Literature Review

The Alliance Celebrates National Care at Home MonthNational Alliance for Care at Home (formerly NAHC and NHPCO); 10/31/24 November marks the start of National Care at Home Month, a new observance created to honor the valuable contributions of home care providers nationwide and inspire outreach to communities, media, and policymakers. National Care at Home Month is spearheaded by the newly formed National Alliance for Care at Home (the Alliance), bringing together the National Association for Home Care & Hospice (NAHC) and the National Hospice and Palliative Care Organization (NHPCO). ... National Care at Home Month, like the new Alliance, honors the full continuum of care-at-home providers and the patients and families they serve. This community of providers is stronger together, and National Care at Home Month brings this message into public awareness. ... “National Care at Home Month is an opportunity for our community to come together, celebrate and honor one another, and highlight the transformative care and support provided to patients and their loved ones across the US each day,” said Dr. Steve Landers, CEO for the Alliance. ... [Click on the title's link to continue reading.]

Happiness is when what you think, what you say, and what you do are in harmony. ~ Mahatma Gandhi

Underrepresentation of Black men in physician assistant and associate trainingJAMA Network Open; Lucy W. Kibe, DrPH, MS, MHS, PA-C; Katrina M. Schrode, PhD; Samuel Paik, MPAS, PA-C; Dominique Frias-Sarmiento, MA; 10/24In this cohort study of PA applicants and matriculants, Black men remained substantially underrepresented despite overall growth of PA training programs. The low representation among matriculants was due in part to the low numbers of applicants but also to substantially lower matriculation success. This persistent underrepresentation highlights systemic barriers and underscores the need for targeted interventions to achieve a more representative health care workforce. To achieve equitable admissions, each PA program should aim to evaluate Black male applicants and matriculate Black men annually.

Promotion of knowledge and trust surrounding scarce resource allocation policies-A randomized clinical trialJAMA Health Forum; Russell G. Buhr, MD, PhD1; Ruby Romero, BA; Lauren E. Wisk, PhD; 10/24The COVID-19 pandemic prompted rapid development of scarce resource allocation policies (SRAPs) in case demand for critical health services eclipsed capacity. [This] trial found that a brief educational video is sufficient to explain complex ethical tenets and mechanics of SRAP and improved knowledge of such policies and trust in health systems to implement them equitably while not exacerbating anxiety about potential policy implications. This informs practice by providing a framework for educating people about the use of these policies during future situations necessitating crisis standards of care.

Perspectives of nursing home staff in advance care planning conversations: Experiences from the APPROACHES projectJournal of the American Medical Directors Association; by Kathleen T. Unroe, Hillary D. Lum, Susan E. Hickman; 9/24Advance care planning (ACP) is considered a best practice in the nursing home setting; however, there is a lack of consistency in the training of nursing home staff and implementation of structured ACP programs. A qualitative study interviewing ACP specialists in nursing homes was conducted to understand the experience of staff engaged in Aligning Patient Preferences e a Role offering Alzheimer’s patients, Caregivers, and Healthcare providers Education and Support (APPROACHES), an embedded pragmatic clinical trial to improve ACP... Findings from this analysis provide insights into tailoring APPROACHES and other ACP programs for full-scale implementation in the nursing home setting. Nursing home staff experiences tailoring the program to fit their environments were reflective of the pragmatic nature of the ACP specialist program.

High-risk medications in persons living with dementia-A randomized clinical trialJAMA Internal Medicine; Sonal Singh, MD, MPH; Xiaojuan Li, PhD, MSPH; Noelle M. Cocoros, DSc, MPH; Mary T. Antonelli, PhD, RN, MPH; Ramya Avula, MS; Sybil L. Crawford, PhD; Inna Dashevsky, MS; Hassan Fouayzi, PhD, MS; Thomas P. Harkins, MA, MPH; Kathleen M. Mazor, EdD; Ashley I. Michnick, PharmD, PhD; Lauren Parlett, PhD; Mark Paullin, MS; Richard Platt, MD, MSc; Paula A. Rochon, MD, MPH; Cassandra Saphirak, MA; Mia Si, MS; Yunping Zhou, MS; Jerry H. Gurwitz, MD; 10/24Question: Does a one-time mailed educational intervention to patients and their clinicians reduce prescribing of antipsychotics, sedative-hypnotics, and strong anticholinergic agents in community-dwelling persons living with Alzheimer disease (AD) or AD-related dementias (ADRD)? In this randomized clinical trial of 12,787 patients, there were no clinically meaningful or statistically significant differences from the mailed educational intervention compared with usual care in continued use of medications targeted for deprescribing. These findings suggest medication-specific educational mailings targeting patients with AD or ADRD and their clinicians are not effective in reducing the use of high-risk medications.

To calm and to commend: Veterans’ musical preferences anticipating end of lifeMilitary Medicine; by Beatrice J Krauss; 11/24Listening to music was the most prevalent of the 20 coping mechanisms for stress in this sample of 30 veterans. Musical preferences were stable across age groups. For calming, music at resting heartbeat rhythms was chosen. Music from early adulthood or from the timelessness of the classics was selected most often. Modern music with lyrics has themes of duty, affirmation, gratitude, and relief. The nearly universal soothing effects of lullabies were recognized. For music for honor ceremonies, desires were often independent of the military branch. Patriotic songs, or songs recognizing multiple service branches, or with themes of peace and affirmation were more often chosen than music from a particular service branch.Publisher's note: Anticipating Veteran's Day on Monday.

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Concurrent care and use of advanced cardiac therapies for hospitalized Veterans with heart failureJournal of Pain and Symptom Management; by Tander Simberloff, Laura Godinez, Tiffany Chen, Lan Jiang, Wen-Chih Wu, Jensy Stafford, James L Rudolph, Mitchell Wice; 11/24Veterans with HF receiving concurrent care were few and experienced higher mortality. Rate of burdensome transitions was similar between Veterans receiving concurrent care and those not on hospice. Further research may explore why Veterans infrequently utilize concurrent care at the end of life.

Nurse burnout the root of decreased resident safety, medication errors, study shows McKnights Long-Term Care News; by Zahara Johnson; 11/6/24 A new study has found a direct link between nurse burnout and unfavorable patient and facility outcomes, including medication errors and a degraded safety culture. The meta-analysis of 85 studies and 288,581 nurses, compiling more than 30 years of research, concluded that nurses who suffer from burnout – emotional exhaustion, depersonalization and a low sense of personal accomplishment – have a negative impact on patients.

Pennsylvania signs home care, hospice efficiency bills into law McKnights Home Care; by Adam Healy; 11/5/24 Pennsylvania Gov. Josh Shapiro (D) signed into law two bills that will reduce operational challenges and improve recruitment efforts for home care and hospice agencies. House Bill 155 allows healthcare providers, including home care and hospice agencies, to use remote video technology for interviews with direct care workers. Meanwhile, Senate Bill 1080 allows licensed practical nurses (LPNs) to pronounce death in home-based hospice settings. These two new laws will make direct care worker recruiting processes more accessible and efficient, while improving end-of-life care for both patients and providers, according to the Pennsylvania Homecare Association. “The signing into law of HB 155 and SB 1080 helps create efficiencies in how we deliver home-based care,” Mia Haney, chief executive officer of PHA, said Friday in a statement. “With a growing demand for these services, efforts such as these allow providers to use their time effectively and focus on what’s most important — quality of care.”

West Virginia voters narrowly approve state constitutional ban on physician-assisted suicide WVNews - West Virginia's News; by Steven Adams; 11/7/24 An amendment to West Virginia’s constitution to prohibit physician-assisted suicide — already illegal in the state — managed to squeak through after Tuesday’s election with just enough votes, though the vote was a statistical tie. According to unofficial election results posted by the West Virginia Secretary of State’s Office, Amendment 1 passed, with 335,822 votes (50.5%) for and 329,742 against (49.5%) — a difference of 6,080 votes. The West Virginia Legislature adopted House Joint Resolution 28 during the 2024 regular session earlier this year. The joint resolution placed on the November general election ballot a proposed state constitutional amendment that would ban medically-assisted suicide and/or euthanasia.