Defining Serious Illness
Identifying Older Adults with Serious Illness: A Critical Step toward Improving the Value of Health Care
Kelly, Covinsky, Gorges, McKendrick, Bollens-Lund, Morrison and Richie, Health Serv Res. 2017 Feb; 52(1): 113–131
The authors describe a way to predict hospitalizations, Medicare spend and mortality by using progressively restrictive definitions of serious illness that examine the intersection between illness, function and utilization patterns. The central goal is to offer a way to deploy the right level of clinical services to those most likely to benefit from that service level. The most intensive home-based palliative care services can then be tightly targeted to the smaller, highest risk group.
Palliative Care Services
Craig Barstow, MD., Brian Shanan, MD and Melissa Roberts, MD discuss how to assess decision-making capacity in an article from the American Family Physician published July 1, 2018.
Home and Community-based Palliative Care: Best Practices and Resources for Providers
Prepared for the Virginia Association for Home Care and Hospice by Jennifer Inker, PHD, Virginia Commonwealth University Department of Gerontology
A concise yet comprehensive guide that includes a definition of palliative care and useful comparisons between palliative care and hospice, and palliative care and all other medical care. The document clearly summarizes the interdisciplinary team, the eight domains of care, metrics, and provides a list of organizations with home-based palliative care programs with evidence of effectiveness.
Jacob J. Strand, MD; Mihir M. Kamdar, MD; and Elise C. Carey, MD
This article discusses the changing role of modern palliative care, addresses common misconceptions, and presents an argument for early integration of palliative care in the treatment of patients dealing with serious illness.
Anthony L. Back, MD, Cynda H. Rushton, PhD, Alfred W. Kaszniak, PhD, and Joan S. Halifax, PhD
Shows how clinicians can reframe helplessness as a self-barometer indicating their level of engagement with a patient.
This paper is a reference for best practices with telemedicine guidelines. Specific steps are provided for administrative, clinical, information technology, financial, training and education, and marketing teams.
The National Comprehensive Cancer Network’s (NCCN) palliative care (PC) guidelines recommend screening all patients for PC issues at the first visit with their oncologist and at subsequent, clinically relevant times.
Identifying Patients in Need of a Palliative Care Assessment in the Hospital Setting
A Consensus Report from the Center to Advance Palliative Care
David E. Weissman, M.D. and Diane E. Meier, M.D.
Workforce shortages, late referrals, and palliative care program resource constraints present significant barriers to meeting the needs of hospitalized patients facing serious illnesses. The Center to Advance Palliative Care convened a consensus panel to select criteria by which patients at high risk for unmet palliative care needs can be identified for a palliative care screening assessment
Stratis Health led efforts to determine palliative care models that work in rural communities and to establish measures to understand how rural palliative care delivers value.
Betty R. Ferrell, PhD, RN
Support of patients and families is a complex process that is influenced by such factors as culture, family roles and relationships, and family communication.
Physicians considering deprescribing as part of comprehensive, patient-centered care should be reassured that a majority of older Americans are open to having 1 or more of their medicines deprescribed if their physician says it is possible, and more than two-thirds want to reduce the number of medicines that they are taking.
Palliative Care Network of Wisconsin Fast Facts on Deprescribing
- #321 Deprescribing
- #322 Discontinuation of Statins at the End of Life
- #369 Communication Techniques for Deprescribing Conversations
Management of Symptoms
Sonderegger Research Center at the University of Wisconsin School of Pharmacy examined a recent American Cancer Society Cancer Action Network survey that showed patients are experiencing problems accessing opioid medications prescribed by their doctors.
A study the effects of lactulose and probiotics for secondary prophylaxis of hepatic encephalopathy (HE).
Pruritus in Kidney Disease
Sara A. Combs, MD, J. Pedro Teixeira, MD, and Michael J. Germain, MD
The most recent epidemiologic data have suggested that approximately 40% of patients with end-stage renal disease experience moderate to severe pruritus associated strongly with poor quality of life, impaired sleep, depression, and increased mortality.
The Business Case for Palliative Care
On average, patients who received palliative care incurred $6,900 less in hospital costs during a given admission than a matched group of patients who received usual care.
T.J. Christian, Ph.D.
A slide presentation to MedPac on Hospice spending and utilization patterns.
Hospice and End of Life Care
A report of the Aspen Institute Health Strategy Group tasked with providing recommendations on important and complex health issues to promote improvements in policy and practice. The report includes five big ideas that will transform the way we provide end-of-life care.
Kaiser Health News article on Barbara Bush's End-of-Life Decision Stirs Debate Over 'Comfort Care.'