Literature Review

Cherokee nation: Closing gap in health care disparities Native News Online; by Churck Hoskin, Jr.; 7/14/24 ... American Indians in Oklahoma die on average 17 years earlier than their non-Indigenous neighbors. While this finding is alarming, it comes as no surprise to the Cherokee Nation or to the nearly 40 other tribal nations in Oklahoma. ... Even as we continue our advocacy efforts, we cannot afford to wait for the federal government to fulfill its responsibilities. That's why the Cherokee Nation, which operates the largest Native American health care system in the country, is taking unprecedented steps to address this crisis head-on. ... [We] are confident our historic investments in health care and wellness are improving health outcomes for our Cherokee citizens. Construction continues on the Cherokee Nation’s new $400 million, 400,000-square-foot state-of-the-art hospital being built in the capital city of Tahlequah. The new hospital will include an ER, surgery, ICU, imaging, pharmacy and lab, neo-natal ICU, hospice, dietary and acute care, and many other services. 

Hospice CARES Act would update medical reviews, seek to reduce audits Hospice News; by Jim Parker; 7/12/24 The forthcoming Hospice Care Accountability, Reform and Enforcement (Hospice CARE) Act from U.S. Rep. Earl Blumenaur (D-Oregon), if enacted, would implement a number of changes to medical review processes. ... Though the bill language is still in development, it will likely contain proposed updates to payment mechanisms for high-acuity palliative services, changes to the per-diem payment process and actions to improve quality and combat fraud. The bill would also implement a temporary, national moratorium on the enrollment of new hospices into Medicare, to help stem the tide of fraudulent activities among recently established providers concentrated primarily in California, Arizona, Texas and Nevada. ... Among the anticipated provisions of the bill would be an item requiring the U.S. Centers for Medicare & Medicaid Services (CMS) to use documentation in a patient’s medical record as supporting material. The documentation would include the reasons that an attending physician certified a patient for hospice and establish a six-month terminal prognosis.

Amorem receives $100,000 grant from The Cannon Foundation Ashe Post & Times, Boone, North Carolina; by Staff Reporter; 7/12/24 Amorem received a $100,000 grant from The Cannon Foundation for its Quality. Compassion. Support: A Patient Care Unit for the High Country campaign. The Cannon Foundation has joined Amorem’s vision to provide more quality, more compassion and more support to residents of the High Country with a $100k grant to assist with the purchase of non-medical equipment needed to operate the patient care unit and meet the needs of patients and their families while in Amorem’s care. “Amorem is honored that The Cannon Foundation has joined our vision,” says Director of Development, Ashley Edwards. “Through this partnership, Amorem is empowered to create a homelike environment for our patients who are facing the end of life and their families at the High Country patient care unit.” 

What is palliative care, and can you get it at home?

A ‘Culture of Caring’: Calvary Hospital’s 125 year legacy in hospice and palliative care Hospice News; by Jim Parker; 7/11/24 Calvary Hospital in New York City is a progenitor of the hospice and palliative care models, but it has its eyes on the future nevertheless. The only hospital in the nation that is specifically devoted to hospice and palliative care, Calvary is celebrating the 125th anniversary of its founding this year. The faith-based organization was established in 1899 by a group of Catholic widows who called themselves the Women of Calvary. Its initial mission was to care for dying women who had been abandoned by the health care system, often with nowhere to live and no one to care for them.

A Hospice Transitions Program for patients in the Emergency Department JAMA Network Open; by Christopher W. Baugh, MD, MBA; Kei Ouchi, MD, MPH; Jason K. Bowman, MD; Ayal A. Aizer, MD; Alexander W. Zirulnik, MD, MPH; Martha Wadleigh, MD; Angela Wise, MHA; Paula Remón Baranda, MEM; Richard E. Leiter, MD, MA; Bradley J. Molyneaux, MD, PhD; Andrea McCabe, RN; Panupong Hansrivijit, MD; Kate Lally, MD; Melissa Littlefield, MBA; Alexei M. Wagner, MD, MBA; Katherine H. Walker, MD, MSc; Hojjat Salmasian, MD, MPH, PhD; Kourosh Ravvaz, MD, PhD; Jada A. Devlin, BSN; Karen Lewis Brownell, RN, BSN, CEN; Matthew P. Vitale, MD; Frantzie C. Firmin, MS, RN; Nelia Jain, MD; Jane deLima Thomas, MD; James A. Tulsky, MD; Soumi Ray, PhD; Lynne M. O’Mara, MPAS, PA-C; Elizabeth M. Rickerson, MD; Mallika L. Mendu, MD, MBA; 7/8/24Patients often visit the emergency department (ED) near the end of life. Their common disposition is inpatient hospital admission, which can result in a delayed transition to hospice care and, ultimately, an inpatient hospital death that may be misaligned with their goals of care. Conclusions and relevance: In this quality improvement study, a multidisciplinary program to facilitate ED patient transitions was associated with hospice use. Further investigation is needed to examine the generalizability and sustainability of the program.Editor's Note: We posted an article on 7/10/24 that describes the significance of this research,"Study finds new program streamlined hospice transitions from the emergency department." 

Stigmas about palliative care are harming our seriously ill patients

A professional’s perspective: Ageism within the healthcare system; does it exist? Northern Kentucky Tribune; by Jeff Rubin; 7/6/24 A friend of mine named Dee recently shared with me a particularly unpleasant experience she had with a young hospital discharge planner regarding her 97-year-old mom in California. It appears Dee had a heck of a time trying to get her mom discharged to home health care rather than hospice, even though the particular care she needed could have been better delivered at home. A geriatrician by training, Dee ... recognized the invaluable role of hospice in providing end-of-life care. However, the situation she found herself in was less a question of end-of-life and more of palliative care. ...  A recent study in the US sampling 2,035 individuals between 50 and 80 years of age revealed that 93.4% experienced ageism firsthand. Their perception extended to professionals like doctors, nurses, therapists, social workers, and psychologists whose services included working with older people. [Click on the title's link for significant data, descriptions, and resources.]

Your brain holds secrets. Scientists want to find them. The New York Times; by Paula Span; 7/6/24 About a month ago, Judith Hansen popped awake in the predawn hours, thinking about her father’s brain. Her father, Morrie Markoff, was an unusual man. At 110, he was thought to be the oldest in the United States. His brain was unusual, too, even after he recovered from a stroke at 99. Now he was nearing death, enrolled in home hospice care. “In the middle of the night, I thought, ‘Dad’s brain is so great,’” said Ms. Hansen, 82, a retired librarian in Seattle. “I went online and looked up ‘brain donation.’” Her search led to a National Institutes of Health web page explaining that its NeuroBioBank, established in 2013, collected post-mortem human brain tissue to advance neurological research. ...

Medicare Program: End-Stage Renal Disease Prospective Payment System, Payment for Renal Dialysis Services Furnished to Individuals with Acute Kidney Injury, etc. Federal Register; Proposed Rule by the Centers for Medicare & Medicaid Services; 7/5/24

Clinician- and patient-directed communication strategies for patients with cancer at high mortality risk JAMA Network Open - Oncology; by Samuel U. Takvorian, MD, MSHP; Peter Gabriel, MD, MSE; E. Paul Wileyto, PhD; Daniel Blumenthal, BA; Sharon Tejada, MS; Alicia B. W. Clifton, MDP; David A. Asch, MD, MBA; Alison M. Buttenheim, PhD, MBA; Katharine A. Rendle, PhD, MSW, MPH; Rachel C. Shelton, ScD, MPH; Krisda H. Chaiyachati, MD, MPH, MSHP; Oluwadamilola M. Fayanju, MD, MA, MPHS; Susan Ware, BS; Lynn M. Schuchter, MD; Pallavi Kumar, MD, MPH; Tasnim Salam, MBE, MPH; Adina Lieberman, MPH; Daniel Ragusano, MPH; Anna-Marika Bauer, MRA; Callie A. Scott, MSc; Lawrence N. Shulman, MD; Robert Schnoll, PhD; Rinad S. Beidas, PhD; Justin E. Bekelman, MD; Ravi B. Parikh, MD, MPP; 7/1/24 Serious illness conversations (SICs) that elicit patients’ values, goals, and care preferences reduce anxiety and depression and improve quality of life, but occur infrequently for patients with cancer. Behavioral economic implementation strategies (nudges) directed at clinicians and/or patients may increase SIC completion. ... In this cluster randomized trial, nudges combining clinician peer comparisons with patient priming questionnaires were associated with a marginal increase in documented SICs compared with an active control. Combining clinician- and patient-directed nudges may help to promote SICs in routine cancer care.

Aligning pill burden and palliative care needs in late-stage CVD: AHA TCTMD - Cardiovascular Research Foundation; by L.A. McKeown; 7/2/24 The first scientific statement from the American Heart Association (AHA) that focuses specifically on pharmacotherapy considerations in the palliative management of patients with CVD [cardiovascular diesease] urges a patient-centered, compassionate approach to de-escalating and deprescribing. ... In addition to shedding light on how and when to start deprescribing and de-escalating common cardiovascular drugs, the statement discusses palliative drugs for pain, shortness of breath, and appetite in the context of CVD, which [Katherine E.] Di Palo [PharmD (Montefoiore Medical Center, NY)] said the committee identified as a gap in knowledge given that much of the evidence for these drugs comes from patients with serious illnesses like cancer. ... Important Takeaways: Di Palo and colleagues note that palliative care complements cardiovascular care in several important ways, including reducing physical symptom burden, managing emotional and spiritual distress, providing sufficient support for caregivers, and helping patients choose treatment in line with their goals for care. Editor's Note: Click here for the American Heart Association's statement, which we posted on 7/2/24. 

Pasadena Hindu Temple offers health planning series for seniors: Interactive session to cover advance care, palliative care, and hospice services Pasadena Now; 7/2/24 The Pasadena Hindu Temple is hosting a health and wellbeing series for seniors, focusing on future healthcare planning. ... Doctors Alka and Pradeep Kapoor, both board-certified in internal medicine, hospice, and palliative medicine, will present on topics including advance care planning, palliative care, and hospice care. The doctors, who have over 45 years of medical experience, are also certified in Post Acute and Long-term care medicine. ... Established in 2002, the Pasadena Hindu Temple has evolved into a hub for Indian heritage and Hindu worship in Southern California. Now operating as the Hindu Temple and Heritage Foundation (HTHF), the nonprofit organization offers various community services. Editor's Note: What cultures and faith communities are in your service areas? Do you reach out to all? Does your staffing reflect your community? Click here for U.S. Census information and search for your geographical areas.