Literature Review

UnitedHealthcare taught us ways to deny claims: Former employee NBC News Channel 8, Tampa, FL; by Damita Menezes; 12/30/24A former UnitedHealthcare claims representative says employees were systematically trained to deny medical claims and rush distressed customers off phone lines, revealing internal practices at the nation’s largest health insurer amid growing scrutiny of the industry. Natalie Collins, who worked for UnitedHealthcare for nine months, said Saturday on “NewsNation Prime” that staff received “so many different ways to deny” claims during their two to three months of training, with supervisors often standing behind representatives instructing them on denial methods. “We weren’t given proper instruction to actually pay the claim, and there wasn’t enough monies in certain files in certain companies to pay medical claims,” Collins said. “We would have to just get the client off the phone as fast as we could.” Collins described crying at her desk while handling calls from desperate patients, as supervisors laughed.

For young adults, caregiving isn't just hard. It can shape you for life. National Public Radio - CAI - Local NPR for the Cape, Coast & Islands; by Kat McGown; 12/23/24 ... There are days when Jordyn Glick, 27, can't eat or drink at all. She gets so tired and weak she can barely stand up. She has gastroparesis, where food stalls out in her stomach and doesn't get digested. It comes with unpredictable bouts of nausea, periods of agony in her guts, and malnutrition. ... Dakota Heath, her 26-year-old boyfriend of four years, is her watchman, "always picking up on the small things," he says. He's on alert for her next flareup, the kind that can leave her bedridden for a week. ... Young caregivers have always been there, doing all the same things that adults do — ... About one-quarter of all family caregivers are between 18 and 36, according to the National Alliance for Caregiving. One survey suggests that almost half of them are men. They're more likely to be Latino or Black; a survey in 2018 found that only 17% were white. They've just been invisible. "They fall into every potential crack that exists," says Melinda Kavanaugh, a professor of social work at the University of Wisconsin Milwaukee who is one of the few researchers who study this population. In terms of resources, "Nothing is targeted for a 22-year-old. Nothing."

Hospice study reveals contrasting views on managing dementia behaviors McKnights Long-Term Care News; by Donna Shryer; 12/20/24 A new study finds that healthcare providers and family caregivers often disagree on how best to manage dementia behaviors during end-of-life care. The research, published in the Journal of the American Geriatrics Society, involved interviews with 23 hospice clinicians and 20 family caregivers. With dementia affecting 33% of adults over age 85 and now ranking as the primary diagnosis for Medicare hospice services, understanding these differing perspectives about managing dementia behaviors has become increasingly important. The study found that while both groups identified agitation as the most concerning behavioral symptom, they approached it from different angles. Clinicians primarily worried about physical safety risks, while family caregivers were more distressed by personality changes in their loved ones.

Loneliness and social and emotional support among sexual and gender minority caregiversJAMA Network Open; Zhigang Xie, PhD; Hanadi Hamadi, PhD; Kassie Terrell, PhD; Laggy George, MPH; Jennifer Wells, BA; Jiaming Liang, PhD; 12/24In the current landscape of US health care, informal unpaid caregiving provided by family members and friends is indispensable for managing diseases and ensuring long-term care in residential settings. Sexual and gender minority (SGM) adults in the US are more likely than their non-SGM counterparts to provide informal care to their family members and/or friends. Caregiving can impose substantial physical, mental, and social connection issues on caregivers.Conclusions and Relevance In this cross-sectional study of social connections, SGM adults experienced significantly higher levels of loneliness compared with straight adults, irrespective of caregiving status. 

[United Kingdom]  'My son died at 24 - now I'm doing his bucket list' BBC News; by Adam Eley and Alison Holt; 12/16/24 Alex Spencer's son Declan - who had Duchenne muscular dystrophy - died last year at the age of 24, and she admits she has still not gone a day without crying. "I think society has a misconception that a carer gets their life back [when a loved one dies]," she said. Declan had drawn up a bucket list but died before he could finish it. Now Alex, who wants to raise awareness of the difficulties disabled people face in getting the right care, is taking up the challenge - including visiting Paris, getting a tattoo Declan designed and taking his adapted van around a famous German race track.

Mom in hospice opens up after video of her dancing with son at wedding goes viral ABC News - GMA; by Yi-Jin Yu; 12/16/24A New York mom is opening up after a video of her dancing with her son at his wedding went viral. In the clip shared on TikTok, which has already picked up over half a million views since it was posted on Nov. 3, Olivia Armao hugs her son Sal Armao as they share a dance on his wedding day. But as the text overlaid on the video explains, what viewers see isn't your typical mother-son wedding dance. The difference is that Olivia Armao is in hospice care. She told "Good Morning America" she was diagnosed with breast cancer for a second time in 2021. Olivia Armao said the special memory with her 30-year-old son was "really sweet" and one she can't put into words. "I was just happy that I was there and I was able to wait to dance with him. ..." the 62-year-old mom of four told "GMA."

Characteristics of patients enrolled in hospice presenting to the emergency department American Journal of Emergency Medicine; by Kayla P Carpenter, Fernanda Bellolio, Cory Ingram, Aaron B Klassen, Sarayna S McGuire, Alisha A Morgan, Aidan F Mullan, Alexander D Ginsburg; 12/9/24, online ahead of print Emergency Departments (EDs) frequently care for patients with life-limiting illnesses, with nearly 1 in 5 patients enrolled in hospice presenting to an ED during their hospice enrollment. This study investigates the reasons patients enrolled in hospice seek care in the ED, the interventions they receive, and their outcomes. ... Patients enrolled in hospice most frequently presented to the ED for trauma [36%; with 15% for pain, 12% for catheter/tube malfunction]. Most received laboratory studies and imaging. Nearly half of patients were admitted to the hospital and short-term mortality was high, particularly for patients enrolled in hospice for needs for ED care? Ie.,

'A blessing': Hospital beds find new homes in families who had been praying for them Austin American-Statesman, Austin, TX; by Nicole Villalpando; 12/13/24 Ron McDaniel had been trying to find a place for the hospital bed both his dad, Robert, and brother, Gary, had used in the assisted living facility where they were before they died. His father was a Navy veteran who was burned over 30% of his body during World War II. His brother had severe brain damage from a car accident in 1976 and was a quadriplegic. The electronic hospital bed with the extra comfortable mattress and the trapeze bar needed a new home. Ron McDaniel wanted it to go to a veteran or a veteran's family because it originally came from the Veterans Affairs, but he tried organization after organization with no luck. Meanwhile, Sandra Daniels was in desperate need of a hospital bed for her mother, Bertha Woodward, 87, who has heart failure, problems with her kidneys and limited mobility caused in part by neuropathy in her feet. Daniels could not afford a hospital bed but had been trying organization after organization for a year and came up empty. She had recently called AGE of Central Texas to see if they might have a hospital bed. ...Editor's note: Organizations who helped include 26th Statesman Season for Caring, Austin Palliative Care, ATX Firefighter Moving, AGE of Central Texas.

Watch: ‘Going It Alone’ — A conversation about growing old in AmericaKFF Health News; by Judith Graham; 12/11/24 KFF Health News’ “Navigating Aging” columnist, Judith Graham, spent six months this year talking to older adults who live alone by choice or by circumstance — most commonly, a spouse’s death. They shared their hopes and fears, challenges, and strategies for aging solo. Graham moderated a live event on Dec. 11, hosted by KFF Health News and The John A. Hartford Foundation. She invited five seniors ranging in age from 71 to 102 and from across the country — from Seattle; Chicago; Asheville, North Carolina; New York City; and rural Maine — to talk candidly about the ways they are thriving at this stage of life.

A centenarian thrives living alone, active and engaged California Healthline - originally published by The Washington Post; by Judith Graham; 12/10/24 “The future is here,” the email announced. Hilda Jaffe, then 88, was letting her children know she planned to sell the family home in Verona, New Jersey. She’d decided to begin life anew — on her own — in a one-bedroom apartment in Hell’s Kitchen in Manhattan. Fourteen years later, Jaffe, now 102, still lives alone — just a few blocks away from the frenetic flashing lights and crowds that course through Times Square. ... She’s an extraordinary example of an older adult living by herself and thriving. ... I’ve spoken with dozens of seniors this past year for a series of columns on older Americans living alone. Many struggle with health issues. Many are isolated and vulnerable. But a noteworthy slice of this growing group of seniors maintain a high degree of well-being. What might account for this, particularly among people in the farthest reaches of old age? [Click on the title's link to continue reading.]

Bridgeport WWII vet who fought at Iwo Jima begins home hospice with 'no regrets' News 12 Connecticut; by Frank Recchia; 12/10/24 Stew Lahey, 98, of Bridgeport, says he's not a hero -- but his life experiences tell a different story. "I'm one of the last surviving veterans who fought at Iwo Jima during the Second World War," the proud great grandfather told News 12 Monday. "I joined the Marine Corps when I was 17. I didn't wait to enlist because it was 1943 and they needed me," Lahey said. The longtime Bridgeport resident began home hospice this week, surrounded by his family. "We love him so much and we are so proud of what he did for our country," said granddaughter Mikela Lahey. "When he began home hospice, ... we all started to cry -- but he didn't want that. He wants us to smile and be happy with him at the end," she said. "He keeps saying he has 'no regrets' -- and we are so grateful to have the chance to be here with him at the end," she said.

What adult children should know when discussing their parents’ end-of-life care StudyFinds; by StudyFindsStaff, reviewed by Christ Melore; 12/8/24 Talking about death can be difficult for anyone at any time. For adult children who need to know their parents’ final wishes, it can be excruciating. A new survey is revealing the stark disconnect between our beliefs and actions when it comes to end-of-life planning. While an overwhelming 90% of adults recognize the importance of these critical conversations, half have yet to take the first step with their closest loved ones. ... The numbers tell a revealing story. Twenty-six percent of respondents simply keep putting off the conversation, while 23% admit they don’t know how to approach the topic. Sixteen percent are outright scared to broach the subject, creating a wall of silence around a universal human experience. ... When people do open up, the conversations prove surprisingly rich and multifaceted.

Reading aloud to my friend in hospice was my long goodbye to her Thrive; by Patty Dann; 12/6/24 Reading a book aloud or being read to are constant threads in the tenderest moments of my life. When I was a child, my mother sat on my bed and read three books to me every night, so it would have been natural for me to sit on her bed and read to her during her final days. COVID-19 prevented that. Four years later, Batya, a woman in my building — the same age my mother was when she died — was in hospice at home. Each day, I read to her. ... Being with someone as they die is like taking a loved one to the airport. There’s often traffic along the way, and you never know how long it will take, but you do get the privilege of saying a final goodbye. Not being with my mother in her end days left an ache in my heart, but reading aloud to Batya helped me pass on a gift, something I was prevented from doing before.