Literature Review

Grant helps launch paramedicine program for patients in need Westfair Business Journal, Sleepy Hollow, NY; by Westfair Online; 11/15/24 Northwell Phelps Hospital received a $125,000 grant from the Phelps Community Foundation to help launch the Westchester Community Paramedicine Program. ... They will utilize remote physiological monitoring to track blood pressure, oxygen saturation and cardiac rhythms, providing convenient and cost-effective care compared to emergency room visits. “This program is designed to address the gap in access to primary and nonemergency medical care for vulnerable populations,” said Barry Geller, M.D., chair of the emergency department and associate medical director at Phelps Hospital. ...  The initiative will first focus on patients served by Phelps’ palliative care, geriatric and emergency medicine programs with plans to expand service to cancer patients. It is expected to reach approximately 200 individuals during the first year, ...

Long-term care market to grow by USD 394.8 billion from 2024-2028, as aging population drives demand with AI impact on market trends - Technavio Cision; by PR Newswire; 11/8/24 Report on how AI is redefining market landscape - The global long-term care (LTC) market size is estimated to grow by USD 394.8 billion from 2024-2028, according to Technavio. The market is estimated to grow at a CAGR of over 3.21% during the forecast period. Growing demand for long-term care from aging population is driving market growth, with a trend towards expansion and growth of several healthcare domain. However, lack of skilled nursing staff for long-term care  poses a challenge.Key market players include Abri Health Care Services LLC, Amedisys Inc., Brookdale Senior Living Inc., CareOne Management LLC, Diversicare Healthcare Services Inc., Extendicare Canada Inc, FCP Live In, Genesis Healthcare Inc., Honor Technology Inc., Illumifin Corp., Kindred Health Holdings LLC, Life Care Centers of America Inc., Revera Inc., SeniorLiving.org, Sonida Senior Living Inc., Sunrise Senior Living LLC, and Wickshire Senior Living.

Most heart failure patients miss out on guideline-recommended palliative care Cardiovascular Business; by Dave Fornell; 11/6/24 Over the past decade, the American Heart Association (AHA) and European Society of Cardiology have recommended integrating palliative care into heart failure management. Despite these recommendations, the use of palliative care for heart failure remains low in the United States. Racial and geographic variations in access and use of palliative care are also pronounced, highlighting health disparities. These were the findings of a recent study in the Journal of the American Heart Association. Researchers at Saint Louis University led the study and said only one in eight patients with heart failure in the United States receive palliative care consultations within five years of diagnosis. Their study highlights the alarmingly low uptake of palliative care among adults with heart failure in the U.S., especially compared to patients with cancers that have the same mortality rates. The study also pointed out significant racial and geographic disparities. Black patients were 15% less likely to receive palliative care compared to their white counterparts. They said this disparity is particularly concerning given the higher cardiovascular risk and mortality rates in the Black population.

The daily balancing act of value-based cancer care The American Journal of Managed Care (AJMC); by Laura Joszt, MA; 10/14/24 In value-based care, there’s a daily balancing act to achieve quality outcomes, cost reduction, and patient care improvements, explained Stuart Staggs, vice president of transformation, quality, and shared services for The US Oncology Network (Network). At the Institute for Value-Based Medicine event, cohosted by The American Journal of Managed Care (AJMC) and Minnesota Oncology, Staggs kicked it off with what he called a “practical look at value-based care.” He highlighted 4 main areas: quality, improvement, adoption, and cost. ... The area of improvement that the Network wanted to focus on was advanced care planning and better supporting and engaging patients and their families around hospice and life support. During the OCM, the Network better engaged patients and families around hospice care and encouraged practices to have difficult conversations. Not only does this improve patient experience by providing them the end-of-life care that they want, but there is also a cost factor. Patients who don’t receive hospice care spend significantly more in the last 30 to 60 days, Staggs said.

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.

Improving post-hospital care of older cancer patients Cancer Health; by University of Colorado Cancer Center and Greg Glasgow; 8/26/24 A few years ago, University of Colorado Cancer Center member and hospitalist Sarguni Singh, MD, began to notice a troubling trend: Older adults with cancer who were leaving the hospital for skilled nursing facilities after treatment were being readmitted to the hospital or having worse outcomes while in rehabilitation. ... Singh knew of an intervention called Assessing and Listening to Individual Goals and Needs (ALIGN) — a palliative care social worker-led protocol aimed at improving quality of life, aligning goals of care, and providing support to patients and caregivers — and she began using it for cancer care. ... The results were overwhelmingly positive, and patients and caregivers told us, ‘This was so helpful,’” says Singh, associate professor of hospital medicine in the CU School of Medicine.

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. ...

‘Good’ death different for everyone Altoona Mirror, Altoona, PA; 7/26/24 The social and economic inequities patients suffer in life often shapes their death” was a key point of a July 13-14 article in the Review section of the Wall Street Journal. ... In the article, which was written by Dr. Sunita Puri, a palliative care physician and the author of “That Good Night: Life and Medicine in the Eleventh Hour,” Puri focuses on the conundrum many families face when dealing with the question of where to spend the final days of life. ... “New research classifies the rise in home deaths as progress,” the message immediately under the article’s headline begins, “but we need to look more closely at what these deaths look like.” ... Puri, now 10 years into her physician career, says it is now clear to her that there is much more to a “good” death than where it occurs. “Presuming a home death is a success obscures important questions about the process,” she wrote. “Did this person die comfortably? Did their caregivers have the resources and guidance they needed? Was dying at home a choice or simply the only option?” 

Empath Health, Trustbridge leaders are setting home health sights high after integration Home Health Care News; by Joyce Famakinwa; 7/26/24 Empath Health is a company in transition. In the spring, it completed an affiliation process with Trustbridge, which formed the largest nonprofit post-acute provider organization in the state of Florida. ... Since completion of the affiliation process, the company has focused on integration, synergistic opportunities and determining how best to deliver care to the communities it serves. One of the people at the helm of this transition is Tarrah Lowry, Empath Health’s chief operating officer and Trustbridge’s interim president. [Click on the title's link to read the recent interview by Home Health Care News' with Tarrah Lowry.]

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. ... 

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.

Tuesday Health launches revolutionary Supportive Care solution with $60 million of strategic investment from healthcare leadersInvestors Observier; by PR Newswire; 5/21/24Tuesday Health, a pioneer in value-based care dedicated to transforming serious illness, has launched its innovative supportive care solution in partnership with Valtruis, Blue Venture Fund, Mass General Brigham Ventures , and CareSource. This alliance brings a $60 million strategic investment to Tuesday Health, fueling its mission to redefine supportive care for patients and caregivers facing serious illnesses. "Leveraging clinical expertise, advanced data solutions, and cutting-edge technology, while partnering with Ohio's largest Medicaid plan, its largest hospice provider and the unmatched palliative care experience of Mass General, Tuesday Health is dedicated to tackling one of healthcare's biggest challenges-providing support and care in the right setting, at the right time, for those facing serious illness", said Jim Wieland, CEO of Tuesday Health.Editor's Note: What is the difference between supportive care and palliative care? Click here for a description from ASCO, the American Society of Clinical Oncology.