Literature Review

Early palliative care perceptions by patients with cancer and primary caregivers: metaphorical languageBMJ Supportive & Palliative Care; by Elena Bandieri, Sarah Bigi, Melissa Nava, Eleonora Borelli, Carlo Adolfo Porro, Erio Castellucci, Fabio Efficace, Eduardo Bruera, Oreofe Odejide, Camilla Zimmermann, Leonardo Potenza, Mario Luppi; 5/13/24Methods: Data were collected through a pen-and-paper questionnaire on respondents’ perceptions of the disease, its treatment and their idea of death, before and after receiving EPC [early palliative care]. The data were analysed by identifying all metaphorical uses of language, following the ‘metaphor identification procedure’ proposed by the Praggjelaz Group.Results: Metaphors were used from a variety of semantic fields. EPC was described using spiritual terms, to indicate that this approach was instrumental in ‘restoring life’, ‘producing hope’ and making patients feel ‘accompanied’. The most recurrent metaphors were those referring to light and salvation; spatial metaphors were used to describe the treatment and the hospital as a ‘safe haven’ and ‘an oasis of peace’. 

Beyond medicine: 'Being Mortal' challenges healthcare's approach to death and dying SwiftTelecast; by Shawn Butlere; 5/11/24 This video from the “Frontline” series, titled “Being Mortal,” follows Dr. Atul Gawande as he explores the complex relationships between doctors, patients, and end-of-life decisions. Based on his best-selling book “Being Mortal,” Gawande discusses how medical training often falls short in preparing doctors for the realities of death and dying. The documentary highlights personal stories, including Gawande’s own experiences with his father’s illness and death, to illustrate the challenges in balancing hope with realistic outcomes and the importance of quality life in the face of terminal illness. 

Volunteering in hospice helps Macalester students contemplate death's mysteries up close MSN - Minneapolis Star Tribune; by Katy Read; 5/10/24 "You think it will never happen to you, that it cannot happen to you, that you are the only person in the world to whom none of these things will ever happen," author Paul Auster wrote about humans' difficulty confronting our own mortality. ... Auster himself died last month at age 77. ... How can humans fully grasp the inevitability of our own death? It's a tough question to answer, maybe close to impossible. Three Macalester College students who just finished a course called the Anthropology of Death and Dying don't have the answer. Their professor, who has spent much of his career studying death as an anthropologist and a former hospice nurse, doesn't have an answer. A hospice nurse doesn't have the answer. And a hospice patient with lung cancer doesn't have the answer, even knowing he soon will confront its reality firsthand.

Paris in spring, Bali in winter. How ‘bucket lists’ help cancer patients handle life and death The Conversation; by Vivan Lam; 5/8/24 In the 2007 film The Bucket List Jack Nicholson and Morgan Freeman play two main characters who respond to their terminal cancer diagnoses by rejecting experimental treatment. Instead, they go on a range of energetic, overseas escapades. Since then, the term “bucket list” – a list of experiences or achievements to complete before you “kick the bucket” or die – has become common. ... But there is a more serious side to the idea behind bucket lists. One of the key forms of suffering at the end of life is regret for things left unsaid or undone. So bucket lists can serve as a form of insurance against this potential regret. The bucket-list search for adventure, memories and meaning takes on a life of its own with a diagnosis of life-limiting illness. Editor's Note: Health acuity (especially for hospice patients), finances, and other practical factors can prevent acutalization of the person's bucket list wishes. Yes, fulfilling items can happen! And when not possible (perhaps the most common response), the clinician's sensitive presence, validation of the person's hope, and gentle exploration of why it matters can bring relevant, meaningful support. Involving family members (with the patient's permission) can inspire other generations to fulfill the person's wish, bringing new purpose to mourning and grief-restoration processes ahead.

Spiritual distress, hopelessness, and depression in palliative care: Simultaneous concept analysisMDPI; by Helga Martins, Rita S. Silva, Joana Braganca, Joana Romeiro, and Silvia Caldeira; 5/7/24The results highlight that the three concepts are different but also share some overlapping points. Spiritual distress is embedded in the rupture of their spiritual/religious belief systems, a lack of meaning in life, and existential issues. Hopelessness is a sense of giving up and an inability to control and fix the patient’s situation. Finally, depression is a state of sadness with a multi-impaired situation. In conclusion, refining the three concepts in palliative care is essential since it promotes clarification and enhances knowledge development towards intervention.

Breaking the silence: The mounting need for trauma-informed hospice care Hospice News; by Holly Vossel; 5/3/24Traumatized and abused hospice patients and providers often experience an array of lingering physical, emotional and psychological effects that can fall into a silent abyss of unmet needs. ... Many seniors have experienced some form of trauma or abuse in their lifetime. ... More data has become available in recent years around the prevalence of different types of abuse and trauma. Roughly 10% of seniors 65 and older nationwide are victims of some type of abuse each year, the U.S. Department of Justice (DOJ) reported. Caregiver neglect represents 5.1% of these cases, with psychological and physical abuse impacting 4.6% and 1.6% of seniors, respectively. ...Editor's Note: This article highights interviews with Dr. Ashwin Kotwal, assistant professor at the University California San Francisco; Carole Fisher, president, National Partnership for Healthcare and Hospice Innovation (NPHI); Dr. Cameron Muir, chief innovation officer, NPHI; Andrea Devoti, executive vice president at the National Association for Home Care & Hospice (NAHC); Lindsey Owen, executive director of Disability Rights Vermont.

Shocked 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.

Patients tell me they've had a paranormal experience. I Believe Them — I had one too. MSN HuffPost, by Scott Janssen; 4/23/24 Tank’s life has been full of conflict and strife. Now he’s stuck in a wheelchair on his back porch with me, a hospice social worker, peppering him with questions. He’s pondering my query about why he’s feeling peace about his impending death. His eyes soften as he motions with his head toward the workshop near the back fence. “You remember me telling you about my older boy?” he asks. “The one that died by suicide?” I ask. “Yeah, I remember.” “If you count my old man, I was the second-worst father that ever lived. Most of my life I figured I’d go straight to hell when I died.” ...

Clinician burnout and effectiveness of guideline-recommended psychotherapies JAMA Network - Psychiatry; by Nina A. Sayer, PhD; Adam Kaplan, PhD; David B. Nelson, PhD; et al; 4/17/24 Importance: Clinician burnout has been associated with clinician outcomes, but the association with patient outcomes remains unclear. Conclusions: This prospective cohort study suggests that clinician burnout was negatively associated with patient outcomes from evidence-based psychotherapies. Findings support research to test the hypothesis that interventions to reduce burnout may improve outcomes from guideline-recommended psychotherapies for PTSD. Future work should determine when and how burnout is associated with intervention delivery and patient outcomes.Editor's Note: Most research on hospice and palliative clinician burnout focuses on physicians and nurses. Examine this in light of your psychosocial/spiritual professionals, i.e. social workers, chaplains/spiritual care, and bereavement counselors. 

Journal of Religion & Health Issues Research Articles in April 2024 Edition Targeted News Service posts list of titles; 4/18/24; Journal published by SpringerThe Journal of Religion and Health, a journal that says it explores modes of religious and spiritual thought with emphasis on their relevance to current medical and psychological research, published research articles on the following topics in its April 2024 edition (Vol. 63, Issue 2): [Click on the title's link]Classification/Subject: Religion (96%), Muslims & Islam (92%), Suicide (91%), Assisted Suicide (90%), Death & Dying (90%), Diseases & Disorders (90%), Ethics (90%), Medicine & Health (90%), Psychology (90%), Research Reports (90%), Cancer (89%), Novels & Short Stories (89%), Associations & Organizations (87%), Indigenous Peoples (79%), Adolescents & Teens (78%), Alternative Medicine (78%), Bioethics (78%), Health Care Professionals (78%), ...Editor's Note: Click here for access to the journal.

Health Talk: Getting into a health care career The Barre Montpelier Times Argus Online, by Peg Bolgioni; 4/13/24According to the American Hospital Association, there will be a shortage of up to 3.2 million health care workers by 2026. America will face a shortage of up to 124,000 physicians by 2033 and will need to hire at least 200,000 nurses per year to meet increased demand, and to replace retiring nurses. ... The mission of Southern Vermont Area Health Education Center is to enhance community efforts to grow and sustain the health workforce in southern Vermont. One of the ways we do this is by delivering pathway programs that connect students to health careers. [Click the title's link to read about this event.]Editor's Note: How might your organization create similar career engagement and education in your community? 

Potential CMS measure shows divide over quality training standards Modern Healthcare, by Mari Devereaux; 4/12/24 Hospitals may soon be required to provide set quality training to staff as part of a Medicare reporting program, but health systems and advocacy organizations are split on whether the standardization of quality-related skill sets is necessary to improve patient care.