Literature Review

The bottom line: Top billing, financial mistakes responsible for home health agency struggles

Embodied decisions unfolding over time: a meta-ethnography systematic review of people with cancer's reasons for delaying or declining end-of-life careBMC Palliat Care, by Jessica Young, Antonia Lyons, Richard Egan, and Kevin Dew; 2/19/24Conclusions: Decisions about when (and for some, whether at all) to accept end-of-life care are made in a complex system with preferences shifting over time, in relation to the embodied experience of life-limiting cancer. Time is central to patients' end-of-life care decision-making. ... The integration of palliative care across the cancer care trajectory and earlier introduction of end-of-life care highlight the importance of these findings for improving access whilst recognising that accessing end-of-life care will not be desired by all patients.

Reduced federal share may force state Medicaid programs to cut services, HCBS expert saysMcKnights Home Care, by Adam Healy; 2/15/24The Congressional Budget Office this month released its “Budget and Economic Outlook” report for the coming decade. In its report, CBO predicted a roughly $58 billion drop in federal Medicaid outlays for 2024 compared to 2023 — a 9% decrease in federal Medicaid spending, due in part to fewer beneficiaries on states’ Medicaid rolls. 

Center for Hospice Care supports patient well-being with four-legged friendsLeadership Life, by Damon Modglin; 2/19/24For all of recorded history, humans have been living alongside their pets. For many people, having an animal companion along for the ride during the ups and downs of living is a comfort that can’t be matched, and it can cause a significant amount of distress to both the person and the animal to be separated. Center for Hospice Care (CHC) understands how stressful this situation can be, which is why it partners with organizations like Pet Peace of Mind to make sure that, as people enter into end-of-life care, the needs of their pets can still be met, allowing owners to keep their fuzzy friends. 

Poll: Md. voters support medical aid-in-dying option, but bill is far from the finish lineMaryland Matters, by Danielle J. Brown; 2/19/24The survey results, released last week, showed that 69.9% of Maryland voters think that a mentally sound but terminally ill adult with only six months to live should have the legal option to request medical aid-in-dying services, while 22% of those who responded to the poll do not support that option. About 8% of the respondents did not answer. ... The overall support for medical aid-in-dying spans political parties and demographics, according to the poll results, as 72% of Democrats surveyed were in support along with 69% of Republicans and 65% of unaffiliated voters.

Death can be isolating and dehumanizing. But what if it didn’t have to be?City Life, by Ben Seal; 2/17/24... In the three years since Elaine’s passing, I’ve longed for a world where more people could be given the chance to die as she did — with the fullness of life surrounding her, and with complete support, emphasizing the emotional and spiritual, not just the medical. In Philadelphia and beyond, a growing community of death-care workers — doulas, nurses, grief counselors, social workers, even funeral directors — is trying to build that world. They are reclaiming death and dying from the institutional model that has become the norm over the past century. Editor's Note: Has hospice now become so institutionalized and medical/regulatory focused that we have lost sight of "emphasizing the emotional and spiritual, not just the medical"? I ask the question, but do not draw judgment, as answers must be contextualized. 

How palliative care could help break the SNF-to-hospital cycle Hospice News, by Molly Bookner; 2/20/24A dearth of coordination or integration between rehab teams and palliative care teams routinely forces some patients into a cycle between the hospital and the nursing home in their last year of life. ...  Nursing homes are incentivized to hospitalize residents eligible for both Medicare and Medicaid because those patients can later return to the nursing home with a higher-paying Medicare benefit before transitioning back to long-term care with lower Medicaid day rates.

Survey: Nearly half of healthcare workers witness discrimination against patientsMcKnights Long-Term Care News, by Foster Stubbs; 2/20/24Healthcare workers (HCWs) are likely to witness discrimination in their workplaces, according to a new report from the Commonwealth Fund and the African American Research Collaborative. This can contribute to negative health outcomes for patients as well as emotional distress for both patients and healthcare workers.Editor's Note: What Policies and Procedures do you have in place for your hospice interdisciplinary teams,  volunteers, and non-clinical staff? What diversity education and competencies do you regularly require and update? 

22 recent CEO exitsBecker's Hospital Review, by Alexis Kayser; updated 2/16/24Ousters, retirements and a slew of C-suite switch-ups — Becker's has reported the following hospital and health system CEO departures in 2024

To be free is not merely to cast off one’s chains, but to live in a way that respects and enhances the freedom of others. - Nelson Mandela