Literature Review

Increasing Medicaid rates: A critical step to support home-based care Association Press, North Salt Lake, UT; by Business Wire; 1/14/25To address the growing challenges facing the healthcare system, the Homecare and Hospice Association of Utah (HHAU) calls for an urgent increase in Medicaid reimbursement rates for Home and Community-Based Services (HCBS) waivers, Private Duty Nursing (PDN), and Home Health. These critical services form the backbone of home-based care, enabling individuals to receive the medical attention and support they need in their homes, while saving tax dollars and alleviating strain on hospitals and long-term care facilities.

Physician engagement in addressing health-related social needs and burnoutJAMA Network Open; Masami Tabata-Kelly, MBA, MA; Xiaochu Hu, PhD; Michael J. Dill, MA; Philip M. Alberti, PhD; Karen Bullock, PhD, LICSW, APHSW-C; William Crown, PhD; Malika Fair, MD, MPH; Peter May, PhD; Pilar Ortega, MD; Jennifer Perloff, PhD; 12/24In this cross-sectional study of 5,447 nationally representative physicians in the US, 34.3% regularly dedicated time to addressing HRSNs [health-related social needs]. The study identified variability in physicians’ engagement in addressing HRSNs and found that higher engagement was associated with a greater likelihood of burnout. The findings suggest the need for thorough assessment of the potential unintended consequences of physicians’ engagement in addressing HRSNs on their well-being.

Introduction: ‘Those who have made death their life’The Daily Yonder - Keep It Rural; by Hannah Clark; 1/15/25 Hannah Clark spent six months riding along with the nurses and certified nursing assistants (CNAs) of Hearth Hospice who provide in-home care to those living in Northwest Georgia and Southeast Tennessee. These hospice workers often drive up to a hundred miles a day to visit a handful of patients scattered across the Appalachian landscape in both rural towns and urban centers. What will follow this introductory essay is her photo reportage in three parts, documenting what she has witnessed accompanying these caregivers. The intimate portraits and vignettes show tender moments at different stages towards the end of one’s life. Their beauty lies in the companionship Clark captured in moments of need and vulnerability. Editor's note: Crucial protocols used for this photographer are worth highlighting. "Before I began working with nurses, I went through a background check, drug screening, and volunteer training. Written permission was given by each household. When patients could not consent due to certain conditions such as Alzheimer’s or Dementia, or patients were non-responsive or actively passing, permission was granted by their power of attorney."

Special Bulletin – CA Wildfires Public Health EmergencyCommunity Health Accreditation Partner (CHAP); Special Bulletin; 1/14/2025 HHS Declares Public Health Emergency for California to Aid Health Care Response to Wildfires. The declaration follows President Biden’s major disaster declaration and gives the Centers for Medicare & Medicaid Services’ (CMS) health care providers and suppliers greater flexibility in meeting the emergency health needs of Medicare and Medicaid beneficiaries. HHS has waived sanctions and penalties for violations of certain provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule against hospitals in the emergency area. [Click on the title's link to continue reading]

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!

How to help people impacted by the California firesNBC News - Today Show; by Becca Wood; 1/8/24, updated 1/12/24... As homes burn to the ground and people seek shelter, various charities and organizations are working to provide help on the ground. For those looking for ways to help, NBC News has reviewed and vetted organizations that are aiding in relief efforts. Here is a list of verified charities. Click on the names of each for more information how to help.

Current use and evaluation of artificial intelligence and predictive models in US hospitalsHealth Affairs; by Paige Nong, Julia Adler-Milstein, Nate C. Apathy, A. Jay Holmgren, Jordan Everson; 1/25Effective evaluation and governance of predictive models used in health care, particularly those driven by artificial intelligence (AI) and machine learning, are needed to ensure that models are fair, appropriate, valid, effective, and safe, or FAVES. We analyzed data from the 2023 American Hospital Association Annual Survey Information Technology Supplement to identify how AI and predictive models are used and evaluated for accuracy and bias in hospitals. Hospitals use AI and predictive models to predict health trajectories or risks for inpatients, identify high-risk outpatients to inform follow-up care, monitor health, recommend treatments, simplify or automate billing procedures, and facilitate scheduling. We found that 65 percent of US hospitals used predictive models, and 79 percent of those used models from their electronic health record developer.Publisher's note: It would be interesting if hospices collected and reported similar information.

Development and outcomes of a provider-driven, online continuing education program on integrative palliative care: Randomized controlled trialGlobal Advances in Integrative Medicine and Health; William Collinge, PhD, MPH; Leila Kozak, PhD; Scott Mist, PhD, MAcOM; Robert Soltysik, MS; 1/25While conventional medicine excels in emergency and acute care, complementary therapies are increasingly being integrated into efforts for symptom management and quality of life (QoL) in hospital, hospice and nursing home environments. The term “complementary” denotes a cooperative or collaborative relationship between conventional and unconventional modalities, and when such integration takes place, the terms “complementary” and “integrative” are commonly used interchangeably. Hospices have been early adaptors of such therapies with surveys in various states showing between 60-90% of hospices offering these modalities. This provider-driven CE/CME program led to significant positive changes in practitioners’ self-efficacy and implementation of integrative care practices in PC settings. The results indicate that CE/CME can have measurable impacts that benefit providers and may potentially impact patients, families and the culture of care.

Preferred and actual location of death in adolescents and young adults with cancerJAMA Network Open; by Oreofe O. Odejide, Colin Cernik, Lauren Fisher, Lanfang Xu, Cecile A. Laurent, Nancy Cannizzaro, Julie Munneke, Robert M. Cooper, Joshua R. Lakin, Corey M. Schwartz, Mallory Casperson, Andrea Altschuler, Lori Wiener, Lawrence Kushi, Chun R. Chao, Jennifer W. Mack; 1/14/25In this cohort study of 1929 adolescent and young adult (AYA) decedents, 1226 (63.6%) had a documented discussion about their preferred location of death, with home being most frequently desired. Among these, 224 of 317 (70.7%) who wanted to die at home were able to do so, as were 164 of 172 (95.3%) who preferred a hospital death. The fact that over a quarter of AYA patients with cancer who preferred to die at home were unable to do so suggests a need for effective interventions to improve goal-concordant end-of-life care for AYA patients with cancer.

Sociodemographic disparities in the use of hospice by U.S. nursing home residents: A systematic reviewAmerican Journal of Hospice and Palliative Medicine; Christine E. DeForge, PhD, RN, CCRN; Hsin S. Ma, MPP, MA; Andrew W. Dick, PhD; Patricia W. Stone, PhD, RN, FAAN, CIC; Gregory N. Orewa, PhD; Lara Dhingra, PhD; Russell Portenoy, MD; Denise D. Quigley, PhD, MA; 1/25 Hospice can improve end-of-life (EOL) outcomes in U.S. nursing homes (NHs). However, only one-third of eligible residents enroll, and substantial variation exists within and across NHs related to resident-, NH-, or community-level factors. Studies adjusting for resident-, NH-, and community-level factors found lower hospice use among male residents, Black/Non-White residents, and residents of rural NHs, with mixed results by payor and ownership. Results were mixed for hospice referral and length-of-stay. These findings suggest complex influences on NH hospice use.

Effective solutions for caregivers of older adults: A review of systematic reviewsJournal of Applied Gerontology; Molly McHugh, Ellen Munsterman, Hannah Cho; 1/25This umbrella review aims to describe caregiver interventions tested across populations of informal caregivers of older adults and to examine the effect of caregiver interventions on depression, burden, and quality of life across intervention types and care-recipient populations. Most commonly, interventions focused on improving outcomes for caregivers of older adults with dementia. Among the included reviews, caregiver depression was most likely to be reduced by caregiver interventions, and cognitive behavioral therapy (CBT) and mindfulness-based interventions (MBI) were most effective. The use of information and communication technologies to deliver caregiver interventions is increasingly common. Standardization of intervention classifications and transparent reports of intervention delivery details will strengthen research in this field.

[The Netherlands] Family concerns in organ donor conversations: A qualitative embedded multiple-case studyCritical Care; Sanne P C van Oosterhout, Anneke G van der Niet, Wilson F Abdo, Marianne Boenink, Jelle L P van Gurp, Gert Olthuis; 12/24Listening and responding to family concerns in organ and tissue donation is generally considered important, but has never been researched in real time. [This study found that] concerns clustered around six topics: 1) Life-event of a relative's death, 2) Dying well, 3) Tensions and fears about donation, 4) Experiences of time, 5) Procedural clarity, and 6) Involving (non-)present family. When concerns were highly charged with emotion, the clinicians' responses were less frequently attuned to families' needs. The identified concerns and the distinction between clearly and less clearly articulated concerns may prove valuable for clinicians to improve family support. We advise clinicians to engage with a curious, probing attitude to enhance the dialogue around concerns, elaborate on less clearly articulated concerns and identify the informational needs of the family.

[Canada] Qualitative bereavement experiences and support in community-dwelling older adults: A scoping reviewOmega-Journal of Death and Dying; Samantha Teichman, Barbara A. Mitchell, Indira Riadi, Habib Chaudhury, Albert Banerjee, William Odom; 12/24This scoping review examines qualitative studies on bereavement experiences and support mechanisms for community-dwelling older adults. This area of research is especially timely given rapid population aging and the interplay of heightened vulnerability, cumulative losses, shrinking support systems, and the critical need for bereavement support. Such support not only acts as a preventative health measure but can also serve as a catalyst for fostering meaning-making and navigating grief in later life. Through a scoping search and synthesis of relevant qualitative studies ..., the findings reveal four key themes: the impact of grief on wellbeing, grief perceived as an individual issue, challenges in seeking and receiving support, and positive support experiences and transformations. This discussion contributes to developing targeted bereavement support strategies for community-dwelling older adults.