Literature Review

Early hospice care has transformative impact McKnights Senior Living; guest column by Aaron Housh, CEO of Good Samaritan Hospice in Roanoke and Christiansburg, VA; 11/25/24 Hospice care is more than a medical service — it’s a lifeline of compassion, connection and support during one of life’s most vulnerable moments. For more than 20 years, I’ve witnessed the profound impact hospice can have, not just on residents and patients but on the families who love and care for them. But this impact is magnified when hospice care is introduced early. ... One of the greatest gifts hospice provides is time — time to prepare, time to connect and time to say goodbye. A friend once shared how hospice changed her family’s experience with her mother’s death. The nurse spent time explaining what to expect, answering questions and normalizing the changes they were seeing. That preparation eliminated panic, allowing the family to focus on being present. Her mother passed with dignity, surrounded by love and understanding. This story illustrates what I’ve seen time and again: families who enter hospice early have the opportunity to build trust with their care team, process emotions and fully use the services available to them. Those families are better equipped to navigate the physical and emotional challenges of end-of-life care, creating space for meaningful moments and lasting memories.

Hospice of Northeast Missouri marks 30 years, eyes future growth KBUR, Burlington, MO; by collinleddy; 11/25/24 Hospice of Northeast Missouri recently marked 30 years of service, expanding from its original focus in Adair County to cover a ten-county region. This growth addresses the critical need for end-of-life care in rural areas, providing support for patients and their families in managing symptoms and caregiving responsibilities. The organization has seen an increase in demand for its services, particularly among Medicare recipients in rural areas. Between 2010 and 2022, the percentage of rural Medicare beneficiaries using hospice care rose from 34% to 42%, reflecting broader trends in aging populations and the growing importance of caregiving. ... As the hospice looks ahead, it plans to further expand its resources and focus on community education, ensuring that more families are aware of the benefits hospice care provides during difficult times.Editor's note: Per the ongoing number of hospices that celebrate decade-marker anniversaries, we typically do not post those articles. However, the growth patterns in these descriptions reflect hospice organizational trends nationwide: expanding geographical access, rural utilization, increased priorities for caregivers, snf the importance of community education.

Providers hoping for better days ahead with ‘suspicious,’ unannounced CMS site visits McKnights Long-Term Care News; by James M. Berklan; 11/25/24 A campaign to strip mystery out of unannounced, often thinly explained site visits by Centers for Medicare & Medicaid Services contractors may be bearing some fruit. Providers have been rattled by visitors’ demands for information and the ability to take photos with little explanation. They’re hoping that the government-hired fact-checkers communicate and execute their mission better moving forward. ... “When the people who educate consultants and others don’t know about something, it’s concerning. It was so suspicious with the way they [contractors] came into facilities,” McCarthy said. Upon investigation, provider advocates were able to confirm the site visits are legitimate and can happen to any provider or supplier as part of their Medicare enrollment or verification process. And while explicit advance notice may not be given, a record of the visits’ orders can be confirmed in the Provider Enrollment, Chain, and Ownership System (PECOS). [Click on the title's link to continue reading.]

Hologram technology wows rural care patients Becker's ASC Review; by Francesca Mathewes; 11/25/24 Cancer patients in rural Tennessee are testing virtual visits from hologram health consultants, Fox 26 News reported Nov. 23. The technology allows healthcare providers, in this case a physician, to consult with patients via a lifelike hologram. Clay Jackson, MD, a palliative care specialist in Germantown, Tenn., said that the technology has expanded access to care in the rural area, where patients might otherwise have to travel more than 100 miles for in-person care. "Two words: blown away. My patients can't believe how great the technology is," said Dr. Jackson in the report. "They may be a one-car family, it may be patients for whom additional travel would cause additional pain or discomfort or stress, especially those who are undergoing active treatment for their cancer," he added. The device and AI-powered spatial computing platform cost $29,000. The technology has been used in the entertainment industry and in professional sports, but this marks the first time the technology has been used in health consultations.

Gratitude makes sense of our past, brings peace for today and creates a vision for tomorrow. ~ Melody Beattie

Hospice of Baton Rouge: New grief center opens offering vital support and healing Unfiltered With Kiran, Baton Rouge, LA; by Megan Kelly; 11/25/24 As the holiday season approaches, a time often filled with joy and togetherness, it can also be a profoundly challenging period for those experiencing grief. The Hospice of Baton Rouge has recognized this need and has transformed a property into a haven of healing: The Retreat at Quarters Lake. This newly established grief center aims to address the significant gap in resources for grieving individuals, a void that became especially apparent during the COVID-19 pandemic. “The Retreat at Quarters Lake provides hope, healing, and connectivity for the grieving through counseling, support groups, alternative grief therapies, and community education,” reads a statement on their website. The facility offers both traditional grief services, such as individual counseling and support groups, and unique, holistic approaches that include art therapy, music therapy, and pet therapy. The goal is to provide a comprehensive support system that caters to individuals of all ages and backgrounds. “We are focusing on some alternative therapies like yoga, meditation, gardening, and even fishing,” said Catherine Schendel, CEO of The Hospice of Baton Rouge. “We want to utilize the beautiful landscaping here to offer non-traditional grief support as well.” 

If my dying daughter could face her mortality, why couldn’t the rest of us? DNYUZ, appearing first in The New York Times; Ms. Wildman; 11/25/24 The first week of March 2022, I flew to Miami with my 13-year-old daughter, Orli; her 8-year-old sister, Hana; and my partner, Ian. We were, by all appearances, healthy. Robust, even. In reality, we were at the end of a reprieve. Orli’s liver cancer had by then been assaulted by two years of treatments — chemotherapy, a liver transplant, more chemotherapy, seven surgeries. Now new metastases lit up a corner of one lung on scans, asymptomatic but foreboding. We asked her medical team if we might show her a bit of the world before more procedures. Our oncologist balked. Hence, this brief weekend away. When we arrived at the beach Orli ran directly to the water, then came back and stretched out on a lounge chair. She turned to me and asked, “What if this is the best I ever feel again?” Three hundred and seventy-six days later, she was dead. In the time since she left us, I have thought often of Orli’s question. All that spring, Orli asked, pointedly, why did we think a cure was still possible, that cancer would not continue to return? Left unspoken: Was she going to die from her disease? It was a conversation she wanted to have. And yet what we found over the wild course of her illness was that such conversations are often discouraged, in the doctor’s office and outside it. ... [Click on the title's link to continue reading this profound story.]Editor's note: While families are gathered for Thanksgiving, many health changes will be observed since this time last Thanksgiving, with countless unknowns to unfold until Thanksgiving next year. Tune into the wide scope of conversations that people do want to have, don't want to have, and--perhaps--that your own family needs to have, with grace and care for all.

Addressing barriers to advance care planning by adults with advanced cancers Regenstrief Institute, Indianapolis, IN; by Shelley Johns, PsyD and Susan Hickman, PhD; 11/25/24 In one of the first studies to test the utility of mindfulness to support advance care planning by adult cancer patients and their family caregivers, researchers from Regenstrief Institute and Indiana University have found that mindfulness showed promise in improving quality of life and advance care planning outcomes in patients and their family caregivers coping with advanced cancer. ... Mindfulness emphasizes paying attention to the present moment with an attitude of openness, compassion and interested curiosity accomplished through meditation and other exercises to manage stress. “Mindfulness is about noticing what’s here so we can choose the wisest response and hopefully be less emotionally reactive,” said Dr. Johns. “Mindfulness practices help individuals increase their mindfulness muscle, so to speak. Anything that we do in our life ... can be done with mindful focus, with mindful attention."

[United Kingdom] Hospice urges people to recycle Christmas trees BBC News; by Holly Phillips; 11/23/24 A charity is asking the public to recycle their Christmas trees this year. St. Barnabas Hospice, in Lincoln, is inviting people to take part in their "tree-cycle" initiative, by disposing of their tree in an eco-friendly way while supporting the charity. People who have bought a real tree can register for it to be collected so it can be recycled or replanted in the new year. Volunteers from the hospice will be picking up trees between 7 and 12 January in return for a voluntary donation. 

Hospice expands compassionate care for nursing home residents McKnights Long-Term Care News; by Liz Barnett and Mat Zucker; 11/22/24 Nursing homes are places of care, community and compassion, particularly for residents in their final stages of life. As we recognize National Hospice and Palliative Care Month, it’s an opportune time to consider how nursing homes can broaden the support they provide by better incorporating hospice services. Hospice offers a path to comfort and dignity at the end of life, yet many families have insufficient information about these services. Our mother, Leslie, benefited from hospice care early this year when her gallbladder cancer no longer responded to treatment. This journey revealed just how powerful hospice can be, not only for the patient but for our entire family. Nursing home staff and administrators can play a crucial role in helping families like ours make informed, compassionate choices like this for their loved ones.

OIG issues nursing facility industry segment-specific Compliance Program Guidance; first in a series in Furtherance of its Modernization Initiative Butzel - Attorneys and Counselors Client Alerts; 11/22/24 On November 20, 2024, the U.S. Department of Health & Human Services, Office of Inspector General (“OIG”) issued the first Industry Segment-Specific Compliance Program Guidance (“ICPG”), which applies to the Nursing Facility Industry. This follows from the OIG’s Modernization Initiative to update publicly available resources for the healthcare industry first announced in September 20211 and finalized in April 2023. This ICPG comes just over a year after the OIG issued the General Compliance Program Guidance (“GCPG”) that kicked off the OIG’s efforts to modernize and consolidate numerous Compliance Program Guidance documents issued between 1998 and 2008. Editor's note: Click here to download the U.S. HHS OIG's 59-page November 2024 "NURSING FACILITY Industry Segment-Specific Complicance Program Guidance." A word search finds 30 references to "hospice."

Early palliative care linked to better end-of-life outcomes in ovarian cancer AJMC - The American Journal of Managed Care, Cranbury, NJ; by Brooke McCormick; 11/22/24 Initiating palliative care (PC) more than 3 months before death was associated with improved quality of care and reduced care intensity at the end of life (EOL) for decedents with ovarian cancer, according to a study published in JAMA Network Open. Alongside oncologic treatment, the American Society of Clinical Oncology recommends all patients with advanced cancer receive early, dedicated PC within 8 weeks of diagnosis. PC benefits include prolonged survival, enhanced quality of EOL care, and improved patient and caregiver quality of life (QOL). Early referral to specialist PC is also linked to less aggressive EOL care. 

Elizabeth Nemacheck: The personal consequences of EPH's discontinuation of in-home hospice Estes Park Trail-Gazette, Estes Park, CO; by Elizabeth Nemacheck; updated 11/22/24 I am writing regarding Estes Park Health's decision to eliminate in-home hospice and home health care in Estes Park. Hospice helps the family by dismantling hospice, Estes Park Health has off-loaded the end-of-life burden solely on the family, during one of the most difficult and totally predictable life events. I hope to illustrate three key issues we identified by sharing my story. My father died at home in September of 2024. After his terminal cancer diagnosis midsummer, my family discussed my dad's wishes in consultation with his oncologist and primary care doctor. Like so many of us, my dad decided that he would very much like to die at home, so that became our goal. We sought alternatives to hospice support beyond Estes Park Health's discontinued home hospice care; once we confirmed that the only hospice available in Estes was in-hospital hospice, we built the infrastructure ourselves to be able to keep my dad at home. Thankfully we had the financial resources to do so, and a lot of gumption. While we were able to keep him at home, we identified three key issues: