Literature Review

Customizing a palliative program to patient, payer priorities Hospice News; by Jim Parker; 10/23/24 While some palliative care programs mirror the hospice model, more operators are working to tailor their services to patients’ specific needs, with varying intensity. This is increasingly important as payment shifts towards value-based payment models in which demonstrating cost savings is crucial to success. Providers need to demonstrate strong performance on quality scores as well as a track record of effectively preventing avoidable hospitalizations, readmissions and emergency department visits. This is particularly the case when negotiating contracts with Medicare Advantage plans, Accountable Care Organizations (ACOs) and other value-based payment arrangements, Sue Lynn Schramm, a partner of the hospice and palliative care consulting company Confidis, LLC, said in a presentation at the National Hospice and Palliative Care Organization Annual Leadership Conference. [Click on the title's link to continue reading.]

Telehealth vs in-person early palliative care for patients with advanced lung cancer-A multisite randomized clinical trialJAMA; Joseph A. Greer, PhD; Jennifer S. Temel, MD; Areej El-Jawahri, MD; Simone Rinaldi, ANP-BC; Mihir Kamdar, MD; Elyse R. Park, PhD, MPH; Nora K. Horick, MS; Kedie Pintro, MS; Dustin J. Rabideau, PhD; Lee Schwamm, MD; Josephine Feliciano, MD; Isaac Chua, MD, MPH; Konstantinos Leventakos, MD, PhD; Stacy M. Fischer, MD; Toby C. Campbell, MD; Michael W. Rabow, MD; Finly Zachariah, MD; Laura C. Hanson, MD; Sara F. Martin, MD; Maria Silveira, MD; Laura Shoemaker, DO; Marie Bakitas, DNSc; Jessica Bauman, MD; Lori Spoozak, MD; Carl Grey, MD; Leslie Blackhall, MD; Kimberly Curseen, MD; Sean O’Mahony, MB, BCh, BAO; Melanie M. Smith, MD; Ramona Rhodes, MD; Amelia Cullinan, MD; Vicki Jackson, MD; for the REACH PC; 9/24The delivery of early palliative care virtually vs in person demonstrated equivalent effects on quality of life in patients with advanced NSCLC [non-small cell lung cancer], underscoring the considerable potential for improving access to this evidence-based care model through telehealth delivery.

Annual wellness visits and early dementia diagnosis among Medicare beneficiariesJAMA Network Open; Huey-Ming Tzeng, PhD; Mukaila A. Raji, MD, MS; Yong Shan, PhD; Peter Cram, MD, MBA; Yong-Fang Kuo, PhD; 10/24Optimal dementia care depends on early recognition of cognitive impairment and timely diagnosis of Alzheimer disease and related dementias (ADRD). Optimal dementia care should reflect what matters most to patients and adhere to evidence-informed ADRD stage-specific health care. These findings indicate that AWV [annual wellness visit] recipients had a timelier first MCI [mild cognitive impairment] diagnosis than those who did not receive an AWV, but first ADRD diagnosis differed little. This study suggests that the Medicare AWV health policy may increase MCI identification, prompting more specialized care.

Martis Capital rumored to purchase Three Oaks Hospice’s in $150m deal Hospice News; by Holly Vossel; 10/18/24 The private equity firm Martis Capital may soon acquire Dallas-based Three Oaks Hospice for a price tag ranging from $150 million to $160 million. Rumors of the potential sale appeared today in an Axios report, in which unnamed sources reportedly confirmed the deal. The Nashville-based investment and management company Petra Capital currently owns Three Oaks Hospice, which reportedly generates between $10 and $13 million in EBITDA, Axios indicated. Rumors that the hospice was considering a potential sale were first reported last month by the website Ion Analytics. The private-equity backed company provides hospice, palliative care and bereavement services across 28 locations in seven states. 

Home health care aide charged with manslaughter in death of elderly central Florida man West Orlando News, Orlando, FL; by Staff; 10/20/24[This article updates the story we posted on 10/1/24, Polk County home health aide accused of sleeping on the job arrested in man’s death: ‘He was old anyway.']... According to the affidavit, Taylor, who was employed by Assisting Hands Home Health Care as a health aide, worked the evening hours at the man’s home in Winter Haven. ...  He was also receiving services from Good Shepherd Hospice beginning on August 14, 2024. ... During an autopsy, it was discovered the patient had an implanted pacemaker. The device manufacturer was later able to conduct a download and provide cardiac data stored on the victim’s implanted pacemaker which confirmed that the victim was still alive at 1:00am when the victim was initially found by Taylor lying on the floor. According to the Medical Examiner, had Taylor called 9-1-1 when she first found the victim, as required by her own company’s policy, the victim would not have died. The Medical Examiner ruled the victim’s cause of death positional asphyxia with a contributory cause of pre-existing health issues. 

Vitas, Big Bend, Heart to Heart, Family Hospice unveil new locations Hospice News; by Holly Vossel; 10/25/24 

Nonprofit endeavors to facilitate food justice Towne Post Network; by Julie Yate; 10/17/24 Bringing Justice Home [in Louisville, KY] is a nonprofit organization committed to alleviating hunger caused by food insecurity for those facing disabilities and chronic or serious illnesses. Now in its fourth year, the completely volunteer-run initiative seeks to facilitate food justice by delivering groceries and household supplies to health-compromised families and individuals who fall below the poverty line. Equally important is the relationship building that occurs as resources are shared and volunteers open their hearts to bringing justice closer to home. ... “Bringing Justice Home is a new kind of neighborhood that goes beyond zip codes, race, disabilities, health labels or status,” says Constance Merritt, who co-founded the organization along with her wife, Maria Accardi. Merritt is a published writer and a licensed social worker with a master’s degree from the University of Louisville. She has worked with older adults in low-income senior housing, patients and families in hospital palliative care, and individuals receiving HIV and AIDS services. 

It takes considerable knowledge just to realize the extent of your own ignorance. ~Thomas Sowell

Virtual reality videos for symptom management in hospice and palliative careMayo Clinic Proceedings - Digital Health; by James R Deming, Kassie J Dunbar, Joshua F Lueck, Yoonsin Oh; 8/24Nature scenes significantly improved total symptom scores, as well as scores for drowsiness, tiredness, depression, anxiety, well-being, and dyspnea. The improved scores were not sustained 2 days later. Overall, bucket-list videos did not significantly improve symptoms. Neither previous experience with an activity nor a strong connection correlated with significant improvement; however, when patients rated video quality as outstanding, scores improved. Patients with lower functional status tended to have more symptoms beforehand and improve the most.

Ethics roundtable state-erected barriers to end-of-life careAmerican Journal of Hospice and Palliative Medicine; by Saima Rashid, Scott P Broyles, Andrew Wampler, Matthew Stolick, Steven J Baumrucker; 10/24[An interesting ethics case study discussed from physician, spiritual care, legal, and ethics perspectives. Discussion focused on conflicts between healthcare ethics and state law.]

"Grief explodes all relationships": Experiences of grief and coping among parents and siblings following the death of a childOmega (Westport); by Katy A Tenhulzen, Amy M Claridge, Abigail McCarthy, Meredith Craven, Libby Faith McClendon; 10/24The death of a child is an intense loss for families, which impacts the wellbeing of parents, surviving siblings, and the family as a whole. This study expanded on existing literature by collecting qualitative accounts from bereaved parents and siblings about their experiences before, during, and after the death of a child in their family... Findings highlighted three periods of the grieving process, which were not linear but rather ongoing and often happening simultaneously: (1) Crisis; (2) Learning to cope; and (3) Establishment of a new equilibrium... Findings have implications for palliative care and bereavement professionals in terms of supporting parent, sibling, and family coping before, during, and after the death of a child.

Beyond infection: Mortality and end-of-life care associated with infectious disease consultation in an academic health systemClinical Infectious Diseases; by Alison G. C. Smith, Michael E. Yarrington, Rasha Raslan, Wil L. Santivasi, Arthur W. Baker, Nicholas A. Turner, Gary M. Cox, Kristen V. Dicks, John J. Engemann, Patricia Kohler, Ahmad Mourad, Rebekah H. Wrenn, Sofia Zavala, Jason E. Stout; 10/24Infectious diseases (ID) physicians are increasingly faced with the challenge of caring for patients with terminal illnesses or incurable infections. This was a retrospective cohort of all patients with an ID consult within an academic health system from 1 January 2014 through 31 December 2023, including community, general, and transplant ID consult services. There were 60,820 inpatient ID consults involving 37,848 unique patients... In total, [2898] 7.5% of patients receiving an ID consult died during admission and 1006 (2.6%) of patients were discharged to hospice... In total 2866 (7.6%) of all patients receiving ID consultation also received palliative care consultation during the same hospitalization... Patients receiving ID consultation were increasingly complex and more likely to die soon after consultation. These results provide a framework for ID clinicians to consider their role in end-of-life care.Publisher's note: How often does your hospice work with infectious disease physicians and patients?

A comprehensive perspective on educational and economic barriers for utilization of palliative radiation therapy in hospice: A narrative reviewAdvances in Radiation Oncology; by Sarah J Hendee, Kareem Fakhoury, Sana D Karam; 10/24Despite the agreed-on efficacy and benefits of palliative radiation therapy (PRT) to alleviate end-of-life complications related to cancer progression, PRT remains an underused treatment in the hospice-care setting. Common barriers for hospice patient use of PRT include educational and economic limitations. This paper discussed these barriers and ways to eliminate them based on previously published interventions.