Literature Review

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. 

TCNtalks - Hurricane Helene

Hurricane Helene Disaster Relief Fund for home care & hospice employees in the CarolinasAssociation for Home & Hospice Care of North Carolina (AHHC of NC); by Judy Penn, Executive Director; 10/3/24 Click here to DONATE. Click here to APPLY for Assistance. urricane Helene has severely impacted our community, with many lives already lost in the Carolinas, and countless missing with no means of communication.  The Carolinas Foundation for Hospice & Home Care is accepting donations to distribute directly to hospice and home care employees devastated by this storm. Agencies are facing tremendous challenges, including displacement and/or evacuation of staff and patients, collapsed roads, failing infrastructure, lack of water, and the inability to communicate with downed lines. There is a major need for gas to continue to power generators for oxygen dependent patients both in home settings and hospice inpatient facilities. The Association staff has been in contact with government agencies to us keep up-to-date on the situation as it unfolds. Our industry is comprised of caring, compassionate individuals who help those in need. Please consider donating to the Hurricane Helene Relief Fund to help home care and hospice employees hit the hardest. ... 100% of ALL ADMINISTRATIVE COSTS are being borne by the Association and the Foundation. 100% of your donation (tax-deductible) comes in, and 100% of your donation goes out.

Fighting ‘phantoms’: How fraud skews competition in the hospice market Hospice News; by Holly Vossel; 9/26/24 Fraudulent operators’ marketing strategies are morphing the competitive landscape, making it difficult for legitimate hospice providers to maintain visibility among patients and families. A mounting concern is that fraudsters stepping into the hospice industry have been implementing marketing and outreach practices that at times mirror strategies utilized by quality providers, according to Jeanne Chirico, president and CEO of the Hospice & Palliative Care Association of New York State (HPCANYS). This makes it difficult for referrals, patients and their families to discern the best end-of-life care option. Another significant concern is that the fraudulent actors may have deeper pockets compared to smaller or nonprofit hospices, allowing them to invest more heavily and saturate the market with their messaging. 

Man accused of choking terminally ill wife accepts plea deal KSL.com; by Pat Reavy; 9/27/24 A man who prosecutors say attempted to end his terminally ill wife's life by choking her has accepted a plea deal. DeWayne McCulla, 46, pleaded guilty on Thursday in 5th District Court to an amended charge of attempted manslaughter, a third-degree felony. The charge comes with a domestic violence sentencing enhancement. Arenda Lee McCulla, 47, died on Dec. 21, 2021, following her battle with breast cancer. The night before, however, as a small group of family members were by her side in La Verkin, DeWayne McCulla "choked the victim in an attempt to kill her to ease her suffering while they were with her during her terminal cancer and being on hospice," according to charging documents. Other family members pulled McCulla off of his wife.Editor's note: Crucial information that is not reported in this article: Where was the hospice team in managing this patient's pain? In educating and supporting the caregiver (the husband?) and family about contacting the hospice? In making required visits when the patient is actively dying? In assessing the caregiver's ability to provide care, especially any history or risks of domestic violence, neglect, or abuse? What safety-in-the-home protocols were used by this hospice, especially when hospice team members followed up? Aware of not-knowing these many factors, I do not ask these with judgment but rather to raise awareness of core, preventive measures for other hospice patients.

BREAKING NEWS: 9/27/2024 11:45 am - Blumenauer proposes overhaul to Hospice Benefit: If enacted, the legislation would be the single most significant update to the hospice benefit and payment structure since its inception in 1982.

Oncology leaders call for ‘ethical deployment’ and ‘responsible use’ of AI in cancer care Healio; by Josh Friedman and Matthew Shinkle; 9/25/24 The AI revolution already has transformed delivery of cancer care. New algorithms rapidly identify patterns or abnormalities on imaging, improving diagnostic accuracy. Large language models can craft responses to patient questions, and machine learning predicts treatments to which a patient is most likely to respond. ... Oncologists are grappling with complex issues as they integrate AI into cancer care, according to results of a nationwide survey. Most oncologists believe they should have the ability to explain how AI models work and must protect patients from biased AI, findings published in JAMA Network Open showed. Most respondents also indicated patients should consent to use of AI before it is implemented in practice. ... Despite the potential benefits of AI to improve decision-making and outcomes, clinicians have expressed concerns about ... AI bias; the ability of AI to detail its decision-making process; who bears responsibility for errors or misuse; and whose treatment recommendation takes precedence when a physician and AI do not agree.

Financial pressures shut down 2 hospice agencies Hospice News; by Jim Parker; 9/20/24 A hospital-based hospice program in Kansas is closing its doors, as is the Visiting Nurses Association of Philadelphia. Holton Community Hospital (HCH) will shut down its home health and hospice department effective December 31st. A range of issues contributed to the decision to end the program, including reimbursement pressures on its home health business and the ascendance of Medicare Advantage, which often pays at a lower rate than traditional Medicare. The Holton, Kansas-based hospital also cited increased competition in its local community as a reason for the closure. ... The organization is working with other local providers to ensure continuity of care for its home health and hospice patients. Meanwhile in Pennsylvania, the Visiting Nurses Association of Philadelphia is also closing. The 138-year-old institution will cease operations on Oct. 28. It is a provider of hospice, home health and palliative care services.Editor's note: For more information about the VNA in Philadelphia, see the article we posted on 9/18/24, After 138 years, the Visiting Nurses Association of Greater Philadelphia will shut down all health care services next month.

Mirror, mirror 2024: A portrait of the failing U.S. health system - comparing performance in 10 nations The Commonwealth Fund; by David Blumenthal, Evan D. Gumas, Arnav Shah, Munira Z. Gunja, and Reginald D. Williams II Goal: Compare health system performance in 10 countries, including the United States, to glean insights for U.S. improvement. Methods: Analysis of 70 health system performance measures in five areas: access to care, care process, administrative efficiency, equity, and health outcomes. Key Findings: The top three countries are Australia, the Netherlands, and the United Kingdom, although differences in overall performance between most countries are relatively small. The only clear outlier is the U.S., where health system performance is dramatically lower. Conclusion: The U.S. continues to be in a class by itself in the underperformance of its health care sector. While the other nine countries differ in the details of their systems and in their performance on domains, unlike the U.S., they all have found a way to meet their residents’ most basic health care needs, including universal coverage.

Hospices improving on public measures Home Health Line - decisionhealth; by DecisionHealth Staff; 9/12/24 Hospice providers are seeing continued improvement on key measures in the Hospice Item Set, according to the latest refresh of Care Compare data on Aug. 28, 2024. [Subscription required] Editor's note: Use this summary information to check your own CMS Hospice Compare Scores at Find Healthcare Providers: Compare Care Near You | Medicare. Select Provider Type "Hospice Care." Type your location or "Name of Agency" and "Search." Select your hospice. For the Hospice Item Set (HIS), scroll down to "Quality" - "Quality of patient care." For your CAHPS data, scroll down to "Family caregiver experience."

Half of home care workers have seen, experienced workplace violence, report findsMcKnight's Home Care; by Adam Healy; 9/10/24The majority of home care workers have had a brush with workplace violence or harassment, so addressing these dangers can yield significant positive impacts for providers and their staff. That’s according to a new report on home care workplace safety by Transcend Strategy Group. More than 50% of home-based care workers have witnessed or experienced at least one incident of workplace violence or harassment, the report found. About 1 in 5 reported having seen at least seven instances of violence or harassment while on the job. Certified nursing assistants, registered nurses and physician assistants were the most likely groups to be subject to workplace dangers.

2024 NHPCO Facts and Figures Report now available National Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 9/10/242022 Data Show First Increase in Hospice Utilization Rates Since COVID The National Alliance for Care at Home (the Alliance) published the 2024 edition of National Hospice and Palliative Care Organization (NHPCO) Facts and Figures, an annual report on key data points related to the delivery of hospice care, including information on patient characteristics, location and level of care, Medicare hospice spending, and hospice providers. Facts and Figures – the leading resource for hospice providers and others interested in understanding the work of the community – has been published annually for over two decades by NHPCO. ... The findings in this report reflect patients who received care in Calendar Year (CY) 2022, or Fiscal Year (FY) 2022, provided by hospices certified by the Centers for Medicare and Medicaid Services (CMS) and reimbursed under the Medicare Hospice Benefit. This year COVID-19 continued to impact patient care as COVID-19 waivers were still in place through May 2023. These waivers included increased telehealth services. With 49.1% of all Medicare decedents in 2022 choosing hospice care, utilization of hospice increased in 2022 for the first time since 2019. The increase hints at a normalization of the utilization rates back to pre-COVID data. Hospice utilization rates increased across all race and ethnicity groups, with the largest increase among Hispanic Medicare beneficiaries seeing. The total number of beneficiaries enrolled in hospice care in 2022 was 1.72 million. Due to the unique impact of COVID-19 on 2020 data, those data are not included in many of the charts this year.