Literature Review

Costs of long-term care: ‘Financial ruin is baked into the system’ KFF Health News, by Jordan Rau and Reed Abelson; 3/9/24 Thousands of readers reacted to the articles in the “Dying Broke” series about the financial burden of long-term care in the United States. They offered their assessments for the government and market failures that have drained the lifetime savings of so many American families. And some offered possible solutions. In more than 4,200 comments, readers shared their struggles in caring for spouses, older parents, and grandparents. They expressed anxieties about getting older themselves and needing help to stay at home or in institutions like nursing homes or assisted living facilities.

Smaller wage increases predicted for 2024: surveyMcKnights Senior Living, by Kathleen Steele Gaivin; 3/8/24Wage increases for senior living and care employees are predicted to dip from 4.43% in 2023 to 3.64% this year, according to responses to a newly released Ziegler CFO Hotline survey.  The news comes as providers continue to be challenged in recruiting and retaining workers, with compensation as one strategy. 

Scientists reveal that nearly all older Americans follow one of nine trajectories in their last three years of life SciTechDaily, by Rutgers University; 3/2/24A Rutgers Health analysis of millions of Medicare records has laid the groundwork for improving end-of-life care by demonstrating that nearly all older Americans follow one of nine trajectories in their last three years of life. “Identifying which paths people actually take is a necessary precursor to identifying which factors send different people down different paths and designing interventions that send more people down whatever path is right for them,” said Olga Jarrín, the Hunterdon Professor of Nursing Research at Rutgers and corresponding author of the study published in BMC Geriatrics.

3 predictions for the future of post-acute careBecker's Hospital Review, by Mariah Taylor; 2/28/24Robust in-home care, advances in technology and seamless access to nursing facilities are some of the ways leaders anticipate post-acute care may change in the next 50 years. Here, three leaders give their predictions and hopes for the industry in the future.

‘Joint employer’ rule effective date now March 11 McKnights Senior Living, by Lois A. Bowers; 2/26/24The National Labor Relations Board’s “joint employer” rule now is set to go into effect on March 11 after a federal judge granted a stay last week. ... Long-term care providers that use temporary or contract workers, as well as operators that are part of franchises, and others, could be affected.

Medicare is booming, and providers are bracing themselvesModern Healthcare, by Alex Kacik; 2/12/24The aging of the baby boomers means Medicare enrollment growth is expected to exceed that of other major payers.

Study highlights financial burden of dementia on older adults, familiesGeorgia State University - School of Public Health, by Sam Fahmy; 2/7/24A team of researchers from the Georgia State University School of Public Health, the University of Washington School of Pharmacy and the University of California San Francisco analyzed data from a national sample of more than 4,500 adults aged 70 and older to arrive at what are thought to be the first comparisons of out-of-pocket expenses by dementia status and care setting. The researchers found that the median adult with dementia in residential facilities such as assisted living centers spent 97% of their monthly income on long-term care. People with dementia in nursing homes spent nearly 83% of their monthly income on long-term care.

Alzheimer's: Watch for signs it's time to start hospice careThe Advocate, by Dana Territo; 2/5/24When is someone with dementia ready for hospice care? ... Some of the characteristics the affected individual may be exhibiting include the lack of ability to ambulate without assistance, incontinence of bowel and bladder, inability to dress and bathe properly, and speech limited to approximately a half dozen or fewer intelligible and different words. There are also intercurrent illnesses associated with advanced dementia in which hospice services would be a benefit. 

The last leaf on the vine: What is lost when a generation passes away Inside Higher Ed, by Steven Mintz; 2/6/24... For my extended family, my mother is (or was, depending on when you read this piece) the last leaf on the vine, the last surviving member of a generation born in the 1920s that personally recalls the hardships of the Great Depression and the disruptions, upheavals, sacrifices and horrors of World War II. And that leaf is poised to fall.

Alabama agencies get new resources for dementia care amid 'great void' in servicesAlabama Reflector, by Alander Rocha; 1/31/24In a meeting of the Interagency Council for the Prevention of Elder Abuse on Tuesday, Alabama Department of Senior Services (ADSS) Commissioner Jean W. Brown said the department is “awash in money to just go where we’ve never gone before in dementia services and dementia care.” ... According to the Centers for Disease Control and Prevention, Alabama in 2021 had the second highest mortality rate from Alzheimer’s disease, behind only Mississippi, at 46.8 per 100,000 people. 

Alternative therapies for pain management in senior careMedCity News, by Bent Philipson; by 1/30/24Chronic pain, an enduring concern for many older adults, is no longer confined to the traditional realm of pharmaceuticals. While traditional pain management methods like medication were once the go-to approach, alternative therapies are emerging as a viable and holistic approach to addressing this issue.

Viewpoint: Care fragmentation, care continuity, and care coordination—How they differ and why it mattersJAMA Intern Med., by Lisa M. Kern, MD, MPH; Julie P. W. Bynum, MD, MPH; Harold Alan Pincus, MD; 1/29/24Health care in the US is characterized by fragmentation, with many patients seeing multiple physicians. Indeed, 35% of Medicare beneficiaries saw 5 or more physicians in 2019.1 Having multiple physicians may be appropriate, but it may also lead to medical errors, unnecessary visits, avoidable hospitalizations, and suboptimal care if all of the physicians do not have complete information about the patient and each other’s care plans.

Despite need, adequate dementia care severely lacking among adult day service providersMcKnights Home Care, by Adam Healy; 1/29/24... More than a quarter of adult day service patients have been diagnosed with dementia, including Alzheimer’s, according to a recent National Health Statistics Report by the HHS and CDC. ... Roughly 23% of adult day service center (ADSC) patients with dementia are enrolled in a center that lacks the capabilities to adequately care for their condition.