Literature Review

A mother’s goodbye-Barriers to microtransitions in careJAMA Internal Medicine; Aval-Na’Ree S. Green, MD, MHA, CMD; Benjamin E. Canter, OTD; 3/25After a long, debilitating battle with lupus, my cousin died at the doorsteps of our health system. The funeral was at 11:00 am. I arrived at the facility at 8:45 am. Although the catheter was in place, my aunt was undressed, with remnants of breakfast on her gown. She had not been bathed. The staff and I wheeled my aunt outside and attempted to load her into the van. Once my aunt was in the chair, it could not fit through the van door. Because this transition was not a medical health care appointment, the facility did not coordinate the resources, including use of the van, that were necessary for it to occur successfully. In contrast, had this been a medical outing, such as a weekend dialysis appointment, the facility would have been required to provide transportation. If this microtransition had been treated like a major health care transition, perhaps it would have had a better chance of success. Nursing teams use checklists during major care transitions; similar procedures should apply to microtransitions.

What role do immigrants play in the direct long-term care workforce? KFF; by Priya Chidambaram and Drishti Pillai; 4/2/25 President Trump has made a slew of immigration policy changes focused on restricting entry at the border and increasing interior enforcement efforts to support mass deportation. While these actions are focused on undocumented immigrants, they likely will have ripple effects across immigrants of all statuses and millions more people living in immigrant families. Mass deportations could negatively impact the U.S. economy and workforce, given the role immigrants play, particularly in certain industries. ...

Senior living demand hits all-time high: NIC McKnights Senior Living; by Kimberly Bonvissuto; 4/3/25 The demand for senior living is at an all-time high, with the first quarter seeing a record number of occupied units, almost 621,000, the National Investment Center for Seniors Housing & Care said Thursday afternoon [4/3]. Senior living occupancy rates increased 0.3 percentage points to 87.4% in the first quarter, up from 87.1% in the fourth quarter of 2024, according to the latest NIC MAP Senior Housing Market Fundamentals report. Independent living occupancy rose to 89%, up from 88.6% in the fourth quarter, whereas assisted living rates increased to 85.8% compared with 85.5% in the fourth quarter.

Strong social connections improve older adults’ well-being regardless of setting, study finds McKnights Long-Term Care News; by Donna Shryer; 4/7/25 Social connections, trust in others in their community and community cohesion significantly improve elderly well-being whether seniors live at home or in nursing facilities, according to a new comparative study published in BMC Public Health. However, researchers found that nursing home residents generally reported lower subjective well-being compared to their community-dwelling counterparts, even after accounting for health status and demographic factors. ... According to the authors, these findings “indicate the necessity for tailored interventions that address the unique needs of each care environment to promote healthier aging experiences. [Continue reading ...]

AGG talks: Home health & hospice podcast - Episode 10: Anti-Kickback Compliance for hospice and skilled nursing providers JD Supra; by Arnall Golden Gregory, LLP; 4/3/25 In this episode, AGG Healthcare attorneys Bill Dombi and Jason Bring discuss recent OIG guidance on hospice and skilled nursing facility relationships, focusing on anti-kickback risks and fraud concerns. They cover key issues such as the importance of documenting fair market value for any services or space provided, being cautious of payments exceeding Medicaid room and board rates, and avoiding arrangements that appear to be made solely to secure referrals. Bill and Jason also touch on increased oversight and enforcement in the healthcare sector under a new presidential administration.

Primary palliative care in assisted living and residential care-A metasynthesisJournal of Hospice & Palliative Nursing; David, Daniel PhD, MS, BSN; Jimenez, Vanessa MPH, BS; Brody, Abraham A. PhD, RN, FAAN; 3/25Assisted living (AL) and residential care (RC) settings are experiencing substantial growth as older adults with lower care needs seek alternatives to nursing homes. Despite this trend, there is a lack of skilled nursing care to support palliative care (PC) in these environments. Studies highlighted challenges and opportunities for delivering primary PC in these environments, emphasizing the importance of addressing physical symptoms, psychological distress, social isolation, and spiritual needs among residents with serious illnesses. The metasynthesis underscores the critical role of primary PC in enhancing quality of life and care continuity for older adults residing in AL/RC settings. It also identifies gaps in current practices and emphasizes the need for tailored interventions and training to support care providers in delivering comprehensive PC to this population. By integrating qualitative research findings with the National Consensus Project guidelines, this metasynthesis provides a comprehensive overview of primary PC in AL/RC settings.

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 ...]

White House cuts $12B in health funds: 5 updates Becker's Hospital Review; by Madeline Ashley and Kristin Kuchno; 3/26/25 HHS has abruptly canceled more than $12 billion in grants to state health departments that supported efforts to track infectious diseases, expand mental health services and modernize outdated systems, according to The New York Times. Late March 25, state health departments started receiving notices that $11.4 billion in grants from the CDC and roughly $1 billion in funds from the Substance Abuse and Mental Health Services Administration were being canceled immediately. “No additional activities can be conducted, and no additional costs may be incurred, as it relates to these funds,” the notices said, according to the Times. [Continue reading ...]

Calvary Hospital doubles down on palliative care and hospice expansion Becker's Hospital Review; by Kelly Gooch; 3/24/25 Michael Fosina began serving as president of Calvary Hospital in New York City in January, bringing decades of healthcare experience to the role. ... Mr. Forsina told Becker’s he’s excited about Calvary’s mission as the organization celebrates its 125th anniversary. Recently, the hospital integrated services with its parent organization, ArchCare, the healthcare ministry of the Archdiocese of New York. Mr. Fosina shared his perspective on Calvary’s role in New York and its future in meeting patient needs. ... [Michael Fosina described:] "ArchCare has all of the components of post-acute care when you include our end-of-life hospital and our hospice program. The integration allows us to accept patients, move patients around, have them stay connected with the physician — the team physician. So the transitions of care are not as dramatic as if you’re going from one organization to the next organization." [Continue reading ...]

From risk to resilience: Leveraging blockchain to safeguard patient data and drive interoperability Healthcare Business Today; by Krista Bowman; 3/21/25 The numbers tell a startling story. Over 42% of the U.S. population is estimated to have had their healthcare records compromised in 2024 alone, exposing critical vulnerabilities within systems meant to protect patient privacy. A staggering 146 million records were impacted in 13 high-profile data breaches, including the largest healthcare breach in history at Change Healthcare, which affected an estimated 100 million individuals. ... In the U.S., a few healthcare companies are exploring blockchain applications. Humana, MultiPlan, Optum, Quest Diagnostics, and UnitedHealthcare have formed the Synaptic Health Alliance to explore the use of blockchain technology to modernize provider data management.

Hastening death by stopping eating and drinking: Hope Wechkin, Thaddeus Pope, and Josh Briscoe GeriPal Podcasts; by Hope Wechkin, Thaddeus Pope, and Josh Briscoe Eric and Alex have featured discussions about complex bioethical concepts around caring for people at the end of life, including voluntarily stopping eating and drinking (VSED), and multiple episodes about the ethical issues surrounding medical aid in dying (MAID). Recently, discussion has emerged about how these issues intertwine in caring for patients with advancing dementia who have stated that they would not want to continue living in that condition: for those with an advanced directive to stop eating and drinking, how do we balance caring for their rational past self and their experiential current self? Should these patients qualify for medical aid in dying medications? And is there a middle path to provide some degree of comfort while also hastening the end of life?

Weinstein Hospice launches innovative VR initiative: The program will allow residents to enjoy "bucket list" experiences Atlanta Jewish Times; by AJT Staff; 3/12/25 Jewish HomeLife and Weinstein Hospice are pioneering a new way to bring joy, comfort, and meaningful experiences to hospice patients through the groundbreaking Weinstein Hospice VR Initiative. This transformative program harnesses the power of virtual reality (VR) to fulfill unforgettable “bucket list” experiences, offering patients moments of joy and cognitive stimulation that transcend their physical limitations. For Vicki and Ed A., this initiative has been nothing short of miraculous. ... One of the most profound moments for Ed came when he was able to experience Scuba diving again—virtually. ...