Literature Review

Poetry, again, confronts death JAMA; by Rafael CAmpo, MD, MA; 10/16/24Poetry can help physicians in many ways at the border between life and death. Though we might think first of the consoling power of elegy in confronting mortality, other poems, like “Again,” [referenced] aid us in wrestling with what death is in the first place—and are even more useful when research falls short in attempting to demystify it. One such scientific controversy surrounds in-hospital resuscitation, especially for older adults, with studies showing inconsistent rates of meaningful survival after these potentially life-saving interventions, confounded by the physical and emotional trauma that accompanies them, poor understanding of patients’ and families’ wishes, unclear definitions of “meaningful,” and varying patient selection criteria. [The poem titled] “Again” distills some sense out of this complexity as only poetry can, with the urgent repetition of “again” expressing the ingrained imperative to act when patients experience cardiac arrest while echoing both the many previous resuscitations hospital staff well remember, along with the 2-beat, up-down muscle memory of performing chest compressions. ... Thus, a reflexive, futile endeavor becomes a human being’s dying moment, allowing us to feel closure. Debates around in-hospital resuscitation suddenly quieted, we recognize life’s inevitable finality, underscored by the poem’s ironically dignified resignation in its concluding line: “Never again did you wake.”Editor's note: Click here to access the poem, "Again."

The daily balancing act of value-based cancer care The American Journal of Managed Care (AJMC); by Laura Joszt, MA; 10/14/24 In value-based care, there’s a daily balancing act to achieve quality outcomes, cost reduction, and patient care improvements, explained Stuart Staggs, vice president of transformation, quality, and shared services for The US Oncology Network (Network). At the Institute for Value-Based Medicine event, cohosted by The American Journal of Managed Care (AJMC) and Minnesota Oncology, Staggs kicked it off with what he called a “practical look at value-based care.” He highlighted 4 main areas: quality, improvement, adoption, and cost. ... The area of improvement that the Network wanted to focus on was advanced care planning and better supporting and engaging patients and their families around hospice and life support. During the OCM, the Network better engaged patients and families around hospice care and encouraged practices to have difficult conversations. Not only does this improve patient experience by providing them the end-of-life care that they want, but there is also a cost factor. Patients who don’t receive hospice care spend significantly more in the last 30 to 60 days, Staggs said.

Palliative care use low in patients with heart failure in the United States Cardiology Advisor; by Ron Goldberg; 10/10/24 Palliative care (PC) use for end-of-life care in heart failure (HF) in the United States is low, with geographic and racial variations in access and application, and PC is becoming necessary for younger, healthier patients seeking a better quality of life, according to study findings published in the Journal of the American Heart Association. ... "PC for HF remains low in the United States. Racial and geographic variations in access and use of PC exist for patients with HF,” the investigators concluded. “These findings suggest that palliative care is not only an end-of-life care for older patients with HF but can be necessary for younger, healthier patients with needs for advanced therapies and for better quality of life.”

The death issue: Austin’s Children’s hospice professionals advocate for honesty The Austin Chronicle; by Maggie Quinlan; 10/11/24 Sometimes parents wait too long to tell their sick children that they will die. Sometimes, by the point of disclosure, their child can no longer speak. ... She said often the dying child will become an “emotional caretaker” in the hospital room where they’ve just learned that their illness will kill them. “Even though it’s happening to them, they tend to really want to protect their family.” It doesn’t have to be that way. Cosby says a lot of the job is beautiful, even fun. Families make memories, and child life specialists help make it happen. They go to see the ocean. They throw private proms and graduation ceremonies. They finger paint. They crack jokes. They decide to make the most of precious little time. ... “Grief is the price of love, and there’s so much love in there,” says Heather Eppelheimer, another Dell Children’s child life specialist. “We have to be able to love fully in order to also grieve fully.” Child life specialists respect family wishes and also advocate for honest, clear language about death. They say to use that word – death, dying, die – and avoid “passing away” (“To where?” Cosby asks). That kind of straightforward communication isn’t part of our cultural hardwiring, Cosby says, but it makes everything easier. In her life, when people aren’t comfortable talking about death, she asks why. What are they afraid of? ...

How to prepare yourself for death when given a terminal diagnosis Yahoo!Life; by Kate Ng; 10/8/24 Receiving a terminal diagnosis can be a devastating blow, for the individual and their loved ones. There is no right or wrong way to react to such news, and people respond with all sorts of emotions - from anger and denial, to acceptance and peace. Having a terminal illness can also give a person new perspective. ...

Heartless activist who took selfie with woman’s dying father in hospice shows no emotion upon learning of her fate following sick harassment campaign What'sNew2Day; written by "Jack," with another author listed "Bethan Sexton for Dailymail.com"; 10/5/24 An activist who snuck into a hospice and took a selfie with a woman’s dying father because he opposed her support for LGBTQ rights showed no emotion as he was sentenced for his sickening campaign of harassment. Bubba Pollock, 35, was sentenced to two months in prison after pleading guilty to criminally harassing Britt Leroux, 38. Pollock, from London, Ontario, openly protested the drag queen stories and was seen on video promising to pay people up to $500 to sabotage events. He had a fierce debate with Leroux, which culminated in him driving 120 miles to the Windsor hospice where Leroux’s father, Andre Leroux, was receiving palliative care and taking the photograph in an attempt to mock his victim.

There’s still joy in end-of-life care The Seattle Medium, Seattle, WA; by Anissa Durham; 10/3/24 Caregiving is an act of love and sacrifice. But for young Black women, it’s often summed up as just being “a good daughter.” More than 100 million Americans provide care to a child, parent, or relative. And about half provide care to a spouse, elderly parent or relative, or special needs child, according to a report by Guardian. But for Black folks, the burden of doing so is often heavier. Due to disparities in education, housing, and nutrition, and less access to health insurance, — along with the “weathering” that accompanies racism-related stress — Black Americans experience higher risk and rates of chronic disease. Which means, Black folks may get sick sooner than their counterparts and make younger generations, often women, more likely to become caregivers. In a 2021 report, Black family caregivers represent 14% of the estimated 48 million unpaid family caregivers in the U.S., with Black women making up a little more than half of this group, according to the American Society on Aging. Overall, women are two times more likely than men to say they’ve left the workforce to keep up with caregiving responsibilities. And nearly 50% of caregivers are either Millennials or Gen Z, according to the Guardian report. 

Bringing Penelope home The Chronicle of The Horse; by Sarah K. Susa; 10/1/2024 Angie was 35 when she, her husband, and son moved into their first home. It was red brick with a big picture window and a pasture out front where their horses could graze. It was almost a dream come true. Almost, because Angie was dying. The lump she’d found just two years earlier had metastasized, multiple times. In the beginning doctors cut off both breasts, hoping to take the cancer with them. But the disease was stealthy, hiding somewhere inside, then popping up here and there: liver, lymph nodes, spine, brain. She was pumped full of chemo. Blasted with radiation. Time and again, surgeons opened her up, removing any fragments of the disease that they could. Then they’d stitch her back together, hoping to buy her more time. But eventually, Angie was told, there was nothing more to do. Hospice was called. A hospital bed in Angie’s new living room allowed her to watch the horses graze from the picture window, her favorite feature of the house. Her son, just 5, would perch on the window’s deep sill, quietly building Legos and trying to process what was happening around him. And it was all happening so fast. 

Palliative care in kidney cancer more than just relieving symptoms Cure; by Ashley Chan; 9/26/24 Patients with kidney cancer who want more support during treatment can consider palliative care, whether it’s for symptoms or discussing goals and values. ... For patients with kidney cancer, understanding how palliative care can help is essential throughout the treatment process. Palliative care, according to the Mayo Clinic, is medical care that specializes in relieving pain and symptoms associated with an illness. This type of care can also help patients cope with treatment-related side effects. However, there’s more to palliative care than just relieving symptoms. It also “aims to help patients and families in one of three major categories,” Dr. Pallavi Kumar explained during an interview with CURE®. Kumar is the director of Oncology Palliative Care and assistant professor of Clinical Medicine in the hematology-oncology division at the University of Pennsylvania. She noted that the three categories of palliative care include:

Polk County home health aide accused of sleeping on the job arrested in man’s death: ‘He was old anyway' Fox 13, Winter Haven, FL; by Fox 13 News Staff; 9/30/24 A home health aide in Polk County is being held without bond after investigators say she fell asleep, and an 86-year-old man died in her care. ... The Polk County Sheriff’s Office says the victim’s family hired around the clock care from Assisting Hands, which consisted of two 12-hour shifts during the day and night. The victim had recently been hospitalized and was diagnosed with congestive heart failure. He was also receiving services from Good Shepherd Hospice. ... After the day shift nurse left, investigators say Taylor fell asleep on the couch in the living room, which is against company policy that states she should not have been sleeping. Deputies say Taylor woke up around 1 a.m. on August 16 and heard a thump coming from the victim’s bedroom. According to PCSO, Taylor went into the bedroom and saw the victim lying on his right side, on the floor, with his head wedged in between the nightstand and the bed. She told detectives that she tried to help him back into bed but that he told her not to touch him, so she left him on the floor and did not call anyone, including 911 or her employer, which is against company policy. ... According to the Medical Examiner, had Taylor called 911 when she first found the victim, as required by her own company’s policy, the victim would not have died. The Medical Examiner ruled the victim’s cause of death positional asphyxia with a contributory cause of pre-existing health issues.

Community partnership helps Veterans navigate their health care U.S. Department of Veterans Affairs, Washington, DC; by Dr. Chien Chen; 9/27/24 VA’s National Center for Healthcare Advancement and Partnerships (HAP) helps create and manage partnerships between VA and community organizations. The goal is simple: bring together VA and those in the community who share the same goals and mission when it comes to providing Veterans with outstanding health care and support. They are called Veteran Community Partnerships, or VCPs. “Developing and nurturing strong partnerships with VA and community providers is crucial to supporting Veteran health care,” said Dr. Jamie Davis, HAP health system specialist. “VCPs are instrumental in ensuring these partnerships enhance the health and well-being of Veterans across the country.” The East Bay VCP at Martinez VA is part of Northern California VA. Martinez VAMC and Veteran Community Partnerships focus on getting Veterans access to all available health care services. 

Celebrate patients’ creativity ehospice; by Fair Havens Hospice, United Kingdom; 9/23/24 Fair Havens hospice recently held an inspiring art exhibition to showcase patients’ artwork produced during a range of wellbeing sessions. The exhibition at Fair Havens hospice in Prittlewell, Southend-on-Sea, showcased over 30 pieces of artwork, including acrylics and watercolours to embroidery and creative writing, all created by patients living with incurable illnesses. There was also the opportunity for people to get creative and take part in activities such as pebble painting and memory box decorating. The artwork on show had all been created by adults supported by the hospices’ Wellbeing Team through various creative therapy workshops and one-to-one sessions. ... Amongst some of the artwork were collages created in the ‘I AM’ workshop, which aimed to provide a space for patients to reflect on the things that are most important to them and express this using colour, textures, and words.