A Tale of 2 Experiences: Navigating End-of-Life Care With a History of Incarceration.

Background: The adverse health effects of incarceration are well-documented, affecting individuals throughout their life course. However, the influence of a history of incarceration on end-of-life (EOL) experiences remains unexplored. This study aims to examine how prior incarceration affects individuals' experiences and care needs as they approach the EOL.

Addressing the Unmet Needs of Patients With Rapidly Progressive Neurological Disease: A Case Report of Palliative Care in Creutzfeldt-Jakob Disease (CJD).

Creutzfeldt-Jacob disease (CJD) is a rare neurodegenerative disorder that typically progresses rapidly and unrelentingly. Providing comfort and support for patients with CJD presents significant challenges for clinicians and caregivers. In comparison to the more typical disease progression experienced in dementias, the trajectory of CJD differs significantly.

The Hidden Toll of Incarceration: Exploring the Link Between Incarceration Histories and Pain Among Older Adults in the United States.

Background And Objectives: Incarceration is linked to poor health outcomes across the life course. However, little is known whether and to what extent incarceration histories shape pain in later life. This study examines the relationships between incarceration histories and pain outcomes among middle-aged and older adults in the United States.

Early Guided Palliative Care Communication for Patients With COVID-19 Receiving ECMO.

Background: Extracorporeal membrane oxygenation (ECMO) combined with COVID-19 presents challenges (eg, isolation, anticipatory grief) for patients and families.

Objective: To (1) describe characteristics and outcomes of patients with COVID-19 receiving ECMO, (2) develop a practice improvement strategy to implement early, semistructured palliative care communication in ECMO acknowledgment meetings with patients' families, and (3) examine family members' experiences as recorded in clinicians' notes during these meetings.

Methods: Descriptive observation of guided, in-depth meetings with families of patients with COVID-19 receiving ECMO, as gathered from the electronic medical record of a large urban academic medical center.

The Corpse: Time for Another Look .

Embalming of the dead is more common in the United States than anywhere else in the world. Battles far from home during the Civil War with concern for contagion from dead bodies being shipped home compelled President Lincoln to direct the troops to use embalming to allow the return of the Union dead to their homes. Viewings were common with war heroes and culminated with the viewing of Lincoln himself.

Moral distress in nurses caring for patients with Covid-19.

Background: Moral distress occurs when constraints prevent healthcare providers from acting in accordance with their core moral values to provide good patient care. The experience of moral distress in nurses might be magnified during the current Covid-19 pandemic.

Objective: To explore causes of moral distress in nurses caring for Covid-19 patients and identify strategies to enhance their moral resiliency.

Impact of Hospice and Palliative Care Service Utilization on All-Cause 30-Day Readmission Rate for Older Adults Hospitalized with Heart Failure.

Background: Acute decompensated heart failure (HF) is the leading cause for hospital readmission. Large-scale sustainable interventions to reduce readmission rate have not been fully explored or proven effective.

Objective: We studied the impact of hospice and palliative care service utilization on 30-day all-cause hospital readmissions for patients with HF.

Heart Failure in Older Adults: A Geriatrician Call for Action.

As the population ages, heart failure is becoming a major public health challenge; clinicians need further evidence-based treatments to bridge the existing gap between guidelines and real-world clinical practice.

Association Between Antipsychotics and All-Cause Mortality Among Community-Dwelling Older Adults.

Background: Antipsychotics are prescribed to treat various symptoms in older adults, however, their safety in this context has not been fully evaluated. The objective was to evaluate mortality risks associated with off-label use of antipsychotics among older adults with no preexisting mental illness or dementia relative to those with diagnosis of dementia.

Methods: Data (2007-2015) were derived from Department of Veterans Affairs registries for 730,226 patients (≥65 years) with no baseline serious mental illness, dementia).

Association between lifetime risk of atrial fibrillation and mortality in the oldest old.

Background: Age is the strongest predictor of atrial fibrillation (AF), yet little is known about AF incidence in the oldest old.

Hypothesis: AF incidence declines after age 90 years, and morbidity is compressed into a brief period at the end of life.

Methods: In this retrospective, longitudinal cohort study of patients (born 1905-1935), we examined cumulative lifetime incidence of AF and its impact on mortality.

At The VA, Healing The Doctor-Patient Relationship.

In opening a dialogue with a veteran, a Syrian American physician is able to overcome prejudices and create a path toward healing.

Characteristics and Incidence of Chronic Illness in Community-Dwelling Predominantly Male U.S. Veteran Centenarians.

Objectives: To assess the incidence of chronic illness and its effect on veteran centenarians.

Design: Retrospective longitudinal cohort study.

Setting: United States Veterans Affairs Corporate Data Warehouse (CDW).

The Multimorbidity Index: A Tool for Assessing the Prognosis of Patients from Their History of Illness.

Background: The Multimorbidity (MM) Index predicts the prognosis of patients from their diagnostic history. In contrast to existing approaches with broad diagnostic categories, it treats each diagnosis as a separate independent variable using individual International Classification of Disease, Revision 9 (ICD-9) codes.

Objective: This paper describes the MM Index, reviews the published data on its accuracy, and provides procedures for implementing the Index within electronic health record (EHR) systems.