Authors ’ Response to Estimation of chronic post-surgical pain after thoracic surgery: case closed?
We would like to express gratitude to Dr. Argo for reading and taking interest in our work1. In the letter “Estimation of chronic post-surgical pain after thoracic surgery: case closed?” 2 Dr. Argo raises interesting and important questions. He points to issues that are of concern in our study, but also more general when conducting studies of chronic postsurgical pain in any patient population. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 7, 2020 Category: Palliative Care Authors: Kari Hanne Gjeilo, Trine Oksholm, Turid Follestad, Alexander Wahba, Tone Rust øen Source Type: research

Pain-Associated Clusters Among Nursing Home Residents and Older Adults Receiving Home Care in Germany
There are no available data regarding pain-associated clusters among nursing home residents and older adults receiving home care with chronic pain. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - February 7, 2020 Category: Palliative Care Authors: Andrea Budnick, Ronny Kuhnert, Arlett Wenzel, Mimi Tse, Juliana Schneider, Reinhold Kreutz, Dagmar Dr äger Tags: Original Article Source Type: research

“Please Keep Mom Alive One More Day”—Clashing Directives of a Dying Patient and Her Surrogate
All medical care providers are legally and ethically bound to respect their patients' wishes. However, as patients lose decision-making capacity and approach end of life, their families or surrogates, who are confronted with grief, fear, self-doubt, and/or uncertainty, may ask physicians to provide treatment that contradicts the patients' previously stated wishes. Our work discusses the legal and ethical issues surrounding such requests and provides guidance for clinicians to ethically and compassionately respond —without compromising their professional and moral obligations to their patients. (Source: Journal of Pai...
Source: Journal of Pain and Symptom Management - January 31, 2020 Category: Palliative Care Authors: Sheron Latcha, Camille Lineberry, Nikoletta Lendvai, Christine A. Tran, Konstantina Matsoukas, Amy E. Scharf, Louis P. Voigt Tags: Ethical Issues in Palliative Care Source Type: research

“Please Keep Mom Alive One More Day” - Clashing Directives of a Dying Patient and Her Surrogate.
All medical care providers are legally and ethically bound to respect their patients wishes. However, as patients lose decision-making capacity and approach end of life, their families or surrogates, who are confronted with grief, fear, self-doubt, and/or uncertainty, may ask physicians to provide treatment which contradicts the patients ’ previously-stated wishes. Our work discusses the legal and ethical issues surrounding such requests, and provides guidance for clinicians to ethically and compassionately respond - without compromising their professional and moral obligations to their patients. (Source: Journal of ...
Source: Journal of Pain and Symptom Management - January 31, 2020 Category: Palliative Care Authors: Sheron Latcha, Camille Lineberry, Nikoletta Lendvai, Christine A. Tran, Konstantina Matsoukas, Amy E. Scharf, Louis P. Voigt Source Type: research

Debatable Issues in Palliative Sedation; Authors' Reply to the Response by Robert Twycross
We appreciate the insightful comments from Dr. Robert Twycross and the chance to respond. He expressed concern about confusion related to the role of midazolam, the definition of palliative sedation (PS), the calculation of survival time, and the possibility of detrimental effect from continuous deep sedation (CDS). (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 30, 2020 Category: Palliative Care Authors: Young-Woong Won, Jung Hun Kang Tags: Letter Source Type: research

Debatable issues in palliative sedation ; Author ’s reply to Robert Twycross’ response
We appreciate the insightful comments from Dr. Robert Twycross and the chance to respond. He expressed concern about confusion related to the role of midazolam, the definition of palliative sedation (PS), the calculation of survival time, and the possibility of detrimental effect from continuous deep sedation (CDS). (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 30, 2020 Category: Palliative Care Authors: Young-Woong Won, Jung Hun Kang Tags: Letter Source Type: research

A response to Clinical patterns of continuous and intermittent palliative sedation in patients with terminal cancer: a descriptive, observational study by Young-Woong Won et al.
Discussion it is stated that ‘PS traditionally refers to CPS’ (Continuous PS). This is incorrect. The original definition from around 20 years ago deliberately made no distinction between continuous and intermittent, and light and deep sedation.1 Although since then many variant definitions have appeared in the literature, guidelines generally stress that PS implies an intended reduction in consciousness and excludes sedation secondary to symptom control measures. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 30, 2020 Category: Palliative Care Authors: Robert Twycross Tags: Letter Source Type: research

Openness Personality Trait Associated With Benefit From a Nonpharmacological Breathlessness Intervention in People With Intrathoracic Cancer: An Exploratory Analysis
Breathlessness is common in people with lung cancer. Nonpharmacological breathlessness interventions reduce distress because of and increase mastery over breathlessness. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 29, 2020 Category: Palliative Care Authors: Miriam J. Johnson, Samantha Nabb, Sara Booth, Mona Kanaan Tags: Brief Report Source Type: research

An Individualized, Interactive, and Advance Care Planning Intervention Promotes Transitions in Prognostic Awareness States Among Terminally Ill Cancer Patients in Their Last Six Months —A Secondary Analysis of a Randomized Controlled Trial
To examine whether an advance care planning intervention randomized controlled trial facilitates terminally ill cancer patients' transitions to accurate prognostic awareness (PA) and the time spent in the accurate PA state in patients' last six months. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 29, 2020 Category: Palliative Care Authors: Chen Hsiu Chen, Wen-Chi Chou, Jen-Shi Chen, Wen-Cheng Chang, Chia-Hsun Hsieh, Fur-Hsing Wen, Siew Tzuh Tang Tags: Original Article Source Type: research

“Openness” personality trait associated with benefit from a non-pharmacological breathlessness intervention in people with intra-thoracic cancer: an exploratory analysis
Breathlessness is common in people with lung cancer. Non-pharmacological breathlessness interventions reduce ‘distress due to’ and increase ‘mastery over’ breathlessness. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 29, 2020 Category: Palliative Care Authors: M.J. Johnson, S. Nabb, S. Booth, M. Kanaan Source Type: research

An individualized, interactive, advance-care planning intervention promotes transitions in prognostic-awareness states among terminally ill cancer patients in their last 6 months —A secondary analysis of a randomized controlled trial
To examine whether an advance-care planning (ACP) intervention, randomized controlled trial facilitates terminally ill cancer patients ’ transitions to accurate prognostic awareness (PA) and the time spent in the accurate-PA state in patients’ last 6 months. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 29, 2020 Category: Palliative Care Authors: Chen Hsiu Chen, Wen-Chi Chou, Jen-Shi Chen, Wen-Cheng Chang, Chia-Hsun Hsieh, Fur-Hsing Wen, Siew Tzuh Tang Tags: Original Article Source Type: research

An evaluation of By My Side: Peer support in written form is acceptable and useful for parents bereaved by childhood cancer
Cancer is the leading cause of non-accidental death in childhood, with the death of a child representing a devastating loss for families. Peer support offers a valuable way to support parents ’ adjustment in bereavement. The By My Side book provides written peer support by sharing bereaved parents’ stories to normalise grief experiences and reduce parents’ isolation. It is available free of charge. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 29, 2020 Category: Palliative Care Authors: C. Raharjo, K. Hetherington, L. Donovan, J.E. Fardell, V. Russell, R.J. Cohn, N. Morgan, J. Siddiqui, C.E. Wakefield Source Type: research

Chronic Obstructive Pulmonary Disease: A Palliative Medicine Review of the Disease, Its Therapies, and Drug Interactions
Despite significant advances in treatment, chronic obstructive pulmonary disease (COPD) remains a chronic and progressive disease that frequently leads to premature mortality. COPD is associated with a constellation of significant symptoms, including dyspnea, cough, wheezing, pain, fatigue, anxiety, depression, and insomnia, and is associated with increased morbidity. Palliative care is appropriate to support these patients. However, historically, palliative care has focused on supporting patients with malignant disease, rather than progressive chronic diseases such as COPD. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 28, 2020 Category: Palliative Care Authors: Andrea Weiss, Sandra Porter, Dmitry Rozenberg, Erin O'Connor, Tiffany Lee, Meyer Balter, Kirsten Wentlandt Tags: Special Article Source Type: research

Chronic Obstructive Pulmonary Disease: A palliative medicine review of the disease, its therapies and drug interactions
Despite significant advances in treatment, chronic obstructive pulmonary disease (COPD) remains a chronic and progressive disease that frequently leads to premature mortality. COPD is associated with a constellation of significant symptoms including dyspnea, cough, wheezing, pain, fatigue, anxiety, depression and insomnia, and is associated with increased morbidity. Palliative care is appropriate to support these patients. However, historically palliative care has focused on supporting patients with malignant disease, rather than progressive chronic diseases such as COPD. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 28, 2020 Category: Palliative Care Authors: Andrea Weiss, Sandra Porter, Dmitry Rozenberg, Erin O ’Connor, Tiffany Lee, Meyer Balter, Kirsten Wentlandt Source Type: research

Addressing Goals of Care —VitalTalk: Intensive Small Group Training (P01)
As a palliative care consultant from any professional background, discussing goals of therapy when things are not going well is the most common reason for an inpatient consult. Discussing goals of care is difficult because it requires the consultant to accomplish a number of interrelated, emotional tasks in a short period of time: deliver bad news, assess what is important to the patient, and make a recommendation about how to best proceed. Using a mix of short didactic talks and experiential practice, this workshop will help participants develop a toolkit of skills useful for handling these difficult conversations. (Sourc...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Stephen Berns, Juan C. Iregui, Tessie W. October, Abby R. Rosenberg Source Type: research

Hospice Medical Director Update and Exam Prep (P02)
Join peers and national experts to explore and further develop the skills needed to successfully navigate today's hospice environment. This intensive review will serve as part of your preparation for the Hospice Medical Director Certification Board exam and is based on the exam blueprint (www.hmdcb.org). The workshop also serves as a great orientation for those new to the hospice field or as a critical update for all hospice practitioners and managers. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Ronald J. Crossno, Patrick White, Bethany Calkins, Bethany Snider Source Type: research

Let's Play Hot Potato! Controversial Topics in the Pharmacopalliation of Serious Illness (P03)
This “not-to-be-missed” preconference is a veritable smorgasbord of head-thumpers! Every day we get emails warning about medication use including benzodiazepines, gabapentinoids, and cannabis. Do these pharmacologic entities increase the risk of death when combined with opioids, or reduce risk? Do th ey have a role in caring for patients? What does the latest evidence show to support opioid equivalencies, including methadone and levorphanol? Why has the equianalgesic table changed and what data supports it? Another head-thumper is how do we manage delirium in serious illness, especially when non -pharmacologic ...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Mary Lynn. McPherson, Mellar P. Davis, Kathryn A. Walker, Akhila S. Reddy, Judith A. Paice, Kasey Malotte, Jeremy M. Hirst, Amy L. Davis Source Type: research

ACHPN Certification Review Course (P04)
The purpose of this HPNA-Endorsed ACHPN Review Course is to promote education of the APRN seeking augmentation of their professional development through specialty hospice and palliative advanced registered nursing certification. This 1-day provider-directed, provider-paced live intensive course is designed  to assist with preparation for the advanced hospice and palliative nurse certification exam through didactic course presentation with active learner engagement, case study examinations, practice exam questions, and self-check/reflection to highlight self-identifying topics that require further pre paration and stud...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Jennifer Gentry, Bronwyn Long Source Type: research

HPM Fellowship Directors Forum: Training the Next Generation —Innovations and Multi-Generational Training in Fellowship (P05)
HPM fellowships will need to evolve and innovate to meet the needs of our growing field, its heterogeneous trainees, and our multigenerational learners. The fellowship directors' preconference will help participants draw inspiration from examples of innovation within the HPM fellowship community, and learn how the ACGME can support such innovations from a senior member of its executive staff. The session will also include a workshop on strategies for effective intergenerational communication. This year's program will begin with a description of innovations supported by the ACGME. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Molly E. Collins, Gary T. Buckholz, April R. Christensen, Eric S. Holmboe, F. Amos Bailey, Laura E. Dingfield, Kathleen P. Doyle, Annette K. Nijjar, Janae K. Heath Source Type: research

AAHPM Leadership Forum: Ignite —Using StrengthsFinder Leadership Strategies to Increase the Performance of You and Your Team in Palliative Care and Hospice Settings (P06)
Would you like to discover what makes you stand out? This half-day session will focus on utilizing a strengths-based approach to create consistent and positive outcomes to everyday challenges in hospice and palliative care settings. Strengths are the unique combination of talents, knowledge, and skills that every person possesses. Participants will complete a StrengthsFinder assessment that will help to identify personal strengths to focus on to become a more effective leader. They will learn how to develop these strengths and leverage them in their everyday friction points. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Christina Rowe Source Type: research

Preparing for Good Grief: Grief and Loss in the Hospice and Palliative Context (P07)
Grief and bereavement are universal human experiences, and inevitable outcomes for those who lose a family member or close friend. For hospice and palliative care providers, understanding the complexities of this universal yet individualized experience, and providing support to the bereaved is a critical part of our field. This practical, interactive workshop will provide an overview of current theories, best practices, and approaches to support healthy grief and manage loss in a modern society. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Stacy S. Remke, Allie E. Shukraft, Katherine P. Supiano, Stephanie P. Wladkowski Source Type: research

Building Partnerships Between Spiritual Care Experts and Generalists in Integrating Spiritual Care for Seriously and Chronically Ill Patients and Their Families (P08)
Spiritual Care is an essential domain of Palliative Care as stated in the World Health Assembly's resolution of Palliative Care. Spiritual distress is highly prevalent in seriously ill and dying patients and in their families. Total pain cannot be fully addressed without addressing spiritual distress. One of the challenges in integrating spiritual care in clinical settings is lack of training. ISPEC is a curriculum program whose aim is to train clinicians and spiritual care professionals in spiritual care. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Christina Puchalski, Betty Ferrell, Trace Haythorn, Marvin O. Delgado Guay, Richard W. Bauer Source Type: research

Advanced Treatments and Technology: Weaning and Deactivating (P09)
Science with treatment and technology advancement, such as inotropes, pacemakers/AICDs, ventilators, and VADs (ventricular assist devices) continues to offer patients opportunities for improved health and survival. With progressive illness, such technologies and treatments may no longer be associated with health and may in fact decrease quality of life and increase suffering with unclear or unwanted life prolongation. Moreover, advance care planning through an advance directive, clinical orders, or stated wishes by the patient or surrogate as part of a goals-of-care conversation often address the role of advanced treatment...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Joseph W. Shega, Quinten Robertson Source Type: research

Ethical Competencies for Clinical Excellence (P10)
In clinical practice, we face ethical conundrums daily. We may be prepared to honor financial and physical limits in our relationships with patients and families, but ethical boundaries in the face of suffering are  about far more than these surface areas. They require exquisite emotional health, intelligence, and resilience. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Carla Cheatham, Jessica Zitter Source Type: research

Cannabis: A New Addition to the Palliative Care Toolkit (P11)
Increasing numbers of patients living with serious illness are requesting access to medical cannabis as well as guidance about its use for pain and symptom management, as a disease-modifying drug for cancer and other diseases, and as a strategy to avoid chronic opioid and benzodiazepine use. Select palliative care clinics have incorporated cannabis into their therapeutic toolkit, and “cannabis consultations” have become an entry point for accessing palliative care for some patients. In many states, physicians and advance practice providers are responsible for counseling and registering patients for medical cann...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Drew A. Rosielle, Ali John Zarrabi, Kathleen Broglio, Ivan Zama, Diana C. Martins-Welch, Kimberly A. Curseen Source Type: research

Practical Strategies for Building and Growing an Effective, High-Functioning Interdisciplinary Team (P12)
A high-functioning interdisciplinary team (IDT) is at the core of high-quality palliative care. However, sustaining an effective team can be difficult. How do you establish a collaborative, team-based culture? Has your team ever experienced high turnover, seemingly unmanageable consult volumes, tensions among team members, role confusion, or less than effective IDT performance? Do you or any of your team members occasionally feel isolated and are all voices being heard? How does your team maintain clinical quality? How does your team work together to solve problems or issues that were causing stress? Whether due to growth,...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Stephanie DePiano, Amy Frieman, Kaitlyn Bender, Tom Gualtieri-Reed Source Type: research

Educators Forum: ‘Getting Better All the Time’—Giving Faculty Tools for Effective Feedback and Quality Improvement (P13)
Hospice and Palliative Care (HAPC) educators are constantly striving to improve their efforts for learners of diverse backgrounds and stages of education. This session will focus on two of the most pressing and quickly developing topics in education: feedback and quality improvement (QI). The session will be facilitated by five recognized educators and experts in these fields. Effective feedback is desired by all, but rarely thought to be delivered. This is true even in HAPC, a field with a great emphasis on communication. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Dominic A. Moore, Anna Beck, Holly B. Yang, Arif H. Kamal, Joshua Lakin Source Type: research

Multidisciplinary and Multimodal Approaches for Refractory Symptoms (P14)
Palliative care multidisciplinary teams are commonly consulted to help with refractory cases, and in most cases our tool box is adequate to address the various levels of suffering. However, in some instances, our traditional palliative care tool box is not enough, which leads teams to search for additional modalities that we can add to our tool box. There is emerging literature and clinical practice protocols which guide us to expanding our toolbox. These include uncommon opioids in the palliative care setting, such as tapentadol, levorphanol, and buprenorphine. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Rabia S. Atayee, Kyle P. Edmonds, Tim Furnish, Angela House, Sarah Housman, Benjamin S. Kematick, Jennifer Kim, Bridget C. Scullion, Karolina Soriano Source Type: research

Improving the Care of Diverse Patient Populations: Let's Advance the Dialogue for Strategies to Address and Navigate the Elephant in the Room (P15)
Cultural beliefs shape one's perceptions of illness, support structure, prognosis, and degree of suffering and may inform preferences for palliative and end-of-life care. Cultural identification encompasses many things − age, gender identity, ethnicity, ability, age, language, sexual orientation, religion, nationality, socioeconomic status. The cultural identifications and beliefs of people living with serious illness are similarly varied and their values, needs and preferences have the potential to dramatically differ from that of the clinicians caring for them. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Aziz Ansari, Michael Barnett, Helen Chen, Ronit Elk, Heather Harris, Perla Macip-Rodriguez, Ruth Thomson, Shellie Williams Source Type: research

Getting Started (or Going Further) in Value-Based Payment Models (P16)
With a new Medicare alternative payment model for serious illness care, new Medicare Advantage benefits, and continued growth in both commercial health plan and ACO interest, palliative care programs have more opportunities for value-based payment arrangements than ever before. But to take advantage of these and other value-based payment models, you must know how to find potential partners, understand costs, and operate efficiently. Led by expert facilitators and real-world program leaders engaged in value-based partnerships right now, this half-day preconference workshop will feature interactive exploration of value-based...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Phillip E. Rodgers, Tom Gualtieri-Reed, Joan M. Hanson, John S. Morris, Laura Patel, J. Russell Kieffer Source Type: research

A Gentle Journey: Transitioning from Childhood to Adulthood with Palliative Care (P17)
In Adult and Pediatric Palliative Care, consultation early in the disease trajectory is considered a best practice. Palliative care patients may live weeks, months, or years and may develop very trusting professional relationships with their providers. For pediatric patients with longstanding illness, these provider relationships may include family members and external caregivers as well. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Daniel M. Karlin, Jeannette (Jeannie) Meyer Source Type: research

Not for the Faint of Heart: Caring for Patients with Advanced Heart Failure (P18)
Today,  people are living longer with heart disease while its prevalence is increasing. Historical trends that have limited the integration of palliative care in cardiology and HF care are shifting. Over the last 10 years, there has been growing evidence to support palliative care interventions for HF pat ients and their families, as well as integrating interdisciplinary HF, palliative care, and hospice. Patients with HF require complex pharmacological and self-care regimens to control symptoms and prevent recurrent hospitalizations. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Erin Donaho, Beth Fahlberg, Joan T. Panke Source Type: research

Psychiatrist in My Pocket: Essential Psychiatric Skills for the Palliative Care Provider (P19)
Addressing the emotional difficulties of patients facing serious illness can present a variety of unique challenges. For instance, depressive disorders can have variable presentations across patient populations due to the complex interplay of symptoms of emotional distress with the symptoms of serious illness. It is challenging to navigate the diagnostic spectrum of grief, persistent complex bereavement disorder, demoralization, adjustment disorder with depressive features, and major depressive disorder. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Alexander Gamble, Paul A. Riordan, Allison E. Jordan, Jason A. Webb, Keri O. Brenner, David Buxton Source Type: research

Bridging the Gap: Telehealth Applications in Palliative Care (P20)
As with many specialties, it is difficult to sustain palliative care programs in rural areas. This is particularly true in areas such as the Southeast where non-urban hospitals tend to be small and for-profit, two characteristics associated with lacking palliative care services. Early efforts to address rural inequities focused on moving specialists into areas of need, but some of these succumbed to a lack of consistent volume and revenue for the time expended by specialists. More recently, efforts to address rural inequities have shifted to using technology to bridge the distances. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Danielle Noreika, J. Brian Cassel, Jennifer A. Hicks, Elizabeth K. Burpee, Kim Twisdale, Janet H. Bull Source Type: research

Afternoon at the Museum: Connection and Meaning at the San Diego Museum of Art (P21)
The practice of hospice and palliative care provides the privilege of presence with patients, families, and colleagues at some of life's most important moments. These moments require close observation, and we often need to connect these observations to infer the deeper meaning for those involved. Within our daily practice and growing clinical demands, nurturing observational skills and reflective capacities in ourselves and our trainees can be a challenge. However, these approaches can be sustaining and restoring. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Laura J. Morrison, Ali John Zarrabi, Joshua Hauser, Barbara Reville, Paul L. DeSandre, Corinne Zimmermann, Elizabeth Gundersen, Gordon J. Wood Source Type: research

Developing Collaborations with Development Professionals: An Essential Competency for Palliative Care Teams (TH301)
A hallmark of comprehensive palliative care is an intra-professional team which is expert in addressing physical, spiritual and psycho-social distress. Funding this team can be challenging. Many essential team members are unable to bill insurance for their services, and the structure of insurance payments may not adequately compensate team members, such as nurses and doctors who bill. Therefore, palliative care programs rely on direct financial support from hospitals and philanthropy. Given budgetary challenges facing both community and academic medical centers, the need to maximize relationships with potential donors is p...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Jennifer Kapo, Rodney O. Tucker, Natasha McCabe, Diane E. Meier Source Type: research

‘The Patient Can See You Now’: Providing Interprofessional Community-Based Palliative Care Using a Video-Based Telehealth Clinic Model (TH302)
Traditional outpatient clinics can present insurmountable challenges for seriously ill patients resulting in a high no-show rate and limited touch-points with palliative providers. To prevent lapses in care, we will describe how we harnessed video-based telehealth to redefine the boundaries of our PC team to provide effective and efficient patient care outside the walls of our hospitals. Our PATCH (Palliative Telehealth Connecting Hospital to Home) program addresses issues patients face after hospitalization, including symptom and medication management, coordination of care, and psychosocial support. (Source: Journal of Pa...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Kathryn A. Walker, Christopher D. Kearney, Nancy E. Eddy Source Type: research

Innovation in the Delivery and Payment of Serious Illness Care Through Health Plan Program Development and the Payer-Provider Relationship (TH303)
The palliative care landscape is evolving with new market entrants, growing program sophistication, and increasing interest in implementation strategies from the state and federal level. With the advent of value-based care, this approach to patient care is becoming ever so important to health providers, payers, and patients alike. How can organizations most effectively develop programs around serious illness care when there is change around every corner of our industry? How can we learn from one another to avoid common pitfalls and well-known, but not well-navigated paths forward? Through two separate convenings, one being...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Victoria Shumulinsky, Torrie K. Fields, Tom Gualtieri-Reed, Daniel C. Johnson Source Type: research

Is Dopamine the Golden Ticket for Symptom Management in Palliative Care? Role of Antipsychotics for Off-Label Uses (TH304)
Antipsychotics are widely used off-label in clinical practice, especially within palliative care. Palliative care and hospice clinicians often prescribe antipsychotics for off-label uses such as delirium, nausea, agitation, and insomnia even though controversial evidence exists for their use for these indications, given antipsychotics daunting side effect profile. A review of literature of antipsychotics for off-label uses will be completed and supplemented by expert opinion in a debate format as there are known risks and benefits to antipsychotic use, even when used more liberally in the palliative care world. (Source: Jo...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Maria F. Lowry, Jeremy M. Hirst, Allison E. Jordan, Eric Prommer, Jennifer Pruskowski Source Type: research

Closing the Gap on the Palliative Care Needs of Patients with Kidney Disease: Innovations from the Pathways Project (TH306)
Among seriously ill patients, those with advanced chronic kidney disease (CKD) and end-stage kidney disease (ESKD) arguably receive among the worst end-of-life care. These patients frequently die in the hospital, often after an intensive procedure like cardiopulmonary resuscitation, and with a low referral rate to hospice. There is now a concerted effort in the nephrology and palliative care communities to integrate palliative care into the treatment of these seriously ill patients. The Pathways Project is a national demonstration, funded by the Gordon and Betty Moore Foundation, to develop scalable innovations in kidney s...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Alvin H. Moss, Dale Lupu, Glenda Harbert, Mary Beth Callahan, Catalina Hanson Source Type: research

‘I Can't Eat, Speak, or Kiss My Wife. It's Half a Life, but at Least I'm Still Alive.’ Navigating the Sequelae of Head and Neck Cancer (TH307)
Depending on age, stage and HPV status, patients with locally advanced head and neck cancer have a high chance of cure, something that can be elusive in other advanced cancers. To achieve cure, patients undergo intense treatment regimens, including a long course of radiation, cytotoxic chemotherapy, and sometimes disfiguring surgery. Treatments are often accompanied by significant physical, emotional, and spiritual pain and other forms of suffering. While the promise of cure is alluring, the physical and psychological impacts of treatment can devastate patients. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Dana L. Guyer, Sumathi Misra, Ariel E. Birnbaum, Joshua Jones, Meredith Oakey Ashford Source Type: research

A Picture Is Worth a Thousand Words: Using PhotoVoice to Promote Resilience in Trainees Who Care for Seriously Ill Patients (TH308)
Healthcare professionals who provide care for patients with serious illness are at risk for compassion fatigue and burnout. A growing body of literature demonstrates that trainees may be particularly susceptible to burnout, and the challenges intrinsic to medical training may not afford frequent opportunities for building the resilience needed to sustain career longevity. Additionally, trainees may grapple with feelings of inadequacy and disenfranchisement within larger healthcare systems. PhotoVoice is a participatory action research approach designed to give a voice to individuals who may feel marginalized or unheard. (S...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Erica C. Kaye, Lindsay Blazin, Michael Terao, Mark Brown, Jami S. Gattuso, Justin N. Baker Source Type: research

Using Film as a Tool to Promote and Enhance ACP in a Faith-Based African American Community (TH309)
Disparities exist between African American and White patients when it comes to medical care at the end of life. African Americans die more often attached to invasive technology, in medical facilities rather than at home, and with untreated pain. Culturally sensitive tools for Advance Care Planning support patient-centered care and can improve health outcomes. Few such tools are tailored for use in the African American community. This must change. The Alameda County Care Alliance (ACCA) is an organization embedded within 14 churches in Alameda and Contra Costa counties in California that teaches local pastors, clergy, and p...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Jessica Zitter, Janice Bell, Jill Joseph, Cynthia Carter Perrilliat, Eilann C. Santo, Valerie Steinmetz Source Type: research

Hospice Hot Topics over Hot Coffee (TH310)
The Hospice Medicine Council works through the Academy governance structure to ensure that issues and programs important to hospice physicians are addressed and developed. The HM Council fosters and builds meaningful communication, connection and collaboration among hospice professionals, expands and develops opportunities for hospice physicians to further engage within the Academy and identify and support resources for hospice physicians. The leadership of the HM Council actively monitors hospice-related discussions and questions posted both on the Connect; Open Forum and on the Council's community site. (Source: Journal ...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Michael Paletta, Ronald Crossno, Edward W. Martin, Shaida Talebreza, Patrick White, Stephanie Patel, Bethany Snider Source Type: research

Empowering Patient Participation in Advance Care Planning Discussions Within Primary Care: The PREPARE Randomized Clinical Trial (TH311A)
Many factors prevent patients from discussing advance care planning (ACP) in busy outpatient settings. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Jennifer Freytag, Richard Street, Deborah Barnes, Ying Shi, Aiesha Volow, Rebecca Sudore Tags: Paper Session Source Type: research

Advance Care Planning for Patients with Heart Failure: An Exploration of Relational Autonomy in the Context of Future Care Decision Making (TH311B)
Advance care planning (ACP) is the process of understanding and sharing personal values and goals to ensure people with serious illnesses receive medical care that is consistent with their preferences. With the increasing complexity of medical options available to patients, ACP is regarded as a means of preserving individual autonomy. Despite significant public awareness and interventions developed to increase ACP participation, this practice remains under-utilized by those with chronic illnesses. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Tieghan Killackey, Jane Maciver, Shan Mohammed, Elizabeth Peter Source Type: research

Impact of Advance Care Planning Coaching for Patients with Chronic Kidney Disease: Results from the ‘My Way’ Randomized Clinical Trial (TH311C)
Guidelines recommend advance care planning (ACP) as essential to quality chronic kidney disease (CKD) management, but the nephrology community has yet to incorporate ACP upstream of the dialysis decision. Others have attempted to improve ACP for dialysis patients, but many patients report wishing they had been engaged in ACP earlier. This project tested integration of ACP coaching in the upstream setting of nephrology offices. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Dale Lupu, Annette Aldous, Elizabeth Anderson, Jane Schell, Hunter Groninger Source Type: research

Impact of Physician Orders for Life-Sustaining Treatment (POLST) Program Maturity Status on the U.S. Nursing Home Resident's Place of Death (TH311D)
The Physician Orders for Life-Sustaining Treatments (POLST) program was developed to enhance quality of care delivered at end-of-life (EoL). Although positive effects of POLST program use on dying individual's EoL care have been identified, the association between a state's POLST program maturity status and nursing home (NH) resident's place of death is unknown. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Aluem Tark, Mansi Agarwal, Pat Stone Source Type: research

Quiet: How to Harness the Strengths of Introverts to Transform How We Work, Lead, and Innovate (101)
Did you know that introverted leaders often deliver better results than extroverts? That the most spectacularly creative people tend to be introverts? That the most innovative thinking happens alone and not in teams? One of the central challenges of any business is to bring out the best in its employees. Yet when it comes to introverts —who make up a third to a half of the workforce—our leadership strategy mainly consists of asking them to act like extroverts. This is a serious waste of talent and energy. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Susan Cain Source Type: research

Palliative Care in Rural Settings: Closing the Gap (TH312)
Although palliative care programs are present in many large hospitals, access and dissemination of the advances taking place in the field of palliative care to patients living in rural communities have been limited. Patients may receive care from palliative care specialists and return home to communities with vastly different resources. Challenges for rural clinicians include collaborating with colleagues in primary palliative care, developing sustainable business and clinical models to support delivery of complex care, and ensuring effective transitions of care across all settings. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Lyn Ceronsky Source Type: research