Literature Review

If you love the work you are doing, then you will love Tuesday! ~ Catherine Pulsifer

Kaiser Health Care: Navigating Aging: Older men’s connections often wither when they’re on their own Tahlequah Daily Press; by Judith Graham; 10/12/24 At age 66, South Carolina physician Paul Rousseau decided to retire after tending for decades to the suffering of people who were seriously ill or dying. It was a difficult and emotionally fraught transition. … Seeking a change of venue, Rousseau moved to the mountains. … Soon, a sense of emptiness enveloped him. … His work as a doctor had been all-consuming. Former colleagues didn’t get in touch, nor did he reach out. His wife had passed away after a painful illness, … His isolation mounted as his three dogs, his most reliable companions, died. Rousseau was completely alone — without friends, family, or a professional identity — and overcome by a sense of loss. “I was a somewhat distinguished physician with a 60-page resume,” Rousseau, now 73, wrote in the Journal of the American Geriatrics Society in May. “Now, I’m ‘no one,’ a retired, forgotten old man who dithers away the days.” In some ways, older men living alone are disadvantaged compared with older women in similar circumstances. Research shows that men tend to have fewer friends than women and be less inclined to make new friends. Often, they’re reluctant to ask for help.

2,400 Kaiser mental health workers to begin open-ended strike: 6 things to know Becker's Hospital Review; by Kelly Gooch; 10/11/24 Members of the National Union of Healthcare Workers are set to begin an open-ended strike Oct. 21 at Kaiser Permanente locations in Southern California. Six things to know:

Hospice in a hurricane: How Empath Health responded to back-to-back disasters Hospice News; by Jim Parker; 10/11/24 Hospice providers in the southeastern United States are reeling from the impacts of two massive hurricanes that have occurred during the past two weeks. ... The Florida-based hospice and senior services provider Empath Health saw the majority of its service region affected by [Hurricane Milton], which caused substantial damage to infrastructure in many communities. Empath reported no major injuries among its employees, according to CEO Jonathan Fleece. However, some employees did lose entire homes or experienced significant damage, as well as cars and other essentials. ... “We do our best through pre-storm planning to come up with our communication plans with our patients and their families, ...” Fleece told Hospice News. “When we can’t reach people by phone, once we have any kind of access to roads, we will do our very best to do some sort of a check in.” These efforts are coordinated through an emergency management team, led by commander Matt Chaloux, that engages in disaster planning and response, Fleece said. Building on lessons learned from Hurricane Ian in 2022, Empath also established a mobile response unit — a vehicle designed to provide clinical, communications and logistical support during catastrophic events. The unit is modeled after similar vehicles used by the Federal Emergency Management Agency. Empath Health has set up a fund to aid employees who were affected by the hurricanes, helping to provide them with housing, transportation, child care and other needs, according to a statement posted by Fleece on LinkedIn. The organization's board of trustees has pledged to mathc donations dollar-for-dollar up to $500,000.Editor's note: Click here to donate to Empath Helath's fund to aid employees. 

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.

Clinical scenario: Patient care through POLST  The Hospitalist; by Mihir Patel, MD, MPH, FACP, CLHM, SFHM; 10/10/24 Physician orders for life-sustaining treatment (POLST) forms are crucial tools in ensuring that patient treatment preferences are respected and followed, particularly during medical emergencies. As hospitalists, integrating POLST into patient care can significantly enhance decision-making processes, aligning treatments with the patient’s wishes. Here, we present a clinical scenario demonstrating the application of POLST in a hospital setting, emphasizing the importance of electronic documentation in the patient’s medical record. ... [Click on the title's link for this Case Study, which includes the Case, Hospitalist Actions,Outcome, and Conclusion.]

Why recent outages are a wake-up call for healthcare and regulators Forbes; by Chris Bowen; 10/11/24 When the CrowdStrike outage first started to show itself in the early hours of that hazy July morning, it was hard to believe that this wasn’t a hack or cyberattack. I was driving in my car that morning and looked up to see a digital billboard glitch into the "blue screen of death" before my eyes. Flights were grounded, travel was delayed, and nearly every Windows machine in the world was unusable. It was total mayhem. Clearly, this was an outage of major proportions, as millions of Windows systems worldwide essentially cratered. Caused by a faulty misconfiguration, we saw firsthand how the very digital advancements that have helped transform and modernize our world also expose us to more vulnerabilities than ever. ... In healthcare, this event laid bare the vulnerabilities we cannot overlook—the gaps that directly threaten patient care and safety. It’s a clear reminder of our industry’s utmost responsibility to patient privacy and well-being. ...

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.]

Janey Godley says it's important to 'talk about death' in hospice update STV News; 10/8/24 Janey Godley has said it is important to “talk about death” as she shared an update on her condition from her hospice.The Scottish comedian is currently receiving end-of-life care after receiving the news that her cancer had spread, after initially being diagnosed with ovarian cancer in 2021. She shared the “devastating news” in September after cancelling her upcoming autumn tour, adding that her “chemo ran out of options” and she couldn’t take anymore. In a video from the hospice, Godley thanked everybody as she confirmed she has had some issues with sickness – and said it is “hard” to speak about death but these are conversations we “all have to have.”

Hurricane Milton challenges home-based care's adaptability Modern Healthcare; by Diane Eastabrook; 10/9/24 [Note, posted just prior to landfall, Wed. Oct. 9.] Hurricane Milton is set to test the resilience of home-based care providers along the west coast of Florida. While hundreds of healthcare sites reported evacuations ahead of the hurricane, some companies that provide care to patients where they live, including CenterWell and Medically Home, continued to send staff into patients’ homes in the hours before the storm hit. Many home-based care companies are ready to activate contingency plans to keep providing care to patients during and after the hurricane. ... Here is how some home-based care providers prepared for Hurricane Milton. ...

How poor health literacy can diminish access to palliative care Hospice News; by Jim Parker; 10/11/24 Low health literacy among seriously ill patients can impede access to palliative care and complicate efforts to improve health equity. Health literacy is the degree to which individuals can obtain, process and understand basic health information and services needed to make appropriate health decisions, according to the Institute of Medicine. A health illiterate patient may have a strong overall ability to read or have an advanced education but have a limited understanding of information specific to health care. ... The issue deepens when it comes to palliative care. An estimated 71% of adults in the United States are unaware that palliative care exists, studies have shown, even though nearly 80% of consumers who received background information on palliative care say they would choose it for themselves or their loved ones. 

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.