Literature Review

Mission Health permanently shutters Asheville specialty hospital NC Health News; by Asheville Watchdog; 11/30/24 Long-term care facility was only one of its kind in western North Carolina; patients will have to seek care elsewhere.  Mission Health has permanently closed Asheville Specialty Hospital, the only long-term acute care hospital in western North Carolina, less than two months after suspending its services following Tropical Storm Helene. “We have made the difficult decision to not reopen Asheville Specialty Hospital, a small, long-term acute care facility located inside the St. Joseph’s campus,” Mission Health spokesperson Nancy Lindell said Nov. 25. “We have had to focus on prioritizing our resources during and after Hurricane Helene to care for the most urgent medical needs of our community." ... The next closest long-term acute facility, or LTACH, is in Greenville, South Carolina, a little more than 60 miles away. 

Michael Dowling: We've revolutionized care for aging adults, but is America's health system ready for the senior population boom? Becker's Hospital Review; by Michael J. Dowling, President and CEO, Northwell Health; 12/2/24 Like many baby boomers and those from earlier generations, I have vivid memories from my younger years of my grandparents and other aging adults struggling with an assortment of ailments that their doctors told them were just an inevitable part of growing old. ... The transformative advancements made over the past half-century in meeting the physical and emotional health needs of the nation's rapidly aging population are remarkable — and that's especially important because more Americans are turning age 65 now than in any other time in our history (4.1 million in 2024, or 11,200 a day). And as we move toward a new year, every healthcare executive must examine whether we are collectively prepared to care for them in the years and decades ahead and take steps to recruit the medical specialists we need to meet burgeoning demand. ... Lastly, all clinicians must embrace palliative care as part of their standard practice in managing the health of aging adults with serious illness. ... 

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.

It gives you a really great feeling, knowing that what you are doing is making somebody's day: Provider perspectives on implementing the individualized positive psychosocial interactionPsychological Services; Cassandra Keiser, Molly Noble, Kimberly VanHaitsma, Katherine M Abbott; 11/24The Individualized Positive Psychosocial Interaction (IPPI) is an evidence-based program that supports engaging people living with dementia and their care partners in the nursing home (NH). IPPIs are brief, one-to-one, preference-based activities to improve well-being and decrease behavioral and psychological symptoms of dementia. Champions voiced that the IPPI program was cost-effective, adaptable to their local contexts, and provided training to staff to support residents experiencing distress. Overall, the IPPI program goals are aligned with nursing home organization goals, supporting staff in providing comfort to residents communicating distress, and can be feasibly implemented.

No One Dies Alone: new Parker hospital program offers companionship to those at the end of life Parker Chronicle; by Haley Lena; 11/27/24 Katherine Wiley, a volunteer at AdventHealth Parker, was in the hospital’s emergency department when she saw first-hand how being alongside a stranger during their final moments of life can have a profound impact on those around them. Wiley sat with an elderly woman who was dying with no one around. The patient’s sons were trying to get to the hospital from Colorado Springs but didn’t make it in time. “When they got there, I told them that I had been with their mom so she was not alone and they were very grateful,” said Wiley. Wiley shared this story with the CEO of the hospital, Michael Goebel, at the annual volunteer luncheon last year, and the following week, the No One Dies Alone program was being set up. “We can provide companionship to patients in the dying process who are truly alone,” said Wiley. “In doing so, (it) provides a gift of respect and dignity to another human being at the end of life.” The volunteers of the program are called “compassionate companions.” They do not provide medical care, but they assist with comfort care measures – they sit beside the patient, hold their hands, play soothing music or read to the patients. For as many circumstances there are that lead a person to be hospitalized, there are also as many reasons why a patient is alone. The patient could have outlived other family members and friends, said Wiley, or are estranged from their family. It could be because the patients themselves don’t want to have their family see them die, but don’t want to be alone. Or they could be a John/Jane Doe who was in an accident. “We want to be there for them, whatever those reasons are,” said Wiley. “This sort of thing feeds my soul.”

Hospice expands compassionate care for nursing home residents McKnights Long-Term Care News; by Liz Barnett and Mat Zucker; 11/22/24 Nursing homes are places of care, community and compassion, particularly for residents in their final stages of life. As we recognize National Hospice and Palliative Care Month, it’s an opportune time to consider how nursing homes can broaden the support they provide by better incorporating hospice services. Hospice offers a path to comfort and dignity at the end of life, yet many families have insufficient information about these services. Our mother, Leslie, benefited from hospice care early this year when her gallbladder cancer no longer responded to treatment. This journey revealed just how powerful hospice can be, not only for the patient but for our entire family. Nursing home staff and administrators can play a crucial role in helping families like ours make informed, compassionate choices like this for their loved ones.

Nursing homes with more black residents lag in care goal discussions Medical Xpress; by Columbia University Irving Medical Center; 11/20/24 New research from Columbia University School of Nursing published in the American Journal of Hospice and Palliative Medicine shows that timely goals of care discussions are less likely to take place in nursing homes with a higher percentage of Black residents. These discussions are crucial to ensuring that nursing home residents receive care that aligns with their wishes, postdoctoral research fellow Jung A. "Chloe" Kang, Ph.D. '24, Professor Patricia Stone, Ph.D., and their colleagues note in the report, published online September 15, 2024. But these conversations are often delayed until patients experience life-threatening events, the authors add, which can lead to unwanted therapies and unnecessary hospitalizations. ... 

BREAKING: CMS issues ‘significant’ survey changes for 2025 [long-term care] McKnights Long-Term Care News; by Kimberly Marselas; 11/19/24 The Centers for Medicare & Medicaid Services on Monday issued “significant revisions” to its long-term care surveyor guidance, with changes affecting everything from admission and discharge standards to the use of psychotropic medications and newly adopted infection prevention practices. CMS released an advance copy of the 900-page document online, including new critical element pathways, to give providers and surveyors time to adjust to the new requirements before they go into effect Feb. 24, 2025. A significant portion of the changes is related to chemical restraints and unnecessary psychotropic medication.

Grant helps launch paramedicine program for patients in need Westfair Business Journal, Sleepy Hollow, NY; by Westfair Online; 11/15/24 Northwell Phelps Hospital received a $125,000 grant from the Phelps Community Foundation to help launch the Westchester Community Paramedicine Program. ... They will utilize remote physiological monitoring to track blood pressure, oxygen saturation and cardiac rhythms, providing convenient and cost-effective care compared to emergency room visits. “This program is designed to address the gap in access to primary and nonemergency medical care for vulnerable populations,” said Barry Geller, M.D., chair of the emergency department and associate medical director at Phelps Hospital. ...  The initiative will first focus on patients served by Phelps’ palliative care, geriatric and emergency medicine programs with plans to expand service to cancer patients. It is expected to reach approximately 200 individuals during the first year, ...

Former employees speak out after 89-year-old woman disappeared from care facility, then died WSB-TV 2 Atlanta, GA; by WSBTV News Staff; 11/12/24 An 89-year-old woman died after she disappeared from the facility that was supposed to keep her safe. ... Lee worked for the Marietta Police Department when he and his team searched for a woman who disappeared from the Greenwood Place Assisted Living and Memory Care facility on Whitlock Avenue. ... Police reports reveal more than a dozen investigations at the facility over the past four years. Of those, two arrests were made for two different alleged crimes which include larceny and assault. “I didn’t think the care was at the level I was told it would be at,” Anthony Argano, who removed his dad from the facility, said. Argano said he pulled his dad out of the facility after staff forgot to turn his dad’s oxygen tank on, which he said resulted in a trip to the hospital and eventually a stay in hospice. ...

‘Everything is lining up’: Home-based care M&A expected to soar in near-term future Home Health News; by Audrie Martin; 11/11/24 Home health, home care and hospice M&A was historically high in 2021, with high valuations serving sellers and solid return on investment serving buyers. Transactions plummeted after that, but recent signs suggest M&A is beginning to pick back up across sectors. ... Sellers should expect questions about employee retention, the company’s track record of growth after M&A and whether their leadership has done due diligence before entering the race. ... Experts predict that large, founder-led home health and hospice businesses will be in high demand in the coming year. Larger home care companies, especially those that are Medicaid-funded, will also be in demand. 

Veterans and Alzheimer's: 6 lifestyle tips for staving off the disease NOLA.com, New Orleans, Louisiana; by Dana Territo; 11/11/24 Are veterans more prone to Alzheimer’s disease? According to the U.S. Department of Veterans Affairs, veterans are more likely to develop Alzheimer's disease and other dementias than the general public, and the number of veterans with Alzheimer's is expected to grow. For instance, in 2021, an estimated 457,391 veterans had Alzheimer’s disease, and that number is projected to increase by 8.4% to more than 488,000 by 2033. Age is the biggest risk factor for Alzheimer’s disease as a whole, and veterans are more likely to have health conditions that further increase that risk, including high cholesterol, traumatic brain injury, post-traumatic stress disorder and depression. Additionally, homelessness contributes to that risk as homeless veterans are more likely to have an Alzheimer’s diagnosis than those who are stably housed.

“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.