Literature Review

Palliative Care Movement achieves significant progress in California California Health Care Foundation, by Claudia Boyd-Barrett; 3/19/24 ... Palliative care has taken root in California over the past 15 years, driven by hundreds of leaders within health plans, hospitals, clinics, home care agencies, advocacy and education organizations, and state government. ... Some of California’s greatest palliative care progress has been accomplished in programs serving people at the lowest income levels through the state’s Medi-Cal program and through public health care systems.

'It's been really inspiring': Grace House continues end-of-life care despite challenges Akron Beacon Journal, by Kelsie Horner; 3/13/24Through a flood and financial challenges, an Akron nonprofit has continued to provide end-of-life care and companionship for people who might otherwise die alone. Since opening its doors 1½ years ago, Grace House has cared for 66 residents during their final days. ... Grace House is one of only three organizations in the nation to provide free, “non-barrier” end-of-life care for people who are unhoused or alone.

Healthcare access dimensions and racial disparities in end-of-life care quality among ovarian cancer patients Cancer Research Communications; by Shama Karanth, Oyomoare L. Osazuwa-Peters; Lauren E. Wilson, Rebecca A. Previs, Fariha Rahman, Bin Huang, Maria Pisu, Margaret Liang, Kevin C. Ward, Maria J. Schymura, Andrew Berchuck, and Tomi F. Akinyemiju; 3/5/24 This study investigated the association between healthcare access (HCA) dimensions and racial disparities in end-of-life (EOL) care quality among Non-Hispanic Black (NHB), Non-Hispanic White (NHW), and Hispanic patients with ovarian cancer (OC).

The Medicare Care Choices Model was associated with reductions in disparities in the use of hospice care for Medicare beneficiaries with terminal illnessHealth Serv Res by Matthew J Niedzwiecki, Lauren Vollmer Forrow, Jonathan Gellar, R Vincent Pohl, Arnold Chen, Lynn Miescier, Keith Kranker; 2/29/24 Conclusions: Medicare Choices Model (MCCM) increased hospice use and quality of end-of-life care for model enrollees from underserved groups and reduced disparities in hospice use and having multiple emergency department visits.

Racial differences in shared decision-making about critical illnessJAMA Intern Med, by Deepshikha C. Ashana, MD, MBA, MS; Whitney Welsh, PhD; Doreet Preiss, PhD; et al; published online 2/26/24Question: How do critical care clinicians approach shared decision-making with Black compared with White caregivers of critically ill patients?Findings: In a thematic analysis of 39 audio-recorded clinician-caregiver meetings, racial differences were most evident in the following clinician behaviors: providing emotional support to caregivers, acknowledging trust and gratitude expressed by caregivers, disclosing medical information, and validating caregivers' treatment preferences.

Urgent need to address health equity at intersection of American Heart Month and Black History Month 2024

Racial and ethnic differences in hospice use among Medicaid-only and dual-eligible decedentsJAMA Health Forum, by Julie Robison, Noreen Shugrue, Ellis Dillon, Deborah Migneault, Doreek Charles, Dorothy Wakefield, Bradley Richards; 12/23Hospice care enhances quality of life for people with terminal illness and is most beneficial with longer length of stay (LOS). Most hospice research focuses on the Medicare-insured population. Little is known about hospice use for the racially and ethnically diverse, low-income Medicaid population.

Corporations award $20K in grants to make hospice care accessible in Texarkana areaTexarkana Gazette; 1/1/24A local nonprofit has received $20,000 in grants to make end-of-life care accessible. Tyson Foods, Weyerhaeuser and Union Pacific recently awarded the funding to Hospice of Texarkana's Diversity & Inclusive Care Project. The project is a comprehensive educational and awareness program to address demographic disparities in hospice and palliative care in Northeast Texas and Southwest Arkansas. It includes staffing, training, and community outreach.

"I don't think there will ever be a time when the principles of Kwanzaa will not be important or timely. It's a great time for reflection and now more than ever our country needs to be reminded of unity." Kellie Carter JacksonHonoring Kwanzaa Celebrations: December 26, 2023 through January 1, 2024

Study uncovers racial, geographic disparities in LTSS accessMcKnight’s Home Care DailyDecember 19, 2023Disparities in access to long-term services and supports (LTSS) create greater financial and health-related challenges for people of color, according to new research by healthcare research firm ATI Advisory. Using data from a University of Michigan Health and Retirement Study, the ATI study sampled 6,232 people aged 55 years old and living in home- or community-based settings. 

Washington, D.C., Needs to Address Hospice Care Utilization DisparitiesBy Donna Gayles and Audrey EasawWashington (DC) InformerDecember 13, 2023Our nation’s capital ranks high in many things, from access to outdoor activities and number of museums to its ethnic and cultural diversity and vibrant LGBTQ+ population. But the city lags far behind in one key area: hospice care utilization. While on average, just under half of Medicare decedents are in hospice care at their time of death, in the District of Columbia, only 25% are—ranking lower than 49 of the 50 states. This is especially meaningful when considering how medical mistrust plays into this underutilization among the city’s extremely diverse population. 

Palliative Care Yield Cost Savings Lymphoma Patients, But Racial Disparities ExistPalliative Care NewsDecember 12, 2023Lymphoma patients who receive palliative care have fewer hospitalizations that those who do not, but racial and ethnic disparities persist. ... The study found that on average palliative care generated cost savings of $24,269 per patient. However, patients that identified as Black or Hispanic were much less likely to receive palliative care than white patients, reflecting widespread inequities in palliative care and the health care system at large, the research found. 

Disability activists also oppose aid in dyingBy Susie MosherDaily Hampshire Gazette (Northampton, MA)December 9, 2023... For the aged or those with degenerative or chronic diseases, many people in the final stages of life are suddenly, newly disabled without having lived a life managing a disability. Inadequate resources, the lack of emotional support, the physical challenges, the stresses on relatives and caregivers—all are overwhelming. ... We know that, despite good intentions, the state of Massachusetts already has many agencies, policies and programs that are underfunded, not carefully monitored, poorly managed, and understaffed. People with mental illnesses, disabilities, without power, and without a voice are not well served. People with disabilities know how the health care system and our government fails them as they struggle daily to advocate for themselves. Legislators and news outlets would do well to listen to people who face existential challenges day to day. The disability community is advocating for palliative services, not lethal doses. They have experienced the terrifying slippery slope of “quality of life” assessments by professionals. Their testimony advocates for education and support for caregivers, not assisted suicide.