Literature Review
31 Photos and stories that show how expensive it is to die in America
12/23/24 at 03:00 AM31 Photos and stories that show how expensive it is to die in America
Hospice study reveals contrasting views on managing dementia behaviors
12/23/24 at 03:00 AMHospice study reveals contrasting views on managing dementia behaviors McKnights Long-Term Care News; by Donna Shryer; 12/20/24 A new study finds that healthcare providers and family caregivers often disagree on how best to manage dementia behaviors during end-of-life care. The research, published in the Journal of the American Geriatrics Society, involved interviews with 23 hospice clinicians and 20 family caregivers. With dementia affecting 33% of adults over age 85 and now ranking as the primary diagnosis for Medicare hospice services, understanding these differing perspectives about managing dementia behaviors has become increasingly important. The study found that while both groups identified agitation as the most concerning behavioral symptom, they approached it from different angles. Clinicians primarily worried about physical safety risks, while family caregivers were more distressed by personality changes in their loved ones.
Samaritan’s 2024 Celebration of Life Gala raises record-breaking $275,000
12/23/24 at 03:00 AMSamaritan’s 2024 Celebration of Life Gala raises record-breaking $275,000 Samaritannj.org, Mount Laurel, NJ; News Release; 12/20/24 Samaritan recently held its annual Celebration of Life Gala, presented by Holman Enterprises, at the DoubleTree by Hilton in Cherry Hill (formerly Crowne Plaza). A record-breaking $275,000 was raised in support of the not-for-profit’s life-enhancing services, which benefit seriously ill patients and their families, as well as those grieving a loss, throughout Atlantic, Burlington, Camden, Gloucester and Mercer counties. .... “Our annual Celebration of Life Gala allows us to continue providing comprehensive care for the people of South Jersey,” said Phillip W. Heath, president and CEO of Samaritan. ...
Delaware Hospice to move to scattered bed model at Saint Francis in Jan.
12/23/24 at 02:15 AMDelaware Hospice to move to scattered bed model at Saint Francis in Jan. Delaware Live; by Jarek Rutz; 12/19/24 Just two months after celebrating its 100-year anniversary, Wilmington’s Saint Francis Hospital is making a logistical shift for its hospice patients. This week, Delaware Hospice announced it will shift its Saint Francis-based operations from a centralized In-Patient Unit (IPU) to a scattered bed model. The move is to increase both patient and hospital flexibility as well as create more financial and operational efficiency. A scattered bed model involves distributing General Inpatient (GIP) Hospice Care across various rooms within the hospital rather than maintaining a centralized unit. Closing the IPU means Delaware Hospice continues to live its mission of providing compassionate, expert care without the costs of maintaining a centralized unit.
House of Goshen makes history as Chicago’s first black-owned independent inpatient hospice house
12/23/24 at 02:00 AMHouse of Goshen makes history as Chicago’s first black-owned independent inpatient hospice house G20 News Today, Flossmoor, IL; 12/21/24 House of Goshen, a state-of-the-art inpatient hospice facility and the first Black-owned independent hospice center in the Chicago Southland area, is now officially accepting patients. Located at 19810 Governors Highway in Flossmoor, the center represents a pivotal advancement in equitable, compassionate end-of-life care in Chicagoland, the South Suburbs and beyond. The 14,000-square-foot facility offers 14 private suites designed to provide comfort, dignity, and peace for patients and their families. ... “Our goal is to create a sanctuary where every patient and family member feels supported, seen, and cared for,” said Sade Bello, co-founder of House of Goshen. “Being the first Black-owned hospice center in the region comes with immense pride and responsibility. We are committed to setting a standard of care that reflects the diversity and humanity of the communities we serve.”
The Denver Hospice delivers holiday meals to 347 Coloradans; initiative ensured Coloradans facing hardship can celebrate with a holiday meal
12/23/24 at 02:00 AMThe Denver Hospice delivers holiday meals to 347 Coloradans; initiative ensured Coloradans facing hardship can celebrate with a holiday meal GlobeNewswire, Denver, CO; by The Denver Hospice; 12/20/24 The Denver Hospice, in collaboration with dedicated staff, provided 76 meals to patients and their families facing hardship during the holiday season. Over 347 people will enjoy a festive dinner as a result of the nonprofit’s healthcare organization’s holiday initiative. “At this time of the year, it can be especially hard for people to admit that they need help,” stated Susan Finke, director of clinical services at The Denver Hospice. “I want to thank everyone who helped deliver dinners today as we are caring for more people than just our patients. Hundreds will now have the opportunity to gather next week and enjoy being with their loved ones.” ... This is an annual event held by The Denver Hospice in support of their hospice and palliative care patients. Working in tandem with social workers, clinical and administrative staff, the nonprofit identifies and supports vulnerable patients across the Denver metropolitan area. The holiday season can be an especially difficult time of year for those facing life-limiting illnesses.
International comparison of underlying disease among recipients of medical assistance in dying
12/22/24 at 03:55 AMInternational comparison of underlying disease among recipients of medical assistance in dyingJAMA Internal Medicine; Brandon Heidinger, BSc; Colleen Webber, PhD; Kenneth Chambaere, PhD; Eliana Close, PhD; Luc Deliens, PhD; Bregje Onwuteaka-Philipsen, PhD; Thaddeus Pope, JD, PhD; Agnes van der Heide, MD, PhD; Ben White, DPhil, LLB, (Hons); James Downar, MD, MHSc; 12/24In 2023, 282 million individuals lived in jurisdictions allowing medical assistance in dying (MAID). But regardless of jurisdiction, cancer and amyotrophic lateral sclerosis (ALS) consistently account for up to 80% of MAID cases, despite accounting for fewer than 30% of all deaths. This observation is consistent with the idea that MAID is driven heavily by illness-related factors common to people with those illnesses and inconsistent with the idea that MAID is driven substantially by factors that are external to the individual and that vary by jurisdiction, such as eligibility criteria, culture, social assistance, or palliative care service availability. The overall incidence of MAID increased over time (per 1 calendar year ... ).
Advance care planning, end-of-life preferences, and burdensome care-A pragmatic cluster randomized clinical trial
12/22/24 at 03:50 AMAdvance care planning, end-of-life preferences, and burdensome care-A pragmatic cluster randomized clinical trialJAMA Internal Medicine; Jennifer L. Wolff, PhD; Danny Scerpella, MPH; Erin R. Giovannetti, PhD; David L. Roth, PhD; Valecia Hanna, MS; Naaz Hussain, MD; Jessica L. Colburn, MD; Martha Abshire Saylor, PhD; Cynthia M. Boyd, MD; Valerie Cotter, DrNP; Maura McGuire, MD; Christine Rawlinson, MSN, RN; Danetta H. Sloan, PhD; Thomas M. Richards, MS; Kathryn Walker, PharmD; Kelly M. Smith, PhD; Sydney M. Dy, MD; for the SHARING Choices Investigators; 12/24Advance care planning (ACP) is a communication process that supports adults at any age or stage of health in understanding and sharing their personal values, life goals, and preferences regarding future medical care. In this pragmatic cluster randomized clinical trial, the SHARING Choices intervention increased new documentation of end-of-life preferences but also increased potentially burdensome care at end of life. Mixed findings underscore the importance of comprehensive support for those with serious illness and prioritizing patient-relevant outcomes in ACP interventional research.
Allostatic load, educational attainment, and risk of cancer mortality among US men
12/22/24 at 03:45 AMAllostatic load, educational attainment, and risk of cancer mortality among US menJAMA Network Open; Cynthia Li, BS, MD; Sydney P. Howard, DrPH, MS; Charles R. Rogers, PhD, MPH, MS, MCHES; Sydney Andrzejak, MS; Keon L. Gilbert, DrPH; Keith J. Watts, PhD, MSW; Malcolm S. Bevel, PhD, MSPH; Myles D. Moody, PhD, MA; Marvin E. Langston, PhD; Judah V. Doty, MS; Adetunji T. Toriola, MD, PhD, MPH; Darwin Conwell, MD, MSc; Justin X. Moore, PhD, MPH; 12/24Social determinants of health, such as income, occupation, and education, can influence cancer disparities in men. Men with limited access to education and income are more likely to have high allostatic load (AL), a measure of cumulative physiologic stress on the body over time. Chronic stress triggers prolonged neuroendocrine responses, resulting in elevated proinflammatory cytokines, catecholamines, and other proteins. This overactivation can lead to physiologic dysregulation and can promote cancer development. The findings indicate that men with lower educational attainment and high AL face up to a 4-fold increased risk of cancer mortality and nearly 70% increased risk of cancer mortality when accounting possible confounders.
Researcher explores using AI to overcome language barriers with patients
12/22/24 at 03:40 AMResearcher explores using AI to overcome language barriers with patientsJAMA Network; Yulin Hswen, ScD, MPH; Kate Schweitzer; 12/24In the US, 25 million people with language barriers receive worse health care by nearly every standard than those who speak English fluently. In a recent Viewpoint in JAMA, K. Casey Lion, MD, MPH, an associate professor of pediatrics at the University of Washington School of Medicine, listed the poorer-quality outcomes: inferior comprehension, lower adherence, higher costs, and more frequent serious safety events, to name a few. In this study, we want to understand how it performs under real-world conditions because those are the conditions we would be using it in. I would also encourage other health care systems that are thinking about implementing AI for language access to think about talking to and involving their patients and families in the work to be sure that it’s reflecting what our patients and families actually want rather than what we think they want.
How the downfall of the ‘Chevron Doctrine’ could affect hospices in the courts
12/22/24 at 03:35 AMHow the downfall of the ‘Chevron Doctrine’ could affect hospices in the courts Hospice News; by Holly Vossel; 12/16/24 Recent court rulings have the potential to make significant differences in the landscape of hospice regulatory oversight in coming years, particularly when it comes to audits and the forthcoming Special Focus Program (SFP). In June the U.S. Supreme Court overturned a ruling that in 1984 established the “Chevron Doctrine,” which instructed lower courts to defer to executive branch agencies to resolve ambiguities in laws passed by Congress. The decision marked the end of the practice known as “Chevron deference,” which required that courts must defer to regulatory agencies’ interpretations of “ambiguous” statutes within federal legislation as long as the enforcement activity is deemed “reasonable.” Hospices could potentially see a vastly different outlook in regulatory enforcement activity during a time of tremendous changes already taking place in the industry, [Bryan Nowicki, partner at the law firm Husch Blackwell] said.
Greater education needed to bring palliative care to cancer patients
12/22/24 at 03:30 AMGreater education needed to bring palliative care to cancer patients Hospice News; by Jim Parker; 12/18/24 Cancer patients generally need palliative care, but widespread misperceptions often stand in their way, both among the public and many clinicians themselves. This is according to Nadine Barrett, president of the Association of Cancer Care Centers (ACCC). The organization has been holding a series of webinars designed to better educate the oncology community about palliative care. The association is also in the process of studying racial and ethnic gaps in advance care planning, among other projects funded by its research arm, the ACCC Community Oncology Research Institute. Palliative Care News sat down with Barrett to discuss the barriers that cancer patients often experience when it comes to accessing palliative care. [Click on the title's link to read more.]
Convicted trio jailed for elder abuse
12/22/24 at 03:25 AMConvicted trio jailed for elder abuse Inland News Today, Riverside, CA; 12/18/24 A 7-year prison sentence has been meted out for the neglect and abuse of six severely disabled residents at an unlicensed Riverside care facility. Ronnel Tiburcio was convicted of six counts of elder abuse likely to produce great bodily harm. Earlier, co-defendants Joel Ombao and registered nurse Nimfa Molina were handed jail sentences. Ombao owned several hospice companies, including the unlicensed Secure Hands board and care facility where the victims were housed. Ombao, his assistant Tiburcio, and registered nurse Molina, were responsible for operating the facility and caring for the residents. When investigators first checked out the care facility, residents were being housed in squalor. Many of them were emaciated and dehydrated.
Lawmakers, health care providers raise alarm about growing antisemitism in medical field
12/22/24 at 03:20 AMLawmakers, health care providers raise alarm about growing antisemitism in medical field Jewish Insider - Health Care Hazard; by Marc Rod; 12/18/24 Speaking on a panel on Capitol Hill on Tuesday, lawmakers, medical professionals and Jewish community advocates sounded the alarm about the spread of antisemitism in the health care field, both within medical schools and in clinical settings. They said that the issue deserves and requires greater attention from Capitol Hill, akin to the attention campus antisemitism has received over the past year. “That’s truly scary, the idea that somehow your religious background or your identity would inform or impact the type of care that you get is not only antisemitic, it’s not only anti-American, it is anti-democratic,” Rep. Dan Goldman (D-NY), the incoming chair of the House antisemitism task force, said at the Jewish Federations of North America-organized briefing.
Michigan Center for Rural Health announces new program focused on improving rural based palliative care
12/22/24 at 03:15 AMMichigan Center for Rural Health announces new program focused on improving rural based palliative care PRLOG - Press Release Distribution, East Lansing, MI; by Michigan Center for Rural Health - Amanda St. Martin; 12/16/24 The Michigan Center for Rural Health (MCRH) has announced Phase Two of its palliative care programming. Palliative care provides relief from symptoms, pain, and stress associated with serious illnesses and can be administered alongside curative treatments. It is suitable for patients of any age or illness stage. The program titled "Cultivating Comfort: Enhancing Palliative Care in Rural Michigan," funded by the Michigan Health Endowment Fund, will launch on January 1, 2025, and continue through December 2026. ... Rural adults tend to experience a higher prevalence of chronic conditions compared to their urban counterparts, as they are often older, poorer, and more likely to have multiple chronic illnesses. MCRH's new program seeks to address this need through a community driven approach.
Hospice utilization rebounds to pre-pandemic levels, but fraud casts a shadow
12/22/24 at 03:10 AMHospice utilization rebounds to pre-pandemic levels, but fraud casts a shadow Hospice News; by Jim Parker; 12/17/24 The nation’s hospice utilization rate among Medicare decedents has once again surpassed 50%, for the first time since the pandemic. However, fraud issues in the space create questions around the quality of care patients are receiving. Hospice utilization reached 51.7% in 2023, up more than two percentage points from the prior year, according to recent data from the Medicare Payment Advisory Commission (MedPAC). This is the highest rate since 2019. MedPAC observed increases in utilization across the board, even when stratified into subgroups by age, sex, race and rural or urban location. ... Despite these positive trends, an influx of new hospices continued in states considered hotbeds for Medicare fraud, including Arizona, California, Nevada and Texas. Many of these new additions came in areas where additional hospices were likely not necessary based on the needs of the patient population. Georgia also saw a large spate of new providers emerge in 2023.
VITAS Healthcare unveils inpatient hospice unit at Lee Memorial Hospital
12/22/24 at 03:05 AMVITAS Healthcare unveils inpatient hospice unit at Lee Memorial Hospital South Florida Hospital News and Healthcare Report, fort Myers, FL; by cfelixcpa; 12/16/24 Residents of Lee County now have access to dedicated end-of-life care at the new VITAS Healthcare Inpatient Hospice Unit at Lee Memorial Hospital, offering expert, patient-centered hospice services in the comfort of a homelike setting. This inpatient unit (IPU) is the only hospital-based hospice facility in the county and is the first VITAS IPU in Lee County and second in Southwest Florida. It is expected to serve more than 400 patients annually. ... The VITAS hospice unit at Lee Memorial features eight private patient rooms with internet access, flatscreen TVs, private bathrooms and overnight accommodations for loved ones. A shared family room provides space for visiting guests, and children’s activities keep little ones occupied.
Today's Encouragement
12/22/24 at 03:00 AMI love people that have no idea how wonderful they are and just wander around making the world a better place. ~Unknown
December challenge: Gift ideas part two
12/22/24 at 03:00 AMDecember challenge: Gift ideas part two ActiveRain; by Kat Palmiotti; 12/17/24 ... My mother dealt with cancer the last four years of her life with an upbeat attitude, ... So what did she do with the time she had left? The same as always. It was late November 2011 at this point. So what she decided to do was to make a point of purchasing us all our last Christmas present. ... So for me, she purchased me a coffee cup with a lid which is pictured in the feature photo. ... But my mom didn't stop there. She also wrote each of her family members a handwritten letter. Her letter to me talked about me being her first born, and about what I was like during my childhood, and how she felt about my life as an adult. It was a beautiful letter that makes me smile and cry every time I read it. I treasure it. ... So why am I sharing this? Because when I think back on all the gifts I've ever received, it's not jewelry or clothing or anything else that pops into my mind first. It's a $5 cup and a piece of paper with writing on it. And both of those were my mom giving me love. So, when giving gifts to those you care about, give them love. Perhaps grab a piece of paper and a pen and let them know how much you care about them. Or buy them a small carefully selected item that they might use on a daily basis, smiling because it's from you. Because really, it truly is the thought that counts. Let that thought be love.
Sunday newsletters
12/22/24 at 03:00 AMSunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!
Today's Encouragement
12/21/24 at 03:55 AMThe Joy of brightening other lives, bearing each others’ burdens, easing each other’s loads and supplanting empty hearts and lives with generous gifts becomes for us the magic of the holidays. ~ W. C. Jones
[Australia] Why mental health clinicians are not engaging in advance care planning with older people with schizophrenia and other psychotic illnesses
12/21/24 at 03:50 AM[Australia] Why mental health clinicians are not engaging in advance care planning with older people with schizophrenia and other psychotic illnessesPsychology Research and Behavior Management; Anne P F Wand, Aspasia Karageorge, Yucheng Zeng, Roisin Browne, Megan B Sands, Daniella Kanareck, Vasi Naganathan, Anne Meller, Carolyn M Smith, Carmelle Peisah; 12/24These clinician-identified attitudes, experiences, and barriers to engagement in ACP [advance care planning] with older people with psychotic illnesses highlight avenues of potential intervention to facilitate ACP in this cohort. Given the complexity of issues, clinicians need education and training in ACP combined with clear processes and policies to support practice. Clinician insights should be combined with the perspectives of older consumers with psychotic illnesses and their families to inform implementation of ACP.
[Iran] The relationship between the quality of oncology nursing care and the resiliency and hope of patients with cancer: a cross-sectional study
12/21/24 at 03:50 AM[Iran] The relationship between the quality of oncology nursing care and the resiliency and hope of patients with cancer: a cross-sectional studyInternational Journal of Palliative Nursing; Nadia Sedri, Mohammad Ali Zakeri, Hakimeh Sheykhasadi, Ala Shamsi, Hosna Akbari, Mostafa Hejazi, Asghar Tavan; 12/24Patients with cancer require emotional support in addition to specialised medical treatments for their physical ailments. The quality of nursing care, resilience and hope can influence a person's cancer trajectory, and understanding these factors and their relationship can be influential in improving the process for these patients. Given the interrelationship between 'resilience' and 'hope' for patients with cancer, it is necessary to focus on the factors that impact these qualities. In addition, paying attention to the concept of resilience can improve the level of hope in patients with cancer. Based on the results, it is recommended that interventions to increase QON [quality of oncology nursing] in patients with cancer be planned and implemented.
Silent invader: A rare case of enterobacter aerogenes empyema in a hospice patient with complex comorbidities
12/21/24 at 03:45 AMSilent invader: A rare case of enterobacter aerogenes empyema in a hospice patient with complex comorbiditiesCureus Case Reports; Hansani Angammana, Kafayat Omadevuae, Victoria Bengualid, Rawand Khader; 11/24Enterobacter aerogenes (recently renamed Klebsiella aerogenes) is an uncommon pathogen in pleural infections and empyema, typically associated with nosocomial urinary and gastrointestinal infections. This case report describes a 69-year-old male patient with chronic kidney disease, diabetes mellitus, and other comorbidities, who developed empyema despite broad-spectrum antibiotics. Despite initial improvement with cefepime and metronidazole, the patient's respiratory status deteriorated, and due to his do not resuscitate/do not intubate (DNR/DNI) status and extensive comorbidities, no further aggressive interventions were pursued, leading to his passing. This case highlights the diagnostic and therapeutic challenges posed by E. aerogenes in pleural infections, emphasizing its rarity in pulmonary involvement and its potential for antibiotic resistance. It also underscores the importance of considering atypical pathogens in complex infections and the need for multidisciplinary management while balancing aggressive treatments with patient-centered care, particularly in end-of-life scenarios.
US FDA approval of pediatric artificial intelligence and machine learning–enabled medical devices
12/21/24 at 03:40 AMUS FDA approval of pediatric artificial intelligence and machine learning–enabled medical devicesJAMA Pediatrics; Ryan C. L. Brewster, MD; Matthew Nagy, MD, MPH; Susmitha Wunnava, PhD; Florence T. Bourgeois, MD, MPH; 12/24Despite rapid growth in the availability of AI/ML [artificial intelligence and machine learning]-enabled devices in recent years, only a small number have been authorized for pediatric use. The current regulatory framework may expose children to off-label use, differential performance of algorithms, and safety risks. Additionally, the lack of standardized reporting of pediatric device characteristics precludes informed decision-making by health care clinicians on appropriate device use. Pediatric AI/ML-enabled devices should be validated using representative datasets and should include complete and standard documentation on pediatric testing and authorization. Such changes will require cooperation across regulatory and industry stakeholders with a commitment to safe, equitable, and effective AI/ML development for children.