Literature Review

Drugs, delirium, and ethics at the end of lifeJournal of the American Geriatric Society, by Columba Thomas, MD; Yesne Alici, MD; William Breitbart, MD; Eduardo Bruera, MD; Liz Blackler, MBE, LCSW-R; Daniel P. Sulmasy MD, PhD; 1/24For older persons with delirium at the end of life, treatment involves complextrade-offs and highly value-sensitive decisions. The principles of beneficence,nonmaleficence, respect for autonomy, and justice establish important parametersbut lack the structure necessary to guide clinicians in the optimal management ofthese patients. We propose a set of ethical rules to guide therapeutics—the canonsof therapy—as a toolset to help clinicians deliberate about the competing concernsinvolved in the management of older patients with delirium at the end of life.

Disparities in the geographic distribution of palliative care specialists in 2022Journal of General Internal Medicine, by Julia L Frydman, Karen McKendrick, Yingtong Chen, Jonathan Wun, Nathan E Goldstein, R Sean Morrison, Laura P Gelfman; 2/12/24In 2022, the number of HPM board-certified clinicians was 8,935 (6,448 = physicians (72.2%); 2,487 = NPs (27.8%)), which represents 0.7% of the NP workforce and 0.6% of the physician workforce... Our study highlights the uneven geographic distribution of board-certified HPM clinicians, which depends on state, metropolitan status, and area-level SES. 

Planning Ahead: Medicare, Medicaid or Hospice for at-home careThe Mercury, by Janet Colliton; 2/21/24If you are seeking at-home care assistance for a family member that is paid either in full or in part by the government, you can find that the system is complicated and, unless your loved one fits within one of the designated categories, you may be limited to paying from your family member’s asset or your own. Here are some of the differences and criteria.Editor's Note: This concise, user-friendly article by a Certified Elder Law Attorney provides simple descriptions of this all-important information. What Hospice Medicare information does your staff need to know and use? What clarity do you provide to the public / community you serve?

New outlook report shows home-based care providers bullish on near-term revenue opportunities in the year aheadWTWH Media LLC, by Marshall Matheson; 2/20/24Home Health Care News, a WTWH Media publication, has released the results of its 2024 Home-Based Care Outlook Survey, identifying the top challenges and opportunities for home-based care providers in the year ahead.

Woman tried to kill 88-year-old father in hospice by choking himDeerfield Beach, FL Local News 10; 2/21/23 A Deerfield Beach woman is facing three felony charges, including attempted murder, after deputies said she tried to choke her 88-year-old father to death while he was under hospice care. 

We gave palliative care patients VR therapy. More than 50% said it helped reduce pain and depression symptomsThe Conversation; 2/22/24Our study, published this week in the journal BMJ Supportive & Palliative Care, found more than 50% of patients experienced clinically meaningful reductions in symptoms such as pain and depression immediately after a 20-minute VR session. ... Personalised VR means each person experiences content that is meaningful to that individual. So rather than asking patients to choose, for example, between a rainforest and a beach VR experience, we interviewed the patients before their sessions to gauge their interests and create a VR session tailored to them.

House of Delegates considering SB 280, Medical Aid in Dying The Connection to Your Community, by Mercia Hobson; 2/20/24Virginia is a battleground state within itself. State legislators are fiercely divided concerning proposed legislation, SB 280. If passed, it would allow an eligible adult diagnosed with a terminal disease to request an attending health care provider to prescribe a fatal dose of a controlled substance to be self-administered for the purpose of ending the patient's life. Senate Bill 280, one of the two Virginia bills concerning Death with Dignity, passed passed the Senate. Its companion, House Bill 858, which was originally "put on hold for the day," failed in committee.

Exploring whether a diagnosis of severe frailty prompts advance care planning and end of life care conversationsNurs Older People, by Stacey Dodson; 2/21/24Findings: Frailty appeared to be complex, multifaceted and at times difficult to identify. A diagnosis of severe frailty did not necessarily prompt advance care planning and end of life care conversations. Such conversations were more likely to happen if the person had comorbidities, for example cancer. Prognostication appeared to be challenging, partly due to the gradual and uncertain trajectory in frailty and a lack of understanding, on the part of healthcare professionals, of the condition and its effects.

Racial differences in hospice care outcomes among patients with advanced heart failure: Systematic review and meta-analysisAm J Cardiol, by Diego Chambergo-Michilot, Victor G Becerra-Gonzales, Veraprapas Kittipibul, Rosario Colombo, Katia Bravo-Jaimes; 2/19/24There remains a paucity of investigational data about disparities in hospice services among people with non-cancer diagnoses, specifically in heart failure. Black patients with advanced heart failure have been disproportionally affected by health care services inequities but their outcomes after hospice enrollment are not well studied. We aimed to describe race-specific outcomes in patients with advanced heart failure who were enrolled in hospice services.

Transaction: Legacy Care Partners acquires Superior Home Health; SSM Health promotes Health at Home ArmNation World News Desk; 2/21/24Legacy Care Partners – which also owns Advanced Home Care – has acquired Superior Home Health and Superior Hospice of Texas. Terms of the deal were not disclosed.

How one hospice owner got convicted of healthcare fraud and how you can avoid that fateHospice Insights: The Law and Beyond, by Husch Blackwell; 2/21/24The owner of a Louisiana hospice was indicted and then convicted of healthcare fraud. How did that happen? In this [podcast] episode, Husch Blackwell's Meg Pekarske and Jonathan Porter talk about how a routine audit led to a whistleblower complaint by a hospice employee, which then led to the hospice owner’s criminal conviction following trial in November 2023. Most importantly, the pair discuss how other hospices can avoid that fate.

Jimmy Carter's hospice care shines light on the vital role of end-of-life services in GeorgiaBNN, by Dil Bar Irshad; 2/19/24As news emerged that former U.S. President Jimmy Carter had entered hospice care at his home in Georgia, the spotlight turned not only to the respected statesman's final chapter but also to the broader narrative of hospice care in America. This development underscores the critical importance of raising awareness about holistic end-of-life services, a mission that hospices around the nation, such as the esteemed Shakespeare Hospice, have been championing for decades.

You can't use up creativity. The more you use, the more you have. – Maya Angelou