Literature Review

Dozens of CarePartners patients in Asheville transferred to other facilities after HCA temporarily shuts down rehab, hospice center Asheville Watchdog; by Andrew R. Jones; 10/14/24 Hundreds of employees uncertain about their jobs after facility is closed to ease pressure on Mission Hospital. Mission Health’s CarePartners Health Services is temporarily closed following the pressures Hurricane Helene put on Asheville’s health care system, disrupting rehabilitative care for more than 50 patients and forcing more than 250 employees to take temporary jobs elsewhere in the system, according to employees and internal emails obtained by Asheville Watchdog.  ... The closing affected nearly 50 inpatient rehab patients, several long-term acute care patients, and eight hospice patients, all of whom were sent to home caregivers, skilled nursing facilities, other inpatient rehab programs, and UNC Health Caldwell in Lenoir, more than an hour’s drive to the east, according to one employee.

Death cafes: Demystifying the inevitable over tea and cookies MD edge - Internal Medicine News; by Megan Brooks; 10/15/24 “Death cafes” — where people gather to discuss death and dying over tea and cookies — have gained momentum in recent years offering a unique way for people to come together and discuss a topic that is often shrouded in discomfort and avoidance. It’s estimated that there are now about 18,900 death cafes in 90 countries, with the United States hosting more than 9300 on a regular basis. This trend reflects a growing desire to break the taboo surrounding discussions of death and dying. But these casual get-togethers may not be for everyone, and their potential benefits and harms may depend on who attends and who facilitates the discussion. ... [Click on the title's link to continue reading these significant cautions.]

Care utilization for neurodegenerative diseases compared to patients with cancer Physician's Weekly; 10/14/24 Neurodegenerative diseases are a leading cause of death, yet healthcare utilization and costs during the end-of-life (EoL) period are poorly understood.  Researchers conducted a retrospective study to describe and compare resource utilization among U.S. Medicare decedents with neurodegenerative diseases and cancer. ... The results showed 1,126,799 Medicare beneficiaries, of which 357,926 had a qualifying diagnosis. Individuals with neurodegenerative diseases were older and more frequently received Medicaid assistance than those with brain or pancreatic cancer. ... The study concluded that individuals with neurodegenerative diseases were more likely to visit ED and less likely to utilize inpatient and hospice services at the EoL compared to those with brain or pancreatic cancer. 

Millions of aging Americans are facing dementia by themselves California Healthline; by Judith Graham; 10/15/24 Sociologist Elena Portacolone was taken aback. Many of the older adults in San Francisco she visited at home for a research project were confused when she came to the door. They’d forgotten the appointment or couldn’t remember speaking to her. It seemed clear they had some type of cognitive impairment. Yet they were living alone. Portacolone, an associate professor at the University of California-San Francisco, wondered how common this was. Had anyone examined this group? How were they managing? ... Portacolone got to work and now leads the Living Alone With Cognitive Impairment Project at UCSF. The project estimates that that at least 4.3 million people 55 or older who have cognitive impairment or dementia live alone in the United States. ... Imagine what this means. ...

How poor health literacy can diminish access to palliative care Hospice News; by Jim Parker; 10/11/24 Low health literacy among seriously ill patients can impede access to palliative care and complicate efforts to improve health equity. Health literacy is the degree to which individuals can obtain, process and understand basic health information and services needed to make appropriate health decisions, according to the Institute of Medicine. A health illiterate patient may have a strong overall ability to read or have an advanced education but have a limited understanding of information specific to health care. ... The issue deepens when it comes to palliative care. An estimated 71% of adults in the United States are unaware that palliative care exists, studies have shown, even though nearly 80% of consumers who received background information on palliative care say they would choose it for themselves or their loved ones. 

Helene will likely cause thousands of deaths over decades, study suggests USA Today; by Doyle Rice; 10/2/24 [Note the 10/2 date of this article. Helene's death toll is now 230+ and rising. Hurricane Milton's predictions were new.] A new study ... says that hurricanes and tropical storms are far deadlier than initial death tolls suggest. ... Overall, the death toll of a tropical cyclone may be a broader public health issue than previously thought, as disasters frequently trigger a domino effect of other threats to affected populations. ... Researchers found that these excess deaths were due to causes such as diabetes, suicide, sudden infant death syndrome or another cause that was not recorded. Cardiovascular disease was the next most common cause, followed by cancer. Official government statistics record only the number of individuals killed during these storms. Usually, these direct deaths, which average 24 per storm in official estimates, occur through drowning or some other type of trauma, according to the study. "People are dying earlier than they would have if the storm hadn't hit their community," said senior study author Solomon Hsiang, a professor of environmental social sciences at Stanford University. Looking at the death and destruction from Helene, Hsiang told the Associated Press that "Watching what’s happened here makes you think that this is going to be a decade of hardship on tap, not just what’s happening over the next couple of weeks.”

Hospital-at-home care’s future still hangs in the balance Home Health Care News; by Joyce Famakinwa; 10/7/24 Even with a proven track record for clinical effectiveness and cost savings, the hospital-at-home model’s future hangs in the balance. “The data suggests that, for the populations that have been studied in multiple different places, it’s a very safe service to be done and with high-quality care, low readmission rates, low escalation rates, low infection rates,” Dr. Adam Groff, co-founder Maribel Health, told Home Health Care News. “The bottom line is people love it, patients love it and it’s a high-quality care experience.” ... In 2020, the hospital-at-home model had its breakthrough. Though the model was common internationally, it was considered niche in the U.S. This changed with the introduction of the Centers for Medicare & Medicaid Services’ (CMS) Acute Hospital Care At Home program. A recent report from CMS found that the program has been largely successful. ... Despite the momentum the model has seen in recent years, challenges still exist when it comes to operations and scalability. Specifically, less than 9% of waiver-approved hospitals accounted for more than 70% of all U.S. admissions, according to data from MedPAC’s June 2024 report to Congress. ... 

Hoping to reach 100? You’re not going to like these new life expectancy projections New York Post; by Tracy Swartz; 10/7/24 Let’s keep it 100 — your chances of becoming a centenarian are slim. Medical breakthroughs, public health achievements and better diets led to steep increases in global life expectancy in the 1800s and 1900s. But startling new research finds this momentum has slowed and the biggest boosts to longevity may be in the rearview mirror. “Most people alive today at older ages are living on time that was manufactured by medicine,” said lead study author S. Jay Olshansky, a professor of epidemiology and biostatistics at the University of Illinois at Chicago. “But these medical Band-Aids are producing fewer years of life even though they’re occurring at an accelerated pace, implying that the period of rapid increases in life expectancy is now documented to be over,” Olshansky added. The analysis, conducted with researchers from the University of Hawaii, Harvard and UCLA, includes data from eight countries with the longest-living populations (Australia, France, Italy, Japan, South Korea, Spain, Sweden and Switzerland), Hong Kong and the US from 1990 to 2019.

Guest column: Hopewest – Breaking the silence: Supporting suicide prevention and survivors of loss Special to the Herald Times; 10/2/24 Those left in the wake of a suicide loss sometimes aren’t sure where to turn or what to do. Uprooted by shock and overcome by the grief of losing someone to suicide can feel painful and isolating. ... The stigma surrounding suicide deaths, particularly on the Western Slope of Colorado, often hinders individuals from seeking the support they need. To address this crisis in our communities, we must not only bring awareness to suicide prevention but also collectively understand and acknowledge the challenges that survivors of suicide loss face. “Grief after the loss of a loved one to suicide is a unique and painful experience. Survivors struggle with a range of challenges, from the heavy weight of stigma surrounding the death, to judgment from others,” said Judy Eskelson, HopeWest Meeker Bereavement Counselor. “And for many in our community, they may not fully understand the ins and outs of this type of grief. Life after this kind of death can be overwhelmingly difficult, leaving families to navigate a path they never expected to walk.” ... Following the devastating loss of a loved one to suicide, the HopeWest bereavement team is here to walk alongside individuals and families needing a source of comfort and guidance through their grief journey. Editor's note: Though many hospices provide bare, minimum grief support, many others--like HopeWest--live out their mission by providing a fuller scope of bereavement counseling and support. What does your hospice provide? Throughout your service area, do bereaved persons (whether hospice deaths or not) think of your agency as the "dying, death and bereavement" expert, or not? 

There’s still joy in end-of-life care The Seattle Medium, Seattle, WA; by Anissa Durham; 10/3/24 Caregiving is an act of love and sacrifice. But for young Black women, it’s often summed up as just being “a good daughter.” More than 100 million Americans provide care to a child, parent, or relative. And about half provide care to a spouse, elderly parent or relative, or special needs child, according to a report by Guardian. But for Black folks, the burden of doing so is often heavier. Due to disparities in education, housing, and nutrition, and less access to health insurance, — along with the “weathering” that accompanies racism-related stress — Black Americans experience higher risk and rates of chronic disease. Which means, Black folks may get sick sooner than their counterparts and make younger generations, often women, more likely to become caregivers. In a 2021 report, Black family caregivers represent 14% of the estimated 48 million unpaid family caregivers in the U.S., with Black women making up a little more than half of this group, according to the American Society on Aging. Overall, women are two times more likely than men to say they’ve left the workforce to keep up with caregiving responsibilities. And nearly 50% of caregivers are either Millennials or Gen Z, according to the Guardian report. 

Asian-American communities face ‘digital divide’ in health equity, hospice care Hospice News; by Holly Vossel; 10/1/24 Recent research has dug into the barriers limiting greater telehealth utilization among Asian American, Native Hawaiian and Pacific Islander (AANHPI) communities. The data come at a time when hospices are striving to better understand how to improve those groups’ end-of-life trajectories. Technology utilization has gained momentum in health care, including in hospice care delivery. Though increased virtual health care access can help hospice providers reach patients upstream, the trend may be worsening disparities and outcomes among Asian American populations, according to Victoria Tsze, an outpatient hospice social worker at Tucson Medical Center (TMC) Hospice. 

‘Much-needed hospice … vital to our community:’ Mayor Elizabeth Roy salutes Whitby Hospice breaking ground after 8-year effort, millions raised and tireless efforts by volunteers DurhamRegion.com, Durham, NC: by Tim Kelly; 9/29/24 After many years of hard work and fundraising by dedicated volunteers, Hospice Whitby — Roger Anderson House is about to break ground. For the chief organizers on the committee Hospice Whitby committee, it was time to really enjoy the moment and they made a video to celebrate it. With the building of Whitby’s hospice, the region will have gone from no hospice beds at all to 29 in under five years. 

Comfort home in Scottsville reopens after four-year hiatus NBC News 10, Rochester, NY; by Eriketa Cost; 9/27/24 A local hospice home in Scottsville re-opened, after four years of rebuilding from the inside out. You may recall how much of an effect COVID-19 had on these services. The home, Patrick Place, was unable to hold fundraisers. Dozens of volunteers stepped down out of fear for the virus, and it took time to bring them back. The emails and phone calls didn’t stop during the downtime, though, said Cissy Leblanc, secretary on the board for Patrick Place. Organizers were eager to open again, but it took hard work. Along the way, the team built a new deck and furnished the basement, adding a conference room and special area for training volunteers. These, are all projects that couldn’t have happened with someone living there, said chairman Patrick Hanley. The home opened in early September with 55 volunteers. The goal is to reach 75. ...