Literature Review

Where is assisted dying legal? How the rules worldwide compare The Times, London, UK; by Bruno Waterfield, Josie Ensor, and Bernard Lagan; 10/16/24In 1937, Switzerland legalised assisted suicide provided those doing the assisting were not motivated by “any selfish intent”. Six decades later, the US state of Oregon legalised physician-assisted suicide for people with less than six months to live. In 2001, the Netherlands became the first country in the world to decriminalise assisted dying. In the two decades since, the debate around a state or nation’s approach to life and death has sped up. Belgium, Australia and ten more US states have decriminalised forms of assisted dying. The approach varies, but they all fall under the umbrella of assisted dying, a term that usually refers either to euthanasia — the practice of a doctor administering a lethal drug — or to assisted suicide, in which a person self-administers a lethal drug, often after someone has helped them to procure it. [Click on the title's link for its list of comparisons.]

The future of healthcare systems with Richard Church Podcast by Teleios Collaborative Network; by Chris Comeaux; 10/15/24 In this conversation, Chris Comeaux interviews Rich Church, the Chief Growth and Strategy Officer of Parkview Health in Ft. Wayne, Indiana.  Chris and Rich discuss the future of nonprofit healthcare systems.  Rich explains that nonprofit systems need to think like for-profit organizations in the future in terms of managing their finances, but the difference lies in how they use their margins to invest back into their communities. Nonprofits use their margins to provide care to those who may not have access otherwise, while for-profits distribute their margins to stockholders.  Rich also emphasizes the importance of innovation and simplification in healthcare, as well as the need for a cultural shift that encourages risk-taking and learning from mistakes.  The conversation explores the importance of preventing high acuity care and keeping patients healthier to bend the cost curve in the long run.

Advice from a pumpkin: be well-rounded, get plenty of sunshine, give thanks for life's bounty, have thick skin, keep growing, be outstanding in your field, think big! ~ Unknown

Estes Park's only hospital joining UCHealth System Fort Collins Coloradoan; by Kelly Lyell; 10/17/24 Estes Park Health has started the process of joining the UCHealth System, with an expected starting date in the spring of 2025, the two organizations announced in a joint news release Wednesday. ... Estes Park Health has been financially challenged in recent years to maintain its services, the news release said, citing problems hospitals across the country have had keeping up with “dramatically increasing expenses, rising uncompensated care and minimal increases in reimbursements from Medicare and Medicaid.” As a result, the only hospital serving the Estes Valley, including visitors to Rocky Mountain National Park, has had to transfer or reduce its obstetrics, home health and hospice services.Editor's note: We've been following this story as but one of many examples of rural healthcare examples that result in reduced utilization for hospice services.

Atria to exit home care business to focus on senior living portfolioMcKnights Senior Living; by Kimberly Bonvissuto; 10/16/24 Atria Senior Living is shuttering its New York-based home care subsidiary in an effort to focus on its core business of senior living. In a  “warn unit” notice filed Oct. 10 with the New York Department of Labor, Atria Home Care cited economic reasons for the layoffs of 161 employees from its Garden City, NY-based home care business, which will be effective Jan. 8. “After careful consideration, we have made the decision to discontinue operations at Atria Home Care in an effort to focus on our core business of social model senior living communities,” a spokesperson for Atria told McKnight’s Senior Living. “We are working with all home care customers and employees on a transition to other home care providers and are committed to supporting our employees and clients through these changes over the next several weeks.”

Why your drug store is closing CNN Business, New York, NY; by Nathaniel Meyerson; 10/16/24 CVS is closing 900 stores. Rite-Aid is closing 500. Walgreens announced Tuesday it plans to close 1,200 stores, meaning 1 in 7 will disappear. What is going on with America’s drug stores? Walgreens and other chains overexpanded during the 1990s and 2000s to drive out competitors and draw more customers. They are now shutting down because of shifting consumer habits, competition and changes in the pharmacy industry. Around 25% of Walgreens’ stores aren’t profitable, CEO Tim Wentworth said in an interview with the Wall Street Journal in June, and the chain will look to close stores that are right by one another or struggling to hold down theft. ... CVS, the largest US chain, closed 244 stores between 2018 and 2020. In 2021, it announced plans to close an additional 900 stores. Earlier this month, CVS said it planned to cut about 2,900 jobs corporate jobs. And Rite Aid filed for bankruptcy last year, closing up to 500 stores.

Music therapist helps patients navigate end-of-life journey on Long Island CBS New York / YouTube; by Jenna DeAngelis; 10/15/24 Music therapy helps with emotional and physical health, and now the healing power of music is being brought to hospice patients on Long Island.

How physicians can navigate ethical conflicts when caring for patients Physician's Weekly; 10/14/24 ... According to the president of The Physicians Foundation, Gary Price, MD, ethics in medical care are particularly complicated regarding end-of-life choices. While decades ago, a patient’s primary care provider (PCP) would have been involved in that patient’s hospitalized care and their end-of-life decisions within the hospital, the fragmented nature of today’s healthcare system has all but eliminated PCPs from involvement in hospitalized patient care. As such, patients often make end-of-life decisions based on the guidance of doctors with whom they have no pre-existing relationship. Other factors that blur ethical lines in healthcare, adds Dr. Price, are the new state of healthcare ownership and financing. Dr. Price mentions, for instance, conflicts of interest due to the US’s biggest employer of physicians, Optum, being a subsidiary of the same company that owns UnitedHealthcare. This situation allows for an insurer who controls reimbursement and who could, as the physician’s employer, influence decisions made regarding patient care. Sadly, this influence largely comes from financial concern instead of concern for the patient’s best health outcomes. 

Hospice of the Western Reserve receives $3M gift Cleveland Jewish News; 10/16/24 Hospice of the Western Reserve announced a landmark $3 million leadership gift from The James and Angela Hambrick Foundation to the Quality of Life capital campaign, according to a news release. The gift to the capital campaign will help build a new Hospice Care and Community Center on Lake Erie in Cleveland, the release said. “The ideal of nonprofit superior end-of-life care for our community runs strong through us,” James Hambrick, retired chairman and CEO of Lubrizol Corp., said in the release. “My wife, Angela, and I are very pleased to make a major leadership gift toward the new Hospice Care center.” ... “We are profoundly grateful to James and Angela Hambrick for their extraordinary generosity,” Bill Finn, president and CEO of Hospice of the Western Reserve, said in the release. ... The new Hospice Care and Community Center, scheduled to open in 2026, will feature 32 private patient rooms, all with views of Lake Erie, enhanced family spaces and state-of-the-art technology to support the increasing complexity of end-of-life care, the release said.

Stratis Health builds framework for expanding rural community-based palliative care Hospice News; by Jim Parker; 10/16/24 The health care performance improvement company Stratis Health has developed a framework for expanding access to palliative care in rural communities. The company’s strategy convenes resources and organizations that already exist in a given community to help meet patient’s palliative care, psychosocial, spiritual and social determinants of health needs. It leverages those resources to offer a wraparound suite of services for seniors and seriously ill patients. Hospice News spoke with Karla Weng, senior program manager for Stratis Health, about how health care providers and other stakeholders serving rural communities can come together to better serve their patients and clients. ... The field has shifted in more recent years, so that community-based really means anywhere but the hospital. It might be in a clinic. It might be home care. We’re not that prescriptive. So we have sometimes shifted to using the language “community centric.” The way that we work with communities who are interested in going down this path is helping them first to do a gap analysis and assessment of the resources that are already there in their community.  ... [Click on the title's link to continue reading.]

Dozens of CarePartners patients in Asheville transferred to other facilities after HCA temporarily shuts down rehab, hospice center Asheville Watchdog; by Andrew R. Jones; 10/14/24 Hundreds of employees uncertain about their jobs after facility is closed to ease pressure on Mission Hospital. Mission Health’s CarePartners Health Services is temporarily closed following the pressures Hurricane Helene put on Asheville’s health care system, disrupting rehabilitative care for more than 50 patients and forcing more than 250 employees to take temporary jobs elsewhere in the system, according to employees and internal emails obtained by Asheville Watchdog.  ... The closing affected nearly 50 inpatient rehab patients, several long-term acute care patients, and eight hospice patients, all of whom were sent to home caregivers, skilled nursing facilities, other inpatient rehab programs, and UNC Health Caldwell in Lenoir, more than an hour’s drive to the east, according to one employee.

Palliative medications: what works in practice for symptom control?Nursing Times; by Sally-Anne Francis, Eunice Sirkett, Emily Anderson and Sarah Yardley; 10/14/24 This article explores the real-life challenges of managing symptoms with medication at the end of life. ... Key points: