Literature Review

Massachusetts makes paid family leave more accessible, offering services in Spanish, Portuguese New England Public Media, by Elizabeth Roman; 3/22/24... The state passed a law in 2018 which provides paid family and medical leave (PFML) for serious injury or illness whether personal or a family member, as well as time for parental leave, but found that people whose primary language is not English were unaware of, or hesitant, to apply for the services. ... While the state portal for applying for PFML services now has options in various languages, some people are still overwhelmed by filling paperwork out online. ... There are representatives who speak Spanish and Portuguese and the state also works with an interpretation service for many other languages.

HHS Secretary Becerra: We’re with you on telehealth flexibilities Hospice News, by Jim Parker; 3/21/24 Telehealth flexibilities must become permanent U.S. Health and Human Services (HHS) Secretary Xavier Becerra indicated in a congressional hearing [Wed]. At the end of this year, telehealth flexibilities implemented during the pandemic are slated to expire. In a hearing before the U.S. House Ways and Means Committee Becerra said that HHS was willing to make them permanent. However, he said this would require closer collaboration with state governments. “We’re with you. We can’t allow those flexibilities to expire, and we need to work closer with our state partners, because much of the flexibility that comes from telehealth means being able to go over state lines,” Becerra said.

5 myths about dying that too many people believeThe Hearty Soul, by Maria Sykes; 3/21/24 Myth# 1: I should always stay positive for the sake of my loved one.Myth #2: I should make sure my loved one eats, drinks, and sleeps as normal.Myth #3: I need to prolong my loved one's life as much as possible.Myth #4: It's important to limit the use of painkillers to keep my loved one healthy.Myth #5: If I seek help to care for my loved one, I'm a failure. 

Home-based care employment exceeding pre-pandemic levels Hospice News, by Jim Parker; 3/19/24 Employment in the home-based care sector rose above pre-pandemic levels in 2023, according to the Medicare Payment Advisory Commission (MedPAC). The U.S. Department of Commerce defines this sector to include hospices, home health agencies, private duty, pediatric agencies and other providers of care in the home. ... Nevertheless, workforce pressures and associated costs are overwhelmingly the industry’s most damaging headwind, including the associated wage hikes, enhanced benefits and bonus programs. The shortages also have reduced clinical capacity, which has contributed to drops in patient census and length of stay for many providers.

Medicare Advantage prior authorization: The impact - increased access to care HHS-OIG; 3/19/24 HHS-OIG’s work on this issue drew national attention to the problem spurring the Centers for Medicare & Medicaid Services, the Industry, and Congress to action.  Editor's Note: You can download the "Impact Brief" from this site. Click on the title's link.

Use of machine learning to optimize referral for early palliative care: Are prognostic predictions enough  Journal of Clinical Oncology - Editorials; by Gary E. Weissman, MD, MSHP; Joseph A. Greer, PhD; and Jennifer S. Temel, MD; 3/15/24  The Takeaway In the article that accompanies this editorial, [Weissman] et al used a machine learning (ML) algorithm to identify patients with advanced cancer who were receiving non–curative-intent treatment and at risk of death within 1 year to allocate early palliative care services at least 6 months before death as a means to increase use of early palliative care in the context of limited resources. While ML prognostic models are one promising strategy for triaging palliative care services, initiation of palliative care based exclusively on estimated survival and in the months before death likely excludes patients who would benefit from early palliative care initiated at the time of diagnosis, regardless of their estimated survival.

Telehealth study investigates reimbursements for rural health care deliveryMedical Xpress, by Vincent Jacobbi, Mayo Clinic; 3/15/24A recent Mayo Clinic study published in the American Journal of Hospice and Palliative Medicine investigated how telehealth in palliative care may provide value for rural caregivers, health care teams and their patients. Researchers were particularly interested in determining what billing models were most cost-effective and sustainable for health care teams and caregivers transitioning patients from hospital to home care

Palliative and end-of-life care in hematologic malignancies: Progress and opportunities JCO Oncology Practice, by Mazie Tsang, MD, MAS, MS and Thomas W. LeBlanc, MD, MA, MHS, FAAHPM, FASC; 3/13/24 ... An important finding from this study was the qualitative data from narratives of volunteer caregivers and hospice staff that described daily patient care, changes in patient status, perceived symptom burden, and indications for medication administration. The authors identified skin integrity concerns, bleeding, pathologic fractures, and delirium as unique issues for patients with hematologic malignancies enrolled on hospice. ... These findings provide further evidence that hospice care can and does work well for some patients with hematologic malignancies. 

Film Festival and local organizations partner to present ‘Lily’ March 21 Sedona.Biz; 3/9/24Accord Hospice & Palliative Care is continuing their educational efforts by partnering with the Hospice Foundation of America (HFA) to marry theater and Advance Care Directive education through the AD Project – a series of 10-minute plays that feature different relationships and settings to illustrate the importance of putting your medical wishes in writing. ...Playwright Bryan Harnetiaux has worked with HFA for years developing a series of shows that depict real life scenarios involving all different family dynamics. The show “Lily” will present a divorced couple who are embarking on a very real dilemma – who to choose to be your voice when you can no longer speak for yourself.

Can we make more accurate prognoses during last days of life?Journal of Palliative Medicine; by Sylvie Bouchard, Andreea Paula Iancu, Elena Neamt, François Collette, Sylvie Dufresne, Patricia Maureen Guercin, Suganthiny Jeyaganth, Desanka Kovacina, Taliá Malagón, Laurie Musgrave, Marilisa Romano, Jenny Wong, Sybil Skinner-Robertson; 3/8/24Background: ... Established methods (Palliative Performance Scale [PPS], Palliative Prognostic Index [PPI]) have been validated for intermediate- to long-term prognoses, but last-weeks-of-life prognosis has not been well studied. Patients admitted to a palliative care facility often have a life expectancy of less than three weeks. Reliable last-weeks-of-life prognostic tools are needed. Conclusions: ... Using SPS [Short-Term Prognosis Signs] along with PPS and PPI during the last weeks of life could enable a more precise short-term survival prediction across various end-of-life diagnoses. The translation of this research into clinical practice could lead to a better adapted treatment, the identification of a most appropriate care setting for patients, and improved communication of prognosis with patients and families.

Navigating Aging: Does our society simply not care about our vulnerable older population? KFF Health News, by Judith Graham; 3/10/24 ... The pandemic made things worse. Prejudice against older adults is nothing new, but “it feels more intense, more hostile” now than previously, said Karl Pillemer, 69, a professor of psychology and gerontology at Cornell University. “I think the pandemic helped reinforce images of older people as sick, frail, and isolated — as people who aren’t like the rest of us,” he said. “And human nature being what it is, we tend to like people who are similar to us and be less well disposed to ‘the others.'" 

ACC updates HFrEF Decision Pathway, reinforcing the Four Pillars of Therapy

CT bill would create a statewide pediatric hospice program: 'Make this a reality for our children' The Darien Times, by Cris Villalonga-Vivoni; 3/11/24There are only a handful of agencies specifically providing end-of-life care to children in the state, said Moss, who is also the founder of Connecticut Children’s Hospital palliative care team, the Sunflower Kids. “Every dying child in the state of Connecticut deserves this expertise and support of the hospice program,” Moss said. “It is time we make this a reality for our children.” The need for pediatric hospice care is felt throughout the state, even if the volume of people seeking out these services is often low, said Tracy Wodatch, president and chief executive officer of the Connecticut Association for Healthcare at Home.