Literature Review

Goals of care among patients with advanced cancer and their family caregivers in the last years of life JAMA Network; by Semra Ozdemir, PhD; Isha Chaudhry, MSc, Chetna Malhotra, MD; et al; 4/11/24 Conclusions and Relevance: In this cohort study of patient-caregiver dyads, findings suggested the importance of interventions aimed at reducing discordance in goals of care between patients and caregivers and helping them develop realistic expectations to avoid costly, futile treatments.

No nightmares and no light at the end of the tunnel. This dream most often repeats itself before death 247 News Agency; 4/12/24 Does our subconscious know that death is inevitably approaching? Taking into account the latest research, this is quite possible. It turns out that at the end of life many people have the same dream. It’s not a nightmare at all. The topic fascinates many people. For scientists, it is still a mystery that they try to solve by talking to people who survived clinical death or were on the verge of life and death. The best example is Dr. Christopher Kerr, a cardiologist and director of Hospice and Palliative Care Center in Buffalo, ... [who researched] the dreams of patients at the end of life.

Angela Hospice opening a hospice residence at Lourdes Senior Community in Waterford Detroit Regional Chamber, by Angela Hospice; 4/10/24 Angela Hospice will expand its caring services to the Waterford community and beyond, when it begins operating a 15-bed hospice residence at Lourdes Senior Community this summer and providing additional home hospice services in the area. The non-profit will extend its geographic reach further into north Oakland County, offering additional outreach to benefit all in the community, not just those on hospice care, through transformational grief support groups, educational outreach, and their Good Samaritan program, which serves those who are without insurance or the ability to pay for hospice.

The transformative power of art in palliative care patients Hardwood Paroxysm, by Shannon Bailey; 4/10/24 Art can often express what is difficult in words. ... Carles joined the program weeks before his death and after undergoing other treatments such as surgery, chemotherapy, radiotherapy or immunotherapy. ... [His partner and mother of his twin daughters described,]  “The art therapy sessions were the most anticipated moment of the day during his stay in palliative care. For him, this was a way to express his feelings. A space for self-care, intimacy, meditation as well as connection with his closest beings.” [Read more for ...]

The Sunday Read: 'What deathbed visions teach us about living' New York Times Podcasts, 4/7/24 Chris Kerr was 12 when he first observed a deathbed vision. His memory of that summer in 1974 is blurred, but not the sense of mystery he felt at the bedside of his dying father. ... Kerr now calls what he witnessed an end-of-life vision. His father wasn’t delusional, he believes. ... Kerr followed his father into medicine, and in the last 10 years he has hired a permanent research team that expanded studies on deathbed visions to include interviews with patients receiving hospice care at home and with their families, deepening researchers’ understanding of the variety and profundity of these visions.

How to talk about death Maine Public Radio, by Jennifer Rooks and Cindy Han; 4/5/24 Talking about death is not easy. We'll discuss why stigma and discomfort can impede end-of-life conversations, for the person who may be nearing death as well as for friends and family members. We'll find out how to address the emotional and spiritual aspects of dying. And we'll discuss the more practical legal, financial and medical matters to handle before and after someone has died.Panelists: Julie Weiss, social worker, Hospice of Southern Maine; Dr. Paul Segal, nephrologist, assistant professor of medicine; helped create curriculum for end-of-life doula students, University of New England; Dr. Fernando Moreno, palliative care specialist; medical director, Hospice of Southern Maine

Study shows strong social ties may ease the way for older adults in life's final chapter Medical & Life Sciences, by Vijay Kumar Maleus; 4/4/24  Study Results: ... The analysis revealed that higher levels of loneliness were significantly associated with increased odds of experiencing anxiety, sadness, and pain in the last month of life, suggesting a pivotal link between social isolation and end-of-life symptomatology. Furthermore, marital status and the receipt of personal care were predictors of dying in a hospital, pointing to the influence of social support structures on the location of death. Interestingly, a larger social network was correlated with a higher likelihood of receiving hospice or palliative care, highlighting the potential benefits of broader social connections. 

Palliative care could be a game changer for public health Harvard Public Health, by Meredith Lidard Kleeman; 4/4/24California and Hawaii are pioneering ways to expand access. ... California is one of the first states in the country to require insurance companies that administer Medicaid benefits to fully cover palliative care services for eligible residents. ... Palliative care is poised to be a game changer for public health. Nearly 50 percent of states now include palliative care services for eligible Medicaid recipients, according to C-TAC. And in California and Hawaii, two paths are being forged toward wider palliative care access. ... 

How’s Your Soul? JAMA Network, by Daivd Vermette, MD, MBA, MHS; 3/28/24 "Brother David, how’s your soul?” The question took me by surprise. It was time for my first advisement meeting with my residency program director. In medicine, the machine runs on competence and achievement of “milestones.” Yet, as I braced for a meeting to trudge through performance evaluations and in-training exam scores, I awoke to humanity. ... Medical education has numerous models for coaching, advising, and mentoring. While these models helped develop my professional life, they missed the fundamental core of who I am: a human being. Perhaps instead we could embrace a model in medical education built on the tenets of pastoral care. ...

Hospice & Palliative Care Handbook: Quality, Compliance, and Reimbursement, 4th Edition McGraw Hill - Access APN; textbook by Tina M. Marrelli and Jennifer Kennedy; 3/28/24 “Hospice & Palliative Care Handbook, Fourth Edition, is an invaluable resource for timely hospice regulatory and compliance information, documentation, care planning, and case management. It provides clear guidance for hospice managers, clinicians, and interdisciplinary group members. I have utilized Tina Marrelli’s home health and hospice handbooks to support training new clinical staff and students for decades and consider these resources to be the gold standard.” – Kimberly Skehan, MSN, RN, HCS-D, COS-C, Vice President of Accreditation - Community Health Accreditation Partner

Meaningful conversations to have with your loved oneMediaFeed.org, by Merritt Whitley; 3/27/24“One of the most important concepts in the field of grief and loss is that people drift in and out of the awareness of dying,” says Kenneth Doka, a senior consultant to the Hospice Foundation of America, and professor emeritus of gerontology at the graduate school of The College of New Rochelle. “Sometimes they do talk about it, sometimes not. The dying one should control the agenda. Don’t force conversations on them.” When your loved one feels ready to talk, the following suggestions can be comforting ways to begin a conversation: ...

Harvard Thinking: Facing death with dignityThe Harvard Gazette, podcast and transcript; moderated by Samantha Laine Perfas; 3/27/24In podcast episode, a chaplain, a bioethicist, and a doctor talk about end-of-life care.

The process of dealing with death is experiencing rebirth in a less-religious Pittsburgh Digital Daily; by Med St-Esprit, PublicSource; 3/24/24 Tanisha Bowman, of the North Side, a palliative care social worker for Butler Health System and a “death walker,” walks amongst the old graves in St. Mary’s Cemetery. ... From green burial to glass orbs containing ashes, the norms of funerals and burials are broadening as religious affiliation declines. ... According to a 2021 survey by Pew Research, 3 in 10 American adults are religiously unaffiliated. Data compiled by Pew Research about the Pittsburgh metro region found that 50% of adults in the region describe religion as “very important” and nearly 20% consider themselves not religious. Shifts in faith and worship mean families as well as businesses related to death and dying have had to alter their approaches.