Nancy Dudley, an associate professor at the Valley Foundation School of Nursing, found that understanding her mother's wishes for end-of-life care was a gift, and she writes that everyone should have an honest discussion with family members about end-of-life issues. Most US adults do not have advance directives, but everyone should consider one during the coronavirus pandemic, even the young and healthy, Dudley writes.
"It's a war zone," said one physician at a Los Angeles County public hospital. "The way most people leave is by dying." Tom Wagner, an executive with the ambulance service American Medical Response, says that "while we're trained to deal with crises, something like this has never been seen in anybody's lifetime that's in healthcare right now."
Integrated palliative and oncology care were associated improved quality of life for patients with acute myeloid leukemia, according to a study in JAMA Oncology. "As these patients spend the majority of their time in the hospital and clinical settings, there are numerous opportunities to engage palliative care clinicians early and longitudinally in their care," the researchers wrote.
Palliative medicine physician Drew Rosielle writes that olanzapine, included in multiple guidelines for treating chemotherapy-induced nausea and vomiting, dramatically reduced chronic nausea for cancer patients not receiving chemotherapy in a randomized controlled trial. Additional research could lead to olanzapine becoming "our first-line dopamine antagonist antiemetic in palliative care," Rosielle writes.
A survey in the PLOS ONE journal by palliative care specialists across Australia looked at teaching more positive ways to discuss death and dying. Survey participants enrolled in Dying2Learn, a six-week online course encouraging open conversations, and by the end of the course, study participants used "more pleasant, calmer and dominating (in-control) words to express their feelings about death," researchers said.
Advances in predictive analytics and interoperable electronic medical records will help hospices and post-acute care providers transition to value-based payment models as more patients choose in-home health care, says WellSky CEO Bill Miller. Interoperable EMR systems will reduce risks inherent in patient transfers as information flows from one health care provider to the next, and analytics will help ensure patients' social determinants of health are addressed, Miller says.
The volume of oxygen needed during the pandemic has stressed the infrastructure for delivering oxygen, and cylinders, oxygen concentrators and nasal cannulas are in short supply. Officials in Los Angeles are warning paramedics to conserve oxygen, and some hospitals are canceling hospital discharges if oxygen equipment is not available.
Paramedics and first responders in Los Angeles County were instructed by state officials to conserve oxygen and stop bringing patients who have little odds of survival to hospitals as the latest COVID-19 surge threatens to overwhelm the county's health care system. The Los Angeles County Emergency Medical Services Agency released a directive Monday asking ambulance workers to only give supplemental oxygen to patients whose oxygen saturation levels fall below 90%, while a separate memo tells paramedics not to transfer cardiac arrest patients unless spontaneous circulation can be restored on the scene.
Join HPNA and AAHPM for the virtual 2021 Annual Assembly of Hospice & Palliative Care, Feb. 17-19. HPNA members can register now for just $469! Registrants will have access to sessions for 90 days post-conference with the ability to earn up to 50 NCPD credits. Experience the premier educational event in hospice and palliative care from the comfort of your home or office. Secure your spot now.
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