Quality of Life Newsletter

Q2 2024 Issue

Providing palliative care (PC) consultations with specialists stationed daily in the emergency department (ED) encourages delivery of goal-concordant care, reduces hospital length of stay, increases referrals to outpatient PC services and hospice, and enhances ED staff’s primary PC skills, according to report…

Decisional Support Often Lacking Among Older Adults With Advanced Chronic Kidney Disease
(Q2, 2023) Older patients with advanced chronic kidney disease (CKD) are often faced with the option of initiating dialysis — a potentially burdensome treatment in this population, with lower quality of life and similar survival compared with conservative management — yet at least half of these patients lack the support provided through shared decision-making (SDM) with their nephrology team…

Heart Failure Patients: Triggers for Palliative Care Referral Identified by International Experts
(Q1, 2023) A set of 25 consensus criteria for referral of patients with advanced heart failure (HF) to specialist palliative care (PC) has been defined and discussed as an important initial step in the much-needed standardization of clinical care of patients with substantial symptom burden in the “global epidemic”…

Depression Linked to Fear and Misunderstanding of Palliative Care in Cancer Patients
(Q4, 2022) Avoidance or rejection of outpatient palliative care services by cancer patients is linked to greater severity of depressive symptoms, which was found more frequently among middle-aged and younger patients than among older adult patients.

Too Few Severe Stroke Patients Receive Inpatient Palliative Care, which can Reduce Suffering
(Q3, 2022) Only 20% of patients admitted for severe stroke received a palliative care consultation (PCC), and less than half (43%) of those who died in the hospital met with a palliative care (PC) team, although PCC was associated with fewer days in the ICU, fewer hospital deaths,…

Seriously ill patients want most to be heard and to participate in care decisions, national survey finds
(Q2, 2022) Patient-physician communication and collaboration were the two most important aspects of high-quality serious illness care identified by U.S. adults. Patients want to know they are listened to and understood…

Experts point out the need for unified clinical definition of “Goals of Care,” offer two-step process
(Q1, 2022) The lack of a uniformly accepted definition of “goals of care” for patients with serious illness can lead to miscommunication. First, between clinicians and patients and among care team members; and subsequently, between referring physicians and consulting palliative care services…

‘Surprise Question’ May Help Predict Mortality, Increase Advance Care Planning in COPD Patients
(Q4, 2021) Inpatients with chronic obstructive pulmonary disease (COPD) whose clinicians asked themselves the surprise question (SQ), “Would you be surprised if this patient died in the next [time period]?  had two times greater odds of dying in the next year when a “not surprised” response was given to the one year time period…

Prediction Tool Significantly Improves Rate of Advance Care Planning Discussions
(Q3, 2021) Providing oncology clinicians with real-time mortality predictions using machine learning algorithms, electronic behavioral “nudges,” and performance feedback significantly increased rates of serious illness conversations (SICs) and advance care planning (ACP) discussions among all cancer patients, not only those identified as being at high risk…

Clinicians Urged to Address Underuse of Hospice for Patients with Heart Failure
(Q2, 2021) Despite the well-established benefits of hospice care for patients with heart failure (HF), its services are underused among a population noted for having a high symptom burden. Compared with those with other chronic illnesses, patients with HF have significantly more impairment in quality of life…

Racial Disparities Persist in End-Of-Life Care Treatment Intensity
(Q1, 2021) Older adults with advanced illness who are Black are more likely than White patients to experience aggressive treatment, hospitalizations, and emergency department (ED) visits in the last six months of life, and less likely to enroll in hospice or to spend three or more days in hospice care, according to a report published in JAMA Network Open.

Palliative Care for Heart Failure Patients Linked to Lower Risk for Re-hospitalization, Invasive Procedures
(Q4, 2020) Patients receiving palliative care while hospitalized with heart failure within the VA healthcare system — where palliative care is offered concurrently with curative care — were less likely than those with no palliative care to be re-hospitalized or to undergo mechanical ventilation or defibrillator implantation in the following six months, according to a report published in the Journal of the American Heart Association.

Outpatient Palliative Care Improves Outcomes For Parkinson’s Disease Patients, Caregivers
(Q3, 2020) Patients with Parkinson’s disease and related disorders (PDRD) randomized to receive outpatient, integrated palliative care (PC) reported better quality of life (QoL) after six months, lower symptom burden, and higher rates of advance directive (AD) completion compared with controls.

New Trend: More Americans Now Dying at Home Than in the Hospital
(Feb/Mar/Apr, 2020) A greater proportion of natural deaths now occur at home rather than in acute care facilities, reversing a decades-long national trend, and necessitating an increased focus on access to quality home care and caregiver support.

Skilled Communication with Seriously Ill Patients Is Both Critical and Learnable, Experts Say
(Nov/Dec/Jan, 2019 – 2020) Serious illness conversations can often be sub-optimal, according to a special article published in the Journal of the American Geriatrics Society.

Minimal Knowledge of Palliative Care Among U.S. Adults Highlights Need to Raise Public Awareness
(Aug/Sep/Oct, 2019) Patients and the general public need to know that palliative care has been shown to help improve quality of life, relieve symptom burden and reduce pschosocial distress.

Patients Less Likely to Receive Palliative Care at Minority-Serving Hospitals, Regardless of Race/Ethnicity
(May/Jun/Jul, 2019) Advanced cancer patients treated at hospitals that primarily serve minorities were 33% less likely than those at other facilities to be provided any palliative care, regardless of their race, ethnicity or insurance carrier.

Palliative Care Linked to Significant Reduction in Suicide Risk Among Veterans with Advanced Lung Cancer
(Feb/Mar/Apr, 2019) Amid growing concern about the high rate of suicide among the nation’s veterans, researchers have found that Veterans Affairs health system patients with advanced lung cancer who had at least one palliative care visit were 81% less likely to die by suicide. 

Nearly 60% of Older Adults with Probable Dementia Are Unaware of Their Condition
(Nov/Dec/Jan, 2018 – 2019) A majority of U.S. adults aged 65 years and older who have probable dementia are either undiagnosed or unaware of their diagnosis, Johns Hopkins researchers have found.