Literature Review

Most heart failure patients miss out on guideline-recommended palliative care Cardiovascular Business; by Dave Fornell; 11/6/24 Over the past decade, the American Heart Association (AHA) and European Society of Cardiology have recommended integrating palliative care into heart failure management. Despite these recommendations, the use of palliative care for heart failure remains low in the United States. Racial and geographic variations in access and use of palliative care are also pronounced, highlighting health disparities. These were the findings of a recent study in the Journal of the American Heart Association. Researchers at Saint Louis University led the study and said only one in eight patients with heart failure in the United States receive palliative care consultations within five years of diagnosis. Their study highlights the alarmingly low uptake of palliative care among adults with heart failure in the U.S., especially compared to patients with cancers that have the same mortality rates. The study also pointed out significant racial and geographic disparities. Black patients were 15% less likely to receive palliative care compared to their white counterparts. They said this disparity is particularly concerning given the higher cardiovascular risk and mortality rates in the Black population.

UP Health System Hospice coming to Dickinson County The Daily News, Iron Mountain, MI; 11/5/24U.P. Health System Hospice will begin bringing its hospice care to Dickinson County. UPHS’s goal is to improve the quality of life for patients and their families by providing compassionate and comprehensive care during the final stages of life. U.P. Health System Hospice has made it the mission of its agency to change end of life care in the U.P. and its most rural communities by bringing awareness to hospice services, advocating for patient rights, and working hand-in-hand with the medical community to help more people receive support in their health care. 

Why home health deserts are spreading across rural states Modern Healthcare; by Diane Eastabrook; 11/1/24 Home health deserts are increasing at an alarming rate across some rural states as home health companies close or reduce services due to financial challenges. Home health companies in Maine, Nebraska and Minnesota say a proposed Medicare rate cut, low Medicare Advantage reimbursements and workforce shortages are forcing them to make difficult business decisions — leaving many communities with limited access or no access to post-acute care in the home. ...  Approximately 800 home health providers have closed over the past five years, according to the National Alliance for Care at Home, a trade group that represents the industry. Alliance CEO Dr. Steve Landers mostly blames a Medicare home health payment model that went into effect in 2020 for reducing Medicare reimbursements and causing financial stress for providers. “While closures are significant, we are also getting reports that providers are restricting the territory they serve as a first step to addressing their financial stresses,” Landers said in an email. “This appears to be especially concerning in rural areas where no other provider is available to step in.”

PACE elderly care center opens in Murrieta [California] Patch, Murrieta, CA; by Kat Schuster; 11/1/24 Neighborhood Healthcare opened the doors to a new 20,000-square-foot medical and care center for older adults in Murrieta on Friday. It is the second Program of All-Inclusive Care for the Elderly (PACE) to open in town. The new facility offers a medical team specializing in aging and chronic conditions. PACE touts itself as an alternative to nursing homes and a program for older adults to get social and medical services in their own homes and communities. Neighborhood Healthcare also offers a bilingual medical team that works with therapists, dieticians, social workers, and home care nurses "to create a customized care plan" for each patient. 

‘Stop Requested’: To Lakeview, Oregon’s ‘Mile High City’ OPB (Oregon Public Broadcasting); by Lillian Karabaic; 10/27/24 Lakeview isn‘t close to much, but locals figure out how to get ’er done. ... OPB “Weekend Edition” host Lillian Karabaic and producer Prakruti Bhatt experience the joys and difficulties of rural transit and talk to many people along the way. ... To reach Lakeview, we turn to the Lake County Cloud, a transit service run by the Lakeview Senior Center. Lake County Cloud doesn‘t have any fixed route services. Its crew of eight part-time drivers mostly do by-reservation trips to medical appointments and a few shopping trips. This became even more important after Lakeview’s only specialty clinic and hospice closed in 2023. ... Because the nearest city is Klamath Falls, more than 90 miles away, Lake County Transit puts in a lot of miles. It also goes up to Medford, down to California, and even all the way to Portland for chemotherapy. “We do about 30,000 [or] 40,000 miles a month … it’s a lot for a little town and little crew," says Linda Mickle, transportation coordinator for Lake County Transit.

80-year-old 'Mom' cares for homeless men in Philadelphia ABC News 7, New York, NY; by Matteo Iadonisi; 10/30/24 Cecelia Robinson has earned the nickname 'Mom' during her two decades of showing motherly love to homeless residents at St. John's Hospice. Her work in environmental services and housekeeping ranges from taking out the trash to developing relationships with clients and making sure their needs are met. Specifically, she works in the Good Shepherd residence at St. John's Hospice, which cares for men who are considered medically fragile. Robinson has helped men like Craig Freeman, who utilized the Good Shepherd for transitional housing and has since moved into his own apartment. Watch the video [here] to see Robinson's story in action.Editor's note: Do you need inspiration? Click here to view this beautiful story about Cecelia Robinson's care for homeless residents at St. John's Hospice.

CCH, foundation working together again to look at possibility of reopening Hospice House Gillette News Record, Gillette, WY; by News Record Staff; 10/24/24 Campbell County Health and the Northeast Wyoming Community Health Foundation are back at the table again to explore the feasibility of reopening the Close to Home Hospice House. According to press releases sent out Wednesday from both groups, this initiative aims to enhance inpatient hospice services by reopening a home that facilitates end-of-life support, providing a compassionate space for individuals to receive care with dignity. “We are considering this in partnership with a third-party operator,  which will be discussed and decided upon collaboratively,” the press releases read. “Our primary focus is the well-being of our community, and we are committed to transparency as we engage in these preliminary discussions." 

Funding approved for homeless hospice program SacCountyNews, Sacramento, CA; by Janna Haynes; 10/22/24 The Board approved, at its Oct. 22nd meeting, up to $1,137,788 in funding to complete construction on Joshua House, a facility that provides end-of-life comfort care for homeless individuals with terminal illnesses, after being discharged from an acute care hospital. Joshua’s House specifically provides a location for homeless patients to receive home-like hospice services when they, by definition, do not have a home to receive such care and may otherwise be unsheltered at the time of passing. Joshua’s House provides shelter, food, clothing and certain volunteer comfort services. In addition, YoloCares will provide licensed expert/specialized end-of-life care for individuals and families facing a life-limiting illness. Yolo Cares has provided high-quality hospice care across the six-county region for nearly 50 years. YoloCares also recently became an enhanced Care Management and Community Supports provider through CalAIM.

Busting palliative care misconceptions in cancer care Cure; by Alex Biese; 10/22/24 Palliative care can serve a crucial function for patients living with serious illnesses such as cancer, as an expert explained in an interview with CURE®. “Palliative care is sub-specialized health care for patients living with serious illness, where we're really focused on alleviating the symptoms and the stress associated with illness, and our goal is to improve quality of life for patients and their families,” said Dr. Cari Low of the University of Utah Huntsman Cancer Institute. ... However, some misconceptions persist regarding palliative care — most prominently that it is synonymous with hospice care. ... "We [i.e., palliative care] follow patients from the time of diagnosis through their curative cancer treatment and throughout their journey and into survivorship. ... Hospice is really focused on end-of-life care and comfort when cancer treatments no longer make sense. So, I really think of palliative care as this great big umbrella of support throughout the entire journey, where hospice is just a tiny piece of that umbrella.”

The powerful companies driving local drugstores out of business DNYUZ; 10/19/24 The small-town drugstore closed for the last time on a clear and chilly afternoon in February. Jon Jacobs, who owned Yough Valley Pharmacy, hugged his employees goodbye. He cleared the shelves and packed pill bottles into plastic bins. Mr. Jacobs, a 70-year-old pharmacist, had spent more than half his life building his drugstore into a bedrock of Confluence, Pa., a rural community of roughly 1,000 people. Now the town was losing its only health care provider. Obscure but powerful health care middlemen — companies known as pharmacy benefit managers, or P.B.M.s — had destroyed his business. This has been happening all over the country, a New York Times investigation found. P.B.M.s, which employers and government programs hire to oversee prescription drug benefits, have been systematically underpaying small pharmacies, helping to drive hundreds out of business.

Low rates of hospice utilization in blood cancer patientsCU Anschutz News; by Tari Advani; 10/24Patients with hematologic malignancies enroll in hospice at significantly lower rates than patients with solid malignancies and are more likely to die in the hospital. Cost of transfusions in comparison to standard per diem reimbursement for hospice is greatest limitation to hospices offering transfusions to blood cancer patients and this lack of option for transfusion is limiting hospice utilization by patients with blood cancers overall and leading to late enrollment when it happens. It is felt that innovative hospice payment models to improve end-of-life care for patients with blood cancers would be the most useful course of action.

Heartlinks expands hospice, palliative programs with new adult family home Hospice News; by Holly Vossel; 10/16/24 Heartlinks is opening a de novo located in Sunnyside, Washington, with an aim of providing a range of services to seniors in the area. Hospice and palliative care will be a “strong focus” of services provided at the new senior living facility, Heartlinks Adult Family Home, said Shelby Moore, the organization’s executive director. Other services available include 24/7 access to personal care, assistance with activities of daily living, medication management and respite care. The new location is designed to create a peaceful and comforting space for individuals with advanced and life-limiting illnesses in an area that lacks resources for patients and their families, Moore stated. 

Stratis Health builds framework for expanding rural community-based palliative care Hospice News; by Jim Parker; 10/16/24 The health care performance improvement company Stratis Health has developed a framework for expanding access to palliative care in rural communities. The company’s strategy convenes resources and organizations that already exist in a given community to help meet patient’s palliative care, psychosocial, spiritual and social determinants of health needs. It leverages those resources to offer a wraparound suite of services for seniors and seriously ill patients. Hospice News spoke with Karla Weng, senior program manager for Stratis Health, about how health care providers and other stakeholders serving rural communities can come together to better serve their patients and clients. ... The field has shifted in more recent years, so that community-based really means anywhere but the hospital. It might be in a clinic. It might be home care. We’re not that prescriptive. So we have sometimes shifted to using the language “community centric.” The way that we work with communities who are interested in going down this path is helping them first to do a gap analysis and assessment of the resources that are already there in their community.  ... [Click on the title's link to continue reading.]