Literature Review

The Tesla Bot is the future of at-home care, but not the way Elon wants you to think AndroidCentral; by Nicholas Sutrich; 10/17/24 Imagine waking up on your 91st birthday to a friendly robot companion that brings your morning coffee and a nice warm robe to start the day in. After making you breakfast, it bids you good day and heads back into the closet for a quick charge-up. At around 11 a.m., you realize there's a new pain in your leg that you haven't experienced before, so you make a quick phone call to the doctor, and, in a minute, your robot companion emerges from the closet, entirely remote-controlled by your doctor. They can run scans, have a full conversation, and even perform exams, all without you having to leave your home and go through the irritating task of trying to find transportation across town. ... Nothing replaces full face-to-face human interaction, but the ability for a fully remote-controlled robot that can be embodied by anyone with a VR headset like the Meta Quest 3 is a future I want to fully embrace.

Home health care and place of death in Medicare beneficiaries with and without dementiaGerontologist; Hyosin Dawn Kim , Paul R Duberstein, Anum Zafar, Bei Wu, Haiqun Lin , Olga F Jarrín; 11/24Home health care supports patient goals for aging in place. Use of home health care during the last 3 years of life was associated with reduced rates of inpatient death without hospice, and increased rates of home death with hospice. Increasing affordable access to home health care can positively affect end-of-life care outcomes for older Americans and their family caregivers, especially those with dementia.

Heartlinks expands hospice, palliative programs with new adult family home Hospice News; by Holly Vossel; 10/16/24 Heartlinks is opening a de novo located in Sunnyside, Washington, with an aim of providing a range of services to seniors in the area. Hospice and palliative care will be a “strong focus” of services provided at the new senior living facility, Heartlinks Adult Family Home, said Shelby Moore, the organization’s executive director. Other services available include 24/7 access to personal care, assistance with activities of daily living, medication management and respite care. The new location is designed to create a peaceful and comforting space for individuals with advanced and life-limiting illnesses in an area that lacks resources for patients and their families, Moore stated. 

Communication gaps among clinicians may limit conversations about prognosis, hospice Healio - HemOncToday; by Jennifer Byrne; 10/16/24 Clinicians in acute or post-acute care settings may delay or avoid serious illness conversations with patients whose cancer prognoses are worsening out of deference to the patient’s oncologist, according to study findings. Researchers conducted 37 semi-structured interviews with physicians and leaders in hospital medicine, oncology, palliative care, home health care and hospice. Investigators coded and analyzed the interviews using thematic content analysis. Evaluation of the responses yielded insights into how care silos, lack of clear clinical roles and other factors may affect communication between oncologists and other clinicians. ... "We know that the 3-month window after an older adult with cancer is discharged to a skilled nursing facility can be comprised of complex medical decision making and changing preferences of care. Lack of appropriate serious illness communication during this time can result in unwanted hospitalizations and unwanted, aggressive care at the end of life."

Dozens of CarePartners patients in Asheville transferred to other facilities after HCA temporarily shuts down rehab, hospice center Asheville Watchdog; by Andrew R. Jones; 10/14/24 Hundreds of employees uncertain about their jobs after facility is closed to ease pressure on Mission Hospital. Mission Health’s CarePartners Health Services is temporarily closed following the pressures Hurricane Helene put on Asheville’s health care system, disrupting rehabilitative care for more than 50 patients and forcing more than 250 employees to take temporary jobs elsewhere in the system, according to employees and internal emails obtained by Asheville Watchdog.  ... The closing affected nearly 50 inpatient rehab patients, several long-term acute care patients, and eight hospice patients, all of whom were sent to home caregivers, skilled nursing facilities, other inpatient rehab programs, and UNC Health Caldwell in Lenoir, more than an hour’s drive to the east, according to one employee.

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.