Literature Review

New Health Equity Guide from Center to Advance Palliative Care provides a roadmap to transform care for black patients with serious illness Cision PRWeb; by Center to Advance Palliative Care; 11/13/24 Having medical concerns dismissed, not being believed when reporting pain, and facing multiple barriers to care are just three of the experiences reported to Center to Advance Palliative Care (CAPC) in a focus group of Black patients with serious illness. In fact, when Black people in the United States are living with a serious illness like cancer, heart failure, or dementia, they experience disproportionately high suffering compared to white patients—often due to poor pain management, low-quality communication from their care teams, and high family caregiver burden. To address these inequities, CAPC has released a new, comprehensive guide, Advancing Equity for Black Patients with Serious Illness, to equip palliative care leaders and health equity change agents with practical tools to implement meaningful change. Drawn from research, examples of health equity initiatives from across the country, and the wisdom of health equity leaders, the guide provides a practical roadmap for transforming care for Black patients, and their families and caregivers.

Sioux City’s first Caregiver Olympics celebrates home care KCAU Sioux City; by Alyssa Tatsch; 11/7/24 November is National Care at Home Month, and to celebrate, several local healthcare organizations came together to participate in Sioux City’s first Caregiver Olympics. “I was watching the Olympics this summer and I was thinking of something fun to do with our caregiving team,” Visiting Angels owner and director Kristen Hammerstrom said. “Then I was at a meeting with some of the other [home care organizations] and I floated the idea to them and they said ‘that would be awesome.’” In honor of National Hospice and Palliative Care month, nine Sioux City caregiving teams went head-to-head competing in a relay race with specialized in-home care tasks. ... “As much as it is difficult to be a caregiver, it is also difficult for these employees too to help and take care of families, so this is just our light heartfelt fun moment to help people,” Hospice of Siouxland marketing & fund director Kim Wilson said. Despite the friendly competitive atmosphere, all nine teams shared one common goal. “While we might be competitors, at the end of the day our main goal is to care for patients and make sure that our patients and their loved ones are taken care of. That is our main goal,” Wilson said.

The case for stronger caregiver vetting in home care Home Health Care News; by Audrie Martin; 10/24/24 Direct care workers are, in many ways, the collective face of home-based care organizations. They are who clients and patients interact with. Therefore, regulators and providers are increasingly taking a closer look at who they’re hiring in the first place. While it is shocking to see caregivers commit crimes against clients, it does happen. About one in six people aged 60 and older experienced some form of abuse during 2023, according to the World Health Organization. Rates of abuse against older people have increased since the COVID-19 pandemic and are predicted to continue rising as many countries experience rapidly aging populations. To combat this trend, increased vetting is essential when hiring individuals to care for seniors in their homes. Editor's note: Related, disturbing articles we posted recently include ...

Survey: Older adults unsatisfied with current healthcare system McKnights Long-Term Care News; by Kristen Fischer; 9/17/24 Older adults aren’t too happy with the healthcare system and many think it doesn’t meet their needs and preferences, according to a new survey. The results of the survey, conducted by The Harris Poll, were published Tuesday, and were released by Age Wave and The John A. Hartford Foundation.  Four in five adults aged 65 and older said that the system isn’t prepared to handle the changing needs of Americans in their age group. In total, only 11% said the US healthcare system deserved a grade of “A.” Results show that older adults want solutions such as affordable care interventions, developments to prevent or reduce cognitive decline, and healthcare professionals who understand what matters to them when they discuss care options.

Palliative care is a viable option for frail elderly patients with neurocognitive disorders admitted for hip fractures BMC Musculoskeletal Disorders; by Justine Boulet, Etienne L Belzile, Norbert Dion, Chantal Morency, Mélanie Bérubé, Alexandra Tremblay, Stéphane Pelet; 8/10/24 Most patients presenting with a hip fracture regardless of their comorbidities are surgically treated. A growing body of research states that a certain type of elderly patient could benefit more from a palliative approach. ... The presence of [a nuerocognitive disorder] NCD and diminished prefracture autonomy strongly support counseling for palliative care. The high rate of complications when surgery is proposed for frail patients with multiple comorbidities suggests that the concept of palliative surgery needs to be revisited. 

Commentary: Prognostication in Alzheimer's disease and related dementias Journal of the American Geriatrics Society / Early View; by Natalie C. Ernecoff PhD, MPH, Kathryn L. Wessell MPH, Laura C. Hanson MD, MPH; 8/8/24  ... Hospice provides comfort-oriented care, emphasizing patient-tailored elements of quality of life, including time with family, access to nature, and music. In late-stage ADRD, studies show that a majority of families prioritize comfort-oriented treatment, and understanding prognosis may help them align treatments accordingly. Yet, only 15% of people enrolled in hospice with a primary diagnosis of ADRD. This is due to difficulty estimating 6-month prognosis required for hospice eligibility—ADRD carries a prognosis of 12–18 months in the latest stage. While low rates of live discharges from hospice are a regulatory requirement for hospices, people who are increasingly experiencing ADRD progression lose access to those beneficial hospice services. ...

Baptist Health taps 3 vendors to build a population health system that works Healthcare IT News; by Bill Siwicki; 7/26/24With help from Oracle, Innovaccer and Salesforce, the South Florida provider is scoring big population health wins, including a 7% increase in coding gap closure rate and a 17% increase in annual wellness visit completion rates. Baptist Health South Florida operates a network of 11 hospitals covering four counties. It also includes numerous ambulatory facilities, urgent care centers and emergency departments to provide comprehensive healthcare services across the region. ... "One of our primary issues was the fragmented nature of patient data across multiple provider organizations and electronic health record systems," said Milady Cervera, vice president, population health and physician integrated networks, at Baptist Health South Florida. "This lack of interoperability made it difficult to gain a comprehensive view of our patients' health status, care history and ongoing needs. ..."

Private nursing services market hits USD 1179 billion by 2032 Market.US; by Trishita Deb; 7/17/24 The Global Private Nursing Services Market, valued at USD 609.7 billion in 2022, is poised for substantial growth. It is projected to reach USD 1179 billion by 2032, expanding at a consistent annual growth rate of 7%. This growth is primarily driven by several critical factors. Firstly, the increasing aging population worldwide necessitates more personalized and attentive healthcare services, which private nursing can provide. Secondly, the rise in chronic diseases, which require long-term care, significantly contributes to the demand for private nursing services. Technological advancements and increased healthcare expenditures also play vital roles in enhancing the service quality and accessibility in this sector​.

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.]

The hidden advantages of having an older workforce in home health care Home Health Care News; by Joyce Famakinwa; 7/2/24In home health and hospice, the amount of nurses who are at retirement age are set to surpass new RNs, according to data from the American Medical Group Association. St. John has noticed that working with more experienced nurses has meant less turnover. "Our highest turnover is in first-year nurses," she said. Another benefit of having a workforce full of mostly seasoned nurses is that they are better equipped to handle burnout, according to Barnett.

HHS to impose penalties on providers that block patients’ health information McKnights Home Care; by Adam Healy; 6/24/24In a bid to promote easier access and exchange of patients’ health records, the Department of Health and Human Services published a final rule Monday outlining penalties for providers that block access to electronic health information. ... Fragmented and inaccessible patient data can prevent long-term and post-acute care providers from seeing the full picture of a patients’ health. Hospitals, for example, are not required to share updates about a patient’s health with the patient’s post-acute care provider. As a result, home health and home care agencies frequently cannot access patients’ electronic health records to help assess and treat patients. Three disincentives: ... First, hospitals that commit information blocking can be subject to a reduction of three quarters of an annual market basket update. Second, clinicians eligible for the Merit-based Incentive Payment System will receive a zero score in the “promoting interoperability performance” MIPS category, which can be equivalent to roughly a quarter of the clinician’s MIPS score in a given year. Lastly, providers that participate in information blocking can have their Medicare Shared Savings Program or Accountable Care Organization eligibility revoked for at least one year. ...Editor's Note: Almost any solution raises additional challenges. How does HIPAA interface with this? How might a cyberattack at a hospital (or other healthcare agency) affect the patients' other agencies, putting them at risk as well?

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.