Palliative and End-of-Life Care in Stroke,” a new scientific statement published today in the Association’s peer-reviewed scientific journal Stroke. ... The new statement complements the Association’s 2014 Scientific Statement on Palliative and End-of-Life Care in Stroke, which covered core palliative care competencies and skills for health care professionals who treat stroke patients. The statement includes strategies to improve communication about prognosis and goals-of-care, address psychosocial needs such as coping with loss, navigate complex health care systems and prepare for death with end-of-life care when necessary. It also highlights the substantial inequities that exist in palliative care after stroke across sociodemographic and regional characteristics and the need to reduce those disparities.

Caring for emotional and spiritual needs of ICU families Medical Xpress; by Regenstrief Institute; 12/10/24 Family members of intensive care unit (ICU) patients often experience psychological and spiritual distress as they deal with serious illness and potential death. A new paper authored by a national team of experts at the intersection of health and spirituality highlights the critical role of the spiritual care provided by chaplains in supporting family members of ICU patients. ... "Our model describes three important ways that chaplain care supports ICU family members and helps them when faced with difficult decisions," said study co-author and chaplain-researcher George Fitchett, DMin, Ph.D., professor of religion, health and human values at Rush University Medical Center. "Chaplains provide family members with spiritual and emotional support. They also facilitate conversation with the medical team and help family members process the information from those conversations. Significantly, our study highlights the care provided by chaplains to ICU patient families and its impact on important outcomes." Editor's note: Click here for Improving Outcomes for for ICU Family Members: The Role of Spiritual Care, published in the Journal of Palliative Medicine, Oct 2024.

A call to action for business leaders in health care: Prioritizing employees’ mental health is a necessity Las Vegas Sun - Veagas Inc; Guest column by Karen Rubel; 12/9/24 As mental health continues to be recognized as a vital component of overall well-being, businesses—especially those in health care—must stay vigilant and proactive in addressing mental health challenges within the workplace. The importance of this issue has never been greater,  ... In a hospice setting, the emotional toll on caregivers is significant. Health care workers often form close bonds with their patients and their families, and the loss of a patient can be deeply affecting. At Nathan Adelson Hospice, our teams regularly come together to review patient care plans, but they also take time to discuss their personal experiences and challenges. These discussions provide an opportunity for our staff to offer mutual support and care. This peer-to-peer connection fosters a sense of community and helps staff process their emotions in a healthy way. ...

Disclosure practices in Muslim patients and the impact on end-of-life care: A narrative review American Journal of Hospice and Palliative Care; by Mona Tereen; 11/26/24 ... Non-disclosure practices hold significant weight in end-of-life care for Muslim communities, where cultural and religious beliefs are deeply intertwined with healthcare decision-making. This narrative review explores the complexities of medical decision-making and disclosure practices among terminally ill Muslim patients, examining how these factors shape palliative care delivery. Conclusion: Non-disclosure practices present significant barriers to effective palliative care in Muslim communities. To improve care outcomes, culturally competent communication strategies and family-centered decision-making models are crucial.

The work of hospicing Stanford Social Innovation Review; by Vanessa Andreotti and Habib Nabatu; Winter 2025 issue, 11/20/24As we stand at the precipice of endings—of species, ecosystems, organizations, and systems themselves—the work of hospicing is to move beyond fear and embrace the deep transitions ahead with wisdom. To be stewards of this time, we must develop the practices and capacities to tend to these endings, not with urgency or control, but with a kind of stillness that invites the birth of new ways of being. Endings are not failures; they are part of a cycle that requires presence, reverence, and humility. Our hyperfocus on growth and expansion has left us ill-prepared to sit with death—whether it be the death of industries or the biosphere—and this discomfort with grief prevents us from being fully alive in the present. How might we allow the crumbling of outdated structures without rushing to rebuild too quickly? How might we hold space for what is irreversibly changing, without rushing to save or fix it? ...

Educating patients and clinicians on end-of-life care and discussions CancerNetwork - home of the journal Oncology; by Kelley A. Rone, DNP, RN, AGNP-c CancerNetwork® sat down with Kelley A. Rone, DNP, RN, AGNP-c, to discuss the importance of speaking compassionately and ensuring patient awareness when leading end-of-life discussions among those with gastrointestinal (GI) cancers. The discussion also focused on combating burnout in the clinic, using opioids to help manage pain and other symptoms, and educating all members of a multidisciplinary team on initiating end-of-life conversations with their patients. ... As part of leading these end-of-life conversations, Rone emphasized the necessity of addressing the discomfort patients tend to feel when talking about the fact that they may die from their cancer. ... When working with other members of a multidisciplinary care team, Rone illustrated the challenge of having physicians understand that their treatments may fail in younger patients and helping other oncologists become more experienced in speaking about death with patients. ...

The dozen phrases doctors warned never say to patients, including ‘everything is going to be fine’ What's New 2Day; by Alexander; 11/8/24 “Everything is going to be okay.” No doubt you or someone you know has heard those words from a doctor, but doctors are now being warned to stop doing so because it could raise false hope. A new report has identified 12 “never phrases” that doctors should never use with patients with serious illnesses, such as heart failure, cancer and lung disease. They explain that these “isolated words or phrases not only lack benefits but can also cause emotional harm and accentuate power differences.” If a patient is seriously ill, for example, a doctor should never mention the words “withdraw care,” as this implies that the medical team is “giving up.” While “everything will be okay” may seem like a comforting phrase, researchers say this could offer false hope when dealing with a serious illness and a better expression might be “I’m here to support you through this whole process.” [Click on the title's link for the dozen phrases they identify, with alternative language and rationale.]

CNY Inspirations: Caregiving is redemptive Syracuse.com, Syracuse, NY; by InterFaith Works of Central New York; 11/3/24 I will carry him with me for my life as one of the greatest examples of caring that I ever met. I will be obscure on the details, but he cared for his wife, who was completely immobilized, with a degree of fidelity, creativity, and painstaking love that I have rarely seen and could only hope to imitate. He lived what Arthur Kleinman calls in his book of the same title, The Soul of Care. ... He says, “Caregiving, for me, at its deepest was redemptive. It redeemed me…. in caregiving, there is a common tug of war between the sometimes-bitter feelings that care is a burden and the more heartening certainty that no matter how burdensome, it is ultimately rewarding.” ... My friend never expressed that verbally, but I saw it lived as I watched him over the years through periods of anxiety, weariness, anger, hurt, despair, and through it all, intense, personal demanding caregiving. “And so, in the end, the soul of care pivots to care of the soul.” Inauspiciously, my friend took good care of his soul…and certainly helped mine.

We invite you to listen to our latest podcast: Imagine Heaven, with John Burke TCN Talks (Teleios Collaborative Network); podcast by Chris Comeaux; 10/30/24 In this inspiring episode of TCNtalks, Chris Comeaux sits down with John Burke, New York Times bestselling author of Imagine Heaven and Imagine the God of Heaven, for a soul-stirring conversation on near-death experiences (NDEs) and their profound implications. John shares the overwhelming evidence of the commonalities of near-death experiences (NDEs) and the evidence that supports their validity from across the world and from across many different cultures.  Chris begins by recounting his own transformative experience reading Imagine Heaven over his summer sabbatical, describing it as a refreshing oasis for the parched soul. John delves into the fascinating and consistent patterns found in NDEs worldwide, revealing how people from vastly different backgrounds describe similar encounters of leaving their bodies, seeing with a spiritual clarity—even those blind from birth—and entering realms filled with light, love, and peace. 

Creating death box eases stress, brings 'peace of mind' to those left behind BradfordToday.ca, Canada; by Andrew Philips; 10/26/24 Creating a death box might sound like sort of a morbid thing to do, but it’s vitally important. That’s according to Tammy Vaters, supportive care coordinator at Hospice Huronia-Tomkins House, ... who leads upcoming workshops on creating a death box or a “legacy box or final wishes box” for those uncomfortable with the more succinct terminology ["death box"]. ... Besides end-of-life wishes, Vaters says the box can include photos that someone would like displayed at a celebration of life or similar offering along with personalized letters to family and friends and personal mementos that have special meaning. “It gives you more opportunities of expressing how you feel about somebody,” she says, noting the boxes should also contain usernames and passwords that may aid one's loved ones after death. “They can be more thoughtful and personal.” Vaters, who is a specialist in thanatology (the study of death, dying and bereavement), says people will often use another term for death. 

‘Let patients lead the way’: Hospice veterans’ advice for new nurses Hospice News; by Jim Parker; 10/25/24 ... A key barrier to building [the hospice and palliative care] workforce is that, with some exceptions, most clinicians receive little to no exposure to those types of care during their training. Nurses who are new to the hospice space often face a learning curve, according to Briana Hilmer, an Iowa-based admissions nurse for St. Croix Hospice.