Literature Review

Health gap at end of life is now wider in US than any other country Science Alert - Health; by Carly Cassella; 12/16/24 A data-crunching survey covering 183 member nations of the World Health Organization has now confirmed what some scientists feared: while years are being added to most people's lives, healthy life is not being added to most people's year. Researchers at the Mayo Clinic found that people around the world in 2019 were living 9.6 years of life burdened by disability or disease – an increase of 13 percent from 2000. In that same time frame, global life expectancy has increased 6.5 years, and yet health-adjusted life expectancy has only increased 5.4 years. In the US, the gap between lifespan and 'healthspan' is growing particularly wide. Between 2000 and 2019, life expectancy in the US increased from 79.2 to 80.7 years for women, and from 74.1 to 76.3 years for men. When adjusting for healthy years of added life, however, the span only increased by 0.6 years among men. And among women, while health-adjusted life expectancy fluctuated slightly over time, in 2019 it matched the figure seen in 2000. The expanding gap means if an American woman lived to the expected 80.7 years of age, the last 12.4 years of her life would on average be impacted by disease or disability.

What they love and loathe: Medscape Nurse Career Satisfaction Report 2024 Medscape; by Jon McKenna; 12/13/24 Despite well-publicized issues buffeting their profession, nurses in a Medscape survey overwhelmingly said they are happy with their career choice, and most said they would make it again. They also told us about their most- and least-favored job features, recounted any experiences with abuse at work, revealed possible alternative careers, and reported union membership, among other insights. [Click on the title's link to continue reading.]

UConn John Dempsey Hospital joins National Age-Friendly Health System Movement UConn Today; by Jennifer Walker; 12/12/24 UConn John Dempsey Hospital was recently accepted for participation in the national Age-Friendly Healthy Systems Movement to improve health care for older adults. The Age-Friendly Health Systems Movement, sponsored by The John A. Hartford Foundation and the Institute for Healthcare Improvement in partnership with the American Hospital Association and the Catholic Health Association of the United States​, is a national collaboration of hospitals and health systems implementing a set of evidence-based interventions to make the care of all older adults equitable and age-friendly. This initiative addresses the reality that a growing proportion of the US population is elderly and has complex healthcare needs which challenge many institutions. This movement is built upon a framework of a set of four best practice interventions known as the 4Ms.

‘Reimagining Hope’ podcast shines a light on the conversation of serious illness The Baltimore Times, Pasadena, MD; podcast hosted by Rachel Jordan; 12/6/24 As families and their loved ones struggle with serious progressive illness, finding information, resources and support is more critical than ever before in our history. In response, Hospice of the Chesapeake and Chesapeake Supportive Care are introducing a new, innovative and informative podcast series, “Reimagining Hope.”  Hosted by Rachel Jordan, Director of Advocacy & Legislative Affairs, the series will feature guests who can provide valuable insight and help you reimagine the hope you may be missing. The podcast will provide quick, easy-to-understand information while giving you the critical skills and real-time tools you can use today to navigate advanced illness. 

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. ... 

Aged care nursing in the digital future Atlassian Jira, Australia; by Flinders University; 11/27/24 The results call for nurses to be included when digital innovations are in development, so they can actively shape their implementation and ensure high-quality, compassionate care for residents in their final stages of life. "In Australia and around the world, we have seen a significant increase in digital technologies in the health care sector," says study lead author Dr. Priyanka Vandersman, a Senior Research Fellow at Flinders University's Research Center for Palliative Care, Death and Dying (RePaDD).  "In aged care, these digital approaches can include helping with care planning and assisting with managing medication, but we need to ensure that nurses are equipped with the digital skills needed to use these tools effectively, while continuing to provide high quality, person-centered care."

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. ..."