Journals American Journal of Hospice & ...

American Journal of Hospice & Palliative Care
Miguel Antonio Sánchez-Cárdenas, Lina María Vargas-Escobar, Juan Esteban Correa-Morales, Mariana Michelsen-Andrade, Laura González-Salazar, Carolina Muñoz-Olivar, Julian Alberto López Alba, Marta Ximena León-Delgado
Background : Infections are common in patients with advanced illnesses for whom the intravenous or oral route is not possible. The subcutaneous administration of antibiotics is a promising alternative, but there is not enough theoretical support for its use. This study aims to explore the effectiveness and safety of subcutaneous antibiotic therapy in the context of palliative care in elderly patients. Methods : A systematic review was conducted using PubMed and Embase, without time or language limits. Seven articles were selected on the effectiveness of subcutaneous antibiotic therapy in adult patients with chronic progressive diseases...
March 25, 2023: American Journal of Hospice & Palliative Care
Kerri A Qualls, Radion Svynarenko, Melanie J Cozad, Jessica Keim-Malpass, Guoping Huang, Lisa C Lindley
Currently, little is known about how geographic information systems (GIS) has been utilized to study end-of-life care in pediatric populations. The purpose of this review was to collect and examine the existing evidence on how GIS methods have been used in pediatric end-of-life research over the last 20 years. Scoping review method was used to summarize existing evidence and inform research methods and clinical practice was used. The Preferred Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA) was utilized...
March 24, 2023: American Journal of Hospice & Palliative Care
Elisa Rabitti, Silvio Cavuto, Matías Eduardo Díaz Crescitelli, Maria Chiara Bassi, Luca Ghirotto
When conscious, about 50% to 60% of hospice patients report a "visitation" by someone who is not there while they dream or are awake: a phenomenon known as End-of-Life Dreams and Visions (ELDVs). Since the dying process is frequently complicated by delirium, ELDVs risk being misidentified as such by professionals and caregivers. To observe these phenomena from patients' perspectives, we conducted a systematic review to aggregate and synthesize the findings from the qualitative studies about ELDVs of patients assisted in hospices to indicate future directions for research and care...
March 22, 2023: American Journal of Hospice & Palliative Care
Alana Sagin, Dorene Balmer, Suzanne Rose, Rosie Musheno, Jennifer M Olenik, Laura Dingfield, C Jessica Dine, Nadia L Bennett
Palliative care (PC) longitudinal curricula are increasingly being recognized as important in Undergraduate Medical Education (UME). They are however, not yet commonplace, and where they do exist may be implemented without a systematic, prospective approach to curriculum evaluation. This paper describes an implementation of a new longitudinal curriculum at the Perelman School of Medicine (PSOM) at the University of Pennsylvania. We used the Context Input Process Product (CIPP) model, a holistic evaluation model, to assess the local environment, design the curriculum, guide the improvement process, and evaluate outcomes...
March 21, 2023: American Journal of Hospice & Palliative Care
Antonio Ramos Sánchez, María Jesús Martínez Beltrán, Juan Manuel Arribas Marín, Julio C de la Torre-Montero, Beatriz Blanco Gil, María Del Carmen Massé García, Ana Sofia Fernandes Ribeiro
BACKGROUND: Communication is one of the central axes around which end-of-life care revolves in the context of palliative care. Communication of bad news is reported as one of the most difficult and stressful tasks by palliative care professionals. Therefore, the aim of this study is to identify aspects related to the communication of bad news in palliative care in Spain. METHODS: Descriptive cross-sectional study. An ad hoc questionnaire was designed and sent by e-mail to all palliative care teams in Spain...
March 21, 2023: American Journal of Hospice & Palliative Care
Amy O'Regan, Laura J Fish, Christina Makarushka, Tamara Somers, Katie Fitzgerald Jones, Jessica S Merlin, Michaela Dinan, Kevin Oeffinger, Devon Check
OBJECTIVES: Many cancer survivors experience chronic pain after completing curative-intent treatment. Based on available data, chronic pain may be undertreated in this context; however, little is known about cancer survivors' experiences with clinical management of chronic pain. The purpose of this study was to better understand cancer survivors' pain management experiences after curative-intent treatment. METHODS: We conducted 13 semi-structured interviews with a convenience sample of cancer survivors who had completed treatment for stage I-III breast, head/neck, lung or colorectal cancer...
March 17, 2023: American Journal of Hospice & Palliative Care
Dympna Waldron, Christine Eileen Mc Carthy, David Murphy, Janusz Krawczyk, Lisa Kelly, Fiona Walsh, Eileen Mannion
BACKGROUND: We describe two complex cases in the setting of COVID-19 at the End of Life, to enhance learning for all patients. CASE PRESENTATION: Maintenance of sustained comfort in two cases required multiple drugs, specifically selected for symptoms that necessitated three separate pumps delivering continuous 24-hour subcutaneous infusion. CASE MANAGEMENT: Management of sustained comfort included opioid, midazolam, anti-secretory, diclofenac for intractable temperature, phenobarbital for extreme agitation, in one, where seizure activity was present, while insomnia, was a prominent feature of another...
March 13, 2023: American Journal of Hospice & Palliative Care
Caroline K Tietbohl, Ashley Dafoe, Sarah R Jordan, Amy G Huebschmann, Hillary D Lum, Kathryn H Bowles, Christine D Jones
BACKGROUND: Early introduction of palliative care can improve patient-centered outcomes for older adults with complex medical conditions. However, identifying the need for and introducing palliative care with patients and caregivers is often difficult. We aim to identify how and why a multi-setting approach to palliative care discussions may improve the identification of palliative care needs and how to facilitate these conversations. METHODS: Descriptive qualitative study to inform the development and future pilot testing of a model to improve recognition of, and support for, unmet palliative care needs in home health care (HHC)...
March 12, 2023: American Journal of Hospice & Palliative Care
Jessica P Lendon, Christine Caffrey, Denys T Lau
Introduction: This study describes the end-of-life (EOL) care planning and bereavement practices among adult day services centers (ADSC) when an ADSC participant is dying or has died. Methods: Data are from the 2018 National Study of Long-term Care Providers' biennial survey of ADSCs. Respondents were asked about the following 4 practices: 1) honoring the deceased in some public way in this center; 2) offering bereavement services to staff and participants; 3) documenting in the care plan what is important to the individual at the end of life (EOL), such as the presence of family or religious or cultural practices; and 4) discussing spiritual needs at care planning conferences...
March 10, 2023: American Journal of Hospice & Palliative Care
Gregory J Cichon, Lucas J Betts, Kathleen M McKillip, Peter T Silberstein
Background: The 5 year survival rate of esophageal cancer is under 20%. Studies have shown that early palliative treatments can improve patient quality of life and lower depressed mood without expediting mortality. Despite these benefits, few studies have analyzed factors associated with the national variation among patients who received palliative treatment for esophageal cancer. Methods: This is a retrospective study of adults diagnosed with stage IV esophageal cancer between 2004 and 2018 in the National Cancer Database (NCDB) who received palliative treatment or not (n = 43,599)...
March 6, 2023: American Journal of Hospice & Palliative Care
Jason Z Niehaus, James E Slaven, Lyle Fettig
OBJECTIVE: Evaluate feasibility and effectiveness of virtual adaptation of in-person simulation-based empathetic communication training. METHODS: Pediatric interns participated in virtual training session then completed post-session and 3 months follow up surveys. RESULTS: Self-reported preparedness on the skills all improved significantly. The interns report the educational value as extremely high both immediately after and 3 months after training...
March 2, 2023: American Journal of Hospice & Palliative Care
Rahim Hirani, Hassan Khuram, Aria Elahi, Parker Alan Maddox, Maya Pandit, Ali Issani, Mill Etienne
End-of-life (EOL) care is a unique area of medicine that emphasizes holistic patient-centered care. It requires clinicians to consider a patients' mental, emotional, spiritual, social and physical comforts and engage patients and their families in complex discussions and decisions. It is an area of medicine that requires sensitivity in communication in order to respond to a wide range of emotions from patients and their families. Given these intricacies, it is essential that healthcare professional trainees are exposed early in their careers so they can be better equipped to address EOL situations effectively...
February 28, 2023: American Journal of Hospice & Palliative Care
Kristin G Cloyes, Miranda Reynaga, Marilisa Vega, Megan C Thomas Hebdon, Casidee Thompson, Susan J Rosenkranz, Djin Tay, Maija Reblin, Lee Ellington
BACKGROUND AND OBJECTIVES: LGBTQ+ people are more likely to be caregivers for family and friends with life-limiting illnesses than non-LGBTQ+ people. LGBTQ+ caregivers may also experience stigma, bias, and discrimination, in addition to caregiving stress. Yet few studies have elicited LGBTQ+ family caregivers' perspectives on their end-of-life (EOL) experiences of home hospice. RESEARCH DESIGN AND METHODS: We conducted semi-structured interviews with LGBTQ+ family caregivers of home hospice patients (N = 20)...
February 23, 2023: American Journal of Hospice & Palliative Care
Anirudh Rao, Mansi Maini, Kelley M Anderson, Nancy A Crowell, Sherry S Gholami, Carroll Foley Lgsw, Diana Violanti, Manavotam Singh, Farooq H Sheikh, Samer S Najjar, Hunter Groninger
Use of continuous intravenous inotropic support (CIIS) strictly as palliative therapy for patients with ACC/AHA Stage D (end-stage) Heart Failure (HF) has increased significantly. The harms of CIIS therapy may detract from its benefits. To describe benefits (improvement in NYHA functional class) and harms (infection, hospitalization, days-spent-in-hospital) of CIIS as palliative therapy. Methods: Retrospective analysis of patients with end-stage HF initiated on CIIS as palliative therapy at an urban, academic center in the United States between 2014-2016...
February 22, 2023: American Journal of Hospice & Palliative Care
Shila Pandey, Renee Wisniewski, Sejal Morjaria, Anabella Lucca Bianchi, Tiffanny Newman, Carrie Tan, William E Rosa, Catherine S Finlayson
Background: Antimicrobials are frequently administered at end-of-life (EOL) and their non-beneficial use may subject patients to unnecessary harms. Studies analyzing factors for antimicrobial prescribing in solid tumor cancer patients at the EOL are lacking. Thus, we aimed to identify factors and patterns associated with antimicrobial use in hospitalized adults with cancer at EOL. Methods: We used a retrospective cohort design to review electronic medical records of terminal hospitalized patients ≥18 years with solid tumors admitted to non-intensive care units in a metropolitan comprehensive cancer center during 2019 and assessed antimicrobial use in the last 7 days of life...
February 22, 2023: American Journal of Hospice & Palliative Care
Ganisher Davlyatov, Mengying He, Gregory Orewa, Haiyan Qu, Robert Weech-Maldonado
Background : Choosing hospice care for your loved ones is often challenging. Online ratings such as Google rating has become a go-to source for most consumers. The Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey for Hospice also provides quality information about hospice care to help patients and their families make decisions. Aim: To evaluate the perceived usefulness of publicly reported hospice quality indicators and compare hospice Google ratings with hospice CAHPS scores. Methods : A cross-sectional observational study was performed to test the relationship between Google ratings and CAHPS measures in 2020...
February 22, 2023: American Journal of Hospice & Palliative Care
Michelle Knox, Adrian Wagg
INTRODUCTION: Following the historic Canadian legislation on medical assistance in dying (MAiD) in 2016, many implementation challenges and ethical quandaries have formed the focus of further scholarly investigation and policy revisions. Of these, conscientious objections held by some healthcare institutions have involved relatively less scrutiny, despite indicating possible hurdles to the universal availability of MAiD services in Canada. METHODS: In this paper, we contemplate potential accessibility concerns that pertain specifically to service access, with the hope to trigger further systematic research and policy analysis on this frequently overlooked aspect of MAiD implementation...
February 20, 2023: American Journal of Hospice & Palliative Care
Ayumi Kihara, Takatoyo Kambayashi, Yasuo Shimonouchi, Makiko Mabuchi, Ayumi Nagai, Iku Kanzaki, Miyuki Fukagawa
COVID-19 pandemic has impacted the families of patients in Palliative Care Units because of the visitor restrictions which were introduced to reduce the risk of infection. This study investigates how the bereaved families of the patients who died in end-of-life care during the pandemic evaluate the visitor restrictions and how the lack of direct communication with the patient affected them. We conducted a quantitative survey using an anonymous self-administered questionnaire. Participants were the bereaved families of patients who died in a Palliative Care Unit from April 2020 to March 2021...
February 19, 2023: American Journal of Hospice & Palliative Care
Michael Pottash, Arvind Suguness, Lily Joseph, Brian Cuneo, Christian Woods
BACKGROUND: Physician trainees in pulmonary medicine are not provided with supervised practice opportunities to gain confidence and skill in having serious illness conversations in the ambulatory setting. OBJECTIVE: We incorporated a palliative medicine attending into an ambulatory pulmonology teaching clinic to provide supervised opportunities for serious illness conversations. METHODS: Trainees in a pulmonary medicine teaching clinic requested supervision from a palliative medicine attending based on a set of evidence-based pulmonary-specific triggers that indicate advanced disease...
February 17, 2023: American Journal of Hospice & Palliative Care
Brystana G Kaufman, Diane E Holland, Catherine E Vanderboom, Cory Ingram, Ellen M Wild, Ann Marie Dose, Carole Stiles, Allison M Gustavson, Alice Chun, Erica M Langan, Henry A Baer-Benson, Jay Mandrekar, Joan M Griffin
OBJECTIVES: Compared to urban family caregivers (FCG), rural FCG experience greater burdens accessing coordinated care for their loved ones during and after hospitalization. The impact of technology-enhanced transitional palliative care (TPC) on caregiver outcomes is currently being evaluated in a randomized control trial. This study evaluates resource use and health system costs of this FCG-focused TPC intervention and potential Medicare reimbursement mechanisms. METHODS: Rural caregivers of hospitalized patients were randomized into an 8-week intervention consisting of video visits conducted by a registered nurse certified in palliative care, supplemented with phone calls and texts (n = 215), or attentional control...
February 16, 2023: American Journal of Hospice & Palliative Care
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