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

Go Fish! Formative Feedback on the Communication Conundrum (TH313)
A “fishbowl” is an active learning technique that allows learners to problem-solve in a culture of safety. This session promises three things: 1.) You will learn what a fishbowl activity is and how to pull it off; 2.) You will learn about communication skills in the face of serious illness; and 3. ) You will have SO much fun doing numbers 1 and 2! Join us as we explore an innovative teaching technique that you can duplicate in your own practice! (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Kathryn A. Walker, Mary L. McPherson, Christopher D. Kearney Source Type: research

Panacea or Pandora's Box? Immune Checkpoint Inhibitors and Palliative Care (TH314)
Over the past several years, a wave of new cancer immunotherapy agents referred to as immune checkpoint inhibitors (ICIs) have transformed the standard of care for patients with cancer. ICIs are most commonly used in advanced cancers with palliative intent and recently as frontline therapy for some cancers. These new agents have been shown to extend overall survival (OS) and progression free survival (PFS) in patients with lung cancer, melanoma, Hodgkin lymphoma, renal cell carcinoma, urothelial carcinoma, Merkel cell carcinoma, head and neck cancer, and more. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Chad Glisch, Laurel J. Lyckholm, James B. Ray, Yuya Hagiwara Source Type: research

SIMplifying Palliative Extubations: A Two-Part OSCE in a Simulation Center to Assess Entrustable Professional Activities (EPAs) in Hospice and Palliative Medicine (TH315)
Healthcare professionals require education and practice to master their communication and procedure skills, especially in potentially distressing circumstances such as palliative extubations. Palliative extubation refers to removal of mechanical ventilator support when, based on an individual's goal of care, it is thought to be prolonging the dying process rather than helping to support through a reversible illness. Removing the endotracheal tube will allow a natural death to occur. In order to provide competent and compassionate care for patients and family members before, during, and after a palliative extubation, health...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Megan E. Rau, Susan E. Cohen Source Type: research

Dying at the Margins: Reflections on Justice and Healing for Inner-City Poor (TH316)
Those challenged by economic and racial barriers suffer more than the rest of us —in life and death. Many patients who live and die at the margins experience mistrust and disempowerment as they navigate serious illness and the complexity of the medical systems that care for them. This presentation will describe how the intersection of racial and economic disempowerment with dy ing creates burden and suffering that is difficult to imagine. It also delineates how patients and families draw on social and spiritual capital to develop resilience and strategies for coping. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: David W. Moller, Diane E. Meier, Robert M. Arnold, Timothy E. Quill, Shirley A. Otis-Green, Tammie E. Quest Source Type: research

Making Measurement Matter: How Will Your Organization Engage with the New Palliative Care Quality Collaborative? (TH317)
All people living with a serious illness deserve high-quality care focused on their own priorities and values. Yet, palliative care is not available for all who could benefit, and measurement and improving care in the context of the proliferation of requirements to measure quality from health systems, payers, and accrediting bodies can challenge busy organizations. To assist palliative care programs in improving the availability and quality of care, AAHPM leads an effort to create a unified registry to track the prevalence of palliative care programs and measure the quality of program operations and clinical care delivery....
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Arif H. Kamal, Maggie Rogers, Joseph D. Rotella, Steven Pantilat Source Type: research

Palliative Care for Chronic Lung Disease: It Really Does Take a Village (TH318)
Chronic lung disease is the fourth leading cause of death in the United States and third leading cause of death worldwide. Patients often live for years with reduced quality of life and significant distress related to symptoms, stigma, reduced functional capabilities, social isolation, and complicated self-management protocols. Evaluating the potential benefits of advanced life support and bronchoscopic or surgical interventions can be daunting, even for actively involved patients. The World Health Organization's GOLD Guidelines recommend pulmonary rehabilitation (PR), a 6- to 8-week course of exercise training, education,...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: DorAnne Donesky, Julie J. Howard, Jessica Zitter Source Type: research

Bilateral Renal Agenesis: Redefining Pediatric Palliative Care Across an Innovative Complex Chronic Care Continuum (TH319)
Bilateral renal agenesis has historically been described as “incompatible with life” as chronic anhydramnios results in pulmonary hypoplasia, leading to respiratory failure at birth. Recent reports have detailed the survival of infants with renal disease and severe oligo-/anhydramnios following prenatal serial amnioinfusions as a bridge to neonatal dialy sis with the goal of pediatric kidney transplant. Subsequently, clinical trials have proposed treating fetuses with bilateral renal agenesis with serial prenatal amnioinfusions to allow for pulmonary maturation and the potential for long-term survival. (Source:...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Christopher A. Collura, Renee Boss, Megan Thorvilson, Brenda M. Schiltz Source Type: research

When Opioids Are Not the Answer: Using the ‘PARTNERS’ Framework to Manage Chemical Coping in Cancer Patients (TH320)
Pain is common in patients with cancer, and opioids are recognized as effective treatments for moderate to severe cancer pain. Yet as Cicely Saunders first recognized in her concept of “total pain,” there are non-physical dimensions to suffering, and these are not adequately addressed with opioids. Existential suffering or emotional pain occurs when severe illness injures a patient's identity, sense of purpose, spiritual faith, or relationships with others and causes anxiety a bout death or an uncertain future. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Amy A. Case, Eric Hansen, Michelle Walter, Marcin Chwistek, Luann Stevens, Megan Pailler, Joseph Arthur Source Type: research

When Calling 911 Is the Answer: Leveraging Resources in EMS to Deliver Emergency Hospice and Palliative Care (TH321)
A distressed call to EMS from families or caregivers of hospice patients in crisis can significantly alter end-of-life care. Hospice patients may have acute symptom management needs exceeding their resources at home, but may not desire to go to the emergency department (ED). However, traditional EMS protocols may not align well with hospice patients' goals of care. While EMS may be able to administer controlled substances in the home setting, this usually requires the patient to then be transported to the ED for further treatment. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Justin K. Brooten, Lisa Evans, David Wang, Joanne G. Kuntz, Crystal T. Wilfong, Jennifer Price Source Type: research

Does Advance Care Planning Actually Reduce Hope in Advanced Cancer? (TH322A)
One of the principal reasons providers cite for deferring advance care planning (ACP) is fear of “taking away hope” from patients. However, research is lacking on the relationship between ACP and hope in advanced cancer. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Michael Cohen, Andrew Althouse, Robert Arnold, Edward Chu, Douglas White, Yael Schenker Tags: Paper Sessions Source Type: research

The Process and Impact of a Stakeholder Driven Adaptation of the Serious Illness Conversation Guide for AYAs and Parents of Children with Serious Illness (TH322B)
Early conversations about advance care planning (ACP) are associated with better outcomes for seriously ill adults. Despite a parental desire for earlier and more ACP, large scale adoption of ACP for seriously ill children, adolescents, and young adults (AYAs) remains unrealized. There are few rigorously developed interventions to support clinicians in pediatric ACP communication to ensure care is aligned with family goals and values. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Danielle DeCourcey, Lindsay Partin, Anna Revette, Rachelle Bernacki, Joanne Wolfe Source Type: research

Development and Validation of the ACP-CAT for Assessing the Quality of Advance Care Planning Communication (TH322C)
High quality advance care planning (ACP) discussions are important to ensure patient receipt of goal-concordant care, however there is no existing tool for assessing communication quality in ACP encounters. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Jacqueline Yuen, Amy Kelley, Laura Gelfman, Elizabeth Lindenberger, Cardinale Smith, Robert Arnold, Brook Calton, Jane Schell, Stephen Berns Source Type: research

The Patient Dignity Question in Routine Palliative Care Consultation: Implementation and Implications (TH322D)
The Patient Dignity Question (PDQ) is a validated psychometric tool designed to assess priorities and stressors relevant to care planning at all stages of illness. Administration of the PDQ has been demonstrated to improve patient and provider perceptions of empathy and communication. The PDQ has been tested in various settings, but never routinely as a component of palliative care consultation. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Rachel Hadler, Matthew Goldshore, Judith Nelson Source Type: research

‘Rehab’ vs Hospice, Let's Seriously Talk; Can Jack Weight-Bear, Will Jill Walk? The Impact and Benefit of Sponsored Physical Therapy Consults for Hospice Enrollees (TH323A)
Medicare covered inpatient rehabilitation ( “rehab”) is a common, and often appealingly expeditious, hospital discharge plan for older patients, despite the fact that many of these people have little capacity to participate in (or gain benefit from) this enterprise. In the past, “rehab” vs hospice enrollment was the frequent choice fa cing patients and families. For the past three years our hospice organization has encouraged our clinicians to utilize the physical therapy division of our visiting nurse sister service to reduce the dichotomy of these two alternatives. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Charles Newton Source Type: research

30-Day Readmission Reduction for Skilled Nursing Facility Readmissions at an Urban Medical Center (TH323B)
Unplanned 30-day hospital readmissions are an important measure of hospital quality and a focus of national regulations. The readmission rate for patients being discharged to skilled nursing facilities (SNF) has been an area of improvement for all healthcare systems. The vast majority of SNF will receive a penalty on their Medicare payments for fiscal year 2019 for poor 30-day readmission rates back to hospitals. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Nidhi Shah Source Type: research

Design and Evaluation of a Pilot Palliative Care Program in the Skilled Nursing Facility (TH323C)
The number of residents in skilled nursing facilities is expected to grow substantially over the next decade. Most SNF residents have serious illnesses that would benefit from Palliative Care intervention but reported data and understanding of best practices are lacking. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Mina Chang, Cheryl Rathje, Haley Sawamura, Jenelyn Lim, Summer Verhines, Neelu Mehra Source Type: research

A National Pilot of Goals of Care Conversations for Seriously Ill Veterans: Patient and Site Variation and Associations with Bereaved Family Survey Outcomes (TH323D)
We examined patient characteristics associated with GoCC and the association of GoCC with Bereaved Family Survey (BFS) data on end-of-life quality. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Marie Haverfield, Ariadna Garcia, Joseph Rigdon, Karleen Giannitrapani, Anne Walling, Derek Boothroyd, David Bekelman, Natalie Lo, Jill Lowery, Mary Beth Foglia, Lisa Lehmann, Karl Lorenz Source Type: research

The Practice of Palliative Medicine in Developing Countries —Part One (TH330)
Please join AAHPM's International Scholars for a panel discussion. Each scholar will present for 10 –15 minutes on the state of the practice of palliative care in their home country, with an emphasis on the roles of physicians, nurses, and other healthcare providers; the status of education and research in the field; and the unique challenges facing patients and providers. There will be time all otted after each presentation to field questions and dialogue from the audience. Prepare to be educated and inspired by these accomplished individuals who are leading and advancing the field of hospice and palliative medicine...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Geoffrey Manda, Sunita Panta, Nasreen Muhammad Saleem, Tashi Dendup Wangdi Source Type: research

PC-FACS: A Year in Review (TH331)
PC-FACS, the highest-rated member benefit of the American Academy of Hospice and Palliative Medicine, offers busy clinicians an efficient way to stay on top of pertinent literature in a field that is growing exponentially. Now in its 12th year, PC-FACS —published in the Journal of Pain and Symptom Management and delivered in a convenient format to the email box of Academy members—provides topical summaries of just published research from more than 100 journals that are not specifically dedicated to hospice and palliative medicine and might not otherwise come to the attention of our readership. (Source: Journal ...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Mellar P. Davis, Robert M. Arnold Source Type: research

Advancing Palliative Nursing Leadership and Professional Development (TH332)
In the next 10 years, the number of patients with serious illness will continue to rise. In order to care for these patients, specialty palliative nurses are essential to lead in ensuring access to quality palliative care. Many clincians lack understanding of the necessary professional development for specialty practice and the linking to leadership. This session will provide an overview of qualifications of specialty palliative nursing practice and identify the areas for palliative nursing leadership. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Marika Haranis, Constance Dahlin Source Type: research

STAMPing Out Antimicrobial Doubt: Collaborative Decisions on End-of-Life Transitions of Care (TH333)
Transitions of care at end-of-life create opportunities for hospice plan of care development. Infections may be present at time of hospice admission or may trigger a transition of care (for example from home to general inpatient care, or hospital to long-term care facility when home is not yet appropriate). Hospice clinicians can interact directly with partner providers at these points of transition, facilitating a patient-centered team approach to decision making. Additionally, patients and caregivers may be more agreeable to modifying infection management treatment plans when a change in level of care is being considered...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Molly R. Sinert, Julie Ann Justo Source Type: research

The Billing Boys Tell All: Preparing to Succeed with Medicare and the Billers at Home (TH334)
Palliative Care (PC) programs are growing nationally. Once niche services well under the fiscal radar, many PC programs now have seven-figure budgets and a dozen or more clinicians. As programs cost more, sponsoring institutions' expectations for clinical revenue grow, leaving PC team members working longer hours to see more patients to help close the yawning budgetary gap. Most PC providers have become accustomed to basic billing and coding practices, but significant opportunities exist, even for seasoned clinicians and program leads, in the rapidly expanding array of billing revenue opportunities. (Source: Journal of Pai...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Christopher Jones, Phillip E. Rodgers Source Type: research

They Said What!? Navigating Conflict with Colleagues Across Specialties (TH335)
A core tenet of Hospice and Palliative Medicine (HPM) is effective communication. While HPM specialty education centers around communication with patients and families, effective communication with colleagues across specialties can be equally challenging. Given increased emotions, various communication approaches, and complexity inherent in caring for seriously ill patients, interpersonal conflict (IPC) between HPM providers and other healthcare team members is not uncommon. IPC is defined as someone experiencing negative emotions due to the perception of disagreement or impediment from another healthcare provider. (Source...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Ethan Silverman, Sara K. Johnson, Jasmine Hudnall, Anne Kelly, Andrew O'Donnell Source Type: research

Teaching Cross-Tolerance for Patients with Opioid Use Disorder Across Settings (TH336)
Palliative care practitioners are increasingly treating patients with comorbid opioid use disorder (OUD), yet guidance is lacking for managing pain in this population. Historically, palliative care clinicians have liberally prescribed opioids to patients with limited prognosis. As medicine has evolved, patients with chronic illnesses, even metastatic cancer, are living longer thanks to immunotherapies and other novel treatments. Thus, palliative care patients are at greater risk of both developing OUD and/or chemical coping while receiving intensive treatments. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Anessa Foxwell, Tanya J. Uritsky, Eleanor Anderson, Rachel Boris Source Type: research

My Pediatric Palliative Care Patient with a DNR Is Going to the Operating Room —Questions to Ask the Anesthesiologist (TH337)
Children with end-stage illness may have DNR orders, which limit common operating room interventions such as intubation, administration of vasoactive medications, and CPR. However, many of these children may still benefit from surgeries, imaging, or other interventions requiring anesthesia, such as radiation therapy to palliate metastases, long-term central venous access for medications or parenteral nutrition, gastric tubes, or pleura or paracentesis to help with breathlessness or abdominal distension. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Sydney Brown, Chris Feudtner Source Type: research

When You Know Less Is More But Need the Patient and Family to Buy In: Using SPIKES for Deprescribing (TH338)
In the United States, the population above 65 years old in 2010 was 13%, and is estimated to be 20% by 2030, and more than 30% in other developed countries by 2030. With the rise of polypharmacy and multi-morbidity in the aging population, polypharmacy has been shown to be associated with an increased risk for adverse drug events, hospitalizations, and falls. Deprescribing is a systematic approach to withdraw or dose reduce medications considered inappropriate in an individual. The American Geriatrics Society has provided an update to the Beer's Criteria in 2019 to guide identification of inappropriate medications in the e...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Sandra DiScala, Shaida Talebreza, Ashlei W. Lowery, Ella H. Bowman, Neris Palunas, Tsewang Ngodup Source Type: research

Grief and Bereavement Support for Families and Healthcare Professionals as Part of Integrated Care in Pediatric/Neonatal Intensive Care Units around the World (TH340A)
Grief and bereavement support (GBS) is important for the wellbeing and functioning of patients, families, and healthcare professionals (HCPs) and is part of the Integrated Model of Care (IMOC) in which ICU personnel address critical and palliative care (PC) needs concurrently. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Michelle Grunauer, Gabriela Bustamante, Kevin Zambrano Tags: Paper Sessions Source Type: research

Prognostic Awareness in Caregivers of Adults with Incurable Cancer (TH340B)
Caregivers' understanding of their loved ones' prognosis is important in helping patients make informed decisions about care. While patients' prognostic awareness is associated with their psychological distress, data are lacking on whether this relationship exists for caregivers. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Tamryn Gray, Deborah Forst, Ryan Nipp, Joseph Greer, Jennifer Temel, Areej El-Jawahri Source Type: research

End-of-Life Experiences for Children with Complex Chronic Conditions and Their Bereaved Parents: Perspectives on Preparedness (TH340C)
Children with complex chronic conditions (CCC) are assisted with technology and receive intensive medical care throughout their lives, resulting in unique end-of-life (EOL) needs. Parent perspectives are necessary to improving care, yet little is known about the lived experience of parents of children with CCC. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Jori Bogetz, Anna Revette, Abby Rosenberg, Joanne Wolfe, Danielle DeCourcey Source Type: research

Experiences of Family Caregivers Providing Support to Individuals Who Voluntarily Stop Eating and Drinking (VSED) to Hasten Death (TH340D)
Voluntarily stopping eating and drinking (VSED) is a method for individuals with serious illness to control the timing and means of their death. The process requires clinical and social support, but no research has investigated the experience of caregivers supporting someone through VSED. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Jane Lowers, Nancy Preston, Sean Hughes Source Type: research

A Quality Improvement Project to Provide Early Referral to Palliative Care Clinic for Advanced Oral Cancer Patients (TH341A)
Recent literature affirms the benefits of early palliative care in advanced cancer patients. The prevalence of oral cancer is high in India and often patients present at advanced stages at the time of diagnosis. Bleak scope of curative treatment and high symptomatic burden detracts from the quality of life of these patients. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Aanchal Satija, Karl Lorenz, Michelle DeNatale, Jake Mickelsen, Odette Spruijt, S.V.S. Deo, Sushma Bhatnagar Source Type: research

Designing an Electronic Point-of-Care Dashboard to Support Serious Illness Clinical Visits: A Multi-Stakeholder Coproduction Project (TH341B)
Healthcare system complexity interferes with effective communication and goal-aligned services for people living with serious illness and their caregivers. Coproduction, a framework for healthcare service production involving real partnership between patients, caregivers, and care teams, may help. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Matthew Wilson, Aricca Van Citters, Inas Khayal, Catherine Saunders, Cathy Ross, Stephanie Tomlin, Amelia Cullinan, Meredith MacMartin, Megan Holthoff, Shoshana Hort, Amber Barnato, Kathryn Kirkland Source Type: research