Literature Review

Hospital-at-home care’s future still hangs in the balance Home Health Care News; by Joyce Famakinwa; 10/7/24 Even with a proven track record for clinical effectiveness and cost savings, the hospital-at-home model’s future hangs in the balance. “The data suggests that, for the populations that have been studied in multiple different places, it’s a very safe service to be done and with high-quality care, low readmission rates, low escalation rates, low infection rates,” Dr. Adam Groff, co-founder Maribel Health, told Home Health Care News. “The bottom line is people love it, patients love it and it’s a high-quality care experience.” ... In 2020, the hospital-at-home model had its breakthrough. Though the model was common internationally, it was considered niche in the U.S. This changed with the introduction of the Centers for Medicare & Medicaid Services’ (CMS) Acute Hospital Care At Home program. A recent report from CMS found that the program has been largely successful. ... Despite the momentum the model has seen in recent years, challenges still exist when it comes to operations and scalability. Specifically, less than 9% of waiver-approved hospitals accounted for more than 70% of all U.S. admissions, according to data from MedPAC’s June 2024 report to Congress. ... 

Hoping to reach 100? You’re not going to like these new life expectancy projections New York Post; by Tracy Swartz; 10/7/24 Let’s keep it 100 — your chances of becoming a centenarian are slim. Medical breakthroughs, public health achievements and better diets led to steep increases in global life expectancy in the 1800s and 1900s. But startling new research finds this momentum has slowed and the biggest boosts to longevity may be in the rearview mirror. “Most people alive today at older ages are living on time that was manufactured by medicine,” said lead study author S. Jay Olshansky, a professor of epidemiology and biostatistics at the University of Illinois at Chicago. “But these medical Band-Aids are producing fewer years of life even though they’re occurring at an accelerated pace, implying that the period of rapid increases in life expectancy is now documented to be over,” Olshansky added. The analysis, conducted with researchers from the University of Hawaii, Harvard and UCLA, includes data from eight countries with the longest-living populations (Australia, France, Italy, Japan, South Korea, Spain, Sweden and Switzerland), Hong Kong and the US from 1990 to 2019.

Guest column: Hopewest – Breaking the silence: Supporting suicide prevention and survivors of loss Special to the Herald Times; 10/2/24 Those left in the wake of a suicide loss sometimes aren’t sure where to turn or what to do. Uprooted by shock and overcome by the grief of losing someone to suicide can feel painful and isolating. ... The stigma surrounding suicide deaths, particularly on the Western Slope of Colorado, often hinders individuals from seeking the support they need. To address this crisis in our communities, we must not only bring awareness to suicide prevention but also collectively understand and acknowledge the challenges that survivors of suicide loss face. “Grief after the loss of a loved one to suicide is a unique and painful experience. Survivors struggle with a range of challenges, from the heavy weight of stigma surrounding the death, to judgment from others,” said Judy Eskelson, HopeWest Meeker Bereavement Counselor. “And for many in our community, they may not fully understand the ins and outs of this type of grief. Life after this kind of death can be overwhelmingly difficult, leaving families to navigate a path they never expected to walk.” ... Following the devastating loss of a loved one to suicide, the HopeWest bereavement team is here to walk alongside individuals and families needing a source of comfort and guidance through their grief journey. Editor's note: Though many hospices provide bare, minimum grief support, many others--like HopeWest--live out their mission by providing a fuller scope of bereavement counseling and support. What does your hospice provide? Throughout your service area, do bereaved persons (whether hospice deaths or not) think of your agency as the "dying, death and bereavement" expert, or not? 

$1.6M grant to focus on nursing home units to reduce racial disparities in dementia care McKnights Long-Term Care News; by Jessica R. Towhey; 10/3/24 Emory University will use a $1.6 million, federal grant to investigate the role Alzheimer’s special care units play in reducing racial and ethnic disparities in dementia care within nursing homes. The research team will be led by Huiwen Xu, PhD, an associate professor in the university’s Nell Hodgson Woodruff School of Nursing, who specializes in gerontology and elder health. The four-year grant from the National Institute on Aging will analyze quality of life and improved health outcomes in the specialized care units, which the school’s press release said are available in only 14% of nursing homes nationwide. Xu’s team will examine the underlying causes of racial disparities for Black and Hispanic residents, who have limited access to the memory care units, the release said. 

Palliative care in kidney cancer more than just relieving symptoms Cure; by Ashley Chan; 9/26/24 Patients with kidney cancer who want more support during treatment can consider palliative care, whether it’s for symptoms or discussing goals and values. ... For patients with kidney cancer, understanding how palliative care can help is essential throughout the treatment process. Palliative care, according to the Mayo Clinic, is medical care that specializes in relieving pain and symptoms associated with an illness. This type of care can also help patients cope with treatment-related side effects. However, there’s more to palliative care than just relieving symptoms. It also “aims to help patients and families in one of three major categories,” Dr. Pallavi Kumar explained during an interview with CURE®. Kumar is the director of Oncology Palliative Care and assistant professor of Clinical Medicine in the hematology-oncology division at the University of Pennsylvania. She noted that the three categories of palliative care include:

Comfort home in Scottsville reopens after four-year hiatus NBC News 10, Rochester, NY; by Eriketa Cost; 9/27/24 A local hospice home in Scottsville re-opened, after four years of rebuilding from the inside out. You may recall how much of an effect COVID-19 had on these services. The home, Patrick Place, was unable to hold fundraisers. Dozens of volunteers stepped down out of fear for the virus, and it took time to bring them back. The emails and phone calls didn’t stop during the downtime, though, said Cissy Leblanc, secretary on the board for Patrick Place. Organizers were eager to open again, but it took hard work. Along the way, the team built a new deck and furnished the basement, adding a conference room and special area for training volunteers. These, are all projects that couldn’t have happened with someone living there, said chairman Patrick Hanley. The home opened in early September with 55 volunteers. The goal is to reach 75. ...

Hispanic Americans and Alzheimer'sAlzheimer's Association; Resources; ongoing webpage, retrieved from the internet 9/25/24 Approximately 13% of Hispanics who are 65 or older have Alzheimer's or another dementia. Learn what the Alzheimer's Association is doing to address health disparities and provide support for Hispanic community members living with Alzheimer's or another dementia. Quick Facts: ...

Bereaved mum shares 'what not to say' in new book BBC News; by Roger Johnson and Jonny Humphries; 9/24/24 A bereaved mother has written a book exploring the sensitive topic of how to speak to a parent struck by the loss of a child. Singer and entertainer Kiki Deville, from Earby, said she felt as if she would "never experience joy again" after losing her four-week-old son Dexter in 2007. Dexter died from the rare genetic condition Zellweger Syndrome and spent his last days in Chorley children's hospice Derian House, of which Ms. Deville is now a patron.  Her work there, including countless conversations with other parents, informed her book 'What Not To Say: A Practical Guide to Supporting Bereaved Parents'. Ms. Deville said 17 years after the loss of Dexter, she still remembers the first time someone made the well-meaning but painful comment: "At least he was just a baby." "Now that infers were he older, his death would have mattered more," she told the BBC.  From speaking to other mothers, Ms. Deville also gave examples such as "at least you have other children" and "they're in a better place" as things not to say. She said: "It's really important to recognise that nobody says anything out of malice, I don't think anybody sets out to hurt."Editor's note, calling all non-clinical hospice and palliative care leaders: Your interactions with bereaved parents speak volumes. Do you convey cheap platitudes or wise empathy? Incorporate these human vulnerabilities into your leadership skills. Open yourself to the pain of experiencing the pain and joys of your organization's palliative/hospice pediatric families. Invest a day of shadowing with a pediatric interdisciplinary team member. Be willing to go there. Be willing to be there: physically, mentally,  emotionally, and spiritually (without imposing your own onto others).

Top 5 regrets people have on their deathbeds: What they can teach us about living healthy, fulfilled lives, from an internal medicine doctor NBC-6 South Florida; by Alex Koller, CNBC; 9/23/24 To live a meaningful, fulfilling life, you have to accept that it'll eventually come to an end, says Shoshana Ungerleider. Over the years of caring for ill hospital patients, Ungerleider — a doctor who specializes in internal medicine — has observed regrets among people near the end of their lives, she tells CNBC Make It. Here are five regrets she says people often express:

Survey: Older adults unsatisfied with current healthcare system McKnights Long-Term Care News; by Kristen Fischer; 9/17/24 Older adults aren’t too happy with the healthcare system and many think it doesn’t meet their needs and preferences, according to a new survey. The results of the survey, conducted by The Harris Poll, were published Tuesday, and were released by Age Wave and The John A. Hartford Foundation.  Four in five adults aged 65 and older said that the system isn’t prepared to handle the changing needs of Americans in their age group. In total, only 11% said the US healthcare system deserved a grade of “A.” Results show that older adults want solutions such as affordable care interventions, developments to prevent or reduce cognitive decline, and healthcare professionals who understand what matters to them when they discuss care options.

10 most, least diverse states in 2024 Becker's Hospital Review; by Erica Carbajal; 9/17/24 ... For the ranking, the financial services company compared all 50 states across six key dimensions: socio-economic diversity, cultural diversity, economic diversity, household diversity, religious diversity and political diversity. ... Here are the 10 most and least diverse states in 2024, per the ranking: Most diverse: [Starting with highest diversity] 1. California 2. Texas 3. Florida 4. New Mexico 5. Hawaii 6. Nevada 7. New Jersey 8. New York 9. Maryland 10. ArizonaLeast diverse: [Starts with lowest diversity] 1. West Virginia 2. Maine 3. New Hampshire 4. Vermont 5. Montana 6. Kentucky 7. Wyoming 8. Iowa 9. Utah 10. North Dakota

Mayo Clinic Minute: Palliative medicine for cancer patients Mayo Clinic; by Sonya Goins; 9/16/24 Patients undergoing cancer treatments often use palliative medicine to cope with nausea, fatigue and other bothersome symptoms. Palliative medicine is a medical specialty whose main focus is supporting patients and families/caregivers who need help managing symptoms related to cancer or side effects related to the treatment of cancer, along with other life-limiting diseases. Dr. Touré Barksdale, a Mayo Clinic cancer rehabilitation and palliative medicine specialist, explains the benefits of palliative care.

Historic numbers of Americans live by themselves as they age California Healthline, originally published by KFF and ran in The Washington Post; by Judith Graham; 9/17/24Gerri Norington, 78, never wanted to be on her own as she grew old. ...  Norington is part of a large but often overlooked group: the more than 16 million Americans living alone while growing old. Surprisingly little is known about their experiences. This slice of the older population has significant health issues: Nearly 4 in 10 seniors living alone have vision or hearing loss, difficulty caring for themselves and living independently, problems with cognition, or other disabilities, according to a KFF analysis of 2022 census data. ... Multiple studies find that seniors on their own are at higher risk of becoming isolated, depressed, and inactive, having accidents, and neglecting to care for themselves. As a result, they tend to be hospitalized more often and suffer earlier-than-expected deaths. ... The most reliable, up-to-date data about older adults who live alone comes from the U.S. Census Bureau. According to its 2023 Current Population Survey, about 28% of people 65 and older live by themselves, including slightly fewer than 6 million men and slightly more than 10 million women. (The figure doesn’t include seniors living in institutions, primarily assisted living and nursing homes.) By contrast, 1 in 10 older Americans lived on their own in 1950. ... [Click on the title's link for the full article. Includes information to republish for free.]