Literature Review
All posts tagged with “Clinical News | Patient Safety.”
CMS releases HOPE Guidance Manual (V. 1.01) and Tables
04/25/25 at 03:00 AMCMS releases HOPE Guidance Manual (V. 1.01) and TablesCenters for Medicare and Medicaid Services (CMS); by CMS; 4/22/25On April 22, 2025, CMS released the HOPE Guidance Manual (V. 1.01) and connected tables. Providers can use v1.01 for HOPE planning, as this is considered final before HOPE implementation. Also note that earlier this month, the final HOPE data specs have also been released, helping software developers to finalize their HOPE software for testing in the coming months.
Prevention of acute hospital transfers for long-term care residents at the end of life
04/24/25 at 02:00 AMPrevention of acute hospital transfers for long-term care residents at the end of life American Journal of Hospice and Palliative Medicine (AJHPM); by Kirsten Lanpher, DMS, MSPA, PA-C and Kirsten Brondstater, DMS, MSPAS, PA-C; 3/24/25 Findings: Long-term care residents are a vulnerable population with advanced comorbidities who often require high acuity care and are subject to preventable transfers to the hospital at the EOL. These disruptions in EOL care cause harm and complications, negatively impacting quality of care. The consequences of these events can be mitigated with early advance care planning to include documentation of EOL care goals, onsite medical clinicians to make critical decisions and provide care within LTC facilities, and adequate staffing with proper palliative and hospice care training. Conclusion: Immediate action is needed to advocate for this high risk population and implement interventions to prevent hospital transfers at the EOL, therefore improving quality of care and positively influencing LTC residents’ EOL experience.
HHS cuts pose threat to older Americans' health and safety
04/18/25 at 03:00 AMHHS cuts pose threat to older Americans' health and safety Newsweek; by Kristin Lees Haggerty and Scott Bane - The National Collaboratory to Address Elder Mistreatment at Education Development Center (EDC); The John A. Hartford Foundation; 4/17/2 On March 27, 2025, the federal government announced major cuts to the department of Health and Human Services (HHS). ... Sounding the Alarm for Elder Justice: The population of older adults is rapidly growing, and one in 10 experience abuse, neglect, and/or exploitation—a risk that is even higher for those living with dementia. ... Cutting services to older adults will increase these risks and costs. Moreover, ... 11.5 million family and friend caregivers provide over 80 percent of help needed for people living with dementia in the U.S. Without access to services like Meal on Wheels, adult day care, and respite care, we can expect caregiver burden and strain to increase significantly and with it, rates of elder abuse, emergency department visits, hospitalizations, and nursing home placements. We know this because of the abuse spike seen clearly during the COVID-19 pandemic, which doubled to over 20 percent of older adults, as services were limited, and older adults were socially isolated. HHS cuts are also likely to result in loss of specialized expertise in identifying and addressing elder mistreatment, so that when elder abuse does occur, we won't have the services to stop it and make sure it won't happen again.
Integrating social determinants into palliative care
04/18/25 at 03:00 AMIntegrating social determinants into palliative care Hospice News; by Holly Vossel; 4/16/25 Strong staff education and reimbursement are among the keys to successfully integrating social determinants of health within a palliative care program. Screening tools developed by the U.S. Centers for Medicare & Medicaid Services’ (CMS) include five areas of social determinants of health: food and housing insecurity, transportation needs, utility difficulties and interpersonal safety. Supplemental domains include financial stability, employment and family and social support, among others.
Palliative care and advanced cardiovascular disease in adults: Not just end-of-life care: A scientific statement from the American Heart Association
04/18/25 at 03:00 AMPalliative care and advanced cardiovascular disease in adults: Not just end-of-life care: A scientific statement from the American Heart Association AHAIASA Journals - American Heart Association; by Lucinda J. Graven, PhD, APRN, FAHA, Lisa Kitko, PhD, RN, FAHA, Martha Abshire Saylor, PhD, MSN, BA, RN, Larry Allen, MD, MHS, FAHA, Angela Durante, PhD, RN, Lorraine S. Evangelista, PhD, RN, CNS, WAN, FAHA, Amy Fiedler, MD, James Kirkpatrick, MD, Lakeisha Mixon, MSW, and Rachel Wells, PhD, MSN, BA on behalf of the American Heart Association Complex Cardiovascular Nursing Care Science Committee of the Council on Cardiovascular and Stroke Nursing; and Council on Cardiovascular Surgery and Anesthesia; 4/17/25 ... This scientific statement (1) discusses the application of effective communication, shared decision-making, age-friendly care, and advance care planning in advanced cardiovascular disease palliative care; (2) provides a summary of recent evidence related to palliative care and symptom management, quality of life, spiritual and psychological support, and bereavement support in individuals with advanced cardiovascular disease and their care partners; (3) discusses issues involving diversity, equity, and inclusion in cardiovascular disease palliative care; (4) highlights the ethical and legal concerns surrounding palliative care and implanted cardiac devices; and (5) provides strategies for palliative care engagement in adults with advanced cardiovascular disease for the care team.
Why cameras are popping up in eldercare facilities
04/11/25 at 03:00 AMWhy cameras are popping up in eldercare facilities The New York Times; by Paula Span; 4/7/25 Roughly 20 states now have laws permitting families to place cameras in the rooms of loved ones. Facility operators are often opposed. ... The assisted-living facility in Edina, Minn., where Jean H. Peters and her siblings moved their mother in 2011, looked lovely. “But then you start uncovering things,” Ms. Peters said. Her mother, Jackie Hourigan, widowed and developing memory problems at 82, too often was still in bed when her children came to see her in mid-morning. So Ms. Peters bought an inexpensive camera at Best Buy. She and her sisters installed it atop the refrigerator in her mother’s apartment, ... Monitoring from an app on their phones, the family saw Ms. Hourigan going hours without being changed. They saw and heard an aide loudly berating her and handling her roughly as she helped her dress. ... Though they remain a contentious subject, cameras in care facilities are gaining ground. By 2020, eight states had joined Minnesota in enacting laws allowing them, according to the National Consumer Voice for Quality Long-Term Care: Illinois, Kansas, Louisiana, Missouri, New Mexico, Oklahoma, Texas and Washington. [Continue reading ...]
Heart & Soul: Nikki Harris
04/11/25 at 03:00 AMHeart & Soul: Nikki HarrisCharleston Area Medical Center, Charleston, WV; 4/8/25 Nikki Harris is a Charge Nurse on 4 West at Memorial Hospital. Harris’ coworkers say she always provides excellent care but went out of her way for one man who wasn’t even her patient. The man’s wife was near the end of life in Hospice at Memorial Hospital. He had not been able to see or visit her since his own hospitalization. Recognizing the importance of this moment, Harris went above and beyond by personally escorting him to his wife’s side. She ensured that he had the time he needed to hold her hand, express his love and say goodbye before her passing. Harris’ compassion and selflessness in providing this extraordinary gesture of care during such a difficult time was deeply appreciated. She made a meaningful difference in this patient’s life and honored the final moments of his wife’s life.
2 nursing staff practices tied to safety risks: Study
04/09/25 at 03:00 AM2 nursing staff practices tied to safety risks: Study Becker's Clinical Leadership, Washington, DC; by Mariah Taylor; 4/3/25 Washington, D.C.-based George Washington University and Premier researchers found overreliance on agency nurses and nurse overtime was associated with lower patient safety. The study, published April 2 in JAMA Network Open, analyzed data on quality measures for pressure ulcers and nurse staff overtime and agency use from 70 U.S. hospitals from January 2019 through December 2022. Researchers found that nearly half of the hospitals in the study utilized more nurse overtime and agency hours than was safe. The average hours exceeding safe thresholds for agency staff reached 140% and 63.6% for nurse overtime. Overuse of agency nurses and overtime hours was associated with increased rates of pressure ulcers. [Continue reading ...]
Housing instability complicates end-of-life care for aging unhoused populations
04/09/25 at 03:00 AMHousing instability complicates end-of-life care for aging unhoused populations The Conversation; by Pilar Ingle, University of Denver; 4/7/25 Research estimates that one-third or more of the unhoused population in the U.S. is age 50 or older. Unhoused people of all ages face high rates of chronic and serious illness. They also die at younger ages compared with people who are not unhoused. Yet, there are few options for palliative and end-of-life care for unhoused people. ... In 2024, Colorado saw a 30% increase in the number of people experiencing homelessness from the year before. Nationally, 771,480 people — the highest number ever recorded — experienced homelessness last year. As the number of people experiencing homelessness in the U.S. grows, so too does the need for palliative and end-of-life care for these individuals. ... [Continue reading ...]
Strong social connections improve older adults’ well-being regardless of setting, study finds
04/08/25 at 03:00 AMStrong social connections improve older adults’ well-being regardless of setting, study finds McKnights Long-Term Care News; by Donna Shryer; 4/7/25 Social connections, trust in others in their community and community cohesion significantly improve elderly well-being whether seniors live at home or in nursing facilities, according to a new comparative study published in BMC Public Health. However, researchers found that nursing home residents generally reported lower subjective well-being compared to their community-dwelling counterparts, even after accounting for health status and demographic factors. ... According to the authors, these findings “indicate the necessity for tailored interventions that address the unique needs of each care environment to promote healthier aging experiences. [Continue reading ...]
What to do if a loved one is evacuated from a nursing home or assisted living
04/07/25 at 03:10 AMWhat to do if a loved one is evacuated from a nursing home or assisted living AARP; by Emily Paulin; 1/10/25, updated 1/23/25 Running from a wildfire is a terrifying ordeal for anyone. But there’s added fear for those who have limited mobility, rely on medical equipment or suffer from dementia and struggle to comprehend what is happening. ... Evacuating these vulnerable, high-needs residents is a complex and precarious operation. Family members may be unsure of how to find their loved one or what to do to support them in a disaster situation. We’ve gathered advice from disaster response and long-term care experts on five topics to help family caregivers navigate these situations.
Jackson County nurse braves floodwaters to reach isolated hospice patient
04/07/25 at 03:00 AMJackson County nurse braves floodwaters to reach isolated hospice patient Fox 56, Jackson County, KY; by Corey Elam; 4/4/25 When deadly flooding cut off access and phone service for a Jackson County hospice patient on Friday [4/4/25], a healthcare worker teamed up with emergency management teams to care for her patient. According to Hospice Care Plus, after finding out her patient was isolated and couldn’t be reached by phone, Nurse Makale Fox worked with Jackson County Emergency Management (JCEM) to find a way to get to her. “With the support of Jackson County Emergency Management, Makale ... was able to safely navigate through the flooded area and reach her patient, ensuring they received the comfort and care they deserved,” Hospice Care Plus wrote. The hospice care nonprofit thanked Makale for her unwavering commitment, as well as JCEM for making it possible for her to get to her patient. [Continue for photos and more ...]
Hospice of the Chesapeake leader aims to think outside the box on hospice, palliative care
04/02/25 at 03:00 AMHospice of the Chesapeake leader aims to think outside the box on hospice, palliative care McKnights Home Care; podcast by Liza Berger with Rachel Jordan; 3/27/25 As the director of legislative affairs and advocacy at Hospice of the Chesapeake, the largest independent not-for-profit hospice provider in the state of Maryland, Rachel Jordan strives to treat the patient and not the disease. This helps explain why she worries less about the line between “curative” and “noncurative” care and more about whether a particular treatment helps to make a patient feel more comfortable. Jordan spoke to McKnight’s Home Care about her views of hospice and palliative care for a Newsmakers podcast. [Continue to the podcast ...]
Executive producer Bradley Cooper's film Caregiving to premiere on PBS for nationwide broadcast June 24, streaming begins May 27
03/26/25 at 03:00 AMExecutive producer Bradley Cooper's film Caregiving to premiere on PBS for nationwide broadcast June 24, streaming begins May 27ABC WHTM-27, Harrisburg, PA; 3/20/25 PBS and WETA Washington, DC, today announced that Caregiving, the documentary created with executive producer Bradley Cooper highlighting the challenges and triumphs of caregiving in America, will premiere Tuesday, June 24, 2025 at 9 p.m. ET on PBS (check local listings), and on the PBS YouTube Channel. Caregiving will be available to stream on PBS.org and the PBS App beginning Tuesday, May 27, 2025. Award-winning actress Uzo Aduba (The Residence, Painkiller, Orange is the New Black) was also announced as the film's narrator, bringing her own experience as a caregiver for her mother to the project. The two-hour documentary is centered on the personal experiences of caregivers providing for loved ones, and the challenges and triumph they face each day. These stories are interwoven with the broader context of the cultural and economic conditions in the U.S., leading to a care system tipping into crisis. [Continue reading ... including "Bradley Cooper Invites the Public to Share Their Caregiving Story]
‘Early discussions on what to expect can lessen the strain’
03/21/25 at 03:00 AM‘Early discussions on what to expect can lessen the strain’ Nursing Times; by Kylie Chaffin; 3/19/25 The article explains the pros and cons of nutrition and hydration at end of life and the several types of artificial nutrition and hydration that can be used, written in a way patients and families can understand. Resources and educational articles, like this one, can also be a great way to introduce new or even more effective ways nurses and care team members can support patients and families when pursuing a palliative approach to their health and wellbeing. My question for readers is, “Should the conversation of end-of-life, hospice and palliative care, and nutritional changes, be initiated sooner rather than later in patients with a terminal diagnosis?”
Health care system adaptation and resilience during the wildfire crisis
03/21/25 at 03:00 AMHealth care system adaptation and resilience during the wildfire crisisJAMA Network; by Attila J. Hertelendy, PhD, Jeremy Maggin, MD, MS, and Gregory Ciottone, MD; 3/19/25 ... Within a span of hours, the Palisades and Eaton fires, propelled by record-breaking Santa Ana winds reaching 150 miles per hour, consumed more than 37,000 acres, destroyed more than 16,000 structures, and claimed 29 lives. All told, greater than 186,000 residents were placed under evacuation orders. ... The experience in Los Angeles County demonstrates the value of maintaining dual-purpose resources: facilities and personnel who can transition between routine operations and emergency response functions. This approach is exemplified by Kaiser Permanente’s successful deployment of mobile health vehicles and the use of clinically trained administrative leaders in direct patient care roles during crisis events. Key elements of successful resource mobilization include:
Hastening death by stopping eating and drinking: Hope Wechkin, Thaddeus Pope, and Josh Briscoe
03/21/25 at 03:00 AMHastening death by stopping eating and drinking: Hope Wechkin, Thaddeus Pope, and Josh Briscoe GeriPal Podcasts; by Hope Wechkin, Thaddeus Pope, and Josh Briscoe Eric and Alex have featured discussions about complex bioethical concepts around caring for people at the end of life, including voluntarily stopping eating and drinking (VSED), and multiple episodes about the ethical issues surrounding medical aid in dying (MAID). Recently, discussion has emerged about how these issues intertwine in caring for patients with advancing dementia who have stated that they would not want to continue living in that condition: for those with an advanced directive to stop eating and drinking, how do we balance caring for their rational past self and their experiential current self? Should these patients qualify for medical aid in dying medications? And is there a middle path to provide some degree of comfort while also hastening the end of life?
Revamped tool can reliably assess pain symptoms in dementia patients: researchers
03/19/25 at 02:00 AMRevamped tool can reliably assess pain symptoms in dementia patients: researchers McKnights Long-Term Care News; by Zee Johnson; 3/17/25 ... A team of researchers reconstructed the End-of-Life Dementia-Comfort Assessment in Dying, or EOLD-CAD, after a multifacility study showed that caregivers could adequately and reliably address a host of pain symptoms seen in end-of-life dementia patients. ... When clinicians working in the SNFs that were part of the trials used the EOLD-CAD, they were able to detect patterns in more than 600 residents that fell into four categories: physical distress, symptoms of dying, emotional distress, and well-being. Common symptoms observed across these categories were restlessness, shortness of breath, choking, gurgling, difficulty in swallowing, fear and anxiety. ...
Less wealth at death linked to more end-of-life symptoms
03/18/25 at 02:30 AMLess wealth at death linked to more end-of-life symptoms McKnights Long-Term Care News; by Kristen Fischer; 3/10/25 Older people with less wealth showed a higher burden of symptoms when they approached the end of their lives compared with those who had more wealth, a study found. The report was published in JAMA Network Open on March 6. Investigators looked at data from 8,976 older adults. The team evaluated 12 end-of-life symptoms including difficulty breathing, frequent vomiting, low appetite, difficulty controlling arms and legs, depression, and severe fatigue or exhaustion.Then they correlated symptoms to individuals’ wealth. Wealth was broken into three categories: low wealth was having less than $6,000; medium wealth was having between $6,000 and $120,000; and high wealth was considered having more than $120,000 at the time of death. Of respondents, 22.5% had low wealth, 50.5% had medium wealth and 27.1% had higher wealth. People who had less wealth were more likely to have a higher burden of symptoms compared to those who had more money. Functional impairment, multimorbidity and dementia were factors that affected the association, data revealed.Editor's note: Click here for this important JAMA article, posted in our Saturday Research issue 3/15/25, "Wealth disparities in end-of-life symptom burden among older adults."
Flu season lingering despite springlike weather in Indiana
03/17/25 at 03:00 AMFlu season lingering despite springlike weather in Indiana NBC WTHR 13, Indianapolis, IN; by Dustin Grove; 3/14/25 With warmer weather moving into central Indiana, you'd think flu season would be over by now, but it's still hanging on. The Centers for Disease Control and Prevention estimates at least 33 million cases of flu nationwide, with 430,000 people hospitalized. So far, 19,000 have died. "(I think) it is more severe than it has been in the past few years. I think that with those numbers ... it really tells a story and that, especially with the 19,000 deaths, we're talking about a serious illness this year," said Dr. Darlene Lawrence. "COVID is waning, folks are having vaccine wariness." ... Even with spring weather arriving and the thought that flu season is waning, it's still not too late to get vaccinated. ... Flu is particularly dangerous for the elderly, people with chronic conditions and children, she said. ... Patients can talk to their doctor or pharmacist to help find the best vaccine for them.
Sarcopenia in terminally ill patients with cancer: Clinical implications, diagnostic challenges, and management strategies
03/17/25 at 03:00 AMSarcopenia in terminally ill patients with cancer: Clinical implications, diagnostic challenges, and management strategies Journal of Hospice & Palliative Care; by Se-Il Go, Myoung Hee Kang, and Hoon-Gu Kim; 3/1/25 Sarcopenia, characterized by progressive loss of skeletal muscle mass and strength, is a prevalent but often overlooked condition in patients with cancer who are terminally ill. It contributes to functional decline, increased symptom burden, and reduced quality of life, yet remains underrecognized in palliative care. Diagnosing sarcopenia in this population is challenging because conventional imaging techniques are often impractical. Instead, alternative assessments, such as the Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls questionnaire (SARC-F), anthropometric measurements, and bioelectrical impedance analysis offer feasible options. Management should focus on symptom relief, functional preservation, and patient comfort, rather than on muscle mass restoration.
[Multi-cultural] Honouring traditions: Integrating cultural wisdom into palliative care – Saif Mohammed
03/13/25 at 03:00 AM[Multi-cultural] Honouring traditions: Integrating cultural wisdom into palliative care - Saif Mohammed ehospice; by Saif Mohammed; 3/10/25[Personal Story] ... "Reflecting on this experience, I realize that caregiving is deeply embedded in tradition and culture, a natural extension of communal life." Caregiving is as old as humanity itself. One of the earliest known cases of palliative care dates back 45,000 years to Shanidar 1, a Neanderthal male found in present-day Iraq. His skeletal remains indicated severe injuries, yet he had survived for decades, suggesting that his community had cared for him. This example highlights that palliative care is a deeply human and historical practice, far predating modern medicine. Cultures around the world continue to recognize the importance of caregiving, often embedding it in traditions and religious beliefs. ... In some societies, the emphasis on independence can make caregiving more complex, as patients may refuse assistance to maintain self-sufficiency. ... Palliative care workers must be equipped to understand and respect the cultural traditions of the communities they serve. This requires training in cultural competence, which involves:
Mid-Ohio Valley emergency rooms ask for breathing room as respiratory illnesses flare up
03/13/25 at 03:00 AMMid-Ohio Valley emergency rooms ask for breathing room as respiratory illnesses flare up The Parkersburg News and Sentinel, Marietta, OH; by Staff Reports; 3/11/25 As flu, COVID and other respiratory illnesses increase, Memorial Health System is advising people to take preventive measures, prioritize rest at home or seek medical attention elsewhere before heading to an emergency department. "When needed, seeking care through a primary care provider or at a Physicians Care Express location can help ensure timely treatment and help keep emergency departments available for those in urgent, life-saving situations,” according to a release from the Health System. ... Emergency care should be sought for respiratory illnesses if people experience the following:
‘The weekend effect’: If you’re planning surgery, doctors say you should think twice about Fridays
03/11/25 at 03:00 AM‘The weekend effect’: If you’re planning surgery, doctors say you should think twice about Fridays DailyDot.com; by Ilana Gordon; 3/7/25 Everybody’s working for the weekend, which, according to a new study, is incidentally the worst time of the week to undergo surgery. A paper published in the JAMA Network on March 4, 2025, concludes that patients experience worse outcomes during the weekends, as compared to weekdays. This phenomenon is known as the “weekend effect” and the study, which examined 429,691 patients in Ontario, Canada, determined that people whose surgeries began directly before the weekend “experienced a statistically significant increase in the composite outcome of death, complications, and readmissions at 30 days, 90 days, and 1 year.”
19-year-old says home hospice is a gift, not doom and gloom
03/03/25 at 03:00 AM19-year-old says home hospice is a gift, not doom and gloom Keloland Media Group, Sioux Fall, SD; by Tom Hanson; 2/27/25 ... Cheyenne may be 19, but she is wise beyond her years, especially when it comes to something doctors discovered when she was 11. “I have stage 4 Metastatic Osteosarcoma, which is bone cancer in my lungs and It hasn’t responded very well to treatment, so that’s so I’m on hospice, but not because, I’m not on hospice because its the end right now, I’m on hospice because just so I have that extra support,” she said. Cheyenne knows people often misunderstand what hospice is all about. “It’s like doom and gloom and it’s like the end, there’s nothing they can do and that’s just not the case, she said. She was able to go on her road trip because Sanford’s Home Hospice team, including Becky Jibben, helped plan the trip and organize support teams along the way if Cheyenne needed help.