Literature Review

Key differences between palliative and hospice care in California Psychology Today; by Bob Uslander, MD; 12/3/24 ... Key Difference Between Palliative and Hospice Care in California: Whether you’re looking for support early in an illness or need end-of-life care, Californians have resources available to help. California also has some unique programs and resources, such as palliative care programs for people covered by Medi-Cal, California’s Medicaid program. Additionally, California has strict laws to protect patients’ rights, ensuring that people are fully informed about your care options and can make choices that align with your personal values and cultural beliefs. Below are some of the key differences highlighted to help you make the best choice possible for you and your family when the time comes. [Click on the title's link for more information.]Editor's note: Through recent years, too many hospice agencies have eliminated references to end-of-life care, a life-expectancy of six months or less, and references to dying, death, or grief. Various fraud and abuse cases have described that persons/caregivers did not even realize they had signed up for "hospice" care. Ethically, this is untenable. Key differences between palliative and hospice care--with applications to the person--are significant.

[England] Hospice leaders warn hundreds of beds out of use BBC News; by Hugh Pym; 12/4/24 About 300 hospice inpatient beds are currently closed or out of use in England, hospice leaders have warned. They say a lack of funding and staff are the primary reasons why some of England's 170 hospices have had to close beds permanently or take them out of use. Hospice UK, which represents the sector, is now calling for an urgent package of government funding to prevent further cuts. The Department of Health said it was looking at how to financially support hospices to ensure they are sustainable. ... Hospice UK says about 300 beds are closed or out of use in England - out of a total of 2,200 - and the number is increasing.  Editor's note: This report is the tip of the iceberg among news articles we regularly see from England about funding, lack of government support, and extreme fundraising (in comparison to the United States) in order to provide hospice services.

[New Zealand] Palliative care podcast’s win a ‘complete surprise’ Otago Daily Times, New Zealand; by Matthew Littlewood; 12/2/24 A Dunedin carer’s attempts to bring conversations about palliative care to a wider audience has been acknowledged at the New Zealand podcasting awards. Otago Hospice care nurse Denise van Aalst told the Otago Daily Times that winning the bronze medal in the Best Interview Podcast category for her podcast Ending Life Well came as a "complete surprise". The 29-episode series was launched about two years ago, and covered subjects such as self-care, legal matters, funeral planning and whānau manaaki (families who provide care to a kaumātua at end of life). "We knew that our podcast was helpful for people. "We don’t talk about death and dying in polite society, and people are often now going in and helping to care for somebody at the end of life with little experience or knowledge, and they don’t know where to go to get that."

705 hospitals at risk of closure, state by stateBecker's Hospital CFO Report; by Molly Gamble; 11/22/24 More than 700 rural U.S. hospitals are at risk of closure due to financial problems, with more than half of those hospitals at immediate risk of closure. The count comes from the latest analysis from the Center for Healthcare Quality and Payment Reform, which is based on CMS's October 2024 hospital financial information. The center's analysis reveals two distinct levels of vulnerability among rural healthcare facilities: risk of closure and immediate risk of closure. ... The report also analyzes hospitals facing immediate threat of closure meaning financial reserves could offset losses on patient services for two to three years at most. Currently, 364 rural hospitals are at immediate risk of shutting down due to severe financial difficulties. [Click on the title's link for] a state-by-state listing of the number of rural hospitals at risk of closure in the next six to seven years and at immediate risk of closure over the next two to three years. Editor's note: Consider how these closures impact patients' trajectories of serious illness, timely treatment plans, referrals to home health, nursing facilities, and hospice care. How do these impact your service areas? What are the root causes for so many potential closures?

Michael Dowling: We've revolutionized care for aging adults, but is America's health system ready for the senior population boom? Becker's Hospital Review; by Michael J. Dowling, President and CEO, Northwell Health; 12/2/24 Like many baby boomers and those from earlier generations, I have vivid memories from my younger years of my grandparents and other aging adults struggling with an assortment of ailments that their doctors told them were just an inevitable part of growing old. ... The transformative advancements made over the past half-century in meeting the physical and emotional health needs of the nation's rapidly aging population are remarkable — and that's especially important because more Americans are turning age 65 now than in any other time in our history (4.1 million in 2024, or 11,200 a day). And as we move toward a new year, every healthcare executive must examine whether we are collectively prepared to care for them in the years and decades ahead and take steps to recruit the medical specialists we need to meet burgeoning demand. ... Lastly, all clinicians must embrace palliative care as part of their standard practice in managing the health of aging adults with serious illness. ... 

Seen Health invests $22m for PACE Care Centers HomeCare, Los Angeles, CA; by Seen Health; 11/26/24 Seen Health, a health care organization focusing on aging-in-place services and culturally-focused care models, announced it has invested $22 million in funding to expand access to its culturally-focused care centers for eligible seniors. The company said [its] first center is set to open in California and will be built upon the Program of All-Inclusive Care for the Elderly (PACE) model. The PACE model aims to deliver comprehensive medical and social support for seniors with chronic conditions who are covered by Medicaid or Medicare. The care model intends to provide an alternative method of care to nursing homes by enabling seniors to stay in their homes and age in place. ... The first Seen Health center, which is set to open in Los Angeles County's San Gabriel Valley, intends to serve the local Asian and Pacific Islander community.

Palliative care bypasses Black heart disease patients The St. Louis American; by Alvin A. Reid; 11/30/24 A study by Saint Louis University researchers paints a grim picture for many heart failure patients in America – and the outlook is worse for African Americans. The study, published in the Journal of the American Heart Association, found that only one in eight patients with heart failure nationwide receive palliative care consultations within five years of diagnosis. Alarmingly, Black people were 15% less likely to receive palliative care compared to white patients with similar heart health illness. Other recent respective studies illustrate the higher risk and mortality rates for cardiovascular disease in the Black population – further demonstrating that the missing palliative care options have a greater negative impact on African American health. New statistics from a medical team at EHproject show African American women are at a greater risk for cardiovascular disease than their white counterparts. It found that 47.3% of Black women have heart disease. If they do not have it currently, they are 2.4 times more likely to develop heart disease. ... A March 2023 study published in JAMA Cardiology showed that Black men remain at the highest risk of dying from cardiovascular disease. ... 

[Netherlands] Electronic health in the palliative care pathway for patients with head and neck cancerJAMA Otolaryngology- Head & Neck Surgery; Boyd N. van den Besselaar, MD; Kira S. van Hof, MD; Aniel Sewnaik, PhD; Robert. J. Baatenburg de Jong, PhD; Marinella P. J. Offerman, PhD; 11/24Head and neck cancer (HNC) generally has a poor prognosis, with more than 40% disease-specific mortality, ... with a median survival of 4 to 5 months. Given the unique nature of HNC, with a wide range of specific cancer-related symptoms, special consideration should be given to end-of-life care. In this quality improvement study, patients and next of kin were satisfied with most aspects of the hybrid palliative care pathway, and remote care seemed to be a promising means of delivery. These insights represent the initial steps toward gaining a deeper understanding of patients’ needs during specific moments in a hybrid palliative trajectory. They may support health care professionals in optimizing personalized and value-based palliative care delivery.

New HFSA Consensus Statement provides practical guide for implementing palliative care with heart failure patients PR Newswire; by Heart Failure Society of America; 11/26/24 Patients with heart failure (HF) suffer from compromised quality of life, high mortality, and complex medical decision-making. Palliative care is an essential part of a comprehensive HF care plan. Integration of Palliative Care into Heart Failure Care: Consensus-Based Recommendations from the Heart Failure Society of America (HFSA), published today in the Journal of Cardiac Failure (JCF), is a practical guide for implementing palliative care as a component of overall HF care. It has been shown that palliative care interventions improve disease-specific quality of life, symptom control, and caregiver burden among patients with HF. Authors of the statement are indicating that HF clinicians should be skilled in providing primary palliative care with competence in basic domains including the management of physical and psychosocial symptoms and serious illness communication.

Disclosure practices in Muslim patients and the impact on end-of-life care: A narrative review American Journal of Hospice and Palliative Care; by Mona Tereen; 11/26/24 ... Non-disclosure practices hold significant weight in end-of-life care for Muslim communities, where cultural and religious beliefs are deeply intertwined with healthcare decision-making. This narrative review explores the complexities of medical decision-making and disclosure practices among terminally ill Muslim patients, examining how these factors shape palliative care delivery. Conclusion: Non-disclosure practices present significant barriers to effective palliative care in Muslim communities. To improve care outcomes, culturally competent communication strategies and family-centered decision-making models are crucial.

Hologram technology wows rural care patients Becker's ASC Review; by Francesca Mathewes; 11/25/24 Cancer patients in rural Tennessee are testing virtual visits from hologram health consultants, Fox 26 News reported Nov. 23. The technology allows healthcare providers, in this case a physician, to consult with patients via a lifelike hologram. Clay Jackson, MD, a palliative care specialist in Germantown, Tenn., said that the technology has expanded access to care in the rural area, where patients might otherwise have to travel more than 100 miles for in-person care. "Two words: blown away. My patients can't believe how great the technology is," said Dr. Jackson in the report. "They may be a one-car family, it may be patients for whom additional travel would cause additional pain or discomfort or stress, especially those who are undergoing active treatment for their cancer," he added. The device and AI-powered spatial computing platform cost $29,000. The technology has been used in the entertainment industry and in professional sports, but this marks the first time the technology has been used in health consultations.

Hospices have long road ahead on improving health equity Hospice News; by Holly Vossel; 11/21/24 Prolific health disparities have driven hospices to implement various strategies to improve diversity, equity and inclusion among underserved patient populations. Some providers say the needle has much farther to go toward equitable access. End-of-life care models have increasingly diversified to reach a broader range of patients with different beliefs, values and spiritual outlooks, according to Altonia Garrett, COO of Blue Ridge Hospice. Garrett is also executive director of the Virginia-based hospice’s Diversity, Equity, Inclusion and Belonging Committee. Yet, hospice providers lack a full scope of understanding around the nuanced challenges impeding utilization and the ways to more effectively address unmet patient needs, Garrett said.