Literature Review

What does death look like for those experiencing homelessness in Southern Nevada?

Higher sepsis mortality in safety-net hospitals linked to fewer post-discharge care options Contagion Live - Infectious Diseases Today; by Kenneth Bender, PharmD, MA; 6/9/24 Purportedly higher sepsis mortality in safety-net hospitals reflects less a difference in acute care than opportunities to discharge to hospice. By extending the measure of sepsis-related mortality from in-hospital events to occurrences within 30 days after the diagnosis, the purported higher mortality rate of sepsis treated in safety-net hospitals decreased to parity with non-safety-net hospitals, in a retrospective national cohort study. The investigators note the particular challenges of safety-net hospitals, which care for a disproportionately high share of low-income and underinsured patients, include fewer resources and narrower operating margins, as well as patient populations with decreased access to preventative care and more complex disease presentations.

Paramedics helping hospice patients make final memories with family CKXS 99.1 News, St. Wallaceburg, Ontario; 6/7/24A new hospice program in Chatham-Kent is giving patients a chance to take one last end-of-life journey with their loved ones. Chatham-Kent EMS and the Chatham-Kent Hospice have partnered to create the Lasting Memories Program, which allows palliative patients to take a day trip to a location of their choosing. The program helps families create lasting memories of their loved ones in the final days through a trip to the farm, a ride to the lake, or enjoying a sporting event. Local paramedic Jon Benoit was credited for helping to get the program off the ground by coordinating services between the hospice and Medavie Health Services. “Medavie is really good about letting us use their ambulances and helping get this program running and supporting us through it… but the medics doing the actual program, it’s all volunteer time,” he said. Staff at the hospice work with families on coordinating the outing with volunteer paramedics, who escort them throughout the excursion, alleviating any health or medical concerns.

Good Samaritan Hospice opens regions first freestanding hospice house CBS WDBJ TV - 7, Roanoke, VA; by Neesy Payne; 6/7/24 A grand opening celebration was held Friday, June 7, for the Sheila S. Strauss Hospice House. It’s the region’s first freestanding hospice house. It was a part of the original plans of Good Samaritan Hospice back in 1992, and 32 years later, it is now a reality. “Our primary focus will always be taking care of patients at home; but when that’s not possible, maybe someone has pain, or needs respite, or a situation just arises that they need a different level of care, then we will be able to provide that in a facility that looks and is designed to be as homelike as possible,” said President and CEO of Good Samaritan Hospice Aaron Housh. ... It includes 16 private rooms, a living room, dining room, a chapel, and a courtyard – all aimed to make residents and their families feel at home.

Palliative care in the intensive care unit: The standard of care AACN - American Association of Critical-Care Nurses; by Clareen Wiencek, PhD, RN, ACNP, FAAN; 6/7/24Intensive care unit–based palliative care has evolved over the past 30 years due to the efforts of clinicians, researchers, and advocates for patient-centered care. ... This article provides an overview of the current state of intensive care unit–based palliative care, examines how the barriers to such care have shifted, reviews primary and specialist palliative care, addresses the impact of COVID-19, and presents resources to help nurses and intensive care unit teams achieve optimal outcomes. [Access to the full article requires subscription or purchase of the individual article.]

Why private equity hospice investors need to re-focus on patients Hospice News; by Jim Parker; 6/7/24 As private equity investors seek out hospice and other health care transactions, they should retrain their sights on potential benefits for patients in addition to financial metrics. Driving this is a changing regulatory environment as scrutiny heats up for both hospices and the private equity firms themselves. Tightened regulation in the hospice space has led to longer, more stringent diligence processes when it comes to buying and selling provider companies. This means that potential buyers are looking hard at compliance and quality metrics before completing a deal, along with the seller’s financials.

Patient’s wish to visit Graceland granted with help of Texarkana’s Heritage Hospice NBC KTAL-6, Texarkana, TX: by Hunter Trombetta; 6/7/24A Texarkana hospice recently fulfilled one of its patients’ wishes. Debora Warren is a patient with Heritage Home Health & Hospice. She says she has been an Elvis fan since she was 10 years old. ... Her favorite Elvis song, “If I Can Dream,” surely takes on a new meaning now because, at the age of 71, her dream to visit Graceland came true thanks to a unique program at Heritage Hospice. “Wishes is a program where we grant our hospice patients their final wishes. Miss Debora Warren wanted to go to Graceland, and so we made that happen,” says Kristy Minton, the Volunteer Coordinator at Heritage Home Health and Hospice.

Union ratifies RN contract with Ascension Genesys WNEM-TV5, Genessee Co., Mich; by Hannah Mose; 6/5/24 The union representing the registered nurses (RNs) at Ascension Genesys Hospital announced the tentative agreement between the union and the hospital has been ratified. On May 20, Teamsters Local 322 president Dan Glass said there had been months of failed negotiations between the union and the hospital, and if there wasn’t an agreement made by May 24, the union would strike. However, on May 22, Teamsters Local 322 said a tentative agreement had been reached between the union and the hospital.

Reply to: Frailty and ethics at the end of life: The importance of a comprehensive assessmentJournal of the American Geriatrics Society; by Colum Thomas MD, Eduardo Bruera MD, William Breitbart MD, Yesne Alici MD, Liz Blackler MBE, LCSW-R, Julia D. Kulikowski MD, Daniel P. Sulmasy MD, PhD; 6/5/24The care of older persons at the end of life often involves competing concerns and highly value-sensitive decisions. In a recent article, we proposed a set of ethical rules—the canons of therapy—to help clinicians navigate complex cases involving older adults with delirium at the end of life. The canons of therapy most pertinent to such cases are restoration, means-end proportionality, discretion, and parsimony (see Table 1 for a description). These canons provide a structured toolset aligned with practical wisdom, which can serve as an ethical heuristic for guiding therapeutic judgments. ...

Sexual function in serious illness: Areej El-Jawahri, Sharon Bober, and Don DizonGeriPal Podcast; Eric Widera, Alex Smith, Areej El-Jawahri, Sharon Bober, Don Dizon; 6/6/24As Eric notes at the end of today’s podcast, we talk about many difficult issues with our patients. How long they might have to live. Their declining cognitive abilities. What makes their lives meaningful, brings them joy, a sense of purpose. But one issue we’re not as good at discussing with our patients is sexual health. On today’s podcast Areej El-Jawahri, oncologist specializing in blood cancers at MGH, says that sexual health is one of the top if not the top issue among cancer survivors. Clearly this issue is important to patients.

Joel Mekler - Medicare Moments: Watch out for these latest scams New Castle News; by Joel Mekler; 6/3/24 ... Across the country, many unscrupulous hospice providers are recruiting and enrolling nonterminally ill patients for end-of-life care they do not need and then billing Medicare for services and items they may never receive. They trick beneficiaries into signing up for hospice by offering freebies, such as additional groceries, nurse visits, durable medical equipment, bus coupons, and more once they enroll. They also make false claims, such as saying “Medicare now covers cooking and cleaning services”. Or they tell beneficiaries they qualify due to age, saying “You’re now old enough to qualify for hospice!” Another tactic is giving money, with some recruiters telling beneficiaries, “You can earn $400/month if you agree to enroll in our program.” ... Tips [to consumers] to avoid hospice fraud:

Hospice of Santa Barbara celebrates 50 years with its Legacy of Compassion Campaign and a strong commitment to the futureSanta Barbara Independent; by Hospice of Santa Barbara; 6/3/24 When Hospice of Santa Barbara (HSB) officially opened its doors in 1974, it was at the forefront of a visionary movement. Only one other hospice existed in the United States at the time and a local group of Santa Barbara leaders committed to meeting the needs of people and families struggling with life-threatening illness or grieving the death of a loved one. Over the past 50 years, HSB has served tens of thousands of people. ... During this time, HSB has repeatedly adapted and grown to meet the changing needs of our community including the many community crises and disasters our community has faced. ... [As] HSB looks to their next 50 years, they see a changing landscape that greatly impacts their mission.Editor's Note: Congratulations Hospice of Santa Barbara! Thank you for pioneering our hospice movement 50 years ago and for continuing to grow and evolve your services through ongoing changes. The "one other hospice" that existed in the U.S. is Connecticut Hospice, which also continues to lead the way. Congratulations and thanks to you, too!

National aging framework outlines governmentwide initiatives promoting home-based careMcKnight's Home Care; by Adam Healy; 6/3/24The Department of Health and Human Services released a new framework for its National Plan on Aging on Thursday. The framework aims to guide a multifaceted, governmentwide approach to help caregivers and home- and community-based service providers enable older adults to age comfortably in place.