Informal Caregivers' Perceptions of Needs From Hospice Providers: An Integrative Review.
CONCLUSION: Particular attention must be paid to ensuring that the IC is acknowledged as an expert part of the team. Clearly explaining available services, creating better ways to ease the IC's transition from caregiving to bereavement, and recruiting minority hospice providers are other important efforts that could improve the caregiving experience. The needs of ICs are complex, but by listening to their perspective, we can begin to clarify the best ways to aid them in their difficult job. PMID: 30991813 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - April 16, 2019 Category: Palliative Care Authors: Engbers RA Tags: Am J Hosp Palliat Care Source Type: research

Outcomes and Cost of Patients With Terminal Cancer Admitted to Acute Care in the Final 2 Weeks of Life: A Retrospective Chart Review.
CONCLUSION: Our study highlighted the importance of PC integration in high-risk patients, such as those in oncology. Patients in our sample had minimal PC involvement, low advanced care directives, and accrued high costs. Based on our analyses, we concluded that these patients would have likely benefited more from hospice care rather than hospitalization. PMID: 30991816 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - April 16, 2019 Category: Palliative Care Authors: Kyeremanteng K, Ismail A, Wan C, Thavorn K, D'Egidio G Tags: Am J Hosp Palliat Care Source Type: research

Prelude to Death or Practice Failure? Trombley-Brennan Terminal Tissue Injury Update.
Abstract In 2012, we published a study in this journal exploring the emergence of unique skin changes in end-of-life patients admitted to a palliative care unit. The purpose of the study was to describe the skin changes and identify the relationship between these changes and time of death. In the above study of 80 patients, the skin changes were found to be unique and different from Kennedy terminal ulcers and deep tissue injuries. Median time from identification of skin changes and death was 36 hours. The phenomenon was named as Trombley-Brennan terminal tissue injury. The current article presents findings that i...
Source: The American Journal of Hospice and Palliative Care - April 16, 2019 Category: Palliative Care Authors: Brennan MR, Thomas L, Kline M Tags: Am J Hosp Palliat Care Source Type: research

How Is End-of-Life Care With and Without Dementia Associated With Informal Caregivers' Outcomes?
CONCLUSIONS: Informal caregivers of people with dementia are at risk not only of high caregiver burden but also of missing out on positive experiences associated with caregiving at EOL. Future research should examine how dementia-related factors reduce positive caregiving experiences, in order to make palliative care a positive reality for those providing informal care to community-dwelling persons with dementia. PMID: 30983373 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - April 14, 2019 Category: Palliative Care Authors: Boogaard JA, van der Steen JT, de Boer AH, van Groenou MIB Tags: Am J Hosp Palliat Care Source Type: research

The Timing of Family Meetings in the Medical Intensive Care Unit.
Abstract PURPOSE: Family meetings in the medical intensive care unit can improve outcomes. Little is known about when meetings occur in practice. We aimed to determine the time from admission to family meetings in the medical intensive care unit and assess the relationship of meetings with mortality. METHODS: We performed a prospective cohort study of critically ill adult patients admitted to the medical intensive care unit at an urban academic medical center. Using manual chart review, the primary outcome was any attempt at holding a family meeting within 72 hours of admission. Competing risk models estimate...
Source: The American Journal of Hospice and Palliative Care - April 14, 2019 Category: Palliative Care Authors: Piscitello GM, Parham WM, Huber MT, Siegler M, Parker WF Tags: Am J Hosp Palliat Care Source Type: research

Simulation-Based Palliative Care Communication for Pediatric Critical Care Fellows.
We describe a simulation-based PPC communication series for PCCM fellows, including presimulation session, simulation session, debriefing, and evaluation methods. From 2011 to 2017, 28 PCCM fellows participated in a biannual half-day simulation session. Each session included 3 scenarios (allowing for participation in up to 18 scenarios over 3 years). Standardized patients portrayed the child's mother. PCCM and interprofessional PPC faculty cofacilitated, evaluated, and debriefed the fellows after each scenario. Fellows were evaluated in 4 communication categories (general skills, breaking bad news, goals of care, and resus...
Source: The American Journal of Hospice and Palliative Care - April 11, 2019 Category: Palliative Care Authors: Brock KE, Tracewski M, Allen KE, Klick J, Petrillo T, Hebbar KB Tags: Am J Hosp Palliat Care Source Type: research

The Support, Education, and Advocacy (SEA) Program of Care for Women With Metastatic Breast Cancer: A Nurse-Led Palliative Care Demonstration Program.
CONCLUSIONS: Purposeful nurse-led assessment for social service and palliative care needs increases referrals with improvement in patient-reported outcomes. PMID: 30974954 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - April 11, 2019 Category: Palliative Care Authors: Reiser V, Rosenzweig M, Welsh A, Ren D, Usher B Tags: Am J Hosp Palliat Care Source Type: research

Moral Distress and Attitudes About Timing Related to Comfort Care for Hospitalized Patients: A Survey of Inpatient Providers and Nurses.
Abstract CONTEXT: Providing nonbeneficial care at the end of life and delays in initiating comfort care have been associated with provider and nurse moral distress. OBJECTIVE: Evaluate provider and nurse moral distress when using a comfort care order set and attitudes about timing of initiating comfort care for hospitalized patients. METHODS: Cross-sectional survey of providers (physicians, nurse practitioners, and physician assistants) and nurses at 2 large academic hospitals in 2015. Providers and nurses were surveyed about their experiences providing comfort care in an inpatient setting. RESULTS:...
Source: The American Journal of Hospice and Palliative Care - April 9, 2019 Category: Palliative Care Authors: Bender MA, Andrilla CHA, Sharma RK, Hurd C, Solvang N, Mae-Baldwin L Tags: Am J Hosp Palliat Care Source Type: research

The Forgotten.
Abstract In this narrative, a third-year medical student recounts an experience with a patient she had while accompanying hospice and palliative workers on home visits. It was a tragic scene to witness, but somehow she left with spirits light. The afternoon with this woman-who suffered from Alzheimer's Disease-stood out. The medical student still thinks about her to this day. PMID: 30955343 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - April 8, 2019 Category: Palliative Care Authors: Tsai J Tags: Am J Hosp Palliat Care Source Type: research

Home Palliative Sedation Using Phenobarbital Suppositories: Time to Death, Patient Characteristics, and Administration Protocol.
CONCLUSION:: The use of compounded phenobarbital suppositories for the purpose of palliative sedation is an alternative for patients and families who desire to remain home despite refractory symptoms. PMID: 30947512 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - April 4, 2019 Category: Palliative Care Authors: Setla J, Pasniciuc SV Tags: Am J Hosp Palliat Care Source Type: research

A Practice Improvement Project to Increase Advance Care Planning in a Dementia Specialty Practice.
This study was conducted to enhance the rate of advance care planning (ACP) conversations and documentation in a dementia specialty practice by increasing physician knowledge, attitudes, and skills. We used a pre- and postintervention paired design for physicians and 2 independent groups for patients. The ACP dementia educational program encompassed 3 objectives: (1) to understand the relevance of ACP to the dementia specialty practice, (2) to provide a framework to discuss ACP with patients and caregivers, and (3) to discuss ways to improve ACP documentation and billing in the electronic medical record. A 10-item survey w...
Source: The American Journal of Hospice and Palliative Care - April 4, 2019 Category: Palliative Care Authors: Cotter VT, Hasan MM, Ahn J, Budhathoki C, Oh E Tags: Am J Hosp Palliat Care Source Type: research

Pediatric Complex Chronic Conditions: Does the Classification System Work for Infants?
CONCLUSIONS:: The findings suggested that the infants are not commonly classified with a CCC and highlighted the significant variation in race with African American infants exhibiting different CCC classifications than Caucasian infants. Given the importance of reducing disparities in palliative care, critical attention to using CCC classifications in research is warranted. PMID: 30943756 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - April 3, 2019 Category: Palliative Care Authors: Lindley LC, Fortney CA Tags: Am J Hosp Palliat Care Source Type: research

Surgical Versus Medical Team Assignment and Secondary Palliative Care Services for Patients Dying in a Cardiac Hospital.
Abstract BACKGROUND:: Secondary palliative care (SPC) provides several benefits for patients with cardiovascular disease, but historically, it has been underutilized in this population. Prior research suggests a low rate of SPC consultation by surgical teams in general, but little is known about how surgical teams utilize SPC in the setting of severe cardiovascular disease. AIM:: To determine if surgical team assignment affects the probability of SPC for inpatients dying of cardiovascular disease. DESIGN:: Retrospective, cohort study. METHODS:: We identified all inpatients at a large cardiac hospita...
Source: The American Journal of Hospice and Palliative Care - February 24, 2019 Category: Palliative Care Authors: Gandesbery B, Dobbie K, Joyce E, Hoeksema L, Perez Protto S, Gorodeski EZ Tags: Am J Hosp Palliat Care Source Type: research

Impact of Hospice and Palliative Care Service Utilization on All-Cause 30-Day Readmission Rate for Older Adults Hospitalized With Heart Failure.
CONCLUSION:: In a large cohort study of older US Veterans, utilization of hospice and palliative care services was associated with a higher 30-day all-cause readmission rate among hospitalized patients with HF. Further prospect studies should be conducted to confirm results and test generalizability outside the Veterans Affairs system of care. PMID: 30773029 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - February 17, 2019 Category: Palliative Care Authors: Kheirbek RE, Alemi Y, Wojtusiak J, Kheirbek L, Madison S, Fokar A, Doukky R, Moore HJ Tags: Am J Hosp Palliat Care Source Type: research

Oral Hygiene Care in Patients With Advanced Disease: An Essential Measure to Improve Oral Cavity Conditions and Symptom Management.
Abstract BACKGROUND:: Oral problems are frequent in palliative care and can cause disabling symptoms such as orofacial pain, dysgeusia, and xerostomia. Even if oral care is an essential aspect of nursing, it is often not considered as a priority, especially when various complex patients' needs have to be managed. OBJECTIVE:: The aim of this study was to describe oral conditions and evaluate the impact of standard oral care on symptom control and patient's perceived comfort in a sample of terminally ill patients. METHOD:: A prospective cohort study was carried out among 415 patients who were admitted to h...
Source: The American Journal of Hospice and Palliative Care - February 12, 2019 Category: Palliative Care Authors: Magnani C, Mastroianni C, Giannarelli D, Stefanelli MC, Di Cienzo V, Valerioti T, Casale G Tags: Am J Hosp Palliat Care Source Type: research

Dealing With Death Taboo: Discussion of Do-Not-Resuscitate Directives With Chinese Patients With Noncancer Life-Limiting Illnesses.
CONCLUSION:: Health-care workers should be sensitive toward the cultural influence during advance care planning. Role of family for ethnic Chinese remains crucial and professionals should respect this family oriented decision-making. PMID: 30744386 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - February 11, 2019 Category: Palliative Care Authors: Cheng HB, Shek PK, Man CW, Chan OM, Chan CH, Lai KM, Cheng SC, Fung KS, Lui WK, Lam C, Ng YK, Wong WT, Wong C Tags: Am J Hosp Palliat Care Source Type: research

Trends in Health-Care Utilization at the End of Life Among Patients With Hematologic Malignancies in a Middle-Income Country: Challenges and Opportunities in Brazil.
This study aimed to identify trends in end-of-life care among patients with HM in Brazil. We conducted a retrospective cohort study (2015-2018) of patients who died with HM, using electronic medical records linked to health insurance databank, to evaluate outcomes consistent with health-care resource utilization at the end of life. Among 111 patients with HM, in the last 30 days of life, we found high rates of emergency department visits (67%, n = 75), intensive care unit admissions (56%, n = 62), acute renal replacement therapy (10%, n = 11), blood transfusions (45%, n = 50), and medical imaging utilization (59%, n = 66)....
Source: The American Journal of Hospice and Palliative Care - February 11, 2019 Category: Palliative Care Authors: Soares LGL, Gomes RV, Japiassu AM Tags: Am J Hosp Palliat Care Source Type: research

Improving End-of-Life Care for Diverse Populations: Communication, Competency, and System Supports.
CONCLUSIONS:: Improvements in care would come from acknowledging diversity within groups, provider demonstration of comfort and competence, more effective care coordination, and recruitment of providers who share similar characteristics with the communities they serve. PMID: 30727741 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - February 6, 2019 Category: Palliative Care Authors: McCleskey SG, Cain CL Tags: Am J Hosp Palliat Care Source Type: research

POLST Registration and Associated Outcomes Among Veterans With Advanced-Stage Lung Cancer.
CONCLUSION:: There was low submission to the POLST Registry among Veterans who received care in Veterans' Health Administration. Veterans who had a registered POLST were more likely to be enrolled in hospice and less likely to die in a VA care setting. The POLST may improve metrics of high-quality EOL care; however, opportunities for improvement in submission and implementation within the VA exist. PMID: 30700127 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - January 30, 2019 Category: Palliative Care Authors: Nugent SM, Slatore CG, Ganzini L, Golden SE, Zive D, Vranas KC, Sullivan DR Tags: Am J Hosp Palliat Care Source Type: research

End-of-life Health-Care Utilization Patterns Among Chronically Ill Older Adults.
Abstract Patients with chronic illness are associated with high health-care utilization and this is exacerbated in the end of life, when health-care utilization and costs are highest. Complex Care Management (CCM) is a model of care developed to reduce health-care utilization, while improving patient outcomes. We aimed to examine the relationship between health-care utilization patterns and patient characteristics over time in a sample of older adults enrolled in CCM over the last 2 years of life. Generalized estimating equation models were used. The sample (n = 126) was 52% female with an average age of 85 years....
Source: The American Journal of Hospice and Palliative Care - January 29, 2019 Category: Palliative Care Authors: Greenle MM, Hirschman KB, Coburn K, Marcantonio S, Hanlon AL, Naylor M, Mauer E, Ulrich C Tags: Am J Hosp Palliat Care Source Type: research

Patients' Perspectives on Approaches to Facilitate Completion of Advance Directives.
CONCLUSION:: Efforts to improve documentation of care planning need to address the disparate methods by which participants complete ADs. Creating options that combine the perceived benefits of a legal approach with greater health professional involvement could appeal to participants. Privacy concerns may limit web use by some patients. PMID: 30696253 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - January 29, 2019 Category: Palliative Care Authors: Rolnick JA, Shea JA, Hart JL, Halpern SD Tags: Am J Hosp Palliat Care Source Type: research

Ginseng: A Qualitative Review of Benefits for Palliative Clinicians.
Abstract Ginseng has been used for centuries to treat various diseases and has been commercially developed and cultivated in the past 300 years. Ginseng products may be fresh, dried (white), or dried and steamed (red). Extracts may be made using water or alcohol. There are over 50 different ginsenosides identified by chromatography. We did an informal systematic qualitative review that centered on fatigue, cancer, dementia, respiratory diseases, and heart failure, and we review 113 studies in 6 tables. There are multiple potential benefits to ginseng in cancer. Ginseng, in certain circumstances, has been shown to ...
Source: The American Journal of Hospice and Palliative Care - January 27, 2019 Category: Palliative Care Authors: Davis MP, Behm B Tags: Am J Hosp Palliat Care Source Type: research

Korean Physicians' Perspectives on Prognostication in Palliative Care: A Qualitative Study.
CONCLUSION:: Palliative care physicians in Korea reported similar perceptions about the role and challenges inherent in prognostication compared to clinicians in Western cultures. However, they emphasize the need to predict final days to keep families with dying patients, reflecting family-centered aspects of Asian culture. They reported frustrations with inaccurate prognostication schemas and called for the development of simpler, more accurate predictors as a focus of future research. PMID: 30686024 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - January 27, 2019 Category: Palliative Care Authors: Lee ES, Suh SY, LeBlanc TW, Himchack SH, Lee SS, Kim Y, Ahn HY Tags: Am J Hosp Palliat Care Source Type: research

ED-PALS: A Comprehensive Palliative Care Service for Oncology Patients in the Emergency Department.
CONCLUSIONS:: This tripartite model of palliative care, hospice, and ED collaboration allows earlier access to palliative care in the ED and direct admissions to the palliative care unit and comfort care rooms. The ED patients who did not need admission were also attended to in the palliative care "Hot Clinics" within a week with home hospice help. Patients who required inpatient hospice care were directly admitted there from the ED. PMID: 30674197 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - January 23, 2019 Category: Palliative Care Authors: Koh MYH, Lee JF, Montalban S, Foo CL, Hum AYM Tags: Am J Hosp Palliat Care Source Type: research

The Photographs of Meaning Program for Pediatric Palliative Caregivers: Feasibility of a Novel Meaning-Making Intervention.
CONCLUSIONS:: Findings suggest that the Photographs of Meaning Program is a practical intervention with life-enhancing potential for pediatric palliative. Future research should aim to collect additional evidence of the intervention's effectiveness. PMID: 30665322 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - January 21, 2019 Category: Palliative Care Authors: Levy K, Grant PC, Depner RM, Tenzek KE, Pailler ME, Beaupin LK, Breier JM, Byrwa DJ Tags: Am J Hosp Palliat Care Source Type: research

Inpatient Goals-of-Care Conversations Reduce Intensive Care Unit Transfers in High-Risk Patients.
Abstract Despite an aging population and an increase in the prevalence of chronic severe illness, many patients will not have end-of-life care discussions with their outpatient physicians. This very likely contributes to considerable hospital utilization toward the end of life, without any clear benefit. At our medical center, we noticed a very high rate of floor-to-intensive care unit (ICU) transfers for patients with life-limiting illness and poor prognosis. We initiated a quality assessment and improvement project aimed at increasing goals-of-care conversations for high-risk patients early in their hospital sta...
Source: The American Journal of Hospice and Palliative Care - January 17, 2019 Category: Palliative Care Authors: Deptola AZ, Riggs J Tags: Am J Hosp Palliat Care Source Type: research

Death or Damnation: Surrogacy and Religious Beliefs.
Abstract MC is a 42-year-old female who was in a motor vehicle accident and suffered multiple contusions as well as a fracture of the left femur, pelvic ramus, and left orbit. Due to contusion of the brain, MC has been comatose for over a week and is on mechanical ventilation to protect her airway. There is no written declaration of surrogacy. During the admission, surgery to repair the left femoral fracture was performed and was complicated by severe blood loss. Currently, MC's hematocrit is 24% with a hemoglobin of 7.4. The trauma team asserts that a blood transfusion would be in MC's best interests. Since MC la...
Source: The American Journal of Hospice and Palliative Care - January 16, 2019 Category: Palliative Care Authors: Baumrucker SJ, Stolick M, Hutchinson L, Eastridge A, Devereux L, Adkins RW, Carter GT Tags: Am J Hosp Palliat Care Source Type: research

Health Disparities in Hospice Utilization and Length of Stay in a Diverse Population With Lung Cancer.
CONCLUSION:: Hospice utilization and LOS were low for all groups with lung cancer in a geographically and racially diverse region of the United States. Given the rates of mortality in lung cancer, discussions about the goals and benefits of hospice care may be beneficial and should be part of an ongoing dialogue throughout the disease trajectory. PMID: 30650989 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - January 16, 2019 Category: Palliative Care Authors: Johnson LA, Blew A, Schreier AM Tags: Am J Hosp Palliat Care Source Type: research

Risk Factors for Polypharmacy in Elderly Patients With Cancer Pain.
Abstract OBJECTIVE:: Polypharmacy (PP) is a burden in elderly patients with cancer pain; however, risk factors for PP remain unclear. The purpose of this study was to investigate the risk factors for PP in this patient population. METHODS:: We retrospectively reviewed the medical charts of patients aged ≥65 years with cancer pain who were treated at Osaka University Hospital between February 2014 and June 2016 according to the World Health Organization 3-step ladder for cancer pain relief. We defined PP as ≥5 medications and conducted exploratory research to examine the association between PP and patien...
Source: The American Journal of Hospice and Palliative Care - January 10, 2019 Category: Palliative Care Authors: Morio K, Maeda I, Yokota I, Niki K, Murata T, Matsumura Y, Uejima E Tags: Am J Hosp Palliat Care Source Type: research

Continuous Inotrope Therapy in Hospice Care: A Case Series.
CONCLUSION:: Cardiac inotropes can align with both the goals of care for the patient with AHF and the philosophy of hospice care. Patients with AHF admitted to hospice care on continuous inotropes may live days to weeks, whether or not inotropes are discontinued. PMID: 30630349 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - January 10, 2019 Category: Palliative Care Authors: Patel K, D'Souza A, Groninger H Tags: Am J Hosp Palliat Care Source Type: research

Knowledge and Self-Efficacy Assessment of Residents and Fellows Following Palliative Care Unit Rotation: A Pilot Study.
CONCLUSION:: An improved PCK and PCSE were observed in physicians who rotated through an SPC unit; this resulted in an increased tangibility of local palliative care and hospice services. The questionnaire was comprehensible, relevant in terms of content, and adequate in length for a prospective multicenter survey. PMID: 30621437 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - January 8, 2019 Category: Palliative Care Authors: Burmann SN, Neukirchen M, Ostgathe C, Beckmann M, Schwartz J, Scheer K, Klco-Brosius S, Hense J, Teufel M, Tewes M Tags: Am J Hosp Palliat Care Source Type: research

Factors That Influence Attitudes Toward End-of-Life Care Among Medical Students: Nationwide Survey for Fourth-Year Korean Medical Students.
CONCLUSIONS:: Clinical experience related to EOL care seems to be the utmost priory in fostering positive attitudes and competency among medical students. PMID: 30614241 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - January 6, 2019 Category: Palliative Care Authors: Kim DY, Kim KJ, Shin SJ, Heo DS, Lee SN, Nam EM Tags: Am J Hosp Palliat Care Source Type: research

Trauma Surgeon and Palliative Care Physician Attitudes Regarding Goals-of-Care Delineation for Injured Geriatric Patients.
CONCLUSIONS:: Both groups believe themselves to conduct GoC discussions for injured seniors better than the other specialty perceived them to do so, which led to disparate views on the optimal leadership of these discussions. PMID: 30614253 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - January 6, 2019 Category: Palliative Care Authors: Cunningham HB, Scielzo SA, Nakonezny PA, Bruns BR, Brasel KJ, Inaba K, Brakenridge SC, Kerby JD, Joseph BA, Mohler MJ, Cuschieri J, Paulk ME, Ekeh AP, Madni TD, Taveras LR, Imran JB, Wolf SE, Phelan HA Tags: Am J Hosp Palliat Care Source Type: research

Androgen Mediation-and Antiandrogens Mitigation-of the Epidermal Growth Factor Receptor (EGFR) Inhibitor-Induced Rash: Results From a Pilot Randomized Trial and Small Translational Case Series.
Abstract BACKGROUND:: Although 50% to 90% of patients who receive epidermal growth factor receptor (EGFR) inhibitors develop a rash, options for rash prevention or palliation remain limited. This issue is particularly important from a palliative care standpoint because these agents are prescribed only to patients with incurable cancer. Here, we report (1) gene expression profiling of skin biopsies from patients with an EGFR inhibitor-induced rash and (2) a randomized, placebo-controlled feasibility trial with the antiandrogen, spironolactone. Both investigations were undertaken to begin to explore the hypothesis t...
Source: The American Journal of Hospice and Palliative Care - January 2, 2019 Category: Palliative Care Authors: Le-Rademacher JG, Rowland K, Atherton PJ, Dakhil C, Sun Z, Tan A, Schmidt L, Nguyen PL, Radecki Breitkopf C, Pittelkow M, Tindall D, Menon S, Jatoi A Tags: Am J Hosp Palliat Care Source Type: research

Teaching Health-Care Providers to Query Patients With Cancer About Sexual and Gender Minority (SGM) Status and Sexual Health.
This article summarizes the mandate for understanding cancer issues in SGM populations and the dearth of cancer-related data within this group. This article also describes an ongoing 3-part study intended to build a mini curriculum with the goal of helping cancer health-care providers to ask patients with cancer about SGM status and to ask all patients with cancer about sexual health issues. The results of this ongoing study could potentially improve end-of-life care for subgroups of patients. PMID: 30599758 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - January 1, 2019 Category: Palliative Care Authors: Cathcart-Rake EJ, Breitkopf CR, Kaur J, O'Connor J, Ridgeway JL, Jatoi A Tags: Am J Hosp Palliat Care Source Type: research

Managing Pain in Chronically Ill Homebound Patients Through Home-Based Primary and Palliative Care.
CONCLUSIONS:: Pharmacological and nonpharmacological treatments are widely used in the setting of HBPC to treat the pain of homebound, older adults. PMID: 30587000 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - December 26, 2018 Category: Palliative Care Authors: Major-Monfried H, DeCherrie LV, Wajnberg A, Zhang M, Kelley AS, Ornstein KA Tags: Am J Hosp Palliat Care Source Type: research

Timely Referral to Hospice Care for Oncology Patients: A Retrospective Review.
Abstract Hospice care is medical care provided to terminally ill patients with a life expectancy of 6 months or less. Hospice services include symptom control, pain management, palliative care, and other supportive services such as providing for home equipment or oxygen; however, it does not provide for life-prolonging therapies such as chemotherapy. Although oncologic benchmarks suggest patients should be enrolled in hospice 3 months prior to death, studies show that most hospice referrals are being made too late. These shorter stays in hospice result in increased cost of care especially at the end of life with m...
Source: The American Journal of Hospice and Palliative Care - December 26, 2018 Category: Palliative Care Authors: Mulville AK, Widick NN, Makani NS Tags: Am J Hosp Palliat Care Source Type: research

Providing End-of-Life Care: Increased Empathy and Self-efficacy Among Student Caregivers in Residential Homes for the Dying.
Abstract BACKGROUND:: Health-care providers report a lack of training in end-of-life care and limited opportunities exist to learn about the dying process in home settings where most prefer to die. AIM:: To evaluate the effectiveness of a Community Action, Research, and Education (CARE) program designed to promote empathy and self-efficacy communicating with and caring for terminally ill patients. METHODS:: This mixed-methods study collected pre-post data from 18 undergraduates (7 men≤ 11 women) in a 8-week immersive program where they served as primary caregivers in residential homes for the dying pr...
Source: The American Journal of Hospice and Palliative Care - December 25, 2018 Category: Palliative Care Authors: Weisse CS, Melekis K, Hutchins B Tags: Am J Hosp Palliat Care Source Type: research

Moving Toward Openness: Blackfeet Indians' Perception Changes Regarding Talking About End of Life.
In conclusion, there was a shift in the Blackfeet Indians' attitude toward end-of-life discussion from reluctance to at ease. Recommendations specific to the Blackfeet-related entities are presented. PMID: 30556405 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - December 16, 2018 Category: Palliative Care Authors: Colclough YY, Brown GM Tags: Am J Hosp Palliat Care Source Type: research

Quasi-Experimental Evaluation of LifeCourse on Utilization and Patient and Caregiver Quality of Life and Experience.
Abstract Whole-person care is a new paradigm for serious illness, but few programs have been robustly studied. We sought to test the effect of LifeCourse (LC), a person-centered program for patients living with serious illness, on health-care utilization, care experience, and quality of life, employing a quasi-experimental design with a Usual Care (UC) comparison group. The study was conducted 2012 to 2017 at an upper-Midwest not-for-profit health-care system with outcomes measured every 3 months until the end of life. Enrolled patients (N = 903) were estimated to be within 3 years of end of life and diagnosed wit...
Source: The American Journal of Hospice and Palliative Care - December 13, 2018 Category: Palliative Care Authors: Britt HR, JaKa MM, Fernstrom KM, Bingham PE, Betzner AE, Taghon JR, Shippee ND, Shippee TP, Schellinger SE, Anderson EW Tags: Am J Hosp Palliat Care Source Type: research

Radiofrequency Ablation and Radiation Therapy Improve Local Control in Spinal Metastases Compared to Radiofrequency Ablation Alone.
CONCLUSION:: This study demonstrates a benefit in local control with RFA+RT versus RFA alone. Palliation of pain was effective using both regimens. This study was limited by a nearly unequal distribution of primary tumor histologies between groups. Literature regarding combined treatment of RFA and RT for spinal metastases is scarce and prospective protocols are warranted. PMID: 30541334 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - December 13, 2018 Category: Palliative Care Authors: Prezzano KM, Prasad D, Hermann GM, Belal AN, Alberico RA Tags: Am J Hosp Palliat Care Source Type: research

Pharmacists' Perspectives on Practice, Availability, and Barriers Related to Opioids in Georgia.
Abstract OBJECTIVES:: To explore pharmacists' perspectives on practice, availability, and barriers related to opioids. METHODS:: This cross-sectional study evaluated pharmacists' perspectives on practice, availability, and barriers related to opioids. Electronic surveys were distributed to pharmacists practicing in Georgia via Survey Monkey. The χ2 or Fisher Exact test was used to test differences in practice, availability, and barriers with respect to type of pharmacy and location of pharmacy. RESULTS:: Most participating pharmacists practiced in an independent (47%) or community chain pharmacies (3...
Source: The American Journal of Hospice and Palliative Care - December 6, 2018 Category: Palliative Care Authors: Lal A, Bai J, Basri D, Yeager KA Tags: Am J Hosp Palliat Care Source Type: research

Competence and Compassion: Key Elements of Professional Care at the End of Life From Caregiver's Perspective.
The objective was to understand, elaborate on, and characterize the key elements of end-of-life care of patients from a caregiver's perspective through a qualitative phenomenological multicenter study. Participants were caregivers who had lost a family member at least 2 months but less than 2 years in the past. The techniques used were 5 discussion groups and 41 in-depth interviews, which included a total of 81 participants. To analyze the information, a protocol developed by Giorgi was followed. Two dimensions or units of meaning, with subdimensions, emerged: (1) Technical competence, with the subdimensions "Control ...
Source: The American Journal of Hospice and Palliative Care - December 5, 2018 Category: Palliative Care Authors: Ortega-Galán ÁM, Ruiz-Fernández MD, Carmona-Rega MI, Cabrera-Troya J, Ortíz-Amo R, Ibáñez-Masero O Tags: Am J Hosp Palliat Care Source Type: research

What Does Death Preparedness Mean for Family Caregivers of Persons With Dementia?
This study contributed a full definition of death preparedness in dementia. Findings aligned with/expanded upon Hebert et al Theoretical Framework of Preparedness for End-of-Life. The use of problem- and emotion-based coping strategies by caregivers with support from health-care providers to promote feelings of death preparedness (including self-efficacy and control) and minimize uncertainty was the implication of this study. Development of a holistic preparedness instrument is underway. PMID: 30518228 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - December 5, 2018 Category: Palliative Care Authors: Durepos P, Sussman T, Ploeg J, Akhtar-Danesh N, Punia H, Kaasalainen S Tags: Am J Hosp Palliat Care Source Type: research

Healthcare Providers' Attitudes, Knowledge, and Practice Behaviors for Educating Patients About Advance Directives: A National Survey.
CONCLUSION:: Various disciplines are represented in this study, which indicates that attitudes and knowledge influence AD discussions. The importance of AD discussions initiated by healthcare providers is critical to providing optimal patient-centered care. PMID: 30486655 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - November 28, 2018 Category: Palliative Care Authors: Nedjat-Haiem FR, Cadet TJ, Amatya A, Mishra SI Tags: Am J Hosp Palliat Care Source Type: research

Honoring Life After Death: Mapping the Spread of the Pause.
CONCLUSION:: The Pause should continue to be taught in clinical scenarios to foster a broader humanistic ethos in health care. PMID: 30482027 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - November 27, 2018 Category: Palliative Care Authors: Ducar DM, Cunningham T Tags: Am J Hosp Palliat Care Source Type: research

Is Annual Income a Predictor of Completion of Advance Directives (ADs) in Patients With Cancer.
CONCLUSION:: Interventions to promote completion of ADs among lower income patients with serious illnesses are needed. PMID: 30477311 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - November 26, 2018 Category: Palliative Care Authors: Saeed F, Xing G, Tancredi DJ, Epstein RM, Fiscella KA, Norton SA, Duberstein PR Tags: Am J Hosp Palliat Care Source Type: research

Preferred Place of Death for Patients With Incurable Cancer and Their Family Caregivers in Egypt.
CONCLUSIONS:: The results of the current study suggest that home is the PPoD for the vast majority of Egyptian patients with incurable cancer and their FCGs. Palliative care interventions that promote home death of patients with incurable cancer are needed in Egypt. PMID: 30477314 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - November 26, 2018 Category: Palliative Care Authors: Alsirafy SA, Hammad AM, Ibrahim NY, Farag DE, Zaki O Tags: Am J Hosp Palliat Care Source Type: research

Health Professionals Perceived Concerns and Challenges in Providing Palliative and End-of-Life Care: A Qualitative Analysis.
CONCLUSION:: Challenges exist in the delivery of quality palliative/EOL care in the hospital setting which may be addressed through educational initiatives that focus on recognition of cultural influences on care preferences, improving communication between patients/families and providers, education about the differences between palliative and EOL care, and increased competency of health providers in having EOL/goals-of-care discussions. Health professionals must recognize the benefit of collaborative palliative care in order to meet patient and family needs holistically and comprehensively. PMID: 30463415 [PubMed - a...
Source: The American Journal of Hospice and Palliative Care - November 21, 2018 Category: Palliative Care Authors: Price DM, Strodtman LK, Montagnini M, Smith HM, Ghosh B Tags: Am J Hosp Palliat Care Source Type: research

Do Health-Care Professionals Really Understand the Role of Occupational Therapy in Hospice Care?
CONCLUSION:: This study revealed that health-care professionals do believe that OTs are vital members of the hospice care team. However, many recipients of hospice care are not receiving OT. More consistent referrals to OT may better ensure that the terminally ill are able to attain end-of-life goals and live their lives to the fullest, regardless of life expectancy. PMID: 30463419 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - November 21, 2018 Category: Palliative Care Authors: Knecht-Sabres LJ, Weppner A, Powers C, Siesel B Tags: Am J Hosp Palliat Care Source Type: research