Literature Review

Telehealth study investigates reimbursements for rural health care deliveryMedical Xpress, by Vincent Jacobbi, Mayo Clinic; 3/15/24A recent Mayo Clinic study published in the American Journal of Hospice and Palliative Medicine investigated how telehealth in palliative care may provide value for rural caregivers, health care teams and their patients. Researchers were particularly interested in determining what billing models were most cost-effective and sustainable for health care teams and caregivers transitioning patients from hospital to home care

Hospices stepping up performance on visits-in-last-days-of-life measure Hospice News, by Jim Parker; 3/14/24 Hospices, in aggregate, are showing improvement on the quality measure for visits in the last days of life. The number of registered nurse and social worker visits during a patient’s final week is one of the seven quality measures that CMS uses to evaluate providers. In Calendar Year 2021, the share of hospice care days with nurse visits in the last seven days of life rose to 63%, up from 62% year over year, according to the National Hospice and Palliative Care Organization (NHPCO). 

The 19 rural emergency hospitals, by state Becker's Hospital CFO Report, by Andrew Cass, 3/15/24Nineteen hospitals have converted to the rural emergency designation since the law that created the designation took effect in January 2023, according to data from University of North Carolina's Cecil G. Sheps Center for Health Services Research in Chapel Hill.  Here are the hospitals that have converted to rural emergency status, by state: ... [Click on the title's link to view]

Colorado Senate passes bill to shorten ‘Medical-Aid-in-Dying’ waiting period Colorado Newsline, by Sara Wilson; 3/8/24 The Colorado Senate approved a bill Friday that would alter the state’s medical aid-in-dying law by shortening the required waiting period and allowing more medical professionals to prescribe the medication. ... Senate Bill 24-68 would tweak the law by shortening the waiting period between a patient’s first and second request for the medication from 15 to seven days. ... Statistics from Denver Health’s medical aid-in-dying program show that about 1 in 4 patients died from their illness during the current 15-day waiting period... The bill would also allow advanced practice registered nurses to prescribe the medication... The bill was amended in committee to reinstate a Colorado residency requirement.

'It's been really inspiring': Grace House continues end-of-life care despite challenges Akron Beacon Journal, by Kelsie Horner; 3/13/24Through a flood and financial challenges, an Akron nonprofit has continued to provide end-of-life care and companionship for people who might otherwise die alone. Since opening its doors 1½ years ago, Grace House has cared for 66 residents during their final days. ... Grace House is one of only three organizations in the nation to provide free, “non-barrier” end-of-life care for people who are unhoused or alone.

Johns Hopkins study reveals medical marijuana lowers pain, hospital visits BNN, by Wojciech Zylm; 3/5/24Recent research highlights significant improvements in well-being for cannabis users, offering hope for those with chronic illnesses. The study showcases a potential shift in the perception and utilization of medical cannabis in healthcare.

Why home care leaders are now banking on ‘Caregiver-First’ culturesHome Health Care News, by Patrick Filbin; 3/4/24 Over the last several years, a notable trend is emerging in home care: Top-tier companies are shifting their focus from prioritizing customers to prioritizing caregivers. This strategic move reflects a growing recognition of the critical role caregivers play, and aims to address persistent caregiver shortages.

CMS hears you, hospice providersMcKnights Home Care, by Liza Berger; 3/8/24 Rarely does the Centers for Medicare & Medicaid Services succeed in shocking us. The large bureaucracy, which is not exactly known for its nimbleness, managed to do so this week when it abruptly cancelled the hospice component of the Value-Based Insurance Design Model. ... For those who wonder whether advocacy works, I’d chalk this up to a win for providers — and a clear example of advocacy in action. 

Sunday newsletters focus on top read stories of the last week (in order) - enjoy!

The PACT Project: Feasibility of a multidisciplinary, multi-faceted intervention to promote goals of care conversationsAmerican Journal of Hospice and Palliative Medicine, by Eytan Szmuilowicz, MD; Rebecca K. Clepp, MA, MEd, MHA; Jayson Neagle, MD; Adeboye Ogunseitan, MD; Martha Twaddle, MD; Gordon J. Wood, MD, MSCI; 4/24Patients living with serious illness generally want their physicians to facilitate Goals of Care conversations (GoCc), yet physicians may lack time and skills to engage in these conversations in the outpatient setting... A multifaceted quality improvement intervention focused on serious illness communication skills can support a diverse clinical workforce to facilitate inpatient GoCc over time.

Social acceptability of psilocybin-assisted therapy for existential distress at the end of life: A population-based surveyPalliative Medicine, by Louis Plourde, Sue-Ling Chang, Houman Farzin, Pierre Gagnon, Johanne Hébert, Robert Foxman, Pierre Deschamps, François Provost, Marianne Masse-Grenier, Jean-François Stephan, Katherine Cheung, Yann Joly, Jean-Sébastien Fallu, Michel Dorval for the P3A Study Group; 2/24Internationally, there is a growing interest in the potential benefits of psilocybin-assisted therapy to treat existential distress at the end of life. However, the social acceptability of this therapy is not yet well known. The social acceptability of psilocybin-assisted therapy for existential distress at the end of life is rather high in Canada. These findings may contribute to efforts to mobilise resources and improve access to this emerging therapy in palliative and end of life care settings.

Palliative ECT for catatonia in a terminal cancer patient: A case reportJournal of the Academy of Consultation-Liaison Psychiatry, by Arushi Mahajan B.S., Thanvi Vatti M.P.H., Andrew Coulter M.D., Elias Khawam M.D., Molly Howland M.D.Common end-of-life illnesses and medications can lead to catatonia. Catatonia can decrease interactivity, which worsens a terminal patient's quality of life. Treatment includes medications and electroconvulsive therapy (ECT). Though treating psychiatric disorders aligns with the palliative care philosophy, end-of-life ECT has been rarely reported. The few case reports on palliative ECT involved continuation of prior ECT courses for chronic psychiatric conditions in psychiatric settings after a terminal diagnosis. No studies have explored palliative ECT for acute catatonia.