Literature Review

Los Angeles wildfires leave older patients vulnerable Direct Relief - California Wildfires; by Talya Meyers; 1/22/25 The radio announcer said nursing home residents were being evacuated to the Pasadena Convention Center, so Dr. Laura Mosqueda headed over. Older adults were arriving at the evacuation shelter with hair and hospital gowns covered in ash. People urgently needed to be on oxygen — in a large convention hall with few electrical outlets — or their catheters were getting full but responders didn’t have gloves. ... Some patients were in hospice and end-of-life care, and getting them placed more comfortably was an urgent priority. ... The wildfires that ripped across Southern California communities this month will hurt the health of millions — causing everything from short-term respiratory symptoms to long-term adverse outcomes from chronic disease — but older adults will likely be among the most vulnerable. ... [And with that,] Dr. Mosqueda cautioned that while older adults may be more likely to be medically fragile, many aren’t. Many have perspectives that help them navigate frightening, uncertain situations like the wildfires. “Older adults…were among the most calm and circumspect people I spoke with,” she recalled. “They just had a lot of wisdom and life experience, and they weren’t getting freaked out. They had so many internal resources.”

The 'paradigm shift’ of hospice service diversification Hospice News; by Holly Vossel; 1/17/25 Some hospices have delved deeper into service diversification to improve timely access and expand their patient reach, while others remain focused on end-of-life care delivery. The decision to launch into new service realms can come with a range of operational and reimbursement questions. Among the keys to diversifying services is establishing a business infrastructure that allows for innovative growth based on communities’ needs, according to Leslie Campbell, COO of Touchstone Communities. The San Antonio, Texas-headquartered company provides hospice, home health, veterans services, assisted living and skilled nursing services. ... Hospice leaders need to ensure that both back-office administrative and interdisciplinary teams are educated on how business growth impacts them, particularly when it comes to quality and compliance across the care continuum, Campbell stated.

Which health facilities have been impacted by L.A.-area fires? AI may paint a clearer picture DirectRelief; by Andrew Schroeder; 1/14/25 Geospatial AI and remote sensing advance health system impact analysis shows where facilities have been damaged or destroyed -- and where medical needs may be greatest. One of the most important factors for humanitarian responders in these types of large-scale disaster situations is to understand the effects on the formal health system, upon which most people — and vulnerable communities in particular — rely upon in their neighborhoods. Evaluation of the impact of disasters ... is traditionally a relatively slow and manually arduous process, involving extensive ground truth visitation by teams of assessment professionals. Speeding up this process without losing accuracy, while potentially improving the safety and efficiency of assessment teams, is among the more important analytical efforts Direct Relief can undertake for response and recovery efforts.

Guidelines for evaluating, diagnosing, and disclosing dementia published by Alzheimer’s Association Practical Neurology; 1/14/25 The Diagnostic Evaluation, Testing, Counseling, and Disclosure Clinical Practice Guideline (DETeCD-ADRD CPG) Workgroup, convened and funded by the Alzheimer’s Association, has developed new recommendations for clinicians to use when evaluating patients with possible Alzheimer disease (AD) or AD and related dementias (ADRD). An executive summary of the recommendations for use in primary care and other practice settings was published in Alzheimer’s & Dementia, along with a companion article summarizing specific guidance for specialists. The Workgroup included representatives from  primary, specialty, subspecialty, long-term, and palliative care disciplines as well as the fields of health economics and bioethics.  Editor's note: Click for open access to the Alzheimer's Association clinical practice guideline ..., executive summary of recommendations for primary care. 

Meals on Wheels volunteers deliver extra food ahead of winter storm Fox 4 KDFW, Dallas, TX; by Alex Boyer; 1/8/25 Volunteers are doing their best to help some of North Texas’ most vulnerable people prepare for the winter storm. ... Meals on Wheels in Dallas County is a service provided by the Visiting Nurses Association. Currently, the organization serves about 5,200 homebound seniors and disabled adults throughout the county each weekday. That’s in addition to those in hospice care.

Daughter arrested for neglect after elderly mother found stuck to mattress The Augusta Press; by Greg Rickabaugh; 1/6/25 An elderly woman from Augusta was found in a state of severe neglect last week, prompting her daughter’s arrest. The 82-year-old was discovered incoherent and physically stuck to her mattress during a medical emergency on Dec. 30 at the home they shared on Rollingwood Drive, authorities said. When paramedics arrived at the family’s home, they found the woman non-responsive, with her skin literally adhered to the mattress due to untreated bedsores. She was rushed to Wellstar MCG Health, where she was stabilized. Authorities later arrested 54-year-old Tyrossale Peak, the woman’s daughter, charging her with neglect of a disabled or elderly adult. ... Investigators revealed that Peak had discontinued hospice care for her mother in June but failed to provide adequate care or maintain a safe living environment. 

Family advocates for hospice care, says it doesn't always mean end-of-life: Highlights case of the late Former President Jimmy Carter who spent nearly 2 years in hospice CBS WTKR 3, Hampton Roads | Northeast NC; by Jay Greene; 12/20/24 Dana Romano's mom, Marilyn, headed home from the Dozoretz Hospice House of Hampton Roads in Virginia Beach on Monday evening after spending a few days in respite care while her family was out of town. "The whole reason not to have my mom in a facility is we want her with us. But when you're doing long periods of time, every once in a while, you need a break, so having a place where you know they're going to take care of her and treat her like, almost like family," Dana said. "We kind of look at this more like a resort than a hospice." ... When at home Marilyn receives hospice care, but it's not because she needs care, the Romano's said. It's because she needs supervision. ... The family told News 3's Jay Greene this is a case where hospice does not mean end-of-life. It actually helped alleviate some stress. ... The Romano's told News 3's Jay Greene hospice ["has no time limit"] is all about extending life as comfortably as possible, citing Former President Jimmy Carter who died at the age of 100 this weekend.Editor's note: These misunderstandings by the family about hospice care is both alarming and expected. Throughout Jimmy Carter's extended hospice Length Of Stay (LOS), far too many hospice organizations misused messaging for its marketing purposes. We have addressed this discrepancy in a dozen posts throughout the year. Click here for the CMS "Face-to-Face Requirement Affecting Hospice Recertification." Disclaimer: We do not specifics about what this hospice communicated with this family. We simply refer readers to this as publicly reported news story.

Top Modern Healthcare stories of 2024 Modern Healthcare; by Mary Ellen Podmolik; 12/31/24 Ups and downs in healthcare kept Modern Healthcare reporters plenty busy in 2024, and 2025 is shaping up as a critical year for the industry, particularly as a new administration takes over in Washington, D.C. Our reporters this year did what Modern Healthcare excels at — bringing readers the news along with the context and analysis our audience needs to stay ahead. Get ready for 2025 by catching up on some hot topics during 2024.

Big senior living stories of 2024McKnights Senior Living; by Lois A. Bowers; 12/23/24Here’s a look at some of the big stories involving senior living providers that captured the attention of McKnight’s Senior Living readers this year.

U.S. health care spending reaches $4.9 trillion Hospice News; by Jim Parker; 12/20/24 The nation’s total health expenditures rose 7.5% to $4.9 trillion in 2023, a new analysis by the U.S. Centers for Medicare & Medicaid Services (CMS) found. This growth took place at a faster pace in 2023 than prior years. In 2022, health care spending rose at a rate of 4.6%. Total Medicare hospice spending accounted for $25.7 billion last year, according to a separate report from the Medicare Payment Advisory Commission (MedPAC). ... About 21% of U.S. health care spending in 2023 was via Medicare, with private insurance representing a 30% share. Medicaid accounted for 21%, and the remaining 10% were out-of-pocket costs. “Hospital care, physician and clinical services, and nursing care facilities and continuing care retirement communities, which collectively accounted for 33% of all out-of-pocket spending in 2023, were the main contributors to the faster growth in 2023,” CMS indicated.

[Canada] First reading: Hundreds seeking death due to loneliness — inside Canada’s new MAID figures National Post, Toronto, Ontario, Canada; by Tristin Hopper; 12/13/24 [Health Canada has] released the official figures on medical assistance in dying (MAID) deaths in 2023. The Fifth Annual Report on Medical Assistance in Dying in Canada, published on Wednesday, reveals that one in every 20 Canadian deaths is now due to assisted suicide. There were 15,343 total MAID deaths in 2023, the median age ... was 77.7 years, and 622 people received MAID for a non-terminal illness. ... The growth rate [in Canada] remains higher than anywhere else. ... Half of non-terminally ill people applying for MAID report being lonely. When applying for MAID, patients are asked to detail all the types of suffering they’re experiencing in order to determine if their condition qualifies as something “grievous and irremediable” — and thus eligible for death. Health Canada’s report reveals that 47.1 per cent of non-terminally ill Canadians who applied for MAID reported “isolation or loneliness” as one of the causes of their suffering. This was significantly higher than the number of terminally ill applicants who said the same (21.1 per cent).

Health gap at end of life is now wider in US than any other country Science Alert - Health; by Carly Cassella; 12/16/24 A data-crunching survey covering 183 member nations of the World Health Organization has now confirmed what some scientists feared: while years are being added to most people's lives, healthy life is not being added to most people's year. Researchers at the Mayo Clinic found that people around the world in 2019 were living 9.6 years of life burdened by disability or disease – an increase of 13 percent from 2000. In that same time frame, global life expectancy has increased 6.5 years, and yet health-adjusted life expectancy has only increased 5.4 years. In the US, the gap between lifespan and 'healthspan' is growing particularly wide. Between 2000 and 2019, life expectancy in the US increased from 79.2 to 80.7 years for women, and from 74.1 to 76.3 years for men. When adjusting for healthy years of added life, however, the span only increased by 0.6 years among men. And among women, while health-adjusted life expectancy fluctuated slightly over time, in 2019 it matched the figure seen in 2000. The expanding gap means if an American woman lived to the expected 80.7 years of age, the last 12.4 years of her life would on average be impacted by disease or disability.