Literature Review

Rural-urban disparities and trends in utilization of palliative care services among US patients with metastatic breast cancerJ Rural Health; by Jincong Q Freeman, Adam W Scott, and Ted O Akhiwu; 2/20/24Purpose: To assess trends and rural-urban disparities in palliative care utilization among patients with metastatic breast cancer.Conclusions: In this national, racially diverse sample of patients with metastatic breast cancer, the utilization of palliative care services increased over time, though remained suboptimal. Further, our findings highlight rural-urban disparities in palliative care use and suggest the potential need to promote these services while addressing geographic access inequities for this patient population.

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.

Hospice experts advocate for early admission to hospice The Herald-Mail, by Hospice of Washington County; 2/19/24“Former President Jimmy Carter’s months-long time in hospice has helped tens of millions of Americans realize that hospice isn’t a brink-of-death service, that it helps patients and families focus on quality of life and not just length of life,” observed Hospice of Washington County CEO Sara McKay. Editor's Note: How is your hospice organization responding to news about President Jimmy Carter's extended hospice care? This article provides a great example.

Hospices see growth opportunities with physician offices, memory careHospice News, by Holly Vossel; 2/16/24Hospice providers are increasingly focused on memory care settings and physician offices as referral sources. ... Physician offices were identified among the most significant referral growth opportunities in 2024 by about 6% of 143 respondents to Hospice News’ 2024 Outlook Survey, conducted with Homecare Homebase. Meanwhile, 7% reported that their hospice organizations saw memory care settings as a significant referral source.

Inclusive hospice care: Gilchrist’s efforts to ensure equal end-of-life care accessAfro News - The Black Media Authority; 2/16/24Despite concerted efforts to address disparities, Black Americans continue to be underrepresented in hospice and palliative care services, a trend Gilchrist, a leading provider of end-of-life care for 30 years, is actively working to change. “We’re creating a paradigm shift around how hospitals communicate with communities of color. We’re going into communities and humbly asking what we can do to better serve their needs,” Wayman Scott, Associate Director of DEI and Community Relations, said.

'A blessing': Sarasota family shares importance of hospice care after losing 5-year-old to cancerCBS News 10 Tampa Bay, by Jenny Dean; 2/16/24While the average time in hospice is 70-80 days, some people defy the odds. And that's largely due to the changes in hospice care over the years. A Sarasota family knows how difficult that decision can be. They lost their 5-year-old daughter to cancer and now say hospice care is something they wish they would have gotten sooner.

Umatilla County resident finds comfort in hospice care amid disparity studyBNN, by Muhammad Jawad; 2/14/24 In the heart of Umatilla County [Oregon], Lila Transue, an 86-year-old Pendleton resident, has found solace in the care provided by Vange John Memorial Hospice. A recent study highlights the underutilization of hospice care, particularly for minority groups and patients with certain types of cancer, but Transue's experience offers a glimmer of hope.

South Dakota campaign joins state and federal efforts to expand rural telehealth accessMcKnights Senior Living, by Aaron Dorman; 2/12/24The continued need for telehealth options is particularly important for older adults living in rural areas. That reality may explain, in part, why South Dakota is working on legislation that would grant $5 million to assisted living communities and nursing facilities in the state to implement telehealth and telemedicine technology. 

Patients with cancer underuse hospice care, often because of disparitiesOncology Nursing Society Voice, by Elisa Becze BA, ELS, Editor; 2/13/24Most patients who die from cancer do not use hospice at the time of their death, ONS member and oncology nurse researcher Dena D. Shore, PhD, RN, OCN®, CNE, reported in an article published in ... the Clinical Journal of Oncology Nursing (CJON). ... Shore conducted an extensive literature search for studies of hospice use in U.S. patients with cancer published from 2017–2023. ... According to her literature review, cancer-related, ethnic and racial, and geographic disparities are frequently involved in delayed or nonuse of hospice care.

Part 2, Latest updates from CMS Office of Minority Health: Advancing health equity in rural, tribal, and geographically isolated communities FY2023 year in review

Alzheimer's: Watch for signs it's time to start hospice careThe Advocate, by Dana Territo; 2/5/24When is someone with dementia ready for hospice care? ... Some of the characteristics the affected individual may be exhibiting include the lack of ability to ambulate without assistance, incontinence of bowel and bladder, inability to dress and bathe properly, and speech limited to approximately a half dozen or fewer intelligible and different words. There are also intercurrent illnesses associated with advanced dementia in which hospice services would be a benefit. 

Rural hospitals caught in aging-facility dilemma Lexington Herald Leader, by Markian Hawryluk; 2/6/24... Rural hospital closures dropped during the pandemic, from a record-high 18 in 2020 to eight in 2021 and 2022 combined, according to the University of North Carolina–Chapel Hill, as emergency relief funds kept them open. But that life support has ended.

Dying mother wins $10m from WA after cancer became terminal in prisonNewsFinale; 2/2/24Washington State has paid just shy of $10 million to settle a lawsuit with a mother-of-two whose cervical cancer became terminal while she was in prison after doctors there failed to diagnose and treat the disease. Paula Gardner, 42, was serving time for drug and burglary offences and did not receive adequate medical care for over two years despite tests showing possible signs of cancer in that time before a scan revealed a growth inside her uterus, according to the lawsuit.