Literature Review

Perspectives on the challenges of planning for and accessing long-term dementia care services through Medicaid and Medicaid WaiversJournal of Applied Gerontology; Justine Scattarelli, Kelly Moeller, Dana Urbanski, Marguerite DeLiema; 4/25 Formal long-term services and supports (LTSS) are essential to support older Americans with chronic conditions, such as Alzheimer’s disease and related dementias (ADRD). However, few older adults have saved enough to pay for LTSS, and navigating Medicaid eligibility criteria presents significant challenges. We conducted semi-structured, in-depth interviews with aging services professionals and caregivers of older adults with ADRD to assess challenges to planning for and accessing LTSS coverage through Medicaid and Medicaid waivers. Using concept mapping, three main themes were identified: (1) Proactive planning, (2) decision points, and (3) the application process. Participants described misconceptions about LTSS coverage, challenges with enrollment, and lack of information about eligibility affecting the LTSS planning trajectory. Results demonstrate a critical need for resources that help caregivers estimate costs and guide them through the eligibility determination, application, and spend down processes for Medicaid programs.

Saturday newsletters focus on headlines and research - enjoy!

[Taiwan] Spiritual well-being of terminally ill patients and next-of-kin caregivers in hospice care: A quantitative and qualitative approachPalliative and Supportive Care; Er-Jung Hsueh, Shu-Chun Tsai, Jun-Hung Lai, Chi-Yu Lu, Tsai-Wei Huang, Made Satya Nugraha Gautama; 4/25Terminal cancer patients often endure significant distress, impacting their quality of life. Spiritual well-being provides peace and meaning during this challenging period. This mixed-methods study included 30 terminally ill patients and 17 next-of-kin caregivers in hospice care. Spiritual well-being was assessed using the Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being Scale (FACIT-Sp-12), and symptom distress with the Edmonton Symptom Assessment Scale. Patients showed a significant improvement in spiritual well-being over time, ... [and] symptoms such as shortness of breath ... , drowsiness ... , and anxiety ... were negatively associated with spiritual well-being. Caregiver spiritual well-being positively influenced patient scores, especially with female caregivers ... Qualitative findings supported these results, revealing themes of spiritual adjustment, the impact of physical symptoms on spiritual well-being, and the crucial role of caregivers in providing emotional and spiritual support.

Memorial Day 2025: Resources, events, and ways to honor our fallen heroes Hope for the Warriors; retrieved from the internet 5/22/25 Each year, as the last Monday of May approaches, we are reminded that Memorial Day is more than just the unofficial start of summer. It is a sacred time to honor the brave men and women who made the ultimate sacrifice for our freedoms. Ways to Honor and Remember:

Proposed California budget calls for prior authorization for hospice in Medicaid Hospice News; by Jim Parker; 5/22/25 The proposed California budget would require prior authorizations for hospice care within the state’s Medicaid program. Currently, Medicaid managed care plans who provide coverage through the state’s Medicaid system, Medi-Cal, may not perform prior authorizations for hospice. California’s Department of Health Care Services (DHCS) indicated in a 2025-2026 budget revision that this could save $25 million over the next two years and more than $50 million in the long term. If enacted, this would make California the first state in the nation to implement such a rule, according to the California Hospice & Palliative Care Association (CHAPCA). The association contends that the anticipated $25 million in cost savings is “speculative and fails to account for the downstream costs and systemic burdens this proposal would create,” according to a position paper shared with Hospice News. ... CHAPCA recommended to the state government three alternative approaches: ...

‘Wake-up call’: Aggressive cancer care common at end of life, supportive care lackingHealio; by Josh Friedman; 5/22/25Nearly half of people with advanced cancer receive aggressive care at the end of life, a rate little changed from a decade ago. At the same time, use of palliative or supportive care remains rare, despite increasing evidence that they are a key component of high-quality, patient-centered care. ... Meanwhile, two other studies showed oncologists’ individual practice patterns and institutional resources can play a significant role in determining which patients receive systemic therapy or early palliative care at the end of life.

Health systems need radical transformation. Are C-suites ready? Becker's Hospital Review; by Laura Dyrda; 5/21/25Health systems faced with ever-thinning margins and uncertain financial future may be tempted to double-down on cost cutting as an immediate option relief. But for most, that’s not the best option. ... “Amid unprecedented volatility, resource constraints, and technological disruption, how can healthcare executives rapidly adapt and transform their organizations to sustainably deliver high-value care, optimize operational efficiency, and preserve workforce resilience and empathy?” posed Craig Albanese, MD, CEO of Duke University Health System in Durham, N.C. The question is urgent and complex. Hospital leaders are searching for connecting points with old friends, rivals, community organizations and other stakeholders to problem-solve together. They’re also pursuing larger strategic changes instead of small fixes to truly build sustainable organizations for the future. ...

First FDA-cleared Alzheimer's blood test could make diagnoses faster, more accurate NPR; by Jon Hamilton; 5/21/25 A new blood test that detects a hallmark of Alzheimer's is poised to change the way doctors diagnose and treat the disease. The test, the first of its kind to be cleared by the Food and Drug Administration, is for people 55 and older who already have memory problems or other signs and symptoms of Alzheimer's. The results show whether the brain of a person with cognitive symptoms also has amyloid plaques, clumps of toxic proteins that build up in the spaces between brain cells. The presence of plaques in a person with cognitive symptoms usually confirms an Alzheimer's diagnosis.Editor's note: Game-changer!

Hospice Care Compare released 5/21/25

Securing philanthropic support for palliative care Hospice News; by Markisan Naso; 5/21/25 Fundraising has long been a necessity for many nonprofit organizations to provide palliative care programs. Currently, Medicare payment for palliative care only covers physician or licensed independent practitioner services and does not support the full range of interdisciplinary care, involving nurses, chaplains, aides and social workers. This shortage of funds has made community-based palliative care into a loss leader for many organizations. Palliative care is among the most “underfunded” services in the health care continuum, according to Deborah Johnson, chief philanthropy officer at Empath Health, a large non-profit post-acute care organization in Florida.

Finding Solutions: Local group makes flowers for everyone WRDW-12 & WAGT-26, Augusta, GA; by Zayna Haliburton; 5/21/25 Flowers are something that can put a smile on someone’s face, whether you’re receiving or giving them. For one local group, they’re making bouquets to bring to nursing homes, shelters and hospitals. They’re now finding solutions in asking the community to consider donating their leftover flowers from weddings and events in order to brighten someone else’s day. “These are going to go to hospice patients that a part of Enhabit Augusta, ..." said Patricia Proctor, co-owner of El Rey and founder of non-profit Corazón Bonito ... which translates to "beautiful heart" in English. 

New Mexico legalizes medical use of psilocybin JD Supra; by Patrick Clark and Jennifer Pacicco; 5/20/25 On April 7, 2025, New Mexico became the third state to legalize psilocybin (colloquially known as “magic mushrooms” or “shrooms”) for medical purposes. New Mexico is the first state to legalize psilocybin via legislation and not a ballot initiative, like its predecessors Colorado and Oregon. Under the new law—the “Medical Psilocybin Act”—the following qualifying conditions are listed as eligible for psilocybin treatment: “(1) major treatment-resistant depression; (2) post-traumatic stress disorder; (3) substance use disorders; (4) end-of-life care.” The law also allows the New Mexico Department of Health to promulgate regulations that would add qualifying conditions to that list. ... Employers are not required to accommodate employees under the influence of psilocybin at work.

‘We need you to work with us’: Home health providers renegotiate better Medicare Advantage deals Home Health Care News; by Joyce Famakinwa; 5/20/25 As Medicare Advantage (MA) enrollment continues to surge, home health providers have seen slim margins deteriorate further. Some providers have openly expressed their decision to reject financially unsustainable MA contracts. Abandoning unfavorable MA contracts may sometimes be necessary, industry executives told Home Health Care News. However, some providers have improved their MA standing by renegotiating rates or returning after walking away, leveraging data and understanding the needs of payer partners. “We have walked away, in specific states, from payers and Medicare Advantage groups because of rates and the inability to raise those rates, and pre-authorization terms,” G. Scott Herman, CEO of New Day Healthcare, told HHCN.