Literature Review

Health care workers aid community members with end-of-life care directives The Journal - Martinsburg, WV; by Tom Markland; 4/16/24Health care workers from Berkeley Medical Center and Hospice of the Panhandle came together on Tuesday to help members of the community learn and assemble various advanced directives concerning end-of-life care. According to a study by the University of Chicago, only 22% of U.S. adults have completed any advanced directive for their end-of-life care. Tuesday’s event aimed to help boost that that number in the Eastern Panhandle. As of 2 p.m. on Tuesday afternoon, more than 35 people had been through the program, completing paperwork for their medical power of attorney, living will or both for free.Editor's Note: We thank and celebrate all hospice and palliative organizations that participated in the National Healthcare Decisions Day, Tuesday April 16, 2024! Collectively, what supportive connections you have made. Individually for each person and with their families, these conversations and advance directives will continue to unfold through years ahead, when needed most.

Mayo Clinic Minute: Creating an advance directive for your future well-being

Association of frailty and cardiopulmonary resuscitation outcomes in older U.S. VeteransAmerican Journal of Hospice and Palliative Medicine, by Dominique M Tosi, MD; Marlena C Fernandez, MD; Shivaan Oomrigar, MD; Lorena P Burton, MD; Iriana S Hammel, MD; Andrew Quartin, MD; Jorge G Ruiz, MD; 4/24CPR outcomes were not different depending on frailty status in our Veteran population. With these results, we cannot use frailty - as measured by the VA-FI - as a prognosticator of CPR outcomes in Veterans.

Where you begin is not necessarily where you end: the mental and physical health trajectories of cancer caregivers over timeSupportive Care in Cancer, by Maureen Wilson Genderson, Maria D. Thomson, Laura A. Siminoff; 10/23Cancer caregiving, a critical component in the cancer-care model, has deleterious effects on the caregiver’s physical and mental health. The degree to which these negative effects are uniformly experienced by caregivers is unclear; effects may be exacerbated at the end of life when caregiving is intensified. Not all caregivers have the support of an additional involved support person (secondary caregiver). The impact of the secondary caregiver’s absence on the primary caregiver’s well-being is understudied.

[Psychology Today] Facing Mortality Honestly Psychology today, by Patricia Prijatel; 4/6/24 Personal Perspective: Being Mortal, by Atul Gawander, explores end-of-life-care. I read Being Mortal by Atul Gawande when it was first published in 2014 and haven’t stopped talking about it. It shot to the top of my list as one of the most important books I’ve ever read. After 10 years, I read it again to see if it held up. It did. I was as entranced the second time as the first—even more so because, as it happens, I am also now 10 years older.

I work with dying Trump supporters. It's ... confusingDaily Kos, by Scott Janssen; 4/6/24I’m driving down a gravel road in rural North Carolina, looking at mailbox numbers. A hospice social worker, I’m headed to meet Petey, a patient dying of metastatic cancer. ...  A few homes down I see a ranch style house with a Trump flag hanging limp from what looks like a homemade flagpole. ...Publisher's Note: In our advocacy, we often say "death and hospice are bipartisan." This (inflammatory) opinion piece challenges us to ethically wrestle with our biases (political or otherwise) to professionally provide excellent end-of-life care to all the people we have the privilege to serve.Editor's Note: In day-to-day care--no matter political, religious, or other beliefs--what can you support, within the appropriate scope of your professional role? What is untenable; you cannot support? Examine the term "moral distress." 

Lutheran Senior Services/Diakon agreement forms one of largest US nonprofit LTC organizations McKnights Senior Living, by Kathleen Steele Gaivin; 3/29/24 Diakon Senior Living operations and its four continuing care retirement / life plan communities will become part of Lutheran Senior Services under an agreement ... that the organizations say will create one of the largest nonprofit senior living and care organizations in the country. The transaction is pending regulatory approvals and is expected to close this summer.

What home health providers need to know about the Medicare TPE Audit ProcessHome Health Care News, by Joyce Famakinwa;  4/2/24... TPE is a medical review program that began for the home health and hospice settings in December 2017. The goal of the program is to weed out improper payments by zeroing-in on providers with high claims denial rates or unusual billing practices. ... TPE has three pillars. Target refers to errors or mistakes that are identified through data in comparison to providers or peers. Probe is the examination of 20 to 40 claims. ... Education means helping providers reduce claim denials and appeals through one-on-one individualized education. 

Mortality, hospice use rates differ in assisted living communities depending on whether memory care is offeredMcKnights Senior Living, by Kimberly Bonvissuto; 4/4/24Assisted living communities that provide memory care services may attract residents closer to the end of life or promote hospice use at the end of life compared with assisted living communities without such services, according to the findings of a new study. ... Researchers from the Brown University School of Public Health, the University of Melbourne and the Johns Hopkins University School of Nursing examined whether end-of-life outcomes — mortality and hospice use — differed between assisted living facilities with and without memory care services among 15,152 residents who moved into larger communities between 2016 and 2018.Editor's Note: Click here for the source article, "Do end-of-life outcomes differ by assisted living memory-care designation?"

Medicare Program; FY 2025 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, and Hospice Quality Reporting Program Requirements Federal Register; A Proposed Rule by the Centers for Medicare & Medicaid Services on 4/4/24This document has a comment period that ends in 53 days, 5/28/24.This proposed rule would update the hospice wage index, payment rates, and aggregate cap amount for Fiscal Year (FY) 2025. This rule proposes changes to the Hospice Quality Reporting Program. This rule also proposes to adopt the most recent Office of Management and Budget statistical area delineations, which would change the hospice wage index. This rule proposes to clarify current policy related to the “election statement” and the “notice of election”, as well as to add clarifying language regarding hospice certification. Finally, this rulemaking solicits comments regarding potential implementation of a separate payment mechanism to account for high intensity palliative care services.

Lutheran Senior Services/Diakon agreement forms one of largest US nonprofit LTC organizations McKnights Senior Living, by Kathleen Steele Gaivin; 3/29/24 Diakon Senior Living operations and its four continuing care retirement / life plan communities will become part of Lutheran Senior Services under an agreement ... that the organizations say will create one of the largest nonprofit senior living and care organizations in the country. The transaction is pending regulatory approvals and is expected to close this summer.

Home care providers hail bill establishing standard classification for direct support workers McKnights Home Care, by Adam Healy; 4/3/24 The Senate last week passed legislation that would address the dire shortage of direct support workers with the establishment of a classification to help stakeholders collect workforce data. Specifically, if signed into law, the Recognizing the Role of Direct Support Professionals Act would require the Office of Management and Budget to consider establishing a standard occupational classification (SOC) for direct support professionals (DSPs). This classification would make it easier for policymakers to gather useful data about these workers and help them better address critical workforce challenges.

Bereaved Parent Support Study: Seeking Participants Sylvester Comprehensive Cancer Center/University of Miami Miller School of Medicine, Memorial Sloan Kettering Cancer Cancer, St. Jude Children's Hospital, and Children's Hospital of Philadelphia; 4/2/24This program is offered as a research study examining three types of support for bereaved parents who have lost a child to cancer. This is a National Institutes of Health-funded trial taking place at Sylvester Comprehensive Cancer Center/University of Miami Miller School of Medicine, Memorial Sloan Kettering Cancer Center, St. Jude Children's Hospital, and Children's Hospital of Philadelphia; however, families need not have received care from one of these institutions. ... For those assigned to receive counseling, services will be provided through videoconferencing, and all study activities can be completed from the participant’s home. ... There will be no charge for any support offered through the study. ... [Click on the title's link for more information.] Editor's Note: If your hospice does not have bereavement services tailored to the needs of parents who have lost a child, consider this opportunity for free support from these reputable sources. Click on the title's link for eligibility requirements and descriptions.