Abstract
Letters to the Editor
A high-quality advance care planning (ACP) system uses a coordinated approach to engage all seriously ill patients in the process of ACP, when and where they need it. To do so, ACP must expand along three axes: time, place, and people.
(page 893)
Brief Reports
Single arm prospective trial examining the feasibility of a stepped peer navigator and social work intervention developed to improve palliative care outcomes.
(page 1011)
Fast Facts and Concepts
Deprescribing Cholinesterase Inhibitors at the End of Life #354 (page 1038)
Deprescribing and Tapering Benzodiazepines #355 (page 1040)
Personal Reflection
Today I still get overwhelmed (more often than I like to admit) by the breadth of issues with which we as oncologists grapple. But that spring evening, after watching the video of David and his possibly last-ever stage appearance, I felt I was at a rare peace. (page 1043)
Case Discussions in Palliative Medicine
Case involving a neonate patient with generalized severe junctional epidermolysis bullosa, a mechanobullous skin disorder occurring in 19.57 per 1,000,000 live births.
(page 1048)
Book and Media Reviews
(page 1053)
Recent Literature
(page 1054)
Emergency Calls from Long-Term Care Facilities
This descriptive study focuses on perceptions of end-of-life emergency calls from long-term care (LTC) facilities. Prehospital providers became the mediators between LTCs and emergency departments by managing tension, conflict, and challenges in patient care between these systems and suggest the importance of collaboration in the care of sick frail residents. (page 987)
Valid and Reliable Measures of Hospice Care
The authors developed and evaluated standard survey measures of hospice care experiences for the purpose of comparing and publicly reporting hospice performance. (page 924)
Variation in Physician Orders for Life-Sustaining Treatment
The authors describe variability in adherence to required and optional physician orders for life-sustaining treatment (POLST) standards, as well as challenges in interpreting and applying existing standards. Although legal and logistical barriers may create barriers to the existence of a national POLST form, standardization remains an important goal to supporting patient-centered care. (page 978)
Interprofessional Competencies
A provincial working group in Nova Scotia adapted the Irish Palliative Care Competence Framework to develop competencies for 22 disciplines, 9 nursing specialties, and 4 physician specialties to guide interprofessional education and training. (page 947)
Pediatric Chronic Critical Illness and Caregiver Burnout
Researchers describe clinician and parent experiences of burnout in caring for children with chronic critical illness. (page 940)
Pediatric End-of-Life Care in India
This retrospective study highlights the demographics of suffering, death, and end-of-life care in children with cancer at a government tertiary cancer center in India. (page 907)
Economic Impact of Early Palliative Care in a Community Hospital
In this retrospective study of almost 450 patients, early intervention with inpatient palliative care consultation resulted in financial benefit as well as earlier referral to hospice. These results were achieved with minimal expense in a medium-sized community hospital. (page 933)
Systemic Barriers to Opioid Access
The authors evaluated the correlation between access to strong opioid analgesics and barriers to access in national legislation and regulations in 11 central and eastern European countries. (page 963)
Prognosis in Intracerebral Hemorrhage
After semistructured interviews with surrogate decision makers of patients with intracerebral hemorrhage, researchers concluded that the current practice of prognostic communication in acute critical illness has many gaps, leading to distress for surrogates and variability in critical treatment decisions. (page 956)
Race and Dementia
In their analysis of national survey data, researchers identified the relationships between race/ethnicity, dementia, and surrogate decision makers' evaluation of end-of-life care quality in older adults. (page 970)