Literature Review

Palliative psychiatry for a patient with treatment-refractory schizophrenia and severe chronic malignant catatonia: case reportAnnals of Palliative Medicine, by Junona Elgudin, Clark Johnsen, Anna Lisa Westermair, Manuel Trachsel; 3/24Palliative psychiatry is an emerging field that suggests a role for palliative interventions in the management of severe and persistent mental illness.

Consciously choosing unconsciousnessVoices in Bioethics, by Yuna Lee; 3/24“Because there are no laws barring palliative sedation, the dilemma facing doctors who use it is moral rather than legal.” Dr. Timothy Quill, a professor of psychiatry, bioethics, and palliative care concisely articulates an ethical intricacy in end-of-life care. ... In summary, the ethical considerations surrounding palliative sedation compel clinicians to navigate the nuances of moral responsibility, patient advocacy, and clinical judgment. In the absence of clear legal guidelines, clinicians bear the weight of deciding the appropriateness of palliative sedation, influencing both individual patient experiences and broader palliative care practices.

The role and professional standards of the Adult-Gerontology Nurse Practitioner in hospice and palliative careJournal of Hospice & Palliative Care Nursing, by Coats, Heather PhD, APRN-BC; Henrichs, Kelly DNP, RN, GNP-BC; 3/24The adult/gerontology (gero) nurse practitioner (NP) delivers primary and/or specialty palliative care to persons and their families who live each day with a myriad of serious illnesses. In this role, the adult/gero NP uses their skill set to address the whole person (physical, psychological, social, and spiritual/existential) to improve the quality of life for persons they care for. This article is the fourth in a series of 6 highlighting the different roles of the adult/gero NP and the advanced certified hospice and palliative registered nurse, and how these 2 roles overlap. The purpose of this article was to provide details of education and certification pathways for these NP roles, describe the overlaps in clinical care, and illustrate how the adult/gero NP in palliative and hospice care can contribute to leadership in program development for care of persons and their families who live with serious illness.

Psychedelic therapy: A primer for primary care clinicians - psilocybinAmerican Journal of Therapeutics, by Burton J Tabaac, Kenneth Shinozuka, Alejandro Arenas, Bryce D Beutler, Kirsten Cherian, Viviana D Evans, Chelsey Fasano, Owen S Muir; 3/24.Aside from ketamine, psilocybin is the most clinically well-researched psychedelic drug, with trials that have enrolled hundreds of participants and multiple therapeutic applications. Phase III trials will determine whether psilocybin lives up to the promise that it showed in previous clinical trials.

Transitions between skilled home health and hospice for persons living with dementia: a systematic review of literatureAnnals of Palliative Medicine, by Sharon E. Bigger, Robin Ann Foreman, Christiana Keinath, Gail L. Towsley; 3/24We found that persons living with dementia are at higher risk for early, unsuccessful discharge from-and readmission to-skilled skilled home health; and persons living with dementia are at higher risk for being discharged alive from hospice.

State of the service: Pediatric palliative and hospice community-based service coverage in the United StatesJournal of Palliative Medicine, by Meaghann S. Weaver, MD, PhD, MPH, HEC-C; Tej Chana; Deb Fisher, PPCNP; Hope Fost; Betsy Hawley, MA; Kristin James, LCPC; Lisa C. Lindley, PhD, RN, FPCN, FAAN; Kaeli Samson, MA, MPH; Steven M. Smith, MD; Alix Ware, JD, MPH; and Christy Torkildson, PhD, RN, PHN; 11/23.Objective: To quantify and describe the inclusion of children in services, staffing, and care scope offered by community-based hospice organizations in the United States. Design and Subjects: This study utilized an online survey distributed to organizational members of the National Hospice and Palliative Care Organization (NHPCO) in the United States. Results: A total of 481 hospice organizations from 50 states, Washington DC, and Puerto Rico responded. Conclusions: Children remain underrepresented in the extension of care offered through community-based hospice organizations in the United States particularly in nonmetro settings.

Perceptions of palliative care: Demographics and health status among the general population in Florida and the United StatesAmerican Journal of Hospice and Palliative Medicine, by Brenda W. Dyal, PhD, DNP; Saunjoo L. Yoon, PhD; Keesha L. Powell-Roach, PhD, RN; Derek M. Li, MSc; Sheri Kittelson, MD; Michael Weaver, PhD, RN, FAAN; Janice L. Krieger, PhD; Diana J. Wilkie, PhD, RN, FAAN; 4/24Palliative care (PC) helps maintain quality of life for seriously ill patients, yet, many Americans lack knowledge of PC. Young adults compared with adults, middle-adults, and older-adults were less likely to agree that the goal of PC is to help friends and family cope with a patient’s illness, and that the goal of PC is to manage pain and other physical symptoms compared with adults, middle-adults, and older-adults. Participants with greater rural identity were more likely to agree that accepting PC means giving up. Increased knowledge of PC might be influenced through targeting educational interventions and educating the general population through social media use.

Palliative ECT for catatonia in a terminal cancer patient: A case reportJournal of the Academy of Consultation-Liaison Psychiatry, by Arushi Mahajan B.S., Thanvi Vatti M.P.H., Andrew Coulter M.D., Elias Khawam M.D., Molly Howland M.D.Common end-of-life illnesses and medications can lead to catatonia. Catatonia can decrease interactivity, which worsens a terminal patient's quality of life. Treatment includes medications and electroconvulsive therapy (ECT). Though treating psychiatric disorders aligns with the palliative care philosophy, end-of-life ECT has been rarely reported. The few case reports on palliative ECT involved continuation of prior ECT courses for chronic psychiatric conditions in psychiatric settings after a terminal diagnosis. No studies have explored palliative ECT for acute catatonia.

Evaluation of a novel hospice-specific patient decision aidAmerican Journal of Hospice and Palliative Medicine, by Channing E. Tate, PHD, MPH; Gwendolyn Mami, JD; Monica McNulty, MS; Deborah J. Rinehart, PhD; Robin Yasui, MD; Nicole Rondinelli, FNP; Jonathan Treem, MD; Diane Fairclough, PhD; Daniel D. Matlock, MD, MPH; 4/24[Randomized Controlled Trial] We tested a novel hospice-specific patient decision aid to determine whether the decision aid could improve hospice knowledge, opinions of hospice, and decision self-efficacy in making decisions about hospice... The intervention demonstrated significant improvements in decision self-efficacy but not in hospice knowledge or hospice beliefs and attitudes.

Ethics Consult: Using hospice as "treatment" for behavioral problems of dementiaAmerican Journal of Geriatric Psychiatry, by Luisa Skoble MD, Jonathan Crane MPhil, PhD; 4/24This session will present 2 cases of individuals with advanced dementia who did not meet the traditional Medicare criteria for hospice, as both were ambulatory and did not have significant co-morbid medical issues. Both had significant aggressive behaviors that responded poorly to extensive trials of various medications during extended stays on a geriatric psychiatry inpatient unit. Both were referred to a local inpatient hospice where the staff use “suffering" as a hospice criteria and were “treated” with the usual hospice medications and expired in less than 3 weeks.

Correcting health disparities at end-of-life in persons of colorJournal for Nurse Practitioners, by Leah D. Ward, Anthony Young; 4/24Forty years after the creation of the Medicare hospice benefit, low use of hospice and palliative care services in persons of color increases suffering and aggressive care at the end of life related to social determinants of death... This article provides tools for nurse practitioners and other health care personnel in spiritual, cultural, and goals-of-care assessments, quality improvement, and an explanation of the benefits of faith-based programs and partnerships

Nonprofit behavior altered by monetary donations: evidence from the U.S. hospice industryThe European Journal of Health Economics; by Miao Guo; Lei Guo; Yang Li; 2/24This study investigates whether reliance on monetary donations alters nonprofit firms’ behaviors. Specifically, in the hospice industry, a shorter patients’ length of stay (LOS) speeds up overall patient turnover, allowing a hospice to serve more patients and expand its donation network.Publisher's note: Correlation does not imply causation...