Literature Review

How Lower Cape Fear LifeCare built its Memory Care affiliate Hospice News; by Jim Parker; 4/22/25 Lower Cape Fear LifeCare built from the ground up a program dedicated to serving dementia patients. A growing number of operators have developed programs tailored to patients with specific diagnoses, providing specialized care tailored to their specific needs. Examples include dementia, heart failure and other cardiac conditions, as well as diseases of the lungs. At Lower Cape Fear LifeCare, the program started small and rapidly expanded. The North Carolina-based hospice provider six years ago launched a support group for dementia caregivers, called Memory Partners. This over time bloomed into a full-fledged dementia services subsidiary called LifeCare Memory Partners, Evan Dressel, director of strategy, development and innovation at Lower Cape Fear LifeCare said at the Hospice News ELEVATE conference in Orlando, Florida.

Appropriate deprescribing and payment in hospice dementia careJAMA Internal Medicine; Nathan M. Stall, MD, PhD; Sharon K. Inouye, MD, MPH; Lona Mody, MD, MSc; 3/25People living with dementia are one of the largest growing users of hospice care in the US, with approximately 20% of enrollees having a terminal diagnosis of dementia. In the setting of advanced dementia specifically, guidelines recommend deprescribing cholinesterase inhibitors and memantine as there is insufficient evidence for benefit, and there are risks of adverse events including bradycardia, falls, and gastrointestinal adverse effects. The Centers for Medicare & Medicaid Services specifies that hospices are responsible for covering all medications under the Medicare Part A hospice benefit, but audits have revealed that millions of dollars of prescription drug costs are being inappropriately shifted to Medicare Part D. The study by Hunt et al occurs within a context of growing concerns about shifts in US hospice care where more than 70% of hospice agencies serving patients with terminal illness across all settings now operate on a for-profit basis, with increasing acquisition of hospices by private equity firms and publicly traded corporations. Compared with nonprofit hospices, for-profit hospices have more acute care utilization, provide less direct care, and have poorer caregiver-reported care experiences. For-profit hospices also enroll a higher proportion of persons living with dementia, which may relate to their lower acuity and longer stays, as well as more profitable margins under the per-beneficiary daily payment.

Alzheimer’s risk rises when amount of deep sleep falls, study suggests CNN Health; by Sandee LaMotte; 4/8/25 Need another reason to prioritize your sleep? Not spending enough time in the two deep stages of sleep — slow-wave and rapid eye movement, or REM, sleep — may hasten the deterioration of parts of the brain associated with Alzheimer’s disease, a new study found. Deficits in slow-wave and REM sleep appear to shrink parts of the brain known to be early indicators of cognitive deterioration and Alzheimer’s disease, said lead study author Gawon Cho, a postdoctoral associate in internal medicine at the Yale School of Medicine in New Haven, Connecticut. [Continue reading ...] 

Global study finds 1 in 5 people with dementia receive no care McKnights Long-Term Care News; by Donna Shryer; 4/7/25 A comprehensive global study led by Yale School of Public Health researchers has revealed that at least 20% of people living with dementia receive no care helping them with daily living, regardless of their country’s wealth or development status. As the world’s population rapidly ages, this alarming care gap has persisted for years, creating what researchers describe as “a public health crisis.” The study analyzed data from over 10,000 individuals across the United States, England, 18 European nations, Israel and China. [Continue reading ...]

The most personal column I’ve ever written The Times, United Kingdom; by Professor Tanya Byron; 3/31/25 ... This column will be more personal than any other I have written in my now 20 years writing for The Times. I write it four days after my sister Katrina and I lost our beloved mum, Elfie, who ... had advanced end-stage dementia. Where do we start when trying to describe the many moments of heartbreak and the challenges that come with the long goodbye we have faced with our parents? Dementia is unpredictable. We say goodbye more than once and so the pain of bereavement does not begin at the time of death. Instead it is a prolonged pain marked by gradual losses. Watching a loved one slowly fade away over months or years brings grief, exhaustion and deep emotional turmoil. Amid all this is the experience of being on a rollercoaster of loss and hope, an experience that creates huge lurches between perceptions and emotions. There are moments of clarity and regression, ... [Continue reading ...]

Assisted Living vs. Memory Care: The key differences U.S. News & World Report; by Elaine K. Howley; 3/17/25 Age brings many challenges, among them a loss of independence that means some seniors will need help taking care of themselves. There are many senior living options available for folks who need hands-on support, and two common ones can provide big benefits for residents: assisted living and memory care. While these two options are similar in many ways, they have some important differences. Here, we’ll unpack everything you need to know about these two senior living options so you can find the best type of care for your loved one. ... [Continue reading ...]

The marginalizing and dehumanizing of our sickest and oldest Americans ABA - The American Bar Association; by Charles P. Sabatino; 3/19/25 Being old and with a disability ranks high as a target for discrimination in American culture, where ageism and ableism often prevent the public from seeing marginalization as an aberration. ... Summary:

Revamped 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. ...

Hospice use among Medicare beneficiaries with Parkinson Disease and Dementia with Lewy bodiesJAMA Network Open; Meredith Bock, MD; Siqi Gan, MPH; Melissa Aldridge, PhD; Krista L. Harrison, PhD; Kristine Yaffe, MD; Alexander K. Smith, MD; John Boscardin, PhD; Lauren J. Hunt, PhD; 3/25Lewy body disease (LBD)—an umbrella term that includes Parkinson disease (PD) and dementia with Lewy bodies (DLB)—describes progressive, incurable neurodegenerative disorders. Parkinson disease is the second most common neurodegenerative disorder after Alzheimer disease (AD) and is the fastest growing neurologic disorder in the world.In this cohort study of ... Medicare beneficiaries enrolled in hospice between 2010 and 2020, hospice enrollees with both PD and DLB were less likely to be disenrolled due to extended prognosis than those with AD. Enrollees with PD—but not DLB–were more likely to have longer lengths of stay and revoke hospice. The findings of this study suggest a higher likelihood of revocation of hospice care in PD, raise important questions about their unmet needs in hospice, and highlight the need to disaggregate dementia subtypes for policy analysis. 

Questions to ask when choosing a memory care facility The Kansas State Collegian; 3/10/25 ...  Your goal is to find a community where your family member can feel safe, truly cared for, and supported during this next chapter of their life. To help, we’ve put together a list of questions you should ask when touring memory care facilities. These questions will help you cut through the sales pitches and get to the heart of what each community offers. ...

J-Sei Home closes after 30 years, leaving Bay Area Japanese seniors in need KQED, San Francisco, CA; by Cecilia Lei; 3/10/25 ... For decades, Bay Area Japanese American families have sought culturally sensitive senior care facilities like J-Sei Home for aging loved ones. Community members said that about a decade ago, there were approximately 10 Japanese senior care homes in the region. Today, that number has declined by about half. The most recent closure came in January, when the last residents of J-Sei Home moved out, and the facility permanently closed its doors after 30 years of operation. A majority of the displaced residents were Japanese Americans in their 90s and had cognitive impairment. ... They had tender caregivers who spoke Japanese. They ate familiar comfort foods like miso soup and pickled vegetables, and they participated in daily activities such as drum circles and singing Japanese songs. ...

Breaking bad news: Guidance on disclosing a dementia diagnosis Medscape; by Megan Brooks; 3/3/25 As biomarker testing for Alzheimer’s disease (AD) evolves, timely and compassionate disclosure of a diagnosis is more complex than ever. Yet, clinicians may struggle with how — or in some cases whether — to disclose that a patient has mild cognitive impairment (MCI) or dementia. A recent perspective offers a practical roadmap to help clinicians navigate these challenging conversations. The authors from the Perelman School of Medicine, University of Pennsylvania, Philadelphia, noted that disclosure of a dementia diagnosis “is particularly nuanced and requires a conscientious approach. Clinicians must assess patients’ understanding and appreciation of symptoms, goals for the evaluation, and desire for information.” 

[UK] Efficacy of music-based intervention for people living with dementia in an inpatient setting: A pilot studyJournal of Alzheimer's Disease; Neha Abeywickrama, Mel N Ellul Miraval, Hari Subramaniam, Qadeer Arshad, Stephanie Pollard, Geeta Chauhan, Shifa Jussab, Elizabeta B Mukaetova-Ladinska; 1/25Pharmacological treatment of behavioral and psychological symptoms of dementia is of limited benefit. The addition of non-pharmacological interventions is often essential for optimal symptom control. Clinical professionals can successfully deliver music-based intervention to inpatients with advanced dementia to help manage their behavioral symptoms in the short term. Music-based interventions' use for inpatient wards must be further investigated as an economical and personalized non-pharmacological therapeutic tool for patients with dementia.