November News Digest for Palliative Care Specialists

Every month, the PACED team prepares a digest of international articles and news about palliative care.
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Misconceptions about palliative care hinder patients and their relatives

According to observations by specialists in Malaysia, despite the growing recognition of palliative care, only 14% of patients in need actually receive it. One reason for this is a set of misconceptions, such as the belief that palliative care is only for the terminally ill, that treatment ends when palliative care begins, or that discussing palliative care robs patients of hope. Meanwhile, collaboration between palliative care and oncology is crucial because over a third of terminally ill patients suffer from various forms of cancer. The article outlines key points of intersection between palliative care and oncology, the joint work of which will ensure the best care for oncology patients.


Family members of oncology patients undergoing treatment and of hospice patients: what are the differences in their perception of hospice care?

We know that an oncology diagnosis changes not only the life of the patient but also that of their closest circle. People in immediate proximity to the patient experience strong emotions, concerns, and fears. The authors of an interesting study conducted in Poland decided to explore the peculiarities of how family members perceive hospice care for two categories of patients: those undergoing treatment in the oncological surgery department and those receiving palliative care in hospices. Respondents’ opinions were assessed based on a 14 points scale, including issues related to end-of-life care, public attention to palliative care, desired religious practices in hospices, and the extent of family involvement in caring for the patient.


Deprescribing and Palliative Care

In recent years, the term “deprescribing”, as a method of rationalising treatment, has gained prominence and is increasingly discussed in the context of palliative care. The article compellingly demonstrates how — as a patient approaches the end of life — it is necessary to regularly assess medication prescriptions to provide adequate support and make adjustments to medication therapy as needed.

Polypharmacy and the prescription of long lists of medications, unfortunately, are common among terminally ill patients, and often, as health conditions worsen, the list of medications significantly increases. Therefore, deprescribing is not a one-time event but rather a continuous process that requires ongoing assessment and monitoring. Regular medication reviews, as well as reassessment of the patient’s goals and preferences, can ensure that decisions to discontinue prescriptions are appropriate and align with the patient’s wishes.


Modern technologies aid in predicting the lifespan of hospice patients

According to surveys, only 22% of Americans have documented their preferences regarding the extent of medical interventions at the end of life. Unfortunately, patients who do not have officially confirmed preferences for end-of-life care often do not achieve what can be considered a “good death”. How can artificial intelligence help address this issue?

A research group from the healthcare system in the state of Illinois (USA) tested an artificial intelligence model that predicts the likelihood of a patient’s death within 5-90 days after hospitalisation. The technology for predicting in-hospital mortality can help prioritise and initiate timely discussions between the hospice team and the patient about plans for extended medical care in the final stages of illness.


Patient story: a good death in hospice after terrible brain cancer

A touching story about the decision of an incurably ill woman to cease attempts at treatment and spend her final days under the care of palliative care specialists, as told by her son. The hospice experience markedly differs from that of an active treatment facility. It brings solace, provides time to be together, talk, and finish unfinished business in the quiet company of loved ones.