Literature Review

The 'paradigm shift’ of hospice service diversification Hospice News; by Holly Vossel; 1/17/25 Some hospices have delved deeper into service diversification to improve timely access and expand their patient reach, while others remain focused on end-of-life care delivery. The decision to launch into new service realms can come with a range of operational and reimbursement questions. Among the keys to diversifying services is establishing a business infrastructure that allows for innovative growth based on communities’ needs, according to Leslie Campbell, COO of Touchstone Communities. The San Antonio, Texas-headquartered company provides hospice, home health, veterans services, assisted living and skilled nursing services. ... Hospice leaders need to ensure that both back-office administrative and interdisciplinary teams are educated on how business growth impacts them, particularly when it comes to quality and compliance across the care continuum, Campbell stated.

Guidelines for evaluating, diagnosing, and disclosing dementia published by Alzheimer’s Association Practical Neurology; 1/14/25 The Diagnostic Evaluation, Testing, Counseling, and Disclosure Clinical Practice Guideline (DETeCD-ADRD CPG) Workgroup, convened and funded by the Alzheimer’s Association, has developed new recommendations for clinicians to use when evaluating patients with possible Alzheimer disease (AD) or AD and related dementias (ADRD). An executive summary of the recommendations for use in primary care and other practice settings was published in Alzheimer’s & Dementia, along with a companion article summarizing specific guidance for specialists. The Workgroup included representatives from  primary, specialty, subspecialty, long-term, and palliative care disciplines as well as the fields of health economics and bioethics.  Editor's note: Click for open access to the Alzheimer's Association clinical practice guideline ..., executive summary of recommendations for primary care. 

Building a smarter long-term care system in New York The National Law Review; by Adam Herbst of Sheppard, Mullin, Richter & Hampton LLP - Healthcare Law Blog; 1/10/25 New York State has a long-standing commitment to supporting its most vulnerable populations through Medicaid-funded services for older adults and those requiring long-term care. However, rising costs and an increasingly complex healthcare landscape have created challenges that demand innovative solutions.  ... The Program of All-Inclusive Care for the Elderly (PACE) offers a clear path forward. This model has consistently demonstrated its ability to reduce healthcare costs while enhancing patient outcomes by integrating medical, social, and behavioral health services under one umbrella. ... Despite these clear benefits, New York has not approved a new PACE program since 2011, leaving this proven model underutilized in the state.

Seven trends in senior living that will define 2025 and beyond McKnights Senior Living; by Michele Hollerand, PhD, MBA; 1/6/25 Senior living is in the midst of a major transformation, and seven major trends have emerged as key drivers of the strategic plans adopted by boards across the country. Those trends will shape the way organizations position themselves for the future to capture a new customer base in 2025 and beyond.

Kaiser's Habitat Health opens first PACE center Modern Healthcare; by Diane Eastabrook; 1/2/25 Habitat Health opened Thursday its first integrated healthcare program for older adults in Sacramento, California, less than 10 months after Kaiser Permanente and Town Hall Partners launched the company. ... Habitat Health estimates approximately 6,500 older adults in the Sacramento area are eligible for the program. Oglevee said the program is targeting potential participants through Kaiser Permanente’s integrated health system and insurance plans.

How private investment is becoming a driving force behind PACE Modern Helathcare; by Diane Eastabrook; 12/23/24 2025 could be the year a 50-year-old program that keeps older adults out of nursing facilities goes mainstream as for-profit companies innovate and launch more programs. Habitat Health, Seen Health, One Senior Care and InnovAge are planning to expand Programs of All-Inclusive Care for the Elderly from California to Ohio. These investor-backed organizations are scaling and innovating PACE at a time when more states are offering the Medicare-Medicaid program for frail older adults, and as legislation before Congress could make its services more widely available. Still, these for-profit programs face administrative hurdles and high start-up costs that have hamstrung PACE for decades.

Taking over affairs for an aging parent in mental decline U.S. News & World Report; by Lisa Esposito and Elaine K. Howley; 12/17/24 ... Taking over affairs for an aging parent is a vast undertaking that must focus on several areas of the individual’s life and health simultaneously. Here is a step-by-step guide to approaching this process:

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.

Characteristics of patients enrolled in hospice presenting to the emergency department American Journal of Emergency Medicine; by Kayla P Carpenter, Fernanda Bellolio, Cory Ingram, Aaron B Klassen, Sarayna S McGuire, Alisha A Morgan, Aidan F Mullan, Alexander D Ginsburg; 12/9/24, online ahead of print Emergency Departments (EDs) frequently care for patients with life-limiting illnesses, with nearly 1 in 5 patients enrolled in hospice presenting to an ED during their hospice enrollment. This study investigates the reasons patients enrolled in hospice seek care in the ED, the interventions they receive, and their outcomes. ... Patients enrolled in hospice most frequently presented to the ED for trauma [36%; with 15% for pain, 12% for catheter/tube malfunction]. Most received laboratory studies and imaging. Nearly half of patients were admitted to the hospital and short-term mortality was high, particularly for patients enrolled in hospice for needs for ED care? Ie.,

Watch: ‘Going It Alone’ — A conversation about growing old in AmericaKFF Health News; by Judith Graham; 12/11/24 KFF Health News’ “Navigating Aging” columnist, Judith Graham, spent six months this year talking to older adults who live alone by choice or by circumstance — most commonly, a spouse’s death. They shared their hopes and fears, challenges, and strategies for aging solo. Graham moderated a live event on Dec. 11, hosted by KFF Health News and The John A. Hartford Foundation. She invited five seniors ranging in age from 71 to 102 and from across the country — from Seattle; Chicago; Asheville, North Carolina; New York City; and rural Maine — to talk candidly about the ways they are thriving at this stage of life.

Ambitious PACE organizations expand services under CalAIM California Health Care Foundation; by J. Duncan Moore, Jr.; 12/9/24 If given the choice, most older adults would prefer to age in place. That’s what organizations within the Program of All-Inclusive Care for the Elderly (PACE) are set up to help people do. ... Today, some ambitious PACE organizations in California are expanding beyond their traditional scope. They’re working with Medi-Cal managed care plans to provide services to a different population. All this is done through California Advancing and Innovating Medi-Cal (CalAIM), the comprehensive state initiative to broaden Medi-Cal, California’s state Medicaid program, to encompass a wider range of social supports for enrollees. ... What do PACE organizations need to succeed in CalAIM? [Click on the title's link to continue reading.]

Resources are expanding for older adults on their own California Healthline; by Judith Graham; 12/9/24 Jeff Kromrey, 69, will sit down with his daughter the next time she visits and show her how to access his online accounts if he has an unexpected health crisis. Gayle Williams-Brett, 69, plans to tackle a project she’s been putting off for months: organizing all her financial information. ... Until a few years ago, few resources were available for this growing slice of the older population. Now, there are several Facebook groups for solo agers, as well as in-person groups springing up around the country, conferences and webinars, a national clearinghouse of resources, and an expanding array of books on the topic. [Click on the title's link to read more.]