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.]

BCBS reaches record antitrust settlement for $2.8B Becker's Payer Issues; by Jakob Emerson; 10/16/24  The Blue Cross Blue Shield Association, along with the 33 independent BCBS companies, have agreed to pay $2.8 billion to settle antitrust claims from healthcare providers, marking the largest settlement of its kind in the healthcare industry. In addition to the cash settlement, the plaintiffs stated in an Oct. 14 filing in Alabama federal court that BCBS plans must implement significant operational changes across 16 categories. These changes include how BCBS processes claims, communicates, contracts with, and makes payments to providers. The new operational requirements are expected to alleviate administrative burdens and inefficiencies experienced by providers, according to the plaintiffs' counsel. The settlement applies to providers who treated BCBS members between July 2008 and October 2024. The tentative agreement still requires approval from U.S. District Judge R. David Proctor. The BCBS Association denies the allegations made in the lawsuit.

State association launches support program for home, hospice, personal care workers The Journal Gazette, Fort Wayne, IN; by Lisa Green; 10/15/24 A statewide association for home and hospice care professionals is launching a support program today with features including training and one-on-one counseling to help with workforce retention. The CARE (Creating Action and Resources for Employees) Connect program is billed as the first of its kind in the U.S., a news release said. A recent report released by MissionCare Collective indicates that caregivers are three times more likely to suffer from anxiety and depression, and 21% of caregivers nationwide self-report poor mental health. And 55% of those workers receive some form of federal or state assistance, the Indiana Association for Home and Hospice Care said in a news release announcing the new support program.

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.”

Hospice Sabbath Progressive Journal; by Hospice of Chesterfield County Foundation; 10/14/24 As you attend your place of worship the weekend of November 1-3, 2024, you may see a single white carnation displayed in a prominent location. Hospice of Chesterfield County Foundation has chosen the white carnation as a symbol for the observance of Hospice Sabbath. Churches are being asked to participate by displaying a white carnation in memory of all who have received Hospice services. ... These individuals were significant to their families and to our community. They were our neighbors, our co-workers, our friends, and our loved ones. ... In its simple elegance, the white carnation symbolizes the hope and dignity which Hospice helped to ensure for these individuals and for their families. In its fragile beauty, the carnation reminds us of the sacredness of life and the mystery of death. Hospice recognizes that endings are inevitable; yet, life is affirmed as persons are encouraged to live each moment to its greatest capacity.

Video: North Hawaii Hospice holds lantern floating ceremony Big Island Video News; 10/15/24 The annual floating lantern ceremony was held Sunday evening at the Fairmont Orchid. ... The event was organized by North Hawaii Hospice, ... “The goal is to honor and remember those who have passed, in a group setting,” said North Hawaiʻi Hospice executive director Faye Mitchell. “We get to share in our grief, but also in our joy about the people that we’ve loved and who are no longer with us.” ... “When people come, they have a lantern paper which they get to decorate and write messages for their loved ones. And then they put that lantern paper onto a base, and at sunset we helped them light a candle in that lantern. ... “I am an organizer of this event, but I am definitely also a participant,” Mitchell said. “I lost my son Geno in February of this year. He was 24 years old. I have to say, one of the key things I learned from the experience is that grief shouldn’t be kept to myself. ... There’s something about sharing your grief with others who know what it’s like. So that’s why I share it even now, with everyone watching, because if … you’ve lost someone you’re not alone, and if you share this experience with others you’d be surprised how many people have gone through this. It’s so much better not to be alone in this."

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:

Communication gaps among clinicians may limit conversations about prognosis, hospice Healio - HemOncToday; by Jennifer Byrne; 10/16/24 Clinicians in acute or post-acute care settings may delay or avoid serious illness conversations with patients whose cancer prognoses are worsening out of deference to the patient’s oncologist, according to study findings. Researchers conducted 37 semi-structured interviews with physicians and leaders in hospital medicine, oncology, palliative care, home health care and hospice. Investigators coded and analyzed the interviews using thematic content analysis. Evaluation of the responses yielded insights into how care silos, lack of clear clinical roles and other factors may affect communication between oncologists and other clinicians. ... "We know that the 3-month window after an older adult with cancer is discharged to a skilled nursing facility can be comprised of complex medical decision making and changing preferences of care. Lack of appropriate serious illness communication during this time can result in unwanted hospitalizations and unwanted, aggressive care at the end of life."

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.

The best way out is always through. ~ Robert Frost

Exploding physician union membership signals a significant labor market shift NJToday.net; 10/16/24 As of 2022, about 70,000 medical doctors in the United States, or about 8% of the physician workforce, belonged to a union—a notable increase of 26.8% since 2014. This shift reflects significant changes in the employment landscape for doctors, with nearly half of all physicians now working for health systems or large medical groups. The rise in union membership comes amidst broader labor movements in healthcare, highlighted by the 2023 Kaiser Permanente strike, recognized as the largest healthcare worker strike in U.S. history. While nurses have typically led these efforts, physicians and residents are increasingly exploring unionization as a means to advocate for improved pay, benefits, and working conditions. 

Researchers raise concerns about the financial sector's rising role in US illness care Medical Xpress; by Mary Ann Liebert, Inc; 10/16/24 The authors of a new article in Journal of Palliative Medicine state that the "growing role of the financial sector in home health and hospice, a reflection of larger trends in U.S. health care, is concerning and has major implications for care quality unless reforms are undertaken." Co-authors Lauren Hunt, Ph.D., RN, FN, with the University of California, San Francisco, and R. Sean Morrison, MD, with the Icahn School of Medicine at Mount Sinai in New York, observe that home health and hospice began as nonprofit organizations with close ties to their communities. However, the overwhelming majority are now for-profit entities, many of which have become targets for private equity buyouts. The authors note that "big business's emphasis on maximizing profit can be at odds with patient welfare. Indeed, a substantial body of evidence now demonstrates that care quality is consistently worse in for-profits as compared to nonprofits," they state. The authors further express concern that "pressure to achieve high returns on very short-term time horizons may conflict with the need for longer-term investments in quality, training, and staffing, thus reducing care quality.