Advance care planning helps families making difficult decisions | Comfort-first palliative model improves outcomes in dementia care | Frailty increases risk of post-surgical complications
October 20, 2017
Hospice and Palliative Medicine SmartBrief
News for physicians caring for the seriously ill
Top Story
Advance care planning helps families making difficult decisions
Many families have to make difficult medical decisions for a loved one on life support, and the best way to make the situation easier is to have conversations about end-of-life care in advance, said AAHPM Chief Medical Officer Dr. Joseph Rotella. Care planning is a topic to revisit throughout life, said Penn State Hershey professor Benjamin Levi.
ConsumerAffairs (10/18) 
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Palliative & Hospice Care Update
Comfort-first palliative model improves outcomes in dementia care
A comfort-first palliative approach to dementia patient care in nursing homes was linked with reduced use of antipsychotic medications, decreased hospital stays and increased satisfaction among residents, families and staff, Ann Wyatt, manager of palliative and residential care for CaringKind, told the American Health Care Association's annual meeting. In this model, comfort is an objective at all times, not just at the end of life, and for dementia patients that includes freedom from pain, the ability to eat and sleep as they wish, and engaging in appropriate events and hobbies.
Skilled Nursing News (10/19) 
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Frailty increases risk of post-surgical complications
Older patients with two or three traits of frailty had twice the risk of serious post-surgical complications as those who were less frail, a study in JAMA Surgery found. Researchers said practitioners should consider frailty part of preoperative planning and decision-making.
Medscape (free registration) (10/16) 
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Study assesses potentially preventable Medicare spending
Researchers said 4.8% of Medicare spending in 2012 was potentially preventable, and 73.8% of that amount was incurred by high-cost patients in the top 10% of total individual spending. The report in the Annals of Internal Medicine showed 4% of Medicare beneficiaries were high-cost frail elderly patients, who accounted for 43.9% of total potentially preventable spending.
Physician's Briefing/HealthDay News (10/17) 
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Patient & Family Perspective
Huntington's disease creates palliative care challenges
Huntington's disease presents challenges in palliative care due to the nature and progression of the disease and the needs of patients and family caregivers. Dr. Benzi Kluger, chief of neurology supportive and palliative care at the University of Colorado School, said Huntington's disease creates palliative care needs even before diagnosis.
Neurology Advisor (10/19) 
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Medical Research
Outlook improves for patients with melanoma brain metastases
Advances in BRAF and immune checkpoint therapies significantly improved overall survival between 2000 and 2012 for patients with melanoma brain metastases who received first-line systemic therapy at Moffitt Cancer Center, according to a study published in Cancer.
Physician's Briefing/HealthDay News (10/18) 
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Frozen gloves, socks may reduce peripheral neuropathy in chemo
A study in the Journal of the National Cancer Institute found patients taking the breast cancer drug paclitaxel were less likely to develop peripheral neuropathy if they wore frozen gloves and socks while receiving the chemotherapy. Researchers found significantly fewer patients developed numbness in the hand and foot covered by the frozen glove or sock, while the majority experienced the effect in the hand and foot that was not covered by the glove or sock.
HealthDay News (10/18) 
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Flu vaccine during treatment may not benefit youths with leukemia
A study in the Journal of Pediatrics found that youths with acute leukemia who received flu vaccinations and booster shots during cancer treatment had similar risk and onset of developing flu or flu-like illnesses, compared with those who were unvaccinated. Researcher Elisabeth Adderson said that annual flu shots are still recommended for pediatric acute leukemia patients undergoing treatment, but additional preventive measures such as avoiding crowds during flu season and proper hand hygiene are needed to curb flu risk among such patients.
Becker's Hospital Review (10/16) 
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Health Policy & Practice
EHR use could help reduce medical testing, study finds
Health care practitioners may use EHRs to reduce unnecessary medical testing, which could affect patient safety and satisfaction, researchers reported in JAMA Internal Medicine. Cedars-Sinai Medical Center in Los Angeles, a participant in the Choosing Wisely campaign, integrated an alert system into its physician EHR workflow that resulted in test ordering reduction.
EHR Intelligence (10/18) 
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Trends & Technology
Nursing students learn with high-tech mannequin
The University of Houston College of Nursing is teaching students about palliative and end-of-life care using a high-fidelity mannequin to facilitate patient discussions. With help from a faculty member playing the part of the patient, the mannequin can take students through scenarios such as coming to terms with a diagnosis, advance care planning and deteriorating health.
Daily Nurse (10/19) 
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October HPMQ Video -- Ethics in Pediatric Patients
AAHPM's video series called HPMQ, Hospice and Palliative Medicine Question, has released its newest video help address difficult topics that you may face in your organization. This month's video asks "What do palliative care teams need to know about advance care planning billing codes?" presented by Phil Rodgers, MD FAAHPM. Watch the video now.
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Mentoring now available through AAHPM Connect
AAHPM is happy to announce their new mentoring program called Mentor Match. Available to only AAHPM members, this program allows participants to either be a mentor or mentee. Join AAHPM today to receive access to Mentor Match and their online private discussion forum, AAHPM Connect.
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We live in deeds, not years; in thoughts, not breaths; in feelings, not in figures on a dial.
Philip James Bailey,
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