The biggest difference between hospice and palliative care is where the patient is in their illness related to prognosis and their goals/wishes regarding curative treatment. Palliative care also takes an interdisciplinary approach using highly trained professionals including physicians, nurse practitioners, nurses, social workers, chaplains, other disciplines, and may be offered where and when the patient first sought treatment for a condition. While palliative care is appropriate earlier in the disease, consultation is often not sought until late in the disease process.

Hospice care is reserved for people at the end of life who meet eligibility requirements and elect a comfort approach to care. Hospice covers all services and care related to the terminal illness and related conditions. Two physicians certify that a patient has less than six months to live if the disease follows its usual course. However, this does not mean that if a patient is still living after six months he or she will be discharged from hospice.

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In 2016, researchers from New York University blindfolded a handful of terminally ill cancer patients and gave them a potent dose of psilocybin—the psychoactive ingredient in magic mushrooms.

Subjects showed a significant and enduring reduction in anxiety, depression, and existential distress. In a follow-up assessment some six months after the treatment, 70 percent of the patients from the NYU trial later reflected on the psilocybin experience as one of the top five most spiritually significant experiences of their entire lives, while 87 percent reported increased life satisfaction overall. More…

With the entire medical industry’s focus being on  disease and  treatment, not much attention is paid to the growing need for palliative care in India says Dr. M.R.  Rajagopal, chairman, Pallium India, who is also  director of the Trivandrum Institute of Palliative Society is on a mission to spread awareness about this neglected aspect of medical care.

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The HIV epidemic played a driving role in developing palliative care services and resources in many countries in Africa, with initial funding in HIV helping to boost hospices and palliative care services on the continent. However, a decrease in funding as well as a move away from vertical, disease-specific funding to horizontal, health systems funding is negatively affecting palliative care service delivery and development in many countries across the continent. Read more…

And a book about this topic

It is estimated that 19 to 83% of people with dementia suffer from pain that is inadequately treated in the last months of life. A large number of healthcare workers who care for these people in nursing homes lack appropriate expertise and may therefore not always recognise, assess and treat pain in those with dementia who have complex problems on time, properly and efficiently. The aim of this intervention trial is to identify care needs of people with dementia suffering from pain living in a nursing home.

More here:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5399861/

The latest death trend is a cross between hygge and Marie Kondo: a sign that dying well has become a defining obsession of our time. By Marisa Meltzer

More in The Guardian:

https://www.theguardian.com/news/2018/jan/12/how-death-got-cool-swedish-death-cleaning

There is a first national survey of palliative medicine physicians in the UK on the assessment and management of anxiety. Findings demonstrate the infrequent use of screening tools, variation in prescribing practice, potentially inappropriate use of benzodiazepines for patients with a prognosis of months, training gaps and poor access to psychological and psychiatric services. This highlights the need for formal training, further research into the pharmacological management of anxiety in this population and evidence-based national guidance to support clinical decision-making and service development. More

The Department of Palliative Medicine, University Hospital Bonn, Germany, invited medical and literature students to collaborate in an innovative storytelling project with patients. Michaela Hesse MSc explains.

Literature can have an impact on a single reader but equally on the thinking of a whole generation – for example, Dostoevsky’s The Brothers Karamazov or Hesse´s Steppenwolf. Books often invite us on a journey to unknown realms. In the project at our palliative care unit, we put it the other way around. We wanted to open a new world by inviting students of comparative literature and linguistics and medical students to collaborate with each other and to interview a patient receiving palliative care. They were asked to write a story based on what the patient told them. More…

Some insights of the students:

• “Most impressive to me was how open and honest patients were reflecting on their lives.”

• “I’ve gained the insight that every life in itself is important (also my own) and that behind every patient’s story is a unique, truly-lived life.”

• “I’ve learned that many things get a new significance with a life-limiting disease. I want to take this into my own life and start to appreciate the small things.”

A study aimed to explore whether, and how, access to specialist palliative care services affected patients’ and carers’ coping with Parkinson’s disease.