Literature Review

Damage from Helene devastating for some veterans [including some on hospice]The VA health system is working to help veterans with medical needs after Helene left many in western North Carolina without power and water — and some without homes.

Data points to need for trauma-centered care at end of lifeMcKnight's Long-Term Care News; by Kristen Fischer; 10/2/24A new study has found that early life and cumulative trauma are linked to poorer physical and psychosocial health at the end of life. The report was published Tuesday in the Journal of the American Geriatrics Society. Among participants, 19% reported no trauma, while 47% experienced one to two traumatic events and 25% had three to four traumatic events. A total of 9% of people reported more than five traumatic events in their lives. “Findings highlight the need for clinicians caring for seriously ill older adults to ensure interdisciplinary care for trauma symptoms and potentially adopting a trauma-informed approach to end-of-life care,” the authors wrote.

Hospice of Golden Isles returns to independent operations Savannah Tribune - Social and Community News; by Savannah Tribune; 10/2/24 Hospice of the Golden Isles (HGI) is pleased to announce it will resume independent operations in the coming months. This decision was made as HGI approaches the final year of its five-year agreement with Alivia Care, a Florida-based nonprofit hospice provider. Throughout the affiliation, HGI faced significant challenges, including the COVID-19 pandemic, increased for-profit competition, and Medicare reimbursement changes. Despite these challenges, HGI has continued to deliver high-quality care to all patients, regardless of their ability to pay. “We are incredibly grateful for the benefits this partnership has brought to Hospice of the Golden Isles,” said Paula DiLandro, Executive Director of HGI. “However, as the Board of Directors assessed the current landscape, they realized the factors that initially drove the affiliation are no longer as pressing. After careful consideration, the Board decided to return to independent operations, ensuring the future success of HGI.”

Hospice policy mandating two-week enrollment prior to ingesting aid-in-dying medicationAcademy of Aid-in-Dying Medicine; by Constance Holden, Jeanne Kerwin, Paula Goodman-Crews, Margaret Pabst Battin; 10/2/24[A white paper from the ACAMAID Ethics Consultation Service.] An aid-in-dying-prescribing physician is concerned about a policy that several local hospices have implemented prohibiting patients from ingesting their aid-in-dying medication during the first two weeks of enrollment. The requesting provider is concerned that this policy requires patients who have made aid-in-dying requests to wait well beyond the 48 hours mandated by law. This potentially results in undue added suffering for the patient. It is also a potentially discriminatory practice, as it leads to unequal access to care.

Asian-American communities face ‘digital divide’ in health equity, hospice care Hospice News; by Holly Vossel; 10/1/24 Recent research has dug into the barriers limiting greater telehealth utilization among Asian American, Native Hawaiian and Pacific Islander (AANHPI) communities. The data come at a time when hospices are striving to better understand how to improve those groups’ end-of-life trajectories. Technology utilization has gained momentum in health care, including in hospice care delivery. Though increased virtual health care access can help hospice providers reach patients upstream, the trend may be worsening disparities and outcomes among Asian American populations, according to Victoria Tsze, an outpatient hospice social worker at Tucson Medical Center (TMC) Hospice. 

Hospitalists use POLST to initiate patient conversations about care goals The Hospitalist; by Larry Beresford; 10/1/24 Physician orders for life-sustaining treatment (POLST) is a single-page medical order form, typically printed on bright pink paper, and signed by a physician, nurse practitioner, or physician assistant to spell out treatment preferences for a seriously ill or frail patient. It is also a process for exploring those preferences in conversation with patients and then communicating them to those who might need to know, such as EMS personnel, in some future medical emergency when the patients can no longer speak for themselves. And, said Steven Pantilat, MD, FAAHPM, MHM, a former clinical hospitalist and the inaugural chief of the division of palliative medicine at the University of California San Francisco, it is “solidly within what hospitalists can and should be doing.” That may involve meeting and talking with patients and their families about their values and treatment preferences, reviewing any existing POLST forms, and even filling out and signing a form.

Executive Personnel Changes - 10/4/24 

SPECIAL EDITION: Helena & Hospice UpdatesOur "Headlines" overload today focuses on Helena and Hospices: current status, ways we can support affected hospices, resources, and more. With a prelude to our "Today's Encouragement" post: In unity, there is strength; when communities come together during a crisis, they can accomplish the impossible. ~ Amanda Ripley

Medicare Advantage is 'jeopardizing' rural hospitals, execs sayBecker's Hospital CFO Report; by Alan Condon; 10/2/24Medicare Advantage is "failing patients" and "jeopardizing" Nebraska hospitals, according to a survey of 92 member hospitals from the Nebraska Hospital Association. MA provides health coverage to more than 55% of the nation's older adults, about 33.8 million people, but some hospitals and health systems are ending their contracts with MA plans over administrative challenges that include excessive prior authorization denial rates and slow payments from insurers. "Medicare Advantage challenges the future of critical access hospitals due to lower reimbursement rates, slower or denied payments, and increased administrative burdens," Jed Hansen, executive director of the Nebraska Rural Health Association, said during an Oct. 2 virtual meeting with hospital leaders. "Without changes to MA, our rural hospitals may be forced to cut staff and services, further harming patient care. Over time, some of our rural hospitals may be forced to close altogether."

Hurricane Helene Disaster Relief Fund for home care & hospice employees in the CarolinasAssociation for Home & Hospice Care of North Carolina (AHHC of NC); by Judy Penn, Executive Director; 10/3/24 Click here to DONATE. Click here to APPLY for Assistance. urricane Helene has severely impacted our community, with many lives already lost in the Carolinas, and countless missing with no means of communication.  The Carolinas Foundation for Hospice & Home Care is accepting donations to distribute directly to hospice and home care employees devastated by this storm. Agencies are facing tremendous challenges, including displacement and/or evacuation of staff and patients, collapsed roads, failing infrastructure, lack of water, and the inability to communicate with downed lines. There is a major need for gas to continue to power generators for oxygen dependent patients both in home settings and hospice inpatient facilities. The Association staff has been in contact with government agencies to us keep up-to-date on the situation as it unfolds. Our industry is comprised of caring, compassionate individuals who help those in need. Please consider donating to the Hurricane Helene Relief Fund to help home care and hospice employees hit the hardest. ... 100% of ALL ADMINISTRATIVE COSTS are being borne by the Association and the Foundation. 100% of your donation (tax-deductible) comes in, and 100% of your donation goes out.

Doctor explains hospice care misconceptions[NBC Denver] 9News; 9/25/24Dr. Payal Kohli explains what hospice care is, what they do at the care facility and explains the misconceptions around hospice.Publisher's note: Nice 5-minute TV interview about hospice.

Maybe we should select leaders based on their characterForbes; by Joyce E. A. Russell; 10/1/24When we hire leaders for our organizations and communities, shouldn’t we pick them based on not only their expertise and ability to do the job, but also their character? Over two decades ago, prominent leadership researchers Kouzes and Posner published a book called Credibility. In their research, they noted that across the globe credibility was the most highly rated and important characteristic of leaders. They stated that, “most of us admire leaders who are honest, forward-looking, inspiring, and competent.” They followed that up with another book with even more evidence called The Truth about Leadership, where they noted that credibility is the foundation of leadership for organizations across the world, and this is based on international data across multiple generations.