Abstract
Letters to the Editor
Study: When a hospitalized schizophrenic patient has developed cancer, psychiatric symptoms of the patient are given first priority, and the cancer stage and treatment options are given low priority. (page 5)
Brief Reports
Assessing the performance and determining acceptability of a content-validated palliative care screening tool to identify seriously ill older adults in the emergency department who may benefit from palliative care referral. (page 69)
Fast Facts and Concepts
Existential Suffering Part 1: Definition and Diagnosis #319 (page 93)
Existential Suffering Part 2: Clinical Response and Management #320 (page 95)
Personal Reflection
With no spouse listed in his medical record, it was not clear who to contact to discuss next steps. However, I learnt from an observant night shift nurse that Mr. D had a faithful companion who visited every evening. One night while staying late, I met Mr. H. He explained that he and Mr. D had been partners for more than 30 years, but because of homophobia experienced in the military, he did not want to bring attention to their relationship in the hospital. (page 97)
Case Discussions in Palliative Medicine
Several universal principles of palliative care emphasized in the care of three children with congenital disorders of glycosylation, a group of rare metabolic diseases with variable clinical phenotypes. (page 104)
Book and Media Reviews
(page 107)
Recent Literature
(page 109)
Home-Based Palliative Care and Cost Savings
Dana Lustbader and colleagues describe their home-based palliative care within an accountable care organization, which was associated with significant cost savings, fewer hospitalizations, and increased hospice us
Prolonged Survival with Hospice
This retrospective study found that hospice enrollment was associated with optimized end-of-life care and longer median survival among almost 200 patients with metastatic nonsmall cell lung cancer. (page 29)
Prognosis after ICU Discharge
In this retrospective study of more than 442,000 critical care patients at the Veterans Administration, the authors found that a multimorbidity risk index improved the accuracy of predicting short- and long-term all-cause mortality after discharge. (page 35)
Depression during Bereavement
In a longitudinal study, the authors found that bereaved caregivers in Taiwan were more likely to have severe depressive symptoms if they had a heavy caregiving load and a history of depression. The likelihood of severe depressive symptoms was buffered by feeling better prepared for the patient's death and having greater social support. (page 15)
Preparatory Grief
The authors describe their use of preparatory grief in advanced cancer instrument with advanced cancer patients to explore demographic, clinical, and psychological factors that may predict higher preparatory grief. (page 48)
Commercial Insurance and Place of Death
In this case series of more than 900 decedents, in-hospital deaths were common among commercially insured cancer patients. Patients with hematological malignancy and patients who died without receiving hospice services had a substantially higher incidence of in-hospital death. (page 42)
Palliative Care in Neurological Diseases
Hospital-based palliative care was primarily utilized to clarify goals of care for more than 200 neurological patients at an academic medical center over 4 years. The authors call for outpatient and hospital neurologists to routinely address advance directives with patients with chronic neurological disease. (page 59)
Risks for Pressure Ulcers
The authors explain how they used the Swedish Register of Palliative Care during 2014 to identify predictors of pressure ulcers at the end of life and to inform quality improvement and research. (page 53)