September Digest of News for Palliative Care Specialists

Every month, the PACED team prepares a digest of international materials and news about palliative care.

You can subscribe to the newsletter on our website.

Why do non-oncological palliative patients have a 1.24 times higher risk of in-hospital mortality than oncology patients?

This study is the first to compare in-hospital mortality trends between two diagnostic groups of patients with confirmed palliative care needs. The study was conducted using regularly collected data from nearly 7,000 patients over 6 years.

Multifactorial analysis showed that patients without cancer are referred to specialised (provided in-hospital) palliative care at the stage of significant deterioration in their primary condition, with lower functional status, a worse prognosis, and a higher likelihood of imminent death. Therefore, their chances of dying in the hospital increased.

This fact indicates that there is an issue with early access to specialised palliative care services in outpatient settings among non-cancer patients.

Palliative Care at Early Stages of Care for Patients with Severe Respiratory Diseases

This is an extensive and highly valuable document developed by a special committee comprising the American Thoracic Society, the American Academy of Hospice and Palliative Medicine, the Hospice and Palliative Nurses Association, and the Social Work Hospice and Palliative Care Network.

An international and interdisciplinary team, using an iterative approach, has formulated a policy for supporting patients with serious respiratory diseases and those who provide care for them.

This document primarily focuses on individuals living with severe respiratory conditions, such as chronic obstructive pulmonary disease (COPD), interstitial lung disease, and lung cancer. These patients often experience a chaotic end-of-life process and seek relief from debilitating symptoms like breathlessness. They may receive limited and burdensome care in emergency care facilities, which may not align with their values and preferences.

"Elegant Expert Care": A New Specialization in Neurology - NeuroPalliative Care

Many neurological diseases, such as dementia, Parkinson's disease, and Huntington's disease, are progressive conditions accompanied by a range of additional symptoms, from pain to depression. An increasing number of neurologists are recognizing the need for specialised palliative care for this population.

Three years ago, the International Society of NeuroPalliative Care was established with the aim of advancing this field within neurology and developing recommendations for healthcare professionals.

In this publication, members of the community explain why future neurologists will undoubtedly need a fundamental understanding of the principles of palliative care.

Are Paediatric Hospices Needed as a Form of Palliative Care for Children?

In this article, Dr. Aisha Javed provides a detailed and well-argued discussion on the necessity of providing parents of terminally ill children with the option of inpatient hospice care. Even in the United States today, there is a gap in the choices available to families for end-of-life care. Inpatient paediatric hospice programs are still not widely accessible, leaving families with the options of either home hospice care (which may not always be suitable for the family) or hospital-based care (which risks excessive medicalization of the child's final moments and can prolong suffering).

The article also delves into the challenges and limitations within the healthcare system, including a shortage of paediatric hospice facilities, workforce issues, financial sustainability, and existing hospice policies.

"Hospice Nurse Julie" - a YouTube channel that discusses death and dying

Julie is a licensed hospice nurse who has been openly and popularly discussing how we die and why it's a natural process since 2011. Her motto is "Live better, die better". On her channel, you can find numerous videos about burnout, the fear of death, the specifics of dying from various illnesses, and what constitutes a "good death." For example, in this video, Julie discusses the difference between hospice and palliative care.