Literature Review

Wind phones help the bereaved deal with death, loss and grief − a clinical social worker explains the vital role of the old-fashioned rotary phone The Conversation; by Taryn Lindhorst; 9/20/24 My mother died in my home in hospice in 2020, on the day my state of Washington went into COVID-19 lockdown. Her body was taken away, but none of the usual touchstones for grief were available to our family. ... As a clinical social worker and health scholar with 40 years of experience in end-of-life care and bereavement, I knew that I needed some way to tend to my grief for my mother. While in lockdown, I began looking for resources to help me. Then I heard about the wind phone. What is a wind phone? At its simplest, a wind phone is a rotary or push-button phone located in a secluded spot in nature, usually within a booth-type structure and often next to a chair or bench. The phone line is disconnected. People use the wind phone to “call” and have a one-way conversation with deceased loved ones. Here they can say the things left unsaid. Wind phones offer a setting for the person to tell the story of their grief, to reminiscence and to continue to connect to the person who is gone. For many, it is a deeply moving, life-affirming experience. About 200 wind phones are scattered throughout the United States. Editor's note: This creative tool is similar to common clinical tools of writing a letter to the deceased person, and the "Empty Chair" technique. Caution: This should never be used as a gimmick. This can be terribly confusing and upsetting for persons with dementia, or supportive if used with professional sensitivity for the patient's awareness and experience. For persons with dementia, be familiar with the ground-breaking "Validation Therapy" techniques by Naomi Feil. 

Mirror, mirror 2024: A portrait of the failing U.S. health system - comparing performance in 10 nations The Commonwealth Fund; by David Blumenthal, Evan D. Gumas, Arnav Shah, Munira Z. Gunja, and Reginald D. Williams II Goal: Compare health system performance in 10 countries, including the United States, to glean insights for U.S. improvement. Methods: Analysis of 70 health system performance measures in five areas: access to care, care process, administrative efficiency, equity, and health outcomes. Key Findings: The top three countries are Australia, the Netherlands, and the United Kingdom, although differences in overall performance between most countries are relatively small. The only clear outlier is the U.S., where health system performance is dramatically lower. Conclusion: The U.S. continues to be in a class by itself in the underperformance of its health care sector. While the other nine countries differ in the details of their systems and in their performance on domains, unlike the U.S., they all have found a way to meet their residents’ most basic health care needs, including universal coverage.

Guidelines for supporting the dying and their families Psychiatric Times; by Ken Druck, PhD; 9/19/24 There are few subjects that most of us, including those who work in mental health, avoid more than death and dying. Meeting the needs of the dying and their families requires a deep and clear understanding of competent and compassionate care for health care professionals and caregivers. Since the death of my 21-year-old daughter several decades ago, I have had the honor and privilege of helping countless individuals, families, and communities that have suffered losses. I have also been given the opportunity to teach and train mental health professionals and developed several programs and guidelines for supporting the dying and their families. My top 7 guidelines to share with patients and their families are as follows:

AI shouldn't decide who dies. It's neither human nor humane Fox News; by John Paul Kolcun and Anthony Digiorgio; 9/20/24 [Opinion] As we write this, PubMed ... indexes 4,018 publications with the keyword "ChatGPT." Indeed, researchers have been using AI and large-language models (LLMs) for everything from reading pathology slides to answering patient messages. However, a recent paper in the Journal of the American Medical Association suggests that AI can act as a surrogate in end-of-life discussions. This goes too far. The authors of the paper propose creating an AI "chatbot" to speak for an otherwise incapacitated patient. To quote, "Combining individual-level behavioral data—inputs such as social media posts, church attendance, donations, travel records, and historical health care decisions—AI could learn what is important to patients and predict what they might choose in a specific circumstance." Then, the AI could express in conversant language what that patient "would have wanted," to inform end-of-life decisions. We are both neurosurgeons who routinely have these end-of-life conversations with patients’ families, as we care for those with traumatic brain injuries, strokes and brain tumors. These gut-wrenching experiences are a common, challenging and rewarding part of our job. Our experience teaches us how to connect and bond with families as we guide them through a life-changing ordeal. In some cases, we shed tears together as they navigate their emotional journey and determine what their loved one would tell us to do if they could speak. 

HHS awards $100M to address workforce shortages Becker's Hospital Review; by Kristin Kuchno; 9/18/24 The Health Resources and Services Administration, an agency of HHS, announced it will award $100 million to organizations including medical schools and state health departments to address healthcare workforce shortages, according to a Sept. 17 news release from HHS. With a shortage of 100,000 healthcare workers expected nationwide by 2028, some health systems have focused on nurse faculty shortages, such as New Bedford, Mass.-based Southcoast Health. ... 

Ascension posts $1.8B annual loss; liquidity 'remains strong,' CFO says Becker's Hospital CFO Report; by Alan Condon; 9/18/24 St.Louis-based Ascension reported a $79 million operating loss (-0.3% margin) for the 10 months ending April 30, a substantial improvement on the $1.2 billion operating loss in the previous 10-month period. The results include $402 million in one-time, non-cash write-downs and non-recurring losses. In May and June 2024, operations were hampered by the May ransomware attack, resulting in reduced revenues from the associated business interruption along with costs incurred to address the issues and other business-related expenses. Despite this incident, Ascension drove a $1.2 billion operational improvement year over year for the 10 months ending April 30. The 136-hospital system's economic improvement plans focused on volume growth, rates and pricing, and cost levers. 

New data explores trust gap between execs and employees HR Daily Advisor; by Lin Grensing-Pophal; 9/19/24Creating a harmonious workplace where trust flourishes between employers and employees is crucial for aligning incentives and driving employee engagement. Unfortunately, that trust is often hard to find in the business world. ... Consider, for example, these data points from the PwC survey:

Woman explains viral video of brother with hospice nurses before he died ABC News - GMA; Shafiq Najib; 9/20/24 Marcella Brown's little brother, Omar Mamoe, died of appendix cancer at 34. A woman explained the story behind the viral video of her brother going on a walk and having fun with the nurses during his final days in hospice before his death. In an Instagram video shared by Marcella Brown of Austin, Texas, recently, her late brother Omar Mamoe can be seen sitting in a wheelchair as he was about to exit his room accompanied by the nurses who entertained him by rapping to a song, "It Was a Good Day," by Ice Cube. The clip, which has garnered over 5 million views, was taken eight days before Mamoe died, showing how he kept his spirits high and brought smiles to those around him. Speaking to "Good Morning America," Brown said she shared the video last month because she was feeling sad at the time, thinking about her late brother. "The video came up, and it just made me feel happy, and it just reminded me that towards the end of his life, like there were these little moments that were good," she said. [Click on the title's link to view the video and read more.]Editor's note: Omar's care was provided by Hospice Austin's Christopher House. Click here (and scroll down) for a different, beautiful video story about Omar and his family. 

How can we make dementia care more human? Practical insights for providers. CHAP - Community Health Accreditation Partner; by Jennifer Kennedy, PhD; 9/20/24 This year’s World Alzheimer’s Day brings a renewed focus on advancing dementia care, especially with the recent launch of the CMS GUIDE Model. This groundbreaking approach emphasizes comprehensive, coordinated care, not only improving the lives of patients but also significantly easing the burden on caregivers. As healthcare providers, there’s a critical opportunity to adopt strategies that go beyond clinical treatment, focusing on the human experience and addressing the emotional, physical, and financial challenges that dementia brings. ... As we reflect on the progress made in dementia care, there are several actionable strategies healthcare providers can implement to enhance their programs:

End-of-life care demand for dementia patients set to surge, study warns Jersey Evening Post, United Kingdom; by UK News; 9/16/24 [United Kingdom] The number of people living with dementia who require end-of-life care is set to “substantially increase” in the coming years, according to a study. ... Researchers said: “Previous projections of the number of people with dementia who will have palliative care needs in England and Wales were based only on the number of people who died with dementia, and did not take into account people living with dementia. Thus, it is likely that the prevalence of palliative care needs among people with dementia in England and Wales has been considerably underestimated. Our analysis shows that even if dementia incidence declines between 2018 and 2040, the number of people living with dementia in England and Wales who have palliative care needs will increase substantially by 2040, reaching levels far greater than previous estimates based on mortality data.”Editor's note: How do these projection processes in the UK compare or contrast with the USA data you use? For more immediate information about current resources:

CMS teases new cybersecurity policies for third-party vendors Modern Healthcare; by Bridget Early; 9/13/24 The Centers for Medicare and Medicaid Services is planning oversight of third-party healthcare vendors in the wake of the Change Healthcare cyberattack, said Jonathan Blum, the agency's principal deputy administrator. Blum, who also serves as chief operating officer for CMS, said at Modern Healthcare's Leadership Symposium Thursday that the agency is working to determine what levers it can pull to ensure severe disruptions in care like those linked to the cyberattack on the UnitedHealth Group subsidiary aren’t repeated. ... Almost 133 million individuals were affected by healthcare data breaches last year, more than double the number of those affected in 2022 and a number equivalent to about 40% of the U.S. population.

What is hospice?JAMA Patient Page; by Vanessa Wagner, Adam Marks; 9/11/24Hospice is a specialized model of medical care for people with terminal illness. The goal of hospice is to provide compassionate care to maximize a person’s comfort and quality of life during the natural dying process. Hospice care teams are composed of doctors, nurses, social workers, chaplains, and other individuals who work together to address the physical, emotional, social, and spiritual needs of people with a terminal illness and to support their families. This generally includes alleviating symptoms (such as pain, shortness of breath, or anxiety), establishing a comfortable and peaceful environment, and facilitating meaningful time with loved ones.Publisher's note: Written by two physicians and appearing in JAMA, this "hospice introductory piece" might be helpful for new employee orientation or community outreach.

Honoring National Hispanic Heritage Month CMS.gov - CMS Office of Minority Health Menu; for 9/15-10/15 September 15 through October 15 is National Hispanic Heritage Month, a time to honor the 63.7 million Hispanic people living in the United States. This month, the Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) would like to raise awareness of the health disparities that impact Hispanic Americans and highlight efforts to reduce gaps in health care. Hispanic Americans are at greater risk of various health conditions due to a lack of preventive care and health insurance, as well as language barriers. In 2022, almost 28% of Hispanic adults didn’t have health insurance compared to Black (13.3%), White (7.4%), and Asian (7.1%) adults. Resources: