Literature Review

The bereavement care crisis in hospice facilities MedCity News; by Cara McCarty Abbott; 7/28/24 Bereavement care is an essential part of the hospice experience, designed to support those coping with loss. Bereavement care is not just a compassionate gesture; it is a critical component of the hospice care continuum. So why is it so underserved in the U.S.? ... Instead of pushing harder on hospice providers to find more ways to deliver comprehensive bereavement care with less, it's key to address the systemic forces hampering their ability to deliver quality care at the scale required and address these challenges. Editor's Note: Additionally, does your hospice still rely on the misnamed, overused "5 Stages of Grief"? These were determined from 1960's persons who were dying, not from bereaved persons who live on--surviving--the death. Extensive fresh, contemporary, hospice-designed grief resources to support bereavement counselors and the persons they serve are provided by Composing Life Out of Loss, a sponsor for our newsletter.

Practicing proactive palliative care in COPD management Medscape - "In Discussion"; podcast by Leah J. Witt, MD and Anand S. Iyer, MD, MSPH; 7/25/24Let's start talking COPD. Today, we're going to keep talking about Mr Rivera, a case we've been following all season. He's a 78-year-old man with COPD, and we're talking to you about palliative care and symptom management. He has group E COPD. He really has a lot of symptoms and frequent exacerbations.

Advance care questions to ask your loved one Parkview Health; 7/27/24 ... To ease into a conversation about decisions and scenarios, we can start with questions that are easier to answer, like: What does a good day look like? If you got to spend the day with your favorite people doing your favorite things, what would you be doing? With whom? ... From there, we can talk about more specifics related to healthcare decisions, such as: If your heart and breathing stop suddenly, would you want to have CPR (cardiopulmonary resuscitation), which can include pushing on your chest, breathing support, medications, and electrical shocks? ... If you knew that death was likely to happen in a brief period of time, would you want to be in the hospital, in a nursing care facility or at home? ... Editor's Note: The wording, sequencing, and open-ended format of these questions gently open the door for the person to reflect on and describe one's wishes, in contrast to some advance care planning questions that focus on filling out a form. Yes, Advance Directives forms are crucial. However, the forms are a tool for now and for needs ahead. The focus is the person, while building a context of relationship and trust.

Empath Health, Trustbridge leaders are setting home health sights high after integration Home Health Care News; by Joyce Famakinwa; 7/26/24 Empath Health is a company in transition. In the spring, it completed an affiliation process with Trustbridge, which formed the largest nonprofit post-acute provider organization in the state of Florida. ... Since completion of the affiliation process, the company has focused on integration, synergistic opportunities and determining how best to deliver care to the communities it serves. One of the people at the helm of this transition is Tarrah Lowry, Empath Health’s chief operating officer and Trustbridge’s interim president. [Click on the title's link to read the recent interview by Home Health Care News' with Tarrah Lowry.]

HIMSSCast: Improving patient safety and employee retention with best incident reporting practicesHealthcare IT News; by Andrea Fox; 7/26/24 By modernizing systems and improving leadership and culture to embrace reporting, healthcare organizations can better address the top 10 patient safety concerns for 2024, says Heidi Raines, founder and CEO of Performance Health Partners. Ultimately improving the quality of care healthcare systems deliver and preventing harm requires a degree of self-reflection. Along with digital transformation, putting an easy-to-use incident reporting system in place can help healthcare organizations address today's chief patient safety concerns, including medication errors, care delays, workplace violence and preventing patient falls, said Raines.

Cultivating humility, making connections in a contentious world Tallahassee Democrat; by Rev. Candace McKibben; 7/27/24 The first time I remember hearing about “cultural humility” was some years ago when I served as a member of the Diversity and Inclusion Team at Big Bend Hospice. I recall reading an article by Silvia Austerlic, a Bereavement Manager and Hospice Latino community liaison, at Hospice of Santa Cruz County. She explained what is required to relate in the best interests of patients and families is not “cultural competence,” which is where our team had been focused, but “cultural humility.” “Cultural competence,” while it may be well-meaning, is a framework to help providers understand, appreciate, and work with individuals from diverse cultures. It is focused on gaining knowledge. “Cultural humility,” on the other hand, is focused on relationships. ... Yet another form of humility that seems critically important to me in our time is “religious humility.” This form of humility involves celebrating the inherent dignity of every individual, regardless of their religious affiliation.

Assisted 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 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.

Youngstown 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.”

How 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.

Top 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.

Ethical 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.