Literature Review

Neuropsychiatric effects associated with opioid-based management for palliative care patientsCurrent Pain and Headache Reports, by Alan D Kaye, Kylie Dufrene, Jada Cooley, Madeline Walker, Shivam Shah, Alex Hollander, Sahar Shekoohi, Christopher L Robinson; 4/24The abundance of opioids administered in the palliative care setting that was once considered a standard of care is at present necessitating that providers evaluate patients for unintentional and deleterious symptomology related to aberrant opioid use and addiction. ... By having an increased understanding and awareness of potential opioid neuropsychiatric effects, patient quality of life can be improved, healthcare system costs can be decreased, and patient outcomes can be met and exceeded.

Do end-of-life outcomes differ by assisted living memory-care designation?Journal of the American Geriatric Society, by Xiao Joyce Wang, Portia Y Cornell, Emmanuelle Belanger, Kali S Thomas; 4/24Residential care/assisted living (RC/AL) is an increasingly common place of end-of-life care for persons with Alzheimer's disease and related dementia (ADRD), who have unique care needs as their health declines. Approximately 22% of RC/ALs provide specialized memory care (memory-care RC/AL). Understanding how end-of-life outcomes differ by memory care among residents with ADRD could facilitate aging/dying in place for this population. The objective of this paper is to examine if end-of-life outcomes (i.e., mortality, hospice use, and number of days receiving hospice in the last month of life) differ between residents with ADRD who moved to memory-care RC/AL, compared with residents with ADRD who moved to RC/AL without memory care (general RC/AL).

Wide variation in differences in resource use seen across conditions between Medicare Advantage, Traditional MedicareHealth Affairs, by Jeah Jung, Caroline S. Carlin, Roger Feldman, Ge Song; 9/23Medicare Advantage (MA) is a rapidly growing source of coverage for Medicare beneficiaries. Examining how MA performs compared with traditional Medicare is an important policy issue. We analyzed national MA encounter data and found that the adjusted differences in resource use between MA and traditional Medicare varied widely across medical conditions in 2019.

HPNA and HPNF President's message : My path to leadershipJournal of Hospice & Palliative Nursing, by Lynn Reinke; 4/24Reflecting on my professional life, I recall several seminal experiences that made me believe I possessed basic leadership skills and that encouraged me to develop them. I advanced my skills in 3 ways:

Funding opportunity now available! Up to 5 grantee awards totaling $1,275,000 for health equity researchCMS Office of Minority Health; 4/1/24The Centers for Medicare & Medicaid Services Office of Minority Health’s (CMS OMH) Minority Research Grant Program (MRGP) is proud to release a Notice of Funding Opportunity (NOFO) for researchers at minority-serving institutions (MSIs). With this grant, you will partner with CMS OMH to grow your research credentials, increase public knowledge of health equity, and join the ranks of other published MRGP awardees.

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.

Physicians, spirituality, and compassionate patient careNew England Journal of Medicine, by Daniel P Sulmasy; 3/24The past few decades have seen an international revival of interest in the role of spirituality in patient care. ... I believe this trend is salutary for patients and health care professionals alike. Yet the success of a biopsychosocialspiritual approach to 21st-century health care will depend on careful attention to ethical guidelines and boundaries in our increasingly pluralistic world.

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.

Top ten tips palliative clinicians should know about rural palliative care in the United StatesJournal of Palliative Medicine, by Jack Kimball, Chamika Hawkins-Taylor, Anne Anderson, Debra Gay Anderson, Mary Lou Clark Fornehed, Patricia Justis, Nasreen Lalani, Sarah Mollman, Brandi Pravecek, Julie Rice, Janelle Shearer, Dillon Stein, Salom M. Teshale, and Marie A. Bakitas; 3/24Palliative care improves outcomes, yet rural residents often lack adequate and equitable access. This study provides practical tips to address palliative care (PC)-related challenges in rural communities. Strategies include engaging trusted community partners, addressing cultural factors, improving pediatric care, utilizing telehealth, networking with rural teams including caregivers, and expanding roles for nurses and advanced practice providers.

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.

Book Review: The Journey’s EndAmerican Journal of Medical Quality, by Casey, Donald E. Jr MD, MPH, MBA; 3/24.Michael Connelly's "The Journey's End" is a highly engaging and insightful guide for bouth ourselves and our loved ones on how we ought to face death with dignity.

The determinants of actual place of death among noncancer patients with end-stage chronic health conditions: a scoping reviewPalliative Care and Social Practice, by Sangduan Ginggeaw and Raeann LeBlanc; 3/24.This scoping review describes the percentage of actual places of death and determines social factors related to home as the place of death among noncancer patients with end-stage chronic health conditions.Publisher's note: While this study did not establish clear cause-and-effect relationships between factors, the authors used interesting methods and included thoughtful discussion.

Mortality risk following end-of-life caregiving: A population-based analysis of hospice users and their familiesSocial Science & Medicine, by Mike Hollingshaus, Ken R. Smith, Huong Meeks, Katherine Ornstein, Eli Iacob, Djin Tay, Caroline Stephens, Rebecca L. Utz; 3/24.Highlights: