Literature Review

Impact of transition to home palliative care on patient support and prescriptions Physician's Weekly; 12/19/24 The following is a summary of “Evaluating the Benefits of Transition to Home Palliative Care: Pharmacological Prescriptions, Social, and Psychological Support Post-Referral,” published in the November 2024 issue of Primary Care by Ribeiro et al. Community palliative care teams provide at-home care based on referral criteria that prioritize functional status and clinical complexity. They focus on patients with limited benefit from continued hospital care. Researchers conducted a retrospective study to assess the quality of referrals and the transition to community palliative care teams. ... They concluded that most complex patients were successfully monitored and died at home, with hospital deaths reserved for exceptional cases. There was no significant difference in the biopsychosocial approach between patients followed by various palliative care teams, indicating varying approaches. 

Weekly US Map: Influenza summary updateCDC - U.S. Centers for Disease Control and Prevention; ongoing, retrieved from the internet 12/16/24A Weekly Influenza Surveillance Report Prepared by the Influenza Division Editor's note: Bookmark this page to your web browser to monitor flu activity in your service areas through these more vulnerable winter months. Click on the map's "State" button for macro data at the state level. Click on the map's "CBSA" to drill down to counties.

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.,

What they love and loathe: Medscape Nurse Career Satisfaction Report 2024 Medscape; by Jon McKenna; 12/13/24 Despite well-publicized issues buffeting their profession, nurses in a Medscape survey overwhelmingly said they are happy with their career choice, and most said they would make it again. They also told us about their most- and least-favored job features, recounted any experiences with abuse at work, revealed possible alternative careers, and reported union membership, among other insights. [Click on the title's link to continue reading.]

UConn John Dempsey Hospital joins National Age-Friendly Health System Movement UConn Today; by Jennifer Walker; 12/12/24 UConn John Dempsey Hospital was recently accepted for participation in the national Age-Friendly Healthy Systems Movement to improve health care for older adults. The Age-Friendly Health Systems Movement, sponsored by The John A. Hartford Foundation and the Institute for Healthcare Improvement in partnership with the American Hospital Association and the Catholic Health Association of the United States​, is a national collaboration of hospitals and health systems implementing a set of evidence-based interventions to make the care of all older adults equitable and age-friendly. This initiative addresses the reality that a growing proportion of the US population is elderly and has complex healthcare needs which challenge many institutions. This movement is built upon a framework of a set of four best practice interventions known as the 4Ms.

HSPN Staffing Summit: Leveraging technology for person-centered care Hospice News; by Sophie Knoelke; 12/9/24 This article is sponsored by CareXM. This article is based on a virtual discussion with Kathleen Benton, President and CEO of Hospice Savannah. ... Dr. Benton has a master’s degree in medical ethics and a doctorate in public health. She has offered and reviewed many publications relevant to the topics of palliative care, ethics, hospice, and communication. [Dr. Benton:] I was schooled in clinical ethics and really mediating ethical dilemmas in health care. Looking at, is this in the best interest of the patient? Are we truly following the patient’s wishes? Many of the dilemmas, I would say a good 90%, occur at the end of life. ... [At] the root of [really trending] cases was one missing element. That element was the lacking area of communication. What do I mean by that? I believe that health care does the worst job of probably all other areas of communicating with folks. We have really taken what it is to be human out of what it is to treat a patient and a person. [Click on the title's link to continue reading this insightful discussion.]

Homebound seniors living alone often slip through health system’s cracks KFF Health News; by Judith Graham; 12/2/24 Carolyn Dickens, 76, was sitting at her dining room table, struggling to catch her breath as her physician looked on with concern. “What’s going on with your breathing?” asked Peter Gliatto, director of Mount Sinai’s Visiting Doctors Program. “I don’t know,” she answered, so softly it was hard to hear. “Going from here to the bathroom or the door, I get really winded. I don’t know when it’s going to be my last breath.” Dickens, a lung cancer survivor, lives in central Harlem, barely getting by. She has serious lung disease and high blood pressure and suffers regular fainting spells. In the past year, she’s fallen several times and dropped to 85 pounds, a dangerously low weight. And she lives alone, without any help — a highly perilous situation. Across the country, about 2 million adults 65 and older are completely or mostly homebound, while an additional 5.5 million seniors can get out only with significant difficulty or assistance. ... It’s a population whose numbers far exceed those living in nursing homes — about 1.2 million — and yet it receives much less attention from policymakers, legislators, and academics who study aging.

Health system C-suites channel 'hospitality energy' for next year Becker's Hospital Review; by Laura Dyrda; 11/27/24 Health system C-suites are taking their organizations "back to the basics" next year to focus on improving quality outcomes and creating an elite patient experience. This means prioritizing a culture of service and training staff in hospitality. Cliff Megerian, MD, CEO of University Hospitals in Cleveland, said the system has focused on reducing variation in care pathways and optimizing clinical services for maximum quality, safety and efficiency this year, an effort that will continue into 2025. University Hospitals is also doubling down on its reputation for compassionate care, said Dr. Megerian. "The goal is for our patients – our guests – to feel truly cared for at each touchpoint along the patient journey, with clinical and non-clinical caregivers alike both bearing the responsibility to make this happen," he said. "The word 'hospitality' has at its root the word 'hospital' — it's our goal to work to bring that 'hospitality' energy to our work in healthcare, always informed by world-class science."Editor's note: The Latin root word described is "hospitium," which branched into contemporary words "hospitality," European "hostels" for travelers, "host," "hotels," and yes, "hospice." At its core, hospitium refers to travelers on a significant life journey, tended by compassionate hosts who provide rest and nourishment. Click here for more information, which emphasizes the relationship between the host and the guest.

Hospital at home saves lives and money: CMS report American Medical Association; by Jennifer Lubell; 11/22/24 A federal report to Congress on the Acute Hospital Care at Home initiative shows that at-home acute care produces lower mortality rates and post-discharge spending than traditional inpatient care while also yielding positive feedback from patients and caregivers. The Centers for Medicare & Medicaid Services (CMS) launched the home-care initiative in response to the COVID-19 public health emergency, granting waivers to individual hospitals to provide Medicare patients with inpatient-level home care. With 358 approved hospitals across 137 health systems in 39 states since its start in November 2020, this innovation in care delivery has become an important feature of the Medicare program. ... Importantly, these programs demonstrate clinically, and often more cost-effective care. “Numerous studies have demonstrated that many types of care that are currently delivered in an office or facility could be provided at home, with clinically appropriate, high quality, and cost-effective outcomes,” wrote the authors of the AMA report. About 15–20% of emergency and urgent care services and up to 35% of hospice services are capable of being administered at home. As home care continues to evolve, this service could provide up to 25% of post-acute and long-term care in the home. 

New Health Equity Guide from Center to Advance Palliative Care provides a roadmap to transform care for black patients with serious illness Cision PRWeb; by Center to Advance Palliative Care; 11/13/24 Having medical concerns dismissed, not being believed when reporting pain, and facing multiple barriers to care are just three of the experiences reported to Center to Advance Palliative Care (CAPC) in a focus group of Black patients with serious illness. In fact, when Black people in the United States are living with a serious illness like cancer, heart failure, or dementia, they experience disproportionately high suffering compared to white patients—often due to poor pain management, low-quality communication from their care teams, and high family caregiver burden. To address these inequities, CAPC has released a new, comprehensive guide, Advancing Equity for Black Patients with Serious Illness, to equip palliative care leaders and health equity change agents with practical tools to implement meaningful change. Drawn from research, examples of health equity initiatives from across the country, and the wisdom of health equity leaders, the guide provides a practical roadmap for transforming care for Black patients, and their families and caregivers.

“I’m 68 and totally alone”: 50 people share what it’s like being seniors AOL.com - Bored Panda; by Dominyka; 11/9/24 People are different in their upbringing, in their tastes, even in their looks. But all people do have one thing in common: we're all heading towards the same end. With the exception of Bryan Johnson, maybe. Still, we're all aging, whether we like it or not. And with aging comes social isolation; according to a 2024 Medicare report, 57% of adults aged 65 and older report feeling lonely. The users of Quora recently tackled this problem when one person wrote: "I'm 63 years old and so lonely. Does it matter to anyone?" Many older people rushed to the comments to share their stories, highlighting the sad realities they face today. Bored Panda sought the expertise of the anti-ageism activist Jacynth Bassett, Founder and CEO of Ageism Is Never In Style about how important social connections are to us as we age. We also spoke with her about the right terminology when referring to older people and how we can all spot ageist attitudes in ourselves. 

Most heart failure patients miss out on guideline-recommended palliative care Cardiovascular Business; by Dave Fornell; 11/6/24 Over the past decade, the American Heart Association (AHA) and European Society of Cardiology have recommended integrating palliative care into heart failure management. Despite these recommendations, the use of palliative care for heart failure remains low in the United States. Racial and geographic variations in access and use of palliative care are also pronounced, highlighting health disparities. These were the findings of a recent study in the Journal of the American Heart Association. Researchers at Saint Louis University led the study and said only one in eight patients with heart failure in the United States receive palliative care consultations within five years of diagnosis. Their study highlights the alarmingly low uptake of palliative care among adults with heart failure in the U.S., especially compared to patients with cancers that have the same mortality rates. The study also pointed out significant racial and geographic disparities. Black patients were 15% less likely to receive palliative care compared to their white counterparts. They said this disparity is particularly concerning given the higher cardiovascular risk and mortality rates in the Black population.

As IV shortage continues after hurricane, U.S. invokes wartime power to speed recovery CBS News; by Alexander Tin; 10/15/24 The Biden administration says it has invoked the wartime powers of the Defense Production Act to speed rebuilding of a major American factory of intravenous fluids that was wrecked by Hurricane Helene last month. Damage to the plant in North Carolina has worsened a nationwide shortage of IV fluids, and hospitals say they are still postponing some surgeries and other procedures as a result. Some 60% of the nation's IV supplies had relied on production from the plant, run by medical supplier Baxter, before it was damaged by the storm. "Ensuring people have medical supplies they need is a top priority of the Administration. It's exactly why we are working closely with Baxter to support cleanup and restoration of the facility, including invoking the Defense Production Act to help production resume as quickly as possible," an official with the Department of Health and Human Services told CBS News on Tuesday.