Literature Review

Rosalynn Carter Institute redefines caregiving field with the launch of research informed profiles of experiences of caregiving© BusinessWire - Rosalynn Carter Institute for Caregivers, Americus, GA; by Ava Jafarmadar; 10/15/24 The Rosalynn Carter Institute for Caregivers (RCI) today announced the launch of the Profiles of Experiences of Caregiving© (Caregiver Profiles©), an innovative framework that leads within the caregiver field by reimagining and elevating family caregivers, so they are better seen, understood, and supported. Developed in partnership with Duke University through an extensive review of over 10,000 research papers and comprehensive caregiver focus groups, these profiles shift the focus from the care recipient’s diagnosis to the caregiver’s unique experience. This new approach aims to provide more tailored, holistic support to the over 105 million people in the United States who are actively engaged in family caregiving. 

Kaiser Health Care: Navigating Aging: Older men’s connections often wither when they’re on their own Tahlequah Daily Press; by Judith Graham; 10/12/24 At age 66, South Carolina physician Paul Rousseau decided to retire after tending for decades to the suffering of people who were seriously ill or dying. It was a difficult and emotionally fraught transition. … Seeking a change of venue, Rousseau moved to the mountains. … Soon, a sense of emptiness enveloped him. … His work as a doctor had been all-consuming. Former colleagues didn’t get in touch, nor did he reach out. His wife had passed away after a painful illness, … His isolation mounted as his three dogs, his most reliable companions, died. Rousseau was completely alone — without friends, family, or a professional identity — and overcome by a sense of loss. “I was a somewhat distinguished physician with a 60-page resume,” Rousseau, now 73, wrote in the Journal of the American Geriatrics Society in May. “Now, I’m ‘no one,’ a retired, forgotten old man who dithers away the days.” In some ways, older men living alone are disadvantaged compared with older women in similar circumstances. Research shows that men tend to have fewer friends than women and be less inclined to make new friends. Often, they’re reluctant to ask for help.

Home health providers, CMS raise red flags over delayed access Modern Healthcare; by Diane Eastabrook; 10/11/24 Delayed home health access for Medicare beneficiaries is increasingly raising alarms from the Centers for Medicare and Medicaid Services and the home health industry as providers place blame on staff shortages and the program's reimbursement rates. More than a third of Medicare fee-for-service beneficiaries referred to home health following hospitalizations did not receive services within seven days of discharge, according to an analysis of 2023 Medicare claims from healthcare analytics company CareJourney. The report echoes a similar study published by the Commonwealth Fund in July, as well as concerns CMS raised about access in its proposed 2025 home health pay rule. ... Years of low Medicare reimbursements are taking a toll on the home health companies trade groups represent, said William Dombi, president emeritus of the National Association of Home Care and Hospice, which is part of the National Alliance for Care at Home, and Cunningham.

Home health sector leads healthcare job growth in September: BLSMcKnight's Home Care; by Adam Healy; 10/7/24Last month, the number of jobs in home healthcare increased by 13,000. That compares with employment gains of 12,000 in hospital care and 9,000 in nursing and residential care facilities. Meanwhile, medical and diagnostic laboratories saw roughly 1,400 workers leave the field. There were approximately 1.8 million home healthcare workers in the US as of September, according to the BLS. That represents a roughly 8.6% increase in the number of home health jobs over the past 12 months.

Sixty-four Fla.-based healthcare facilities report evacuations  Healthcare Purchasing News - Regulatory; by Janette Wider; 10/8/24 Ahead of Hurricane Milton the Agency for Health Care Administration initiated an event in the Health Facility Reporting System. ... Health care providers have been requested to provide information on census, available beds, evacuation status, accepting evacuees and generator needs from counties declared under EO-24-114. This information allows AHCA to assist health care providers in transferring patients if needed and ensure that health care providers in impacted areas have the necessary resources and adequate power. 64 health care facilities have reported evacuations. This includes:

Temporary regulatory relief for South Carolina health care providers responding to Hurricane Helene Baker Donelson; Alissa D. Fleming; 10/4/24 South Carolina Governor Henry McMaster declared a State of Emergency on September 25, 2024, to prepare for Hurricane Helene. On September 29, 2024, the Federal Emergency Management Agency (FEMA) issued a Federal Major Disaster Declaration (FEMA-4829-DR) for South Carolina. On September 30, 2024, the United States Department of Health and Human Services (HHS) declared a public health emergency in South Carolina, and the Centers for Medicare and Medicaid Services (CMS) issued several blanket waivers to provide greater compliance flexibility and continuity of care while responding to Helene in the geographic area covered by the President's declaration. These waivers [detailed in the article] provide health care facilities with flexibility in service delivery, staffing, and patient care, aimed at alleviating the strain caused by Helene. Further, HHS, the South Carolina Department of Health and Human Services (SCDHHS), and other regulatory bodies have announced relief efforts, all aimed at reducing administrative burdens so providers can continue to care for and treat those in need. ...7. Hospices Assessment Timeframe Extension: CMS is extending the timeframe for updating comprehensive hospice patient assessments from 15 to 21 days, though initial and ad-hoc assessments must still be completed based on patient needs. ...Editor's note: Click on the title's link to continue reading. Other CMS waivers are defined for 1. General ... for Health Care Facilities; 2. Critical Access Hospictals; 3. Hospital and Long Term Care Facilities; 4. Skilled Nursing Facilities; 5. Home Health Agencies; 6. DME, Prosthetics, Orthotics, and Supplies; 7. Hospice (above); 8. Practioner Licensure and Enrollment ... HIPAA; Disaster Relief

There’s still joy in end-of-life care The Seattle Medium, Seattle, WA; by Anissa Durham; 10/3/24 Caregiving is an act of love and sacrifice. But for young Black women, it’s often summed up as just being “a good daughter.” More than 100 million Americans provide care to a child, parent, or relative. And about half provide care to a spouse, elderly parent or relative, or special needs child, according to a report by Guardian. But for Black folks, the burden of doing so is often heavier. Due to disparities in education, housing, and nutrition, and less access to health insurance, — along with the “weathering” that accompanies racism-related stress — Black Americans experience higher risk and rates of chronic disease. Which means, Black folks may get sick sooner than their counterparts and make younger generations, often women, more likely to become caregivers. In a 2021 report, Black family caregivers represent 14% of the estimated 48 million unpaid family caregivers in the U.S., with Black women making up a little more than half of this group, according to the American Society on Aging. Overall, women are two times more likely than men to say they’ve left the workforce to keep up with caregiving responsibilities. And nearly 50% of caregivers are either Millennials or Gen Z, according to the Guardian report. 

Comfort home in Scottsville reopens after four-year hiatus NBC News 10, Rochester, NY; by Eriketa Cost; 9/27/24 A local hospice home in Scottsville re-opened, after four years of rebuilding from the inside out. You may recall how much of an effect COVID-19 had on these services. The home, Patrick Place, was unable to hold fundraisers. Dozens of volunteers stepped down out of fear for the virus, and it took time to bring them back. The emails and phone calls didn’t stop during the downtime, though, said Cissy Leblanc, secretary on the board for Patrick Place. Organizers were eager to open again, but it took hard work. Along the way, the team built a new deck and furnished the basement, adding a conference room and special area for training volunteers. These, are all projects that couldn’t have happened with someone living there, said chairman Patrick Hanley. The home opened in early September with 55 volunteers. The goal is to reach 75. ...

Man accused of choking terminally ill wife accepts plea deal KSL.com; by Pat Reavy; 9/27/24 A man who prosecutors say attempted to end his terminally ill wife's life by choking her has accepted a plea deal. DeWayne McCulla, 46, pleaded guilty on Thursday in 5th District Court to an amended charge of attempted manslaughter, a third-degree felony. The charge comes with a domestic violence sentencing enhancement. Arenda Lee McCulla, 47, died on Dec. 21, 2021, following her battle with breast cancer. The night before, however, as a small group of family members were by her side in La Verkin, DeWayne McCulla "choked the victim in an attempt to kill her to ease her suffering while they were with her during her terminal cancer and being on hospice," according to charging documents. Other family members pulled McCulla off of his wife.Editor's note: Crucial information that is not reported in this article: Where was the hospice team in managing this patient's pain? In educating and supporting the caregiver (the husband?) and family about contacting the hospice? In making required visits when the patient is actively dying? In assessing the caregiver's ability to provide care, especially any history or risks of domestic violence, neglect, or abuse? What safety-in-the-home protocols were used by this hospice, especially when hospice team members followed up? Aware of not-knowing these many factors, I do not ask these with judgment but rather to raise awareness of core, preventive measures for other hospice patients.

NY home care agency pays $400K in racial prejudice lawsuit A home care agency in Brooklyn, NY, was ordered to pay $400,000 to settle a race and national origin discrimination lawsuit filed by the US Equal Employment Opportunity Commission. ACARE HHC Inc., doing business as Four Seasons Licensed Home Health Care Agency, routinely assigned home health aides based on clients’ racial preferences, according to a consent order filed with the US District Court for the Eastern District of New York. These workers, which included Black and Hispanic aides, would either be transferred to new client assignments based on clients’ wishes or lose their employment entirely, EEOC found. These practices were a violation of the Civil Rights Act, which prohibits employers from making job assignments based on workers’ race or national origin. Four Seasons will pay $400,000 in monetary relief for the home health aides affected, according to the consent order. It will also update its internal policies and training processes related to Civil Rights Act requirements, cease making home health aide assignments based on clients’ race or nationality preferences, and provide semi-annual reports to the EEOC regarding any reports or complaints surrounding race discrimination.

The growing, troublesome issues around non-solicitation agreements in home care Home Health Care News; by Audrie Martin; 9/23/24 In August, Comfort Keepers was fined $500,000 and forced to remove language from its contracts restricting caregivers from accepting positions with home care clients up to one year after terminating employment. That contract language, dubbed a non-solicitation agreement, is a widely used clause in home care contracts to protect providers’ businesses. On its end, the Irvine, California-based Comfort Keepers is a large franchise that offers non-medical in-home support, including meal preparation, companionship and personal assistance. The company required each client to execute a care agreement containing this language before receiving services. California Attorney General Rob Bonta concluded that this agreement violated California law by restraining worker mobility, as caregivers could not be hired by any Comfort Keepers client, not just the client to whom they were assigned to provide services. ... 

Building a clinic-based palliative care program Hospice News; by Jennifer Murtoff; 9/25/24 Palliative care is often delivered in the hospital setting or in the home, but a number of organizations have set up clinics to deliver those services. These locations often assist patients by offering a variety of services beyond symptom management. While they offer an alternative to home-based services, they present their own unique benefits and challenges. One of the agencies that uses the clinic model is Hospice of Northwest Ohio, which serves both Ohio and Michigan. Their palliative care subsidiary, Sincera — Supportive Care and Symptom Relief, launched in 2008 and recently opened a location in Oregon City, Ohio. At Sincera clinics, patients of any age who have chronic, serious illnesses can receive expert palliative care services. Creating the clinic-based model was a challenge, according to Richard Russell, president and CEO of Hospice of Northwest Ohio.