Literature Review

Home health providers, CMS raise red flags over delayed access Modern Healthcare; by Diane Eastabrook; 10/11/24 Delayed home health access for Medicare beneficiaries is increasingly raising alarms from the Centers for Medicare and Medicaid Services and the home health industry as providers place blame on staff shortages and the program's reimbursement rates. More than a third of Medicare fee-for-service beneficiaries referred to home health following hospitalizations did not receive services within seven days of discharge, according to an analysis of 2023 Medicare claims from healthcare analytics company CareJourney. The report echoes a similar study published by the Commonwealth Fund in July, as well as concerns CMS raised about access in its proposed 2025 home health pay rule. ... Years of low Medicare reimbursements are taking a toll on the home health companies trade groups represent, said William Dombi, president emeritus of the National Association of Home Care and Hospice, which is part of the National Alliance for Care at Home, and Cunningham.

Integration of palliative care in the management of multiple chronic conditions: An expert consensus paper with policy implications George Washington University; by Kim Kuebler, DNP, ANP-BC, FAAN, Todd Monroe, PhD, RN, FAAN, Richard Ricciardi, PhD, CRNP, FAAN, Cheryl Westlake, PhD, ACNS-BC, FAAN, Matthew Sorenson, PhD, ANP-C, FAAN, Jane Pederson, MD, MS, Michael Neft, PhD, CRNA, FAAN, Sandra A. Mitchell, PhD, CRNP, FAAN, Kathryn Daniel, PhD, AGNP, FAAN, Susan De Santo-Madeya, PhD, APRN-CNS, FAAN, Susan Renda, DNP, ANP-BC, FAAN, Elizabeth Henneman, PhD, RN, FAAN, Eduardo Bruera, MD; 10/10/24 This paper was jointly developed from members of the American Academy of Nursing Expert Panels on Palliative and End of Life Care, Primary Care, Aging, Acute and Critical Care, and two expert physicians. Purpose: The overarching goal is to promote the integration of palliative care as symptom management into the primary care setting to transform care for patients living with multiple chronic conditions. ... Discussion: Earlier palliative interventions reduce disease exacerbation, prevent hospitalization, maintain physical functioning, and support health-related quality of life. Conclusion: This is a needed paradigm shift as the nation’s aging population escalates, Americans are living longer, and the healthcare costs for the nation are unprecedented. [Click on the title's link for this full description; then scroll down to "Download PDF" for the actual paper.]

Caring for the family caregivers made ill by their work Penn LDI; by Hoag Levins; 10/11/24 A randomized controlled trial (RCT) led by LDI Senior Fellow Barbara Riegel, PhD, RN, of the University of Pennsylvania School of Nursing has identified a virtual health coaching intervention that helped lessen stress for unpaid family caregivers who often neglect their own care. Published in Circulation: Heart Failure, the study focused on unpaid family caregivers providing care to adults with chronic heart failure (HF)—a condition that occurs when the heart can’t pump enough blood for the body’s minimal needs. Because the disease has a variety of symptoms and manifestations that limit palliative care and respite services, it places a heavy burden on home caregivers who are “are commonly overwhelmed and face emotional, psychosocial, and financial risks that result in a decline in their own health and wellness.”Editor's note: Family Support Through Serious Illness is an online video library of 30 brief, state-of-the-art videos for family caregivers, used upstream in the trajectory of serious illness and through palliative/hospice care. These pair with a staff video training, "Empathy for Hospice Professionals."  These are designed and provided by Composing Life Out of Loss, a sponsor for this newsletter.

[From NHPCO/NACH] Hurricane Helene | Getting and Providing SupportNational Alliance for Care at Home / formerly NHPCO; Elyssa Katz; 10/3/24 Hurricane Helene has absolutely devastated the Carolinas and surrounding areas. The Alliance stands with our members, the communities they serve, and all at-home providers across the impacted regions. If you or your organization has been impacted, please see the collection of resources and the Ways to Get Support section below. If you’re looking to help fellow providers or peers in need, see the Ways to Provide Support section.

Amazon Wish List for 3 hospices impacted by Hurricane HeleneWe have gathered a list of items needed by each of our member organizations that were significantly impacted by Hurricane Helene.  If you are interested in donating items, please click on the links below to make a purchase.  The items will be shipped directly to the member organization(s).  Wish lists from member organizations:

Heartless activist who took selfie with woman’s dying father in hospice shows no emotion upon learning of her fate following sick harassment campaign What'sNew2Day; written by "Jack," with another author listed "Bethan Sexton for Dailymail.com"; 10/5/24 An activist who snuck into a hospice and took a selfie with a woman’s dying father because he opposed her support for LGBTQ rights showed no emotion as he was sentenced for his sickening campaign of harassment. Bubba Pollock, 35, was sentenced to two months in prison after pleading guilty to criminally harassing Britt Leroux, 38. Pollock, from London, Ontario, openly protested the drag queen stories and was seen on video promising to pay people up to $500 to sabotage events. He had a fierce debate with Leroux, which culminated in him driving 120 miles to the Windsor hospice where Leroux’s father, Andre Leroux, was receiving palliative care and taking the photograph in an attempt to mock his victim.Editor's note: What social media Policies and Procedures do you have in place for any and all persons who might abuse the privacy and rights of the persons and families you serve? Based on this incident--which could be replicated easily--what might you need to write, educate, and enforce in order to protect your patients and their families?

World Hospice & Palliative Care Day - Saturday October 12, 2024 WHPCA - Worldwide Hospice Palliative Care Alliance; webpage retrieved 10/7/24 World Hospice and Palliative Care Day is an annual unified day of action to celebrate and support hospice and palliative care around the world. WHPCD has been marked every year for the last 20 years. Join us on Saturday 12 October to advocate for better hospice and palliative care services around the world. The WHPCD theme for 2024:Ten Years Since the Resolution: How are we doing? The year 2024 marks 10 years since the World Health Assembly (WHO’s Governing Body) passed the only stand-alone resolution on palliative care, calling for all countries to “strengthen palliative care as a component of comprehensive care throughout the life course.” This is what inspired the theme for 2024. [Click on the title's link for this article and to download a wealth of resources.] 

PACE Programs emerge as ‘natural allies’ to home-based care providers Home Healthcare News; by Joyce Famakinwa; 10/4/24 Home-based care providers and Program of All-Inclusive Care for the Elderly (PACE) organizations are in a unique position to strengthen the work one another is doing to care for seniors. No one understands this better than Alivia Care, a home-based care provider that also has PACE programs under its umbrella. In 2021, Alivia Care opened up Jacksonville, Florida-based The PACE Place. “We thought No. 1, it related to the type of care that we gave, in terms of chronic elderness, geriatric frailty, many of the things that we see in our hospice patients, so we felt that we had some core competencies there,” Alivia Care CEO Susan Ponder-Stansel told Home Health Care News. ...

'Trying not to cry:' Helene's wrath sets new normal in battered western North Carolina townCBS WBTW-13, Florence, SC; by Adrianna Lawrence; 10/8/24 Kyle Katona has lived through his share of hurricanes. But nothing could ready him for the wrath Helene unleashed across the idyllic valleys of western North Carolina. "I've never seen the amount of devastation that Hurricane Helene caused in the mountains," the Four Seasons hospice store driver said. He wasn't alone. "I don't think anybody was prepared for the level of catastrophe that was going to occur," said Rikki Hooper, Four Seasons' clinical operations officer. Traumatized residents awoke to the sound of water coursing into their homes before the sun came up -- taking everything and, in some heartbreaking instances, everyone, with it. ... At Lake Lure -- a beloved vacation spot minutes from Chimney Rock -- mud stands in for where water once flowed. Instead, officials and first responders were providing medical treatment. Military helicopters flicked across the sky and bulldozers cleared out areas. If it sounds like a warzone, that's because it was as close as it could be to one, Pixie Moore [a resident] said. Editor's note: Click here to donate directly to Four Seasons' hurricane relief needs; or Amazon Wish List. Click here for our 10/2 interview with TCN leaders about Helene's devastation and hospice needs for Four Seasons, Amorem, Compassionate Care of Western North Carolina (CCWNC), and Carolina Caring. 

Between what is said and not meant, and what is meant and not said, most love is lost. ~Gibran Khalil

There are two ways of spreading light: to be the candle or the mirror that reflects it. ~Edith Wharton

Disbelief, distress, & distrust: trending institution related emotional distress during COVID-19Journal of Social Work in End-of-Life & Palliative Care; Jillian Sherman, Shannon Petros; 10/24The COVID-19 pandemic had an unprecedented impact on the well-being of individuals working in the healthcare sector. Numerous themes were identified [in this study], including the importance of caseload, general support, team support, management, and professional flexibility. Additional end-of-life themes were identified, including the impact of death, lack of personal protective equipment, fear of transmitting the virus, COVID disbelief, and the inability of clinicians and/or family to be with patients in person. From the experience participants had during COVID-19, four areas of change were identified: professional resilience, management/ethics support, professional development, and physical and emotional safety.

Fear of cancer recurrence in adult survivors of childhood cancerJAMA Network Open; Alex Pizzo, MSc; Wendy M. Leisenring, ScD; Kayla L. Stratton, MSc; Élisabeth Lamoureux, BA; Jessica S. Flynn, MSc; Kevin Alschuler, PhD; Kevin R. Krull, PhD; Lindsay A. Jibb, PhD, RN; Paul C. Nathan, MD, MSc; Jeffrey E. Olgin, MD; Jennifer N. Stinson, PhD, RN; Gregory T. Armstrong, MD, MSc; Nicole M. Alberts, PhD; 10/24In this cross-sectional study of 229 North American adults who survived childhood cancer, one-third of survivors reported experiencing elevated fear that their primary cancer will recur or a subsequent malignant neoplasm will develop. Fear of cancer recurrence was associated with chronic health conditions, treatment-related factors, anxiety, depression, and perceived health status.