Literature Review

Incurable but not hopeless: How hope shapes patients’ awareness of their advanced cancer prognosis The Conversation, by Jean Mathews and Michael Brundage; 3/24/24Hope is defined as the expectation of achieving a future good. Patients with cancer, whether it is curable or not, prioritize cure as their highest hope. ... Previous research indicates that less than half of patients with incurable cancer are aware of their prognosis. This is often attributed to a failure of communication. ... In the context of advanced cancer, the relationship between hope and hopelessness is balanced by acceptance, which can re-direct hope to new goals beyond cure, such as hope for connection with others and enjoyment of daily pleasures. 

The process of dealing with death is experiencing rebirth in a less-religious Pittsburgh Digital Daily; by Med St-Esprit, PublicSource; 3/24/24 Tanisha Bowman, of the North Side, a palliative care social worker for Butler Health System and a “death walker,” walks amongst the old graves in St. Mary’s Cemetery. ... From green burial to glass orbs containing ashes, the norms of funerals and burials are broadening as religious affiliation declines. ... According to a 2021 survey by Pew Research, 3 in 10 American adults are religiously unaffiliated. Data compiled by Pew Research about the Pittsburgh metro region found that 50% of adults in the region describe religion as “very important” and nearly 20% consider themselves not religious. Shifts in faith and worship mean families as well as businesses related to death and dying have had to alter their approaches.

My Mother is in Hospice Care Reformed Journal, by Doug Browser; 3/25/24 My 96-year-old mother entered hospice care a few months ago. For a while, it seemed as though she would go on forever, even though we knew that was unlikely. ... [Here’s] the thing, maybe the most striking thing I’ve learned while sitting with my mom over these last few months. Loss of memory can sometimes be a gift. ... I realize that there can be a kind of grace in not remembering a few things. ... We don’t have to go back and revisit any of it. We have this time together. ... And together we are a mom and a son, present in the moment, a moment with a surprising amount of grace. I never expected to get there.

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.

How the healthcare sector is handling cybersecurity trainingModern Healthcare, by Mari Devereaux; 3/21/24... Healthcare entities should use the Change Healthcare incident as a lesson on how to strengthen their own cybersecurity and an opportunity to have conversations about third-party risk, contingency planning and vendor backups, said John Riggi, national adviser for cybersecurity and risk at the American Hospital Association. ... Both executives and lower-level staff need to be trained on how to spot a potential social engineering attack, best practices around cyber hygiene, and how to enact downtime procedures in the event that third party services are lost for up to 30 days or longer, Riggi said.

Physicians often shy away from preparing their patients to dieToday'sHospitalist, by Colleen Poggenburg, MD, MS; 3/22/24 There's beauty in death if we can tolerate looking. ... The beauty in death is the reflections that occur in the weeks, days and minutes prior to it, which together make up a summary of someone’s life. Why then do physicians view this time-honored decline as a series of clustered medical problems, when it really is just someone moving toward death? Are we so concerned about treating just one more condition, and do we actually think it will solve the growing list of medical problems that dying patients have? ... I compared dying to pregnancy to “soften” the description of this decline. Here’s how I see that comparison: ...Editor's Note: The author offers a fascinating, meaningful comparison of physician/patient conversations with someone who is pregant versus someone who is dying. I encourage you to share this article with your clinical leaders (and adapt it for staff), as this model beautifully reframes important conversations that can empower patients and their families.

Amid tense negotiations, Oregon nurses allege patient neglect by PeaceHealth during strike Eugene Register-Guard, by Miranda Cyr; 3/20/24 Tensions between PeaceHealth and Sacred Heart home health and hospice nurses persist, with the Oregon Nurses Association (ONA) claiming last week that PeaceHealth neglected patients during the nurses' two-week strike in February. ... ONA has been negotiating a new contract with PeaceHealth for a full year. The last contract expired in April of 2023. Despite 40 negotiation meetings, no agreement has been reached, according to ONA.

Medi-Cal Update - Hospice Care Program BulletinMedi-Cal, March Bulletin[Topics include:]

Give generative AI another decade to revolutionize healthcare Modern Healthcare - Opinion, by Keith Figoli; 3/15/24... Generative artificial intelligence is poised to transform healthcare by enabling solutions to effectively address [common patient care] challenges. This cutting-edge technology opens new avenues for innovation in diagnosis, treatment planning, operations efficiency and overall healthcare delivery–and industry leaders are taking notice. A recent survey revealed that 25% of healthcare organizations implemented a generative AI solution in 2023, while 58% plan to adopt one this year. However, the generative AI-driven transformation won’t – and shouldn’t – happen overnight.

Care coordination, quality data crucial to hospice referral growthHospice News, by Holly Vossel; 3/18/24Care coordination and quality data will be engines for hospice referral growth. Hospices saw census volumes drop during the COVID-19 public health emergency as facilities nationwide restricted access to patients amid mandated state closures. Providers often turned to electronic communications to reach patients in facility- and community-based settings alike. Adaptability has been among the keys to coping with the pandemic’s lingering punches in referral streams, according to Craig Dresang, CEO of California-based YoloCares. As end-of-life care received a spotlight during a global pandemic, the historical viewpoints around hospice care delivery have been undergoing a “fundamental shift,” Dresang said.

Giving hospice patients a dignified end-of-life experience Steve Adubato On the Air, with Charles Vialotti, MD; 3/13/24On--location at Villa Marie Claire Residential Hospice, Steve Adubato is joined by medical director, Charles Vialotti, MD to talk about his personal commitment to hospice care and giving residents and their families a dignified end-of-life experience.

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.