Literature Review

The value of screening for a history of incarceration in the palliative care settingAmerican Journal of Hospice and Palliative Medicine; by Joseph Michael Schnitter, Joshua Hauser; 5/24In this article, we explore existing literature that highlights the unique physical, cognitive, and psychosocial challenges that formerly incarcerated patients face. We proceed to argue that palliative care providers should screen for a history of incarceration to identify and address the needs of this patient population. We also offer strategies to create a safe, welcoming environment to discuss past traumas related to these patients’ time in prison.

In praise of hospiceJAMA; by James R. Nicholas, MD; 4/24... Joan did what she wanted to do: she, with the help of hospice, made her dying as easy as possible for me and our children. I have the same wish for myself. I doubt if I will achieve it as well as did Joan, but I will have her as a guide. And I hope I will have the kind of hospice team that Joan had.

Associations between Certificate of Need policies and hospice quality outcomesAmerican Journal of Hospice & Palliative Medicine; by Arlen G. Gaines, John G. Cagle; 5/24Approximately 86% of hospices are in states without a hospice CON provision. The unadjusted mean HIS scores for all measures were higher in CON states (M range 94.40-99.59) than Non-CON (M range 90.50-99.53) with significant differences in all except treatment preferences. ... The study suggests that CON regulations may have a modest, but beneficial impact on hospice-reported quality outcomes, particularly for small and medium-sized hospices.

Success is stumbling from failure to failure with no loss of enthusiasm. ~Winston Churchill

Inpatient palliative care and healthcare utilization among older patients with Alzheimer's Disease and Related Dementia (ADRD) and high risk of mortality in U.S. hospitalsAmerican Journal of Hospice and Palliative Care; by Zhigang Xie, Guanming Chen, Oluwadamilola T Oladeru, Hanadi Y Hamadi, Lucinda Montgomery, Maisha T Robinson, Young-Rock Hong; 5/24PC substantially reduced hospital expenditures for older patients with ADRD-HRM, but the prevalence remained low at 14.6% in the study period. Future studies should explore the unmet needs of patients with lower sociodemographic status and those in rural hospitals to further increase their PC consultation utilization.

Does assisted living provide assistance and promote living?Health Affairs; by Sheryl Zimmerman, Robyn Stone, Paula Carder, Kali Thomas; 5/24Assisted living has promised assistance and quality of living to older adults for more than eighty years. ... As assisted living has evolved, the needs of residents have become more challenging; staffing shortages have worsened; regulations have become complex; the need for consumer support, education, and advocacy has grown; and financing and accessibility have become insufficient. Together, these factors have limited the extent to which today’s assisted living adequately provides assistance and promotes living, with negative consequences for aging in place and well-being. This Commentary provides recommendations in four areas to help assisted living meet its promise: workforce; regulations and government; consumer needs and roles; and financing and accessibility. Policies that may be helpful include those that would increase staffing and boost wages and training; establish staffing standards with appropriate skill mix; promulgate state regulations that enable greater use of third-party services; encourage uniform data reporting; provide funds supporting family involvement; make community disclosure statements more accessible; and offer owners and operators incentives to facilitate access for consumers with fewer resources. Attention to these and other recommendations may help assisted living live up to its name.Publisher's note: Many of these ALF recommendations may be helpful in hospice, too...

[Honoring Nurses Week] Too many nurses are being assaulted. Some say they are being blamed for the attacks. Chief Healthcare Executive; by Ron Southwick; 5/9/24 With disturbing regularity, nurses in hospitals and other healthcare settings are being physically assaulted and verbally harassed. More than half of emergency nurses say they’ve been assaulted or threatened within the past 30 days, according to the Emergency Nurses Association. In a separate study, researchers found that healthcare workers faced at least one violent or aggressive incident for every 40 hours worked, according to findings published by The Joint Commission Journal on Quality and Patient Safety. With the observance of National Nursing Week, the increased violence in healthcare can’t be ignored. Nursing leaders say the regular exposure to violence or threatening behavior is one factor adding to stress and burnout of nurses and, in some cases, spurring them to seek new jobs.

Action is key to continue to break down barriers for equitable cancer care OncLive; by Ryan Scott; 5/8/24 Experts from the University of Wisconsin (UW) School of Medicine and Public Health, including Catherine Zhang, MD, MPH, ... Monica Patel, MD, ... Janelle N. Sobecki, MD, ... and Loyda Braithwaite, NP ... participated in an interview with OncLive® on disparities in cancer care. In [this] interview, these experts addressed significant barriers to equitable cancer treatment and highlighted challenges for rural communities to access specialized oncologic care. Furthermore, they emphasized financial limitations affecting treatment access, specifically for marginalized groups, and the need to push for health policy changes.  ... 

Financial strain on nursing homes sparks buying binge Modern Healthcare; by Diane Eastabrook; 5/8/24Skilled nursing facility deals increased more than 80% in the first quarter of 2024 compared with the same period in 2023. There were 57 nursing home acquisitions valued at nearly $1.4 billion in the first quarter of this year compared with 31 deals valued at $448 million during the same period last year, according to Levin Associates, which tracks healthcare mergers and acquisitions. ... Last year was the worst year for healthcare bankruptcies in five years, according to restructuring and consulting firm Gibbins Advisors. Senior living and pharmaceuticals accounted for half of the 79 Chapter 11 filings in healthcare in 2023, the company said. It predicted continued distress for the senior care industry this year in a January research report.

2024 Hastings Center Cunniff-Dixon Physician Awards announcedThe Hastings Center email; 5/9/24The Hastings Center and The Cunniff-Dixon Foundation are pleased to announce six recipients of awards that honor physicians for providing exemplary care to patients nearing the end of life. The awards are based on technical competence, personal integrity, empathic dialogue with patients, active engagement with the family and loved ones, practical and heartfelt communication regarding advance directives, and compassionate alleviation of suffering. Congratulations:

Amedisys to sell 100 locations to advance UnitedHealth group deal Hospice News; by Holly Vossel; 5/8/24 Amedisys Inc. has agreed to divest upwards of 100 home health and hospice locations to an undisclosed private equity buyer as the company addresses regulators’ antitrust concerns in its pending acquisition by the UnitedHealth Group’s (UNH) health care services arm Optum. The news came in a recent social media post from The Capitol Forum. Selling off some of Amedisys’ locations in overlapping markets within Optum’s service region may help push the transaction forward amid mounting regulatory concerns. The U.S. Department of Justice (DOJ) is mulling a possible lawsuit to block the acquisition, citing potential antitrust issues related to the deal. The concerns center around the ability for other providers to compete if Optum and Amedisy combine their geographic footprints. 

Paris in spring, Bali in winter. How ‘bucket lists’ help cancer patients handle life and death The Conversation; by Vivan Lam; 5/8/24 In the 2007 film The Bucket List Jack Nicholson and Morgan Freeman play two main characters who respond to their terminal cancer diagnoses by rejecting experimental treatment. Instead, they go on a range of energetic, overseas escapades. Since then, the term “bucket list” – a list of experiences or achievements to complete before you “kick the bucket” or die – has become common. ... But there is a more serious side to the idea behind bucket lists. One of the key forms of suffering at the end of life is regret for things left unsaid or undone. So bucket lists can serve as a form of insurance against this potential regret. The bucket-list search for adventure, memories and meaning takes on a life of its own with a diagnosis of life-limiting illness. Editor's Note: Health acuity (especially for hospice patients), finances, and other practical factors can prevent acutalization of the person's bucket list wishes. Yes, fulfilling items can happen! And when not possible (perhaps the most common response), the clinician's sensitive presence, validation of the person's hope, and gentle exploration of why it matters can bring relevant, meaningful support. Involving family members (with the patient's permission) can inspire other generations to fulfill the person's wish, bringing new purpose to mourning and grief-restoration processes ahead.