Palliative care improves cancer, CHF, COPD, and dementia outcomes. Effective models include nurses, social workers, and home-based components, and a focus on communication, psychosocial support, and the patient or caregiver experience. High-quality research on intervention costs and cost outcomes in palliative care is limited.

Palliative care is one of the newer health specialties and continues to mature. While there has been remarkable progression of clinical skills and education, there has been a lack of focus on palliative care interdisciplinary leadership or development of leadership skills. This article highlights the importance of interdisciplinary palliative leadership within the 5 realms of clinical practice, research, education, policy/advocacy, and administration. A definition of leadership is offered and discussion of successful leadership skills is described. A current review of leadership opportunities is provided.

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Objectives: This paper aims to provide a conceptual review of prior research on the effect of a history of parental childhood maltreatment on the experiences and outcomes of adult-child caregivers who provide care to their perpetrating parents. Methods:We performed a search using several databases including PsycINFO, ScienceDirect, and Academic Search Premier (EBSCO) for relevant papers and reviewed reference sections of selected papers.Results: Histories of childhood maltreatment are associated with adverse psychological health in adult-child caregivers and reduced frequencies of providing support to their parents. The potential factors affecting the experiences and outcomes of such caregivers include contemporaneous relationships with perpetrating parents; caregivers' sense of choice about providing care; opportunities for posttraumatic growth; and participating in care through the end of life. Conclusions:Caregiving for perpetrating parents can be particularly challenging due to complex, intersecting factors; thus, healthcare practitioners' increased awareness of and knowledge about such caregivers are crucial to provide effective support. Clinical Implications:We highlighted the importance of ensuring caregivers' sense of choice and assessing their posttraumatic growth. In caregiving at the end of life, we noted the importance of using a trauma-informed approach when interacting with caregivers and their family members during illness and bereavement.

This study investigated how experiencing childhood family violence can affect aspects of adult sibling relationships. Background: Established evidence shows the long-term effects of childhood adversity on several domains of adult lives. Few studies, however, have examined the impact that childhood family violence exposure has on sibling relationships later in adulthood. To address this gap, this study examined the latent class structure of childhood exposure to family violence. We also investigated whether and how latent class membership predicted aspects of adult sibling relationships, including geographical proximity, contact frequency, perceived closeness, similarity in outlook, and support exchange. Method: Data for the study were obtained from 3921 adult participants in the Wisconsin Longitudinal Study. Using the Bolck, Croon, and Hagenaars (BCH) approach of latent class analysis (LCA), we identified five latent classes (prevalence rate noted): No Exposure to Family Violence (75%), Exposed to Intersibling Violence (7%), Exposed to Overall Family Violence (4%), Exposed to Paternal and Interparental Violence (10%), and Exposed to Maternal and Interparental Violence (5%). Results: Childhood family violence was a significant predictor of adult sibling relationships. Specifically, we found that the Intersibling Violence, Overall Family Violence, and Paternal and Interparental Violence classes showed lower levels of perceived emotional closeness and similarity in values/outlook with their siblings than the No Exposure to Violence class. Conclusion: Findings suggest that childhood exposure to family violence may have long-term negative effects on the emotional aspect of sibling relationships in adulthood.