Literature Review

Risky business: Home sweet home or nursing home? American Nurse - Perspectives; by Christopher Hirschler, PhD, MCHES; 7/18/24 In 2018, “Nursing homes: Good intentions, sad realities” chronicled Rita Hirschler’s experience in a nursing home after decades of being a private care nurse. In response to the ideas espoused in the article, namely that a person has a right to live and die in their home and risks are unavoidable whether one lives at home or in a nursing home, a commentator asked, “What is the solution?” ... According to the Center for Medicare Advocacy and Lu and Lu, ownership and sponsorship type have been shown to significantly impact the quality of care in nursing homes, with for-profits generally having lower staffing levels and poorer patient outcomes. The Centers for Disease Control and Prevention, Meyer, and KFF Health News say for-profit nursing homes now account for approximately 72% of the more than 15,000 U.S. nursing homes, and they provide varying levels of care to 1.3 million residents. 

Cedar Rapids nursing home worker needlessly exposed to infectious disease, judge rules The Gazette; by Clark Kauffman, Iowa Capital Dispatch; 7/16/24 A social worker for an Iowa nursing home was justified in quitting after the facility failed to inform her and others of residents who had serious, contagious diseases, according to a judge’s ruling. State records indicate Mary Lovejoy Castaneda was employed by the nursing home chain Care Initiatives as a full-time social worker at Cedar Rapids’ Heritage Specialty Care from March through May of this year. She resigned after citing “stress and anxiety” related to the job, which entailed working with hospice patients. ... [Additionally,] when Care Initiatives hired Castaneda the company assured her it would refrain from assigning her hospice patients, only to later begin doing so. Editor's Note: Yes, lack of information about patients with "serious, contagious diseases" with the need to wear PPE is a significant offense. However, the social worker employee requesting [refusing?] to serve hospice patitents within a nursing home facility raises significant ethical concerns about care for patients and their families. The staff/patient ratio for social workers in a nursing facilities requires extensive, broad coverage. Click on the title's link to continue reading.

Fewer deaths after serious illness in veterans treated with PARC Care Model U.S. Medicine; by LaTina Emerson; 7/11/24 After a serious illness, veterans who received medical care via the Post-Acute Recovery Center (PARC) model experienced fewer deaths and more days outside of the hospital compared to those not treated with PARC, according to a recent study. ...  Using telehealth, PARC is administered by nurse practitioners to address the complex needs of intensive care unit (ICU) survivors as they transition from hospital to home and improve access to post-ICU care for high-risk veterans, ... Each year, “more than 100,000 veterans transition from ICUs to their home after treatment for life-threatening illnesses, but this transition presents many challenges, including unresolved acute medical issues and the lingering effects of acute organ dysfunction,” according to the study authors. ... 

Caregiver charged with abusing dementia patient The Freeman, Waukesha County, WI; by Freeman Staff; 7/9/24 A West Allis woman has been charged after she allegedly struck a dementia patient in her care and put a pillow over the woman’s face out of frustration. Erica Junger, 22, was charged Monday in Waukesha County Circuit Court with a count of intentionally abusing a patient, and faces up to six years in prison if convicted. She made an initial appearance in court Monday, where she was released on a $2,500 signature bond and ordered by Court Commissioner David Herring not to work in any job where she is responsible for the health care and safety of others. ... She said she "snapped" and did things she wasn’t supposed to do, but didn’t mean anything by it. ... The complaint did not identify the facility where the incident took place. But it did identify Junger as an employee of Agrace Hospice, which contracts with the facility.

A professional’s perspective: Ageism within the healthcare system; does it exist? Northern Kentucky Tribune; by Jeff Rubin; 7/6/24 A friend of mine named Dee recently shared with me a particularly unpleasant experience she had with a young hospital discharge planner regarding her 97-year-old mom in California. It appears Dee had a heck of a time trying to get her mom discharged to home health care rather than hospice, even though the particular care she needed could have been better delivered at home. A geriatrician by training, Dee ... recognized the invaluable role of hospice in providing end-of-life care. However, the situation she found herself in was less a question of end-of-life and more of palliative care. ...  A recent study in the US sampling 2,035 individuals between 50 and 80 years of age revealed that 93.4% experienced ageism firsthand. Their perception extended to professionals like doctors, nurses, therapists, social workers, and psychologists whose services included working with older people. [Click on the title's link for significant data, descriptions, and resources.]

Long-term care providers among 193 criminally charged, $2.75 billion in fraud recoveries so far in 2024McKnight's Senior Living; by Kathleen Steele Gaivin; 7/1/24The Justice Department has recovered more than $2.75 billion in false claims against healthcare providers and charged 193 defendants so far this year in criminal cases through its 2024 National Health Care Fraud Enforcement Action, and many of the cases involve nursing homes, home health or hospice agencies, and assisted living providers, according to a Thursday report from the department’s criminal division.

Nursing Home Star Ratings and end-of-life care quality: Lessons learned from the Veterans Health AdministrationJournal of the American Medical Directors Association; by Joan Carpenter, Daniel Kinder, Dawn Smith, Mary Ersek, Melissa Wachterman, Joshua Thorpe, Donald R Sullivan, Jennifer Bailey, Scott Shreve, Ann Kutney-Lee; 6/24Our findings suggest that the current [VA nursing homes, known as Community Living Centers (CLCs)] star rating system is not sufficient to assess the quality of EOL care. [The VA's Bereaved Family Survey (BFS)] scores, or a comparative EOL quality of care measure, should be integrated into CLC quality rating systems.Publisher's Note: If the VA is integrating an EOL quality measure into their NF Star Rating, should Medicare?

Grief care efforts should include settings outside of hospice, provider group say McKnights Senior Living; by Kimberly Bonvissuto; 7/3/24 If standards are developed for high-quality bereavement and grief care, they must apply to settings outside of traditional hospice care, such as affordable senior housing, where there is a “critical lack” of mental health services. That’s according to LeadingAge, which submitted comments last week to the Agency for Healthcare Research and Quality on a draft report from a research project that will inform an independent panel that will develop standards for high-quality bereavement and grief care. Katy Barnett, LeadingAge director of home care and hospice operations and policy, highlighted the need for cross-continuum grief and bereavement assessments, interventions and resources, including in settings outside of traditional hospice care, such as affordable senior housing.

Chronic loneliness and the risk of incident stroke in middle and late adulthood: a longitudinal cohort study of U.S. older adults eClinical Medicine, Part of THE LANCET Discovery Science; by Yenee Soh, Ichiro Kawachi, Laura D. Kubzansky, Lisa F. Berkman, and Henning Tiemeier; 6/24/24 Loneliness has been implicated as a stroke risk factor, yet studies have examined loneliness at only one time point. The association of loneliness changes and risk of incident stroke remains understudied. Our aim was to examine the association of loneliness with incident stroke, particularly the role of loneliness chronicity. Chronic loneliness was associated with higher stroke risk independent of depressive symptoms or social isolation. Addressing loneliness may have an important role in stroke prevention, and repeated assessments of loneliness over time may help identify those particularly at risk.Editor's Note: This is the source research for an article we posted yesterday, 6/28/24, titled 

Chronic loneliness can raise stroke risk in older adults, findings show McKnights Long-Term Care News; by Kristen Fischer; 6/24/24 A new study links loneliness to stroke risk, showing that those who are regularly lonesome have a 56% higher risk for stroke than those who are more socially connected. Situational loneliness wasn’t linked to a higher risk for stroke, which indicates that the stroke risk stems from chronic loneliness. Investigators led by a team from Harvard T.H. Chan School of Public Health published their report Monday in eClinicalMedicine. Research has already linked loneliness to an increased risk for cardiovascular disease. The new report is one of the first to evaluate the association between loneliness and stroke risk.

Hospice of Marion County trains first responders to care for dementia patients Hospice News; by Jim Parker; 6/18/24 Florida-based Hospice of Marion County, an affiliate of Empath Health, is training first responders in its community on how to treat dementia patients. For several years, the nonprofit hospice has been educating family caregivers and others in their community about the experiences of dementia patients and how to better interact with them. More recently, Hospice of Marion County [Ocala, Florida] has been expanding that training to include local law enforcement and fire departments, as well as medical students and staff at assisted living facilities, among others. The training uses a series of tools to simulate symptoms of dementia, related to visual, tactile, auditory senses, their ability to process information and perform certain tasks. The education helps first responders address the unique challenges associated with caring for dementia patients, according to Dr. Mery Lossada, chief medical officer of Hospice of Marion County.Editor's Note: Bravo, Hospice of Marion County!

Nursing homes are left in the dark as more utilities cut power to prevent wildfires News-Medical.net; by KFF Health News; 6/10/24 When powerful wind gusts created threatening wildfire conditions one day near Boulder, Colorado, the state's largest utility cut power to 52,000 homes and businesses — including Frasier, an assisted living and skilled nursing facility. It was the first time Xcel Energy preemptively switched off electricity in Colorado as a wildfire prevention tool, according to a company official. The practice, also known as public safety power shut-offs, has taken root in California and is spreading elsewhere as a way to keep downed and damaged power lines from sparking blazes and fueling the West's more frequent and intense wildfires. 

Palliative care considerations in frail older adults Annals of Palliative Medicine; by Andrew E Russell, Rachel Denny, Pearl G Lee, Marcos L Montagnini; 6/6/24, online ahead of print...This paper aims to guide clinicians in providing patientcentered care for older adults with frailty in the outpatient setting. Through a comprehensive literature review, we describe the leading models of frailty, frailty screening tools used in the clinical setting, and the assessment and management of palliative care needs in frail patients. We also describe emerging models of care focusing on palliative care for older adults with frailty and discuss issues related to access to palliative care for this population.