here:now - Conceptual model of the impact of an experiential arts program on persons with dementia and their care partners.

Community-based arts programs for persons with dementia and their care partners hold tremendous potential for increasing cognitive, social, and creative engagement and improving quality of life for these dyads. This is a qualitative, grounded theory analysis of here:now, a joint arts engagement program for persons with dementia and their care partners that involves gallery tours and art classes. Twenty-one care partners and 13 persons with dementia completed in-depth, semi-structured telephone interviews approximately two weeks following participation in the program.

Reframing the goals of care conversation: "we're in a different place".

Purpose: Existing recommendations for communicating with patients with metastatic cancer about redefining goals of care when anticancer treatment is unlikely to provide benefit are based on limited evidence. This study was designed to elicit patient and family views on commonly used communication practices.

Study Design And Methods: Participants were 37 patients with metastatic gastrointestinal cancer and 20 bereaved family members who listened to audiorecordings of oncology fellows instructed to discuss a transition in goals of care with a standardized patient for whom evidence-based palliative chemotherapy was no longer effective.

What patients value when oncologists give news of cancer recurrence: commentary on specific moments in audio-recorded conversations.

Purpose: Recommendations for communicating bad or serious news are based on limited evidence. This study was designed to understand patient perspectives on what patients value when oncologists communicate news of cancer recurrence.

Study Design And Methods: Participants were 23 patients treated for a gastrointestinal cancer at a tertiary U.

Why don't patients enroll in hospice? Can we do anything about it?

Background: United States hospice organizations aim to provide quality, patient-centered end-of-life care to patients in the last 6 months of life, yet some of these organizations observe that some hospice-eligible patients who are referred to hospice do not initially enroll.

Primary Objective: To identify reasons that eligible patients do not enroll in hospice (phase 1).

Secondary Objective: To identify strategies used by hospice providers to address these reasons (phase 2).

Surviving surrogate decision-making: what helps and hampers the experience of making medical decisions for others.

Background: A majority of end-of-life medical decisions are made by surrogate decision-makers who have varying degrees of preparation and comfort with their role. Having a seriously ill family member is stressful for surrogates. Moreover, most clinicians have had little training in working effectively with surrogates.

Beyond substituted judgment: How surrogates navigate end-of-life decision-making.

Objectives: To characterize how surrogates plan to make medical decisions for others.

Design: Descriptive study using semistructured qualitative interviews.

Setting: Surrogates were interviewed by telephone from their homes.

How do surrogate decision makers describe hospice? Does it matter?

We interviewed 71 surrogate decision makers of older, chronically ill veterans to explore their knowledge of hospice and their role in helping loved ones access hospice services. We asked them to describe hospice and any previous hospice experiences. Of the group, 24 percent with hospice experience and 14 percent without hospice experience correctly described three key aspects of hospice: who hospice cares for, where the care is provided, and the goal of the care.