Literature Review

Destitute and dying: Interventions and models of palliative and end of life care for homeless adults – a systematic review BMJ Supportive & Palliative Care; United Kingdom; by Megan Rose Coverdale and Fliss Murtagh; 8/24 We identified key components of care to optimise the support for homeless adults needing palliative and end of life care: advocacy; multidisciplinary working; professional education; and care in the community. Future research must include the perspectives of those who are homeless. 

Navigating end-stage blood cancer: When there are no more options Medscape Medical News; by Randy Dotinga; 8/14/24 Blood cancer death rates have dipped in recent decades, dramatically boosting 5-year survival rates in leukemia, lymphoma, and myeloma. Still, the three diseases were expected to kill more than 57,000 people in the United States in 2023 — almost 10% of all cancer deaths. ... Here are five things to understand about navigating end-of-life care in blood cancer.

Factors associated with Do Not Resuscitate status and palliative care in hospitalized patients: A national inpatient sample analysis Palliative Medicine Reports; by Jean-Sebastien Rachoin, Nicole Debski, Krystal Hunter, Elizabeth CerceoIn the United States, the proportion of hospitalized patients with DNR, PC, and DNR with PC increased from 2016 to 2019. Overall, inpatient mortality and LOS fell, but hospital charges per patient increased. Significant gender and ethnic differences emerged. Black patients and males were less likely to have DNR status and had higher inpatient mortality, LOS, and hospital charges.

Health group expands to Presque Isle The County, Presque Isle, ME; 8/14/24 Andwell Health Partners (formerly Androscoggin Home Healthcare + Hospice) has expanded its hospice services to Aroostook County. “As Maine’s largest non-profit home and community-based healthcare and care management organization, we are driven to meet the growing and evolving needs of individuals and families,” said Ken Albert, president and CEO, Andwell Health Partners, who has deep family roots in Aroostook County. ... Serving all ages of hospice patients, from infancy to those who have lived full lives, Andwell’s hospice services are available to individuals regardless of ability to pay.

Perfecting healthcare’s 360° consumer-centric strategy Guidehouse; 8/13/24 To ably compete in today’s healthcare environment while meeting their mission of quality patient care, health systems must make patient access and the consumer experience a core value across their entire organization. That means placing a relentless focus on reducing friction to meet customer expectations and aligning people and tech resources with standardization and scale. ... 

‘The Last Ecstatic Days’ one day screening strives to teach the world how to die without fear Bangor Daily News, Bangor, ME; by BDN Community; 8/13/24 Hospice Volunteers of Waldo County invites Greater Waldo County to a single night screening on Tuesday, Aug. 20 at 7 p.m. Post-screening, there will be a Community Conversation with Hospice and Palliative Care Physician Aditi Sethi, MD and Director of the Center for Conscious Living & Dying/Hospice Volunteers of Waldo County’s Flic Shooter. Sethi, MD’s end-of-life palliative work is featured in the film. “The Last Ecstatic Days” focuses on a young man with terminal brain cancer (Ethan Sisser) as he sits alone in his hospital room. When Sisser starts live-streaming his death journey on social media, thousands of people around the world join to celebrate his courage. Still, he envisions more–to teach the world how to die without fear. To do that, Sisser needs to film his actual death. What unfolds next is a rarely-glimpsed perspective of how a community of strangers helps a young man die with grace.Editor's Note:  This movie has been featured on PBS. The Boston Globe describes, "... courageous end-of-life chronicle, which overflows with compassion." The Louisiana Mississippi Hospice & Palliative Care Organization shared this as a viewing and discussion at their July 2024 conference. For the trailor and more information, click here. 

Letter: Closing Cottage of the Meadow [Hospice House] is a loss for allYakima Herald-Republic, Yakima, WA; by Lee Murdock; 8/13/24, with news post from 8/5/24 [Letter] To the editor — I was devastated to learn that Cottage in the Meadow, our local hospice facility, is ending hospice care. Both of my parents were fortunate enough to spend their final days in this serene and caring environment. The difference between the overrun hospital setting with its short staffing and the compassionate, individualized care at Cottage in the Meadow was stark. This facility provided invaluable support not only to those at the end of life but also to their families. As our population ages, the need for such services will only increase. Studies have shown that hospice care can reduce healthcare costs by up to 30% compared to traditional hospital care (Journal of Palliative Medicine). Additionally, hospice care significantly reduces hospital readmissions and emergency room visits, further reducing healthcare costs (JAMA). In a healthcare system with ample profit margins, ensuring access to hospice care is the least we can do. ...Editor's Note: This letter to the editor was in response to Yakima Herald-Republic's 8/5/24 article, "Yakima's Cottage in the Meadow will close its hospice house. It will reopen as a skilled nursing facility."

Free CHAP Webinar: CMS Posts Final Hospice Rule - Quality changes and regulatory requirement Community Health Accreditation Partner (CHAP); taught by Dr. Jennifer Kennedy; posted 8/13/24, webinar will be 8/21/24, 1:00-2:00 pm EDTCMS posted the final rule for hospice providers which drives big changes into motion for 2025.  [Click here for the] Final FY 2025 Hospice Wage Index and Payment Rate Update/Quality Reporting Rule  (CMS-1810-F), posted on the Federal Register on August 7, 2024. This free webinar will be taught by Jennifer Kennedy, Vice President, Quality, Compliance and Standards, CHAP. She spent many years as a leader and nurse in diverse healthcare settings with the past 25 years in hospice and palliative care. Dr. Kennedy came to CHAP in 2021 with a vision of moving the organization’s quality forward as “the” accreditation partner of choice for the majority of community-based providers. She believes no matter what type of care a patient receives or how many times they receive care, every experience should be of the highest quality. Webinar Objectives:

ETC model is failing to boost home dialysis utilization, nephrologists say McKnights Home Care; by Adam Healy; 8/9/24 Nephrologists are worried that the End-Stage Renal Disease Treatment Choices (ETC) model has not made good on its promise to promote home-based kidney care and advance health equity. The Centers for Medicare & Medicaid Services launched the ETC model in 2021, randomly selecting about 30% of providers treating end-stage renal disease for participation. The model uses financial incentives to encourage greater use of home dialysis treatment and increase kidney transplant access. However, these incentives have not been effective in producing their intended results, according to Amit Kapoor, MD, the chief nephrologist at Strive Health. ... A March study published in JAMA found that the ETC model may unintentionally punish providers who serve high-needs, low-income or minority patients. 

Dr. El-Jawahri on the impact of palliative care on end-of-life care for AML and MDS OncLive; by Areej R. El-Jawahri, MD; 8/12/24 Areej El-Jawahri, MD, associate director, Cancer Outcomes Research and Education Program, director, Bone Marrow Transplant Survivorship Program, associate professor, medicine, Massachusetts General Hospital, discusses findings from a multi-site, randomized trial (NCT03310918) investigating a collaborative palliative oncology care model for patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) receiving nonintensive therapy at 2 tertiary care academic hospitals. Patients in the study who received the palliative care interventions had a median of 41 days from end-of-life care discussions to death, compared with 1.5 days in the standard care group (P < .001). Additionally, patients who received the palliative care interventions were more likely to articulate their end-of-life care preferences and have these preferences documented in electronic health records, El-Jawahri begins. This documentation correlated with fewer hospitalizations in the final 30 days of life, she notes. Furthermore, palliative care recipients experienced QOL improvements and a trend toward reduced anxiety symptoms vs the patients who received usual care, El-Jawahri says. These findings underscore the necessity of integrating palliative care as a standard of care for patients with AML and high-risk MDS, El-Jawahri emphasizes.

Making your Customer Experience [CX] investment strategy work CMSWire [not to be confused with CMS=Centers for Medicare & Medicaid Services]; by Jeb Dasteel, Amir Hartman, Brian P. O'Neill and Marc Madigan; 8/12/24 Uncover the key elements of a successful customer experience strategy, from capability planning to aligning with core business objectives. ... Investing in a customer experience strategy is fraught with complications and feelings. Most of us in the world of CX are here because we believe that thoughtful CX spending will make an impact on the performance of our company.Editor's Note: This article is written for a much larger scope than our hospice and palliative readership. However, it highlights the importance of tying "customers' experiences" to the company/organization's core goals and business objectives. The Centers for Medicare & Medicaid Services' CAHPS Hospice Compare Scores [not to be confused with this CMSWire source] reflect the hospice "customer experience," from the perspective of the bereaved caregiver. While the CMS Hospice Compare site sorts these public information scores alphabetically (per location and organization), our newsletter's sponsor Hospice Analytics' National Hospice Locator sorts this same data by the highest scores, for the purpose of helping the public "consumer" find the hospice that will provide them with the best "customer experience."

New play focuses on Advance Care Planning for LGBTQ+ families and caregivers Hospice Foundation of America; by Lisa Veglahn; 7/29/24 Hospice Foundation of America (HFA) has added a new version of the short play “Lily” by award-winning playwright Bryan Harnetiaux to its AD (Advance Directives) Project, a collection of plays that dramatize the importance of advance directives. In the play, Jo visits her ex-wife, Lily, who is seriously ill. Jo is surprised that after years apart, Lily has asked to see her. She is even more surprised by Lily’s request that Jo serve as her surrogate decision maker when or if she cannot make healthcare decisions for herself. Hospice Foundation of America’s AD Project uses two-character, 10-minute plays featuring different relationships and settings. The plays are easy to produce and are intended for use by hospices, hospitals, and other community-based organizations wanting to engage audiences in discussions about advance care planning.The world premiere of the newest version of “Lily” was produced by Accord Hospice & Palliative Care in Sedona, AZ, in partnership with PFLAG Sedona, Unify Sedona, and the Sedona International Film Festival.Editor's Note: Click here for licensing information, to use this play in your community.