Literature Review

Hospice of Baton Rouge: New grief center opens offering vital support and healing Unfiltered With Kiran, Baton Rouge, LA; by Megan Kelly; 11/25/24 As the holiday season approaches, a time often filled with joy and togetherness, it can also be a profoundly challenging period for those experiencing grief. The Hospice of Baton Rouge has recognized this need and has transformed a property into a haven of healing: The Retreat at Quarters Lake. This newly established grief center aims to address the significant gap in resources for grieving individuals, a void that became especially apparent during the COVID-19 pandemic. “The Retreat at Quarters Lake provides hope, healing, and connectivity for the grieving through counseling, support groups, alternative grief therapies, and community education,” reads a statement on their website. The facility offers both traditional grief services, such as individual counseling and support groups, and unique, holistic approaches that include art therapy, music therapy, and pet therapy. The goal is to provide a comprehensive support system that caters to individuals of all ages and backgrounds. “We are focusing on some alternative therapies like yoga, meditation, gardening, and even fishing,” said Catherine Schendel, CEO of The Hospice of Baton Rouge. “We want to utilize the beautiful landscaping here to offer non-traditional grief support as well.” 

Thanksgiving Day is a good day to recommit our energies to giving thanks and just giving. ~Amy Grant, quoted here

How to manage sibling relationships strained by family caregiving AARP; by Christine A. Di Pasquale; 11/25/24 ... Conflict around caregiving is not unusual, especially between sisters, says Megan Gilligan, Ph.D., an associate professor of Human Development & Family Science at the University of Missouri. Gilligan is a co-author of the longitudinal Within-Family Differences Study that looks at understanding the “relationships between parents and their adult children and grandchildren, as well as between siblings in adulthood.” Gilligan and her colleagues found that sisters tend to be more critical of one another than sons when it comes to parental caregiving. “Daughters are raised with a sense of expectation, obligation, of wanting to provide that care and wanting that care to look a certain way,” she explains. “And we found that when multiple daughters were involved in care, maybe sometimes they’re kind of stepping on each other’s toes whereas … sons were more likely to kind of step back and let sisters navigate that,” she says. ... Gilligan suggests that we replace the idea of equality with equity in caregiving. Siblings should ask what the parents want each child to do and then divide that work equitably if not equally in order to reduce sources of stress for the ailing parent and among siblings.

The Alliance applauds Gerald’s Law passing through Congress National Alliance for Care at Home (the Alliance; formerly NAHC and NHPCO); Press Release; 11/19/24 The National Alliance for Care at Home (the Alliance) celebrates the historic passage of H.R. 8371, the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act in the U.S. House of Representatives last night with a bipartisan vote of 389-9. This landmark legislation includes Section 301, Gerald’s Law, which addresses a critical gap in benefits impacting seriously-ill veterans and their families receiving hospice care. The story of Gerald “Jerry” Elliott, a U.S. Army veteran, underscores the importance of this legislative achievement. Diagnosed with cancer, Jerry was admitted to his local Veterans Affairs (VA) hospital in 2019 before transitioning to VA hospice care at home to be surrounded by his family. After his passing, his family discovered they were ineligible for full burial and funeral financial support because Jerry died outside of a VA facility.

Navigating the aftermath of natural disasters Teleios Collaborative Network (TCN); by Lara McKinnis; 11/15/24 This morning I woke up to two bears outside, a little cub sitting on our front steps eating the pumpkin that my daughter recently carved, the mom nearby completely sprawled out lounging in the sun in a bed of freshly fallen yellow and orange oak leaves.  This is the “fall” that I look forward to every year in Asheville. I wanted to hold onto this feeling, all of us standing at our screened-in window talking to the bears as if they understood us, our dog enthusiastically joining in the conversation.  This feeling is alive and vibrant; however, so is the visceral awareness of the horrific despair that has engulfed my beloved community and so many communities in Western North Carolina. ...  Adjusting to a natural disaster is nuanced and layered.  [Click on the title's link to continue reading this hospice leader's reflections and professional guidance.]Editor's note: We thank Lara McKinnis for raising our awareness to what matters most--large and small. We alert you to the needs of hospice and other healthcare needs as the Associated Press reports "Wildfire threat continues in much of the US Northeast as dry conditions persist."

Alzheimer Disease—What’s in a name?JAMA Neurology; Ronald C. Petersen, PhD, MD; Elizabeth Mormino, PhD; Julie A. Schneider, MD, MS; 11/24Back in 2018, the National Institute on Aging (NIA)–AA [Alzheimer Association] group proposed a biological definition of AD [Alzheimer Disease] stating that if a person had the biomarker evidence of brain amyloid (A) and tau (T), the pathologic hallmarks of the disease, the patient had AD irrespective of the person’s clinical state. In their recent 2024 revision, they maintain a biological definition but have extended it to incorporate more recent biomarkers for AD; ... positivity on core 1 biomarkers that indicate the crossing of a specific amyloid threshold on amyloid positron emission tomography (PET), cerebrospinal fluid, and foreseeably, plasma biomarkers. A major question pertains to the requirement for tau in the definition [as] the AA group argues that the vast majority of individuals who have amyloid-positive PET scans have some tau pathology. Furthermore, the AA group proposes a clinical staging scheme that provides a framework to define the frequent mismatch between AD biomarker positivity (and underlying neuropathology) and the clinical expression of the disease, often an indicator of mixed pathologies or resilience. Importantly, although the AA group does base the AD diagnosis on biomarker positivity, they do not currently advise testing in asymptomatic persons in a clinical setting.

Hospices leaders: ‘Vigilant’ compliance pivotal in MAC auditing climate Hospice News; by Holly Vossel; 11/18/24 e auditing environment has heated up in the hospice industry, with inconsistencies reportedly proliferating among the various types of regulatory enforcement activity — particularly those performed by Medicare Administrative Contractors (MACs). The issue has some hospice providers delving deeper into a range of compliance strategies. ... Hospices in recent years have seen a plethora of auditing types picking up steam in frequency, including MACs, Targeted Probe and Education (TPE), Supplemental Medical Review Contractors (SMRC), Unified Program Integrity Contractors (UPIC) and Recovery Audit Contractors (RAC). A main purpose of most audit types is to identify hospice providers with frequent errors on their billing claims or other activity that the U.S. Centers for Medicare & Medicaid Services (CMS) considers to be unusual.

Solo but not alone: An examination of social and help networks among community-dwelling older adults without close familyJournal of Applied Gerontology (J Appl Gerontol); by Jane Lowers, Duzhi Zhao, Evan Bollens-Lund, Dio Kavalieratos, Katherine A Ornstein; 11/31/2022... Nearly one in four adults is at high risk for aging without a spouse or children ... Previous descriptions of adults aging solo have focused on social isolation (Chamberlain et al., 2018; Roofeh et al., 2020), yet diverse, non-kin social networks can provide robust emotional and instrumental (task-oriented) support and such networks are becoming more common over time (Suanet & Antonucci, 2016; Verdery et al., 2019), although the type and intensity of support may vary by the type of relationship (e.g., kin vs non-kin) and factors including frequency of interaction (Wellman 1990). ... Therefore, as a first step, we sought to define the population of adults aging solo and compare its social networks and sources of help to adults with close family nearby. Editor's note: Though this article is from 2022, we are posting it due to our post on 11/13/24, Older Americans living alone often rely on neighbors or others willing to help, and our readers' frequent "most read" articles about seniors' challenges with isolation, depression, and caregiving challenges. 

Mother, doctor, CEO: one woman’s journey to reshape health care [podcast] MedPage Today's KevinMD.com; podcast by KevinMD; 11/16/24 We dive into the powerful story of a physician-mother whose world changed with the onset of COVID-19. Our guest, Arian Nachat, a palliative and emergency medicine physician, shares her journey through the pandemic, balancing the demanding roles of mother and doctor. From navigating childcare crises and homeschooling to reimagining her career beyond the confines of traditional health care, she sheds light on the struggles faced by frontline workers. Listen as she reveals how these challenges inspired her to reshape her path, create a health care company addressing critical system gaps, and advocate for a patient-centered, physician-led approach to medicine.

The Alliance applauds Gerald’s Law passing through Congress National Alliance for Care at Home (the Alliance; formerly NAHC and NHPCO); Press Release; 11/19/24 The National Alliance for Care at Home (the Alliance) celebrates the historic passage of H.R. 8371, the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act in the U.S. House of Representatives last night with a bipartisan vote of 389-9. This landmark legislation includes Section 301, Gerald’s Law, which addresses a critical gap in benefits impacting seriously-ill veterans and their families receiving hospice care. The story of Gerald “Jerry” Elliott, a U.S. Army veteran, underscores the importance of this legislative achievement. Diagnosed with cancer, Jerry was admitted to his local Veterans Affairs (VA) hospital in 2019 before transitioning to VA hospice care at home to be surrounded by his family. After his passing, his family discovered they were ineligible for full burial and funeral financial support because Jerry died outside of a VA facility.

Bringing stories to life, and death: Why animated movies are more than entertainment for kids The Stony Brook Press; 11/19/24 ... Whether it is the parents of the protagonist dying in the first few minutes in Frozen or the epic finale where the villain succumbs to a fatal fate like in The Hunchback of Notre Dame or The Princess and the Frog, it is somewhat of an oxymoron to call animated movies “childish,” as they often deal with serious topics. These movies are not outliers; there are videos dedicated to Disney’s “body count,” which counts how many characters have died in Disney movies. While these films may be magical or fantastical in plot, the moral truths of death and life covered in them often stir conversations about mortality. “Despite the fact that we would love to have people or animals or our loved ones forever, death is inevitable,” explained Bonnie Nickels, co-writer of the study End-of-Life in Disney and Pixar Films: An opportunity for Engaging in Difficult Conversation. “We can use these films as opportunities to introduce our young viewers and our young children to this idea.” To Nickels, these movies can create a dialogue between parents and children about dying and even model coping methods. “The fact that it’s a common feature in these films, kind of reiterates this idea that it’s common in life.” Editor's note: What movies will your intergenerational family watch through the holidays? This article's referenced study--"End-of-Life in Disney and Pixar Films"--describes, "A content analysis of 57 movies resulted in a total of 71 character deaths. For different generations, what reactions do you remember having experienced yourself, or from others? Bambi's mother. The Lion King's Mufasa. Frozen's parents of the two sisters. Coco's family members. Click here for a related article, "15 Saddest Disney Death, Ranked." 

Seven of thirty hospices reviewed did not comply or may not have complied with terms and conditions and federal requirements for Provider Relief Fund payments HHS Office of Inspector General; issued on 11/8/24, posted on 11/14/24Why OIG Did This Audit: The Provider Relief Fund (PRF), a $178 billion program, provided funds to eligible providers for health care-related expenses or lost revenue attributable to COVID-19. ... This audit is part of a series reviewing PRF payments to various provider types. Specifically, this audit assessed whether 30 selected hospices expended taxpayer funds in accordance with Federal and program requirements. ... What OIG Found: ... Of the 30 selected hospices, 23 hospices used PRF funds for allowable expenditures and lost revenues attributable to COVID-19; however, 7 hospices did not comply with or may not have complied with Federal requirements. Of these seven hospices, which received $98.1 million in PRF payments, six hospices claimed a total of $8.3 million of unallowable PRF expenditures and inaccurately reported $1.5 million of lost revenues, and one hospice claimed $4 million in expenditures that may not have been allowable. ... What OIG Recommends: We made two recommendations to HRSA, including that it require the selected hospices to return any unallowable expenditures to the Federal Government or ensure that the hospices properly account for these expenditures. ...

Homecare owner allegedly withholds $86k in wages HomeCare, Indianapolis, IN; 11/11/24 The U.S. Department of Labor (DOL) has alleged that home health care company owner Hahn March violated federal wage laws and withheld $86,000 in wages by using improper pay practices at her two Indianapolis, Indiana, companies: Signal Health Group Inc. and SHG Employee Leasing Company. In 2018, federal investigators cited March for not paying overtime wages to employees at her then-owned company, Aging and Disabled Home Healthcare. ... The complaint was filed following an investigation by the DOL Wage and Hour Division, which discovered March and Nancy Stanley, the chief financial officer of both companies, used an artificial regular rate pay scheme to lower hourly pay rates and, in turn, shortchanged employees $86,427 in overtime wages. ... The DOL is seeking $172,854—including $86,427 in back wages and an equal amount in liquated damages—for 43 current and former employees. ... “Employees who work in home health care—one of our nation’s lowest-paying professions—provide necessary daily and hospice care that allow individuals to remain in their homes and aid them in navigating their basic needs, providing dignity and comfort to clients and their families,” said Aaron Loomis, Wage and Hour Division district director.