Literature Review
Assisted dying bill introduced in Parliament
07/29/24 at 03:00 AMAssisted dying bill introduced in Parliament BBC News; 7/26/24 A bill which would allow terminally ill adults with six months or fewer to live to get medical help to end their own lives has been introduced in the House of Lords, by former Labour Justice Secretary Lord Falconer. He told the BBC his bill would apply only to people "mentally able to make the decision." Their choice would also need to be approved by two doctors and the high court. Private members' bills introduced in the Lords rarely become law. However, Lord Falconer says he hopes a backbench MP will introduce a similar bill in the Commons, where it will have a greater chance of success.
No One Dies Alone: a movement against isolation and loneliness in the final hours
07/29/24 at 03:00 AMNo One Dies Alone: a movement against isolation and loneliness in the final hours The Optimist Daily; by The Optimist Daily Ediorial Team; 7/27/24 The fear of dying alone is one of the most powerful and agonizing feelings that many harbor, especially during the COVID-19 pandemic. For some, this fear sadly becomes a reality. To address this issue, the No One Dies Alone (NODA) initiative trains and supports volunteers who provide companionship to people in their final hours. ... The NODA concept began in 1986 in Oregon, United States [by] Sandra Clarke, a nurse. ... [Alison] Bunce founded Compassionate Inverclyde (CI) in 2016 as an Ardgowan Hospice-funded project, where she worked as director of care. Starting with 20 volunteers, CI sought to sit with people who were dying alone, initially in hospices and local hospitals before extending to private homes. Today, CI has grown substantially, with over 100 volunteers available to provide companionship at a moment’s notice.
Caregivers of end-of-life patients reveal the last words they hear most often and the most common regrets from patients
07/29/24 at 03:00 AMCaregivers of end-of-life patients reveal the last words they hear most often and the most common regrets from patients WhatsNew2Day; by Alexander; 7/27/24... While each person’s final moments are different, chaplains and palliative care nurses have said most people approach their death with “radical acceptance.” People who are actively dying also often have a new sense of clarity about the universe and may even have a temporary burst of energy or sudden moments of clarity if they have dementia. The last words patients usually say to their families are to tell them they love them... [Often, people] who are in the midst of dying want to be surrounded by their loved ones and pets. Their final words are often words of love and pleas for forgiveness, as well as expressions of regret, ... [Another described that people show] "a desire for connection" with loved ones and faith. Editor's Note: This article provides a balanced scope of descriptions from several professionals, notably Catherine Duncan, Annemarie Switchulis, Neal Shah, and Zackary Price. In this day of social media, some hospice professionals (past or present) tout definitive, authoritative descriptions of what all dying persons experience, with too many assumptions and generalizations. Beware what you read and distribute, especially if the tone and language (of other articles) are sensationalized in a way to garner social media "expertise," followers and Shares--at the expense of more balanced, sensitive, diverse, personalized experiences.
Hospices strategize sustainable growth for Veteran Programs
07/29/24 at 03:00 AMHospices strategize sustainable growth for Veteran Programs Hospice News; by Holly Vossel; 7/26/24 Hospices combat both operational and financial challenges as they seek to grow and evolve their veteran programs around the diverse and complex needs of patients and their families. Some of the largest expenses associated with offering veteran services include staffing and training costs ... In addition to staff training, this includes having ways to honor veterans for their service, assess the social determinant of health resources they may need and identify gaps of caregiver support. ...Editor's Note: Notable mentions include Carlos Graveran, executive director at Maryland-based Frederick Health Hospice; Sherri Bickley, vice president of patient support services at Oklahoma-based Crossroads Hospice & Palliative Care; and Carla Creegan, PACE director of clinical services and director of adult day swervices at Empath Health.
Today's Encouragement: Passion is a huge prerequisite to winning ...
07/29/24 at 03:00 AMPassion is a huge prerequisite to winning. It makes you willing to jump through hoops, go through all the ups and downs and everything in between to reach your goal. ~ Kerri Walsh, American beach volleyball player and three-time gold medalist
[Community & Caregivers] Stay ahead of Medicare fraudsters
07/29/24 at 03:00 AM[Community & Caregivers] Stay ahead of Medicare fraudsters The NB Xpress, North Baltimore, OH; by Sue Miklovic; 7/26/24 Every day, criminals target older Americans with one goal – to steal their Medicare numbers and other protected health information. To fraudsters, this information is just as valuable as credit card information. These criminals steal Medicare numbers and unlawfully bill Medicare for medical services that were never provided to the patient or overbill for provided services. ... Consider these tips to help protect yourself against Medicare fraud and stay one step ahead of fraudsters: ...
What would make AI voice in health care ethical and trustworthy?
07/29/24 at 03:00 AMWhat would make AI voice in health care ethical and trustworthy? The Hastings Center; 7/25/24 Voice as a health biomarker using artificial intelligence is gaining momentum in research, but it’s a challenge to develop diverse AI-ready voice datasets that are free from bias. A first-of-its kind study, published in Digital Health and co-authored by Hastings Center President Vardit Ravitsky, aims to better understand the perspectives of voice AI experts, clinicians, patients, and other stakeholders regarding ethical and trustworthy voice AI. The results will support technological innovation informed by ethical inquiry.
Youngstown hospice nurses help alert feds on alleged insurance fraud; company pays settlement
07/29/24 at 03:00 AMYoungstown hospice nurses help alert feds on alleged insurance fraud; company pays settlementMahoning Matters; by Erina Anwar; 7/26/24 ... The U.S. Department of Justice announced on July 17 that federal prosecutors had settled with Gentiva, formerly known as Kindred at Home, after more than 20 whistleblowers — including two hospice nurses from Youngstown, Ohio — alerted the government for alleged fraud. The [Youngstown] nurses, Jason Medved and Anthony Donnadio, will receive a portion of the payout for reporting the fraud at a Youngstown hospice via a lawsuit they filed in 2023 under the federal False Claims Act (FCA). “As registered nurses, Jason and Anthony owed a duty to their hospice patients first and foremost,” Janel Quinn, a principal of The Employment Law Group said. “They were advocates for ethical medicine, even when it wasn’t easy. This settlement is a fitting recognition of their professionalism and their bravery.”
‘Bad apples in a barrel’: How fraudsters in home health care impact the entire space
07/28/24 at 03:55 AM‘Bad apples in a barrel’: How fraudsters in home health care impact the entire space Home Health Care News; by Joyce Famakinwa; 7/19/24 The home health industry has its very own boogeyman--the bad actor. However, there's a difference between providers that had made errors in claims ... [Additional subscription may be required]
How well does Medicare cover end-of-life care? It depends on what type
07/28/24 at 03:50 AMHow well does Medicare cover end-of-life care? It depends on what type Medical Xpress; by Mark Harden, CU Anschutz Medical Campus; 7/19/24 Not all versions of Medicare are created equal—and when it comes to end-of-life care, some versions may serve a patient's needs better than others. That's the focus of newly published research by Lauren Hersch Nicholas, Ph.D., MPP, a University of Colorado Department of Medicine and CU Cancer Center health economist, and her colleagues. The researchers analyzed the experiences of more than a million people receiving Medicare-funded services in the last six months of their lives. ... Their paper was published July 19 in JAMA Health Forum. What Nicholas and her colleagues found is that the kind of Medicare a patient is enrolled in can make a difference in whether that patient gets certain treatments, and whether the patient dies in a hospital or in hospice care.
Screening for Dementia: A Podcast with Anna Chodos, Joseph Gaugler and Soo Borson
07/28/24 at 03:45 AMScreening for Dementia: A Podcast with Anna Chodos, Joseph Gaugler and Soo BorsonGeriPal Podcast; Eric Widera, Alex Smith, Anna Chodos, Joseph Gaugler, Soo Borson; 7/19/24The US Preventive Services Task Force (USPSTF) concluded back in 2000 that there is insufficient evidence to recommend for or against routine screening for dementia in older adults. Are there, though, populations that it may be helpful in, or should that change with the advent of the new amyloid antibodies? Should it? If so, how do we screen and who do we screen? On this week’s podcast we talk with three experts in the field about screening for dementia.
Top Projects of 2023: Our Lady of Peace
07/28/24 at 03:40 AMTop Projects of 2023: Our Lady of Peace Finance & Commerce, Minnesota Business; by Kate Leibsle; 7/19/24 Jamey Flannery and her team at Flannery Construction took seriously their obligation not just to their client, Our Lady of Peace, but to the patients, their families, and staff to make the construction project at the hospice center as smooth and transparent as possible. Limiting disruptions when you are renovating or adding on to an existing, occupied building is always important, but when the facility you are working on is a hospice center, it becomes paramount. ... The project turned the facility’s 21 double-occupancy rooms into private suites. Each room now is big enough for family and friends to gather in a living area, have a TV and offer more privacy, Flannery said.
Tools for tomorrow: a scoping review of patient-facing tools for advance care planning
07/28/24 at 03:35 AMTools for tomorrow: a scoping review of patient-facing tools for advance care planning Palliative Care and Social Practice; by Sean R. Riley, Christiane Voisin, Erin E. Stevens, Seuli Bose-Brill, Karen O. Moss; 6/24/24 first published online Our scoping review reveals an evolving landscape of ACP tools [Advanced Care Planning], marked by increasing diversity in delivery methods and a trend toward personalized, adaptable resources. The integration of technology and patient- and family-centered approaches signifies promising progress in end-of-life care, offering new paths for engagement with patients and families. Critics questioning the utility of ACP may need to revisit their perspectives in light of these innovative developments. Our findings highlight the need for further research on the effective implementation and integration of these tools as well as other unique approaches into healthcare systems and community-based settings. Ultimately, the continual advancement of these tools may reshape health services research, leading to more patient- and family-centered care and improving end-of-life decision-making processes outcomes for all people thereby promoting health equity.
Ethical challenges in the treatment of patients with severe anorexia nervosa
07/28/24 at 03:30 AMEthical challenges in the treatment of patients with severe anorexia nervosa Psychiatry Online; by Patricia Westmoreland, MD; Jole Yager, MD; Jonathan Treem, MD; and Philip S. Mehler, MD; 7/15/24 Ethical principles assist us in determining the best course of action with regard to patients with [anorexia nervosa] AN. The vast majority of patients with AN should be offered high-quality, restorative-informed care. But for a minority of patients (e.g., those with SE-AN) other treatment options need to be considered. Clinicians are obliged to realistically assess each patient’s potential for recovery or ability to engage in harm reduction and palliative care approaches, and be cognizant of the wishes of the patient, family, and treatment team. In addition, the burden on caregivers and stewardship in the expenditure of health care resources should also be considered when deciding whether involuntary treatment, harm reduction, palliative care, or end-of-life care be recommended for a particular patient.
Acupuncture as a support in palliative care at Sun City Center HAW
07/28/24 at 03:25 AMAcupuncture as a support in palliative care at Sun City Center HAW The Tidewater News, Ruskin, FL; 7/22/24 Sun City Center Health and Wellness (HAW) is dedicated to providing comprehensive care for patients managing serious illnesses, championing the use of acupuncture as a key supportive treatment in palliative care. This practice, grounded in traditional Chinese medicine, offers relief from common symptoms and enhances overall well-being. ... The role of acupuncture in palliative care is gaining recognition for its potential to improve the quality of life for patients dealing with serious illnesses.
Why home health providers should expect to see a ‘less draconian’ final payment rule
07/28/24 at 03:20 AMWhy home health providers should expect to see a ‘less draconian’ final payment rule Home Health Care News; by Joyce Famakinwa; 7/22/24 As home health providers continue to digest the proposed payment rule for 2025, National Association for Home Care & Hospice (NAHC) President William A. Dombi believes that the industry will ultimately see a comparatively toned down final rule. “We believe we will not end up with this proposed rule as a final rule,” he said during the opening presentation at NAHC’s Financial Management Conference in Las Vegas on Sunday. “We will end up with something less draconian. The cuts will be reduced because, No. 1, that’s what they’ve done for the last several years, and, No. 2, it’s an election year.” Even with a prediction of a “less draconian” final payment rule, NAHC is still gearing up to fight against home health cuts and the Centers for Medicare & Medicaid Services’ (CMS) payment-setting methodologies.
Hospice enrollment and central nervous system–active medication prescribing to Medicare decedents with dementia
07/28/24 at 03:15 AMHospice enrollment and central nervous system–active medication prescribing to Medicare decedents with dementia JAMA Psychiatry; by Lauren B. Gerlach, DO, MS; Lan Zhang, PhD; Joan Teno, MD, MS; Donovan T. Maust, MD, MS; 7/17/24 Central nervous system (CNS)–active medications, including benzodiazepines and antipsychotics, are commonly prescribed in hospice for behavioral and physical symptom management.1 Such medications are not without risks, especially among patients living with Alzheimer disease and related dementias (ADRD), where potential harms may outweigh benefits for some patients.2 We explored the extent to which hospice enrollment is associated with CNS–active medication exposure among Medicare decedents with ADRD.
Sasha McAllum Pilkington on grace and storytelling at the end of life
07/28/24 at 03:10 AMSasha McAllum Pilkington on grace and storytelling at the end of life Psychotherapy.net; by Lawrence Rubin; 7/22/24 Narrative Clinician, Sasha McAllum Pilkington [of New Zealand], shares poignant stories she co-created with hospice clients which honor and celebrate their lives. [This interview includes: ...
These are the most common jobs in each state in the US
07/28/24 at 03:05 AMThese are the most common jobs in each state in the US USA Today; by Sara Chernikoff; 7/22/24 The most common job in the U.S. is a three-way tie, according to data from the Bureau of Labor Statistics. Home health care and personal aides, retail workers and fast food counter workers ranked at the top of the list with 3.6 million workers in each occupation. ... The desire for home health and personal care aides is on the rise as the share of the elderly U.S. population grows exponentially. This occupation is the fastest growing among most states, news outlet Stacker, reported. ... Home health care aides typically assist people living with disabilities or with chronic illness. Personal care aides are often hired to care for people in hospice care, according to BLS. Advanced degrees are not required for most home health aides, rather those employed by home health or hospice agencies may need to complete formal training or pass a standardized test.Editor's Note: (1) Federal requirements for nursing aides in hospice care are defined in the CMS Hospice of Conditions Participation §418.76 and for home health in the CMS Home Health Conditions of Participation §484.80. Additionally, extensive state laws exist, with differences between states. (2) Pair this with theprevious article in today's newsletter, Homecare Homebase opens nominations for 2024 Home Care Aide Scholarship Program.
Today's Encouragement
07/28/24 at 03:00 AMSomeday I hope you get the chance to live like you were dying. He said, “I was finally the husband, that most the time I wasn’t. And I became a friend a friend would like to have…” ~Tim McGraw, Live Like You Were Dying
Sunday newsletters
07/28/24 at 03:00 AMSunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!
End-of-life care is a profound and essential aspect of medical practice
07/28/24 at 03:00 AMEnd-of-life care is a profound and essential aspect of medical practice Market.US Media, New York; by Samruddhi Yardi; 7/19/24 According to End-of-Life Care Statistics, End-of-life care, also known as palliative care, refers to the comprehensive medical, emotional, and psychological support provided to individuals who are nearing the end of their lives, often due to terminal illnesses or conditions. [This article includes data on the following:]
Fulfilling last wishes: improving the compassionate discharge process
07/27/24 at 03:25 AMThree Plan-Do-Study-Act (PDSA) cycles were used to refine a ComD resource package that was developed; this consisted of a checklist, a kit and caregiver resources ... in order to ... to support nurses, doctors and families during this difficult and emotional transition. The 12-month ComD success rate ... demonstrated ... a consistent reduction in the level of family anxiety before and after caregiver training and resources.
The Uniform Determination of Death Act is not changing. Will physicians continue to misdiagnose brain death?
07/27/24 at 03:25 AMThe Uniform Determination of Death Act is not changing. Will physicians continue to misdiagnose brain death?The American Journal of Bioethics; Michael Nair-Collins; 7/24Efforts to revise the Uniform Determination of Death Act [UDDA] in order to align law with medical practice have failed. It has long been common practice to declare some patients dead by neurologic criteria even though they do not meet the legal standard for death. Thus, legally living people will continue to be declared dead, not because of a mistake, but because of a choice. The decision to continue misdiagnosing death according to the law will create routine violations of civil rights, will continue to violate the DDR [dead donor rule] that allegedly is such an important red line for organ transplantation, and will contribute to a well-deserved mistrust in the determination of death.
Psychiatric manifestations of neurological diseases: a narrative review
07/27/24 at 03:05 AMPsychiatric manifestations of neurological diseases: a narrative reviewCureus Journal of Medical Science; Anthony J. Maristany, Brianna C. Sa, Cameron Murray, Ashwin B. Subramaniam, Sean E. Oldak; 7/24Neurological diseases like Alzheimer's, FTD [frontotemporal dementia], Parkinson's, MS [multiple sclerosis], stroke, epilepsy, Huntington's, ALS [amyotrophic lateral sclerosis], TBI [traumatic brain injury], andMSA [multiple system atrophy] are not only characterized by neurological symptoms but also by various psychiatric manifestations, complicating diagnosis and treatment. For instance, Alzheimer's induces cognitive decline and emotionaldistress, Parkinson's leads to motor impairments and mood disorders, and MS intertwines physicalsymptoms with emotional disturbances. Understanding these complex relationships is crucial forcomprehensive care. Collaboration, innovation, and ethical commitment are essential for improvingoutcomes.