Literature Review

Overcome fear of financial regret to embrace a fulfilling life Advisorpedia, Viewpoints by Ross Levin; 4/8/24 ... A primary job of financial planners is to help their clients see what is possible. It is also to help them balance living today while preparing them for tomorrow. But not knowing how many tomorrows we have can create too much emphasis on an uncertain future. ... One of our long-term clients is now in hospice. As we were talking, she said how grateful she was for what she and her husband did with their family ... Although cancer will rob her of some years, she has lived her life fully. I have worked with countless clients, and here is some wisdom I have discovered that helped them avoid regret: [click on the title's link to read]

Hospice wedding a declaration of love in the face of medical challenge Penticton Western News, by Alistair Taylor; 4/4/24 The essence of hospice philosophy – emphasizing the significance of cherishing every moment and embracing life to the fullest – was exemplified by the touching and beautiful wedding of Sean Adelberg and Mary Davidson at Campbell River’s Hospice House on Tuesday, April 2. ... “This journey to the altar accompanies Mary’s heroic battle with stage 4 Glioblastoma—an incurable brain cancer. Despite the odds, we’re seizing this incredible chance to celebrate our love,” Adelberg said.

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.

Blue Shield's Palliative Care Program wins national recognition for improving lives Blue Shield California; 3/28/24 During the first quarter of this year, the Journal of Palliative Medicine published results of a study entitled “Cost and Utilization Implications of a Health Plan’s Home-Based Palliative Care Program” from leaders at Blue Shield and researchers from West Health Research Institute that garnered attention from industry publications. ...  Major findings from the study were that home-based palliative care delivered to people not yet eligible for hospice reduced their hospital and emergency room use, showed trends towards an increased length of life, and extended the continuum of care for people with serious illness and their caregivers.

Instead of an elegy for my dying brother Santa Cruz Sentinel, by Stephen Kessler; 3/31/24Week before last I wrote about my elder brother Bruce, the racing driver, film director, deep-sea fisher, boat designer and global circumnavigator, who was on the last laps of his extraordinary life. ... I found him at home in hospice care, in a hospital bed by the big slider off the balcony in his seventh-floor apartment in Marina Del Rey with a lovely view of the marina and all its pretty white boats with their slender masts afloat on the dark-blue water. ... 

I'm 34 and terminally ill, but I'm not scared of death anymore Metro / Microsoft Start, by Jyoti Smith; 3/31/24 I’ve spent the last nine years living with the idea of dying. In 2015, aged 25, I received my terminal diagnosis. ... My prognosis: three-to-five years. But here I am, almost 10 years on, at 34, and I’m living life to the fullest – if on the edge – and it’s largely down to one thing. Embracing hospice care. ... Editor's Note: Jyoti describes her journey and the care she now received from Marie Curie (hospice), in the United Kingdom.

Antibiotics in end-of-life care NEJM Journal Watch, by Abigail Zuger, MD; 3/27/24Antibiotics often are considered to be among the gentler and more comfort-oriented interventions in end-of-life care, certainly far less aggressive than intubation or last-ditch surgery. ... Still, antibiotics do entail their own costs in the form of toxicities and need for intravenous access, and liberal antibiotic use reliably worsens institutional and community drug-resistance profiles. ... A new review was written for infectious disease consultants but contains specific suggestions that should interest both generalists and other subspecialists caring for dying patients. 

Hospice nurse plays instrumental role in patient’s joyCity Sun Times, by Lin Sue Flood; 3/27/24You see it at every symphony performance - people so enraptured by the music that their eyes close and their fingers dance in the air. Stuart Brown is one of those people. But as illness began to limit his mobility, the 81-year-old relinquished the thought of ever attending a live concert again. That’s when his Hospice of the Valley nurse secretly reached out to the Phoenix Symphony with a request to hold a small private concert in his Scottsdale home. “We absolutely can make this happen for him and his family,“ said Valerie Bontrager, director of community engagement. Editor's Note: Need some inspiration? Read this heart-warming story.

Why California doesn't know how many people are dying while homelessKQED, by Vanessa Rancano; 3/25/24 The grants manager and his team at Alameda County Health Care for the Homeless knew people were dying on the streets, but they wanted more than anecdotal evidence; they wanted data that could show them the big picture and help them hone their strategies. ... Alameda County’s latest homeless mortality report is now prompting the team to focus on how to extend palliative care services to unhoused people with terminal illnesses. Garlin estimates almost one-fifth of those who died in 2022 would likely have been eligible for hospice care.

Last Dance: Holland Home throws prom for retirees, end-of-life patients Fox 17 West Michigan, by Sam Landstra; 3/23/24 The timeless nature of the suit and tie was again proven on Saturday by senior promgoers at Holland Home as they danced with their longtime dates at the Grand Rapids retirement home and hospice care facility. ... Donning formal wear donated by Belding Beauties & Bro's, residents walked and wheeled down a fourth floor hallway in Holland Home, gathering in a room decorated with streamers and disco balls.

Incurable but not hopeless: How hope shapes patients’ awareness of their advanced cancer prognosis The Conversation, by Jean Mathews and Michael Brundage; 3/24/24Hope is defined as the expectation of achieving a future good. Patients with cancer, whether it is curable or not, prioritize cure as their highest hope. ... Previous research indicates that less than half of patients with incurable cancer are aware of their prognosis. This is often attributed to a failure of communication. ... In the context of advanced cancer, the relationship between hope and hopelessness is balanced by acceptance, which can re-direct hope to new goals beyond cure, such as hope for connection with others and enjoyment of daily pleasures. 

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.

Student-run Arizona non-profit uses origami to connect with hospital [and hospice] patients The State Press, by Pippa Fung; 3/19/24The Wishing Crane Project, founded by Arizona student Charles Zhang, serves hospice and hospital patients through art. In the story of Sadako and the Thousand Paper Cranes, a young girl tried to fold 1,000 paper cranes in the hopes that it would help her push through a terminal illness. Years later, students across Arizona and at ASU are folding their own cranes [and writing hopeful messages] to support others through their difficult journeys.