Literature Review
Saturday newsletters focus on headlines and research - enjoy!
05/04/24 at 03:00 AMSaturday newsletters focus on headlines and research - enjoy!
Association between opioid use disorder and palliative care: a cohort study using linked health administrative data in Ontario, Canada
05/04/24 at 02:55 AMAssociation between opioid use disorder and palliative care: a cohort study using linked health administrative data in Ontario, CanadaCMAJ; by Jenny Lau, Mary M. Scott, Karl Everett, Tara Gomes, Peter Tanuseputro, Sheila Jennings, Rebecca Bagnarol, Camilla Zimmermann and Sarina R. Isenbergl; 4/29/24Background: People with opioid use disorder (OUD) are at risk of premature death and can benefit from palliative care. We sought to compare palliative care provision for decedents with and without OUD.Conclusion: We identified important differences in palliative care provided at the end of life between people with and without OUD. People with OUD were less likely to receive palliative care despite accessing palliative care earlier, which may reflect their end-of-life illness trajectories and underlying structural vulnerability that may prompt them to receive palliative care primarily in acute care. Health care providers should receive training in palliative care and addiction medicine to support people with OUD.
Substance use disorders in hospice palliative care: A narrative review of challenges and a case for physician intervention
05/04/24 at 02:45 AMSubstance use disorders in hospice palliative care: A narrative review of challenges and a case for physician interventionCambridge University Press; by Lauren Rudy and Emilie Lacroix; 2/29/24Objectives: Substance use disorders (SUDs) are frequently encountered in hospice palliative care (HPC) and pose substantial quality-of-life issues for patients. However, most HPC physicians do not directly treat their patients’ SUDs due to several institutional and personal barriers. ...Results: ... Recommendations for physicians and training environments to address these challenges include developing familiarity with standardized SUD assessment tools and pain management practice guidelines, creating and disseminating visual campaigns to combat stigma, including SUD assessment and intervention as fellowship competencies, and obtaining additional training in psychosocial interventions.
An exploration of managing emotional labour and maintaining professional integrity in children's hospice nursing
05/04/24 at 02:35 AMAn exploration of managing emotional labour and maintaining professional integrity in children's hospice nursing International Journal of Palliative Nursing; by Mandy J Brimble, Sally Anstey, Jane Davies, Catherine Dunn; 4/17/24Aim: To investigate how children's hospice nurses manage emotional labour and professional integrity in their long-term relationships with parents. Findings: Three overarching, cross-cutting themes were identified—purposeful positioning; balancing personability and professionalism; coping with and counterbalancing emotional labour. All themes were indicative of and/or built upon emotional intelligence constructs, such as self-awareness, self-regulation, appropriate (managed) empathy, social skills and intrinsic motivation. Innate features of children's hospice work were important for perpetuating intrinsic motivation and satisfaction.
When a parent dies: A scoping review of protective and risk processes for childhood bereavement
05/04/24 at 02:30 AMWhen a parent dies: A scoping review of protective and risk processes for childhood bereavementDeath Studies; by Rebecca Hoppe, Marcia A. Winter, Chelsea D. William, and Irwin Sandler; 4/15/24Abstract: The death of a parent can have profound effects on child development. ... A scoping review was conducted in samples of parentally bereaved children to identify key processes, synthesize results, and determine research gaps. This scoping review identified 23 studies (mainly from the United States), published between 1990 and 2023, that reported child (ages 3–22 years) individual and/or environmental protective and/or risk processes that contributed to bereavement outcomes. Findings can be used to apprise clinicians, families, and policymakers of the unique nature of childhood bereavement and to identify malleable processes to target in interventions designed to prevent problematic outcomes in bereaved children.Funding: This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development through the Ruth L. Kirschstein National Research Service Award [F31HD110247].
Nonphysical Suffering: An under-resourced and key role for hospice and palliative care social workers
05/04/24 at 02:25 AMNonphysical Suffering: An under-resourced and key role for hospice and palliative care social workersJournal of Social Work in End-of-Life & Palliative Care; by Maxxine Rattner & Cheryl-Anne Cait; 11/10/23... Nonphysical suffering is suffering that may be emotional, psychological, social, spiritual and/or existential in nature. The study found an absence of specialist social workers on hospice and palliative care teams or limited time for specialist social workers to address patients’ nonphysical suffering due to high caseloads and complex practical needs. While the study recognizes social workers have expertise in supporting patients’ nonphysical suffering, a competency and skill that has not been sufficiently captured in the existing literature, the systemic barriers they face in providing care may leave patients’ needs unmet. The study also highlights the unique pressure social workers may feel to relieve patients’ nonphysical suffering due to the psychosocial focus of their role.
What's in the Black Box of a successful nurse and social worker team palliative telecare intervention (ADAPT)? (RP317)
05/04/24 at 02:20 AMWhat's in the Black Box of a successful nurse and social worker team palliative telecare intervention (ADAPT)? (RP317)Journal of Pain and Symptom Management; by Lyndsay DeGroot, PhD, RN, CNE; Kevin Wells; Brianne Morgan, BSN; Michelle Upham, MSW, LICSW; David B. Bekelman, MD, MPH; 5/24Key Message: A nurse and social worker palliative telecare team provided structured symptom management, psychosocial care, and individualized medical changes to improve quality of life, depression, and anxiety for patients with COPD, HF, and ILD. Impact: A nurse and social work palliative telecare team used collaborative care to tailor recommendations to the unique needs and symptoms of each patient, thereby improving quality of life.
Exploring unmet concerns in home hospice cancer care: Perspectives of patients, informal caregivers, palliative care providers, and family physicians
05/04/24 at 02:15 AMExploring 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.
Home care clinicians' perspectives on Advance Care Planning for patients at risk for becoming incapacitated with no evident advance directives or surrogates
05/04/24 at 02:10 AMHome care clinicians' perspectives on Advance Care Planning for patients at risk for becoming incapacitated with no evident advance directives or surrogates Journal of Hospice & Palliative Nursing; by Landau, Aviv Y. PhD, MSW; Venkatram, Chinmayi BA; Song, Jiyoun PhD, AGACNP-BC, APRN; Topaz, Maxim PhD; Klitzman, Robert MD; Shang, Jingjing PhD; Stone, Patricia PhD; McDonald, Margaret MSW; Cohen, Bevin PhD; 4/24 Abstract: ... This qualitative descriptive study elicited perspectives of home health nurses and social workers regarding barriers and facilitators to creating advance care plans in home health settings, with particular attention to patients with few familial or social contacts who can serve as surrogate decision-makers. ... Participants reported a multitude of barriers to supporting patients with advance care planning at the provider level ... Participants noted that greater socialization and connection to existing educational resources regarding the intended purpose, scope, and applicability of advance directives could benefit home care patients.
The spectrum of end-of-life experiences: A tool for advancing death education
05/04/24 at 02:05 AMThe spectrum of end-of-life experiences: A tool for advancing death educationOmega; by Shared Crossing Research Initiative; 3/24 Abstract: Studies on end-of-life experiences (ELEs) suggest that caregivers and loved ones of dying patients also have ELEs, though these are rarely explored. This article introduces the Spectrum of End-of-Life Experiences (SELE) as a descriptive list of types of ELEs reported by all members of the care unit, including dying patients, their caregivers, and their loved ones. We applied SELE towards identifying ELEs reported by 143 caregivers and loved ones and successfully identified every experience. Interviews revealed that participants viewed their ELEs as profound communicative events, yet a substantial minority also reported struggling to name and process these experiences. We propose that SELE be included in death education to raise awareness about ELEs that can occur within the care unit, and we suggest that SELE has additional applications, including use as a prognostic aid in end-of-life care and as a therapeutic aid for bereavement support.
Shocked at end-of-life: An educational video for hospice workers about Implantable Cardioverter-Defibrillators
05/04/24 at 02:00 AMShocked at end-of-life: An educational video for hospice workers about Implantable Cardioverter-Defibrillators Journal of Pain and Symptom Management; by Sarah Godfrey, MD, MPH; Christine L. Chen, MD; Melanie S. Sulistio, MD; Sharika Kumar, MD; and Kelley Newcomer, MD; 2/24 Introduction: Hundreds of thousands of patients with implantable cardioverter-defibrillators (ICDs) die yearly. Though ICD shocks can be lifesaving, they can also be severely painful. One third of ICD patients are shocked in the last day of life irrespective of DNR status. Over 97% of hospice programs admit patients with ICDs, yet only 10% have deactivation policies and less than 50% of hospice patients have their ICD deactivated. ... Conclusion: Hospice personnel have limited knowledge about ICDs, prohibiting best care of patients with these devices at EOL. A short educational video increased knowledge and may serve as a helpful tool. Improving ICD knowledge amongst hospice personnel is essential to ensuring the unique needs of hospice patients with ICDs are met.
America’s favorite, weed, comes with big health risks: Pyschosis is an increasing risk of today's strong marijuana.
05/03/24 at 03:30 AMAmerica’s favorite, weed, comes with big health risks: Pyschosis is an increasing risk of today's strong marijuana.Psychology Today; by Mark S. Gold, MD; 4/30/24Key Points:
Aetna hit with $900M in surprise MA costs, CVS Health reports
05/03/24 at 03:00 AMAetna hit with $900M in surprise MA costs, CVS Health report Modern Healthcare; by Nona Tepper; 5/1/24 CVS Health will launch a multiyear plan to boost Medicare Advantage profitability after its Aetna subsidiary recorded $900 million in higher-than-anticipated medical costs during the first quarter, President and CEO Karen Lynch said during an earnings announcement Wednesday. “We continue to evaluate our cost structure and productivity and will accelerate these and other initiatives over the next few months,” Lynch said.
Why hospital executives think Walmart Health failed
05/03/24 at 03:00 AMWhy hospital executives think Walmart Health failed Becker's Health IT; by Giles Bruce; 5/1/24 Health system leaders told Becker's they're not surprised by the failure of Walmart Health given the arduous economics of healthcare and the difficulty of providing primary care at scale.Walmart said April 30 it would be closing its 51 Walmart Health Centers and virtual care offerings five years into its foray into healthcare. The company cited the "challenging reimbursement environment" and "escalating operating costs" that left its healthcare arm unprofitable.
43 health systems ranked by long-term debt
05/03/24 at 03:00 AM43 health systems ranked by long-term debt Becker's Hospital CFO Report; by Alan Condon; 4/29/24 Long-term debt has long been a staple in healthcare, but many hospitals and health systems are responding to the increasing cost of debt and debt service in the rising rates environment. Highly levered health systems are looking to sell hospitals, facilities or business lines to reduce their debt leverage and secure long-term sustainability, which creates significant growth opportunities for systems with balance sheets on a more solid financial footing. Forty-three health systems ranked by their long-term debt: ... [Click on the title's link for the list.]
Transitional Bridges offers compassionate alternative to plastic belongings bags
05/03/24 at 03:00 AMTransitional Bridges offers compassionate alternative to plastic belongings bagsABC 8 News, Richmond, VA; by EIN Presswire; 4/30/24Transitional Bridges, a San Diego-based nonprofit focused on inspiring compassion and improving end-of-life care through art, has created Transitional Belongings Bags, a compassionate and eco-friendly alternative to the plastic bags hospitals use to hand over belongings to loved ones after a patient has died. The concept was first introduced 17 years ago by the Irish Hospice Foundation Hospice Friendly Hospitals Program to promote dignity and sensitivity when returning a loved one’s possessions to bereaved family and friends. ... Lorene Morris, the founder and president of Transitional Bridges, became inspired to bring the movement to the U.S. after her mother, an artist, died unexpectedly from postoperative complications. When the family was handed their mother's possessions in two large, clear plastic bags, Morris recalls, “I felt like the whole world could see those intimate items. It was just so wrong.”
Prioritizing patient care: Medical technology innovations on the horizon
05/03/24 at 03:00 AMPrioritizing patient care: Medical technology innovations on the horizon MedCityNews; by Dhaval Shah; 5/1/24 The MedTech industry is poised for breakthroughs, owing to the rapid integration of digital ecosystems and technologies like AI and cloud. 2023 was a banner year for MedTech, especially in terms of technological innovations. Incidentally, it also witnessed the largest ever number of FDA approvals on novel medical devices in a single year. This list included a number of AI-enabled MedTech products, among others. ... Three key areas are continuing to shape the industry:
New federal rule meant to strengthen nondiscrimination protections, advance civil rights in healthcare
05/03/24 at 03:00 AMNew federal rule meant to strengthen nondiscrimination protections, advance civil rights in healthcare McKnights Senior Living; by Kathleen Steele Gaivin; 4/30/24 The Department of Health and Human Services on Friday released a final rule aiming to protect individuals from discrimination in healthcare, including members of the LBGTQ+ community. ... The rule “reverses a Trump-era regulation and restores gender identity and sexual orientation discrimination protections under Section 1557 of the Affordable Care Act,” Bloomberg Law reported. Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age or disability by entities that primarily provide healthcare and receive federal funding. It is enforced by the HHS Office for Civil Rights.
Assessing caregiver burnout for hospice, palliative patients
05/03/24 at 03:00 AMAssessing caregiver burnout for hospice, palliative patients Hospice News, by Jim Parker; 4/30/24 Burnout is a state of complete mental, physical and emotional exhaustion. Symptoms of burnout can include depression, compassion fatigue, stress and anxiety, and apathy, both in general life and towards work tasks, according to the Mayo Clinic. To help address these issues — and to help ensure that caregiving remained sustainable — a team of researchers from the Ann & Robert Lurie Children’s Hospital of Chicago and the University of Pittsburgh launched a project to improve assessment of caregiver burnout.
Physician-Assisted Suicide Bill recommended by second committee in Massachusetts legislature
05/03/24 at 03:00 AMPhysician-Assisted Suicide Bill recommended by second committee in Massachusetts legislature New Boston Post; 5/1/24 A bill that would legalize physician-assisted suicide has gotten a favorable vote from a second legislative committee, ... This is the earliest in the state’s two-year legislative session that the bill has been recommended by the Joint Committee on Public Health, and it’s the first time the bill has made it out of the Joint Committee on Health Care Financing, said Melissa Stacy, Northeast regional advocacy manager for Compassion & Choices, according to MASSterList.
Nurse pleads guilty to 22 counts of patient murder, attempted murder
05/03/24 at 03:00 AMNurse pleads guilty to 22 counts of patient murder, attempted murder Becker's Hospital Review; by Mariah Taylor; 5/2/24 Heather Pressdee, a Pennsylvania nurse, pleaded guilty to three counts of first-degree murder and 19 counts of attempted homicide, the Pittsburgh Post-Gazette reported May 1. Ms. Pressdee pleaded guilty on May 2 in an ongoing hearing that is expected to go until May 3. She was given three consecutive life sentences and 380 to 760 years consecutively. Ms. Pressdee, 41, was first charged in May 2023 in connection with the mistreatment of three nursing home patients while working at Quality Life Services in Chicora, Pa., including two counts of homicide and one count of attempted murder. In November, she was charged in connection with the mistreatment of 19 additional patients that were in her care at five different facilities since 2020.
Today's Encouragement: Be like bacon ...
05/03/24 at 03:00 AMBe like bacon. Bacon makes everything better! - Heard from someone, somewhere on the Food Network
CVS buys Medicare Advantage brokerage
05/03/24 at 03:00 AMCVS buys Medicare Advantage brokerage Modern Healthcare; by Nona Tepper; 4/30/24 CVS Health paid an undisclosed sum to acquire Hella Health, according to the Medicare Advantage brokerage's founder. Hella Health debuted in 2020 and claims to offer more than 3,000 Medicare plans from insurers such as CVS Health subsidiary Aetna, UnitedHealth Group subsidiary UnitedHealthcare and Humana.
InnovAge launches PACE Center, helping seniors independently with high-quality care
05/03/24 at 03:00 AMInnovAge launches PACE Center, helping seniors independently with high-quality care Los Angeles Sentinel; 5/1/24 InnovAge Holding Corp., the healthcare industry leader in providing comprehensive healthcare programs to dual-eligible seniors through the Program of All-inclusive Care for the Elderly (PACE), celebrated the grand opening of its newest center in California on April 24. ... Guests toured the 22,000 square foot, two-level renovated center — which includes a medical clinic with exam rooms, dining room, four-day rooms, quiet room, outdoor patio, and other amenities. The program’s service area extends beyond Crenshaw, providing care and support to seniors residing in West and South Los Angeles.
Is pot legal now? Despite big marijuana news, it's still in legal limbo.
05/03/24 at 03:00 AMIs pot legal now? Despite big marijuana news, it's still in legal limbo. USA Today; by Joel Shannon and Jeanine Santucci; 5/1/24 Tuesday brought big marijuana news: The Biden Administration is expected to soon reclassify marijuana for the first time in decades, putting it in a less restrictive drug category that would allow it to be studied and prescribed more easily. But that news comes in a nation where many states have already crafted their own marijuana policy: Some states allow for it to be prescribed already; others allow people to use it recreationally. Few states ban it outright. ... Here's what to know.