Literature Review

Racial/ethnic differences in care intensity at the end of life for patients with lung cancer The ASCO Post, by Matthew Stenger; 3/21/24 The study used data from the California Cancer Registry linked to patient discharge data abstracts. The primary outcome measure was intensity of care in the last 14 days before death, with greater intensity defined as any hospital admission or emergency department visit, intensive care unit (ICU) admission, intubation, cardiopulmonary resuscitation (CPR), hemodialysis, and death in an acute care setting. ... The authors concluded: “Compared with [non-Hispanic White] patients, [Asian/Pacific Islander], Black, and Hispanic patients who died with lung cancer experienced higher intensity of [end-of-life] care. Future studies should develop approaches to eliminate such racial and ethnic disparities in care delivery at the [end of life].”

Physicians often shy away from preparing their patients to dieToday'sHospitalist, by Colleen Poggenburg, MD, MS; 3/22/24 There's beauty in death if we can tolerate looking. ... The beauty in death is the reflections that occur in the weeks, days and minutes prior to it, which together make up a summary of someone’s life. Why then do physicians view this time-honored decline as a series of clustered medical problems, when it really is just someone moving toward death? Are we so concerned about treating just one more condition, and do we actually think it will solve the growing list of medical problems that dying patients have? ... I compared dying to pregnancy to “soften” the description of this decline. Here’s how I see that comparison: ...Editor's Note: The author offers a fascinating, meaningful comparison of physician/patient conversations with someone who is pregant versus someone who is dying. I encourage you to share this article with your clinical leaders (and adapt it for staff), as this model beautifully reframes important conversations that can empower patients and their families.

Preventing adverse drug events in hospice care Hospice News, by Holly Vossel; 3/15/24 Documentation errors and a fragmented health system pose the greatest risks for adverse drug events among hospices. ... Evaluating these risks involves having solid medication reconciliation processes in place — both at the time of a patient’s admission and throughout their end-of life care experience, according to Mary Lynn McPherson, professor and executive program director of advanced post-graduate education in palliative care at the University of Maryland’s School of Pharmacy. McPherson also serves on the board of the American Academy of Hospice and Palliative Medicine (AAHPM).

Medicaid Fraud Control Units Fiscal Year 2023 Annual ReportU.S. Department of Health and Human Services, Office of Inspector General; 3/14/2024Medicaid Fraud Control Units (MFCUs or Units) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. [This 32 page, downloadable document includes:]

Responding to Soul Injury: Tools for hope and healing Journal of Hospice & Palliative Nursing; by Deborah Grassman, Abi Katz, Luann Conforti-Brown, Josephine F Wilson, Angie Snyder; 3/13/24Soul Injury is defined as a wound that separates a person from their real self, caused by unmourned loss and hurt, unforgiven guilt and shame, and fear of helplessness or loss of control. Tools and interventions have been developed to guide people impacted by Soul Injury. This study assessed the effectiveness of 12 tools and interventions, ... The Anchor Your Heart tool was the most frequently used tool and had the most enduring utilization across time and settings.Editor's Note: Click here for The Anchor Your Heart Tool identified in this article. Share this research and article with your clinical teams and bereavement counselors.

Home-focused PACE model continues to gain traction across US Home Health Care News, by Joyce Famakinwa; 3/19/24 A Georgia House Bill that would create a Program of All-Inclusive Care for the Elderly (PACE) was passed by the state senate earlier this month. House Bill 1078 passed in a 49 to 1 senate vote.Specifically, the bill creates a new adult day center licensure exclusion in order to authorize the Department of Community Health to establish and implement PACE in Georgia as part of the state’s medical assistance program. The Department of Community Health would manage the program. 

Student-run Arizona non-profit uses origami to connect with hospital [and hospice] patients The State Press, by Pippa Fung; 3/19/24The Wishing Crane Project, founded by Arizona student Charles Zhang, serves hospice and hospital patients through art. In the story of Sadako and the Thousand Paper Cranes, a young girl tried to fold 1,000 paper cranes in the hopes that it would help her push through a terminal illness. Years later, students across Arizona and at ASU are folding their own cranes [and writing hopeful messages] to support others through their difficult journeys.  Editor's Note: To Hospice Volunteer Directors/Managers, do you receive requests from high school students/groups requesting community service hours? Click here for The Wishing Crane Project.

Hearing with Health and Human Services Secretary BecerraHouse Ways and Means CommitteePublisher's note: CA Representatives Steel (@ 4:01) and Van Duyne (@ 4:14) ask pointed questions of Secretary Becerra regarding hospice fraud, particularly focused on Southern California. Thanks to Sheila Clark, California Hospice & Palliative Care Association, for sharing this link. Also, yesterday (3/20/24) Judi Lund Person, Lund Person & Associates Hospice Consulting, presented on this specific topic at the Nebraska Hospice & Palliative Care Association Annual Conference.

MedPAC releases March 2024 report on Medicare payment policy CMS MedPAC; 3/15/24 Washington, DC, March 15, 2024—Today, the Medicare Payment Advisory Commission (MedPAC) releases its March 2024 Report to the Congress: Medicare Payment Policy. The report presents MedPAC’s recommendations for updating provider payment rates in traditional fee-for-service (FFS) Medicare for 2025 and for providing additional resources to acute care hospitals and clinicians who furnish care to Medicare beneficiaries with low incomes. ... MedPAC recommends ... eliminating the payment update for hospice providers; and payment reductions for three post-acute care sectors (skilled nursing facilities, home health agencies, and inpatient rehabilitation facilities).Editor's Note: Click here to download this report's "Chapter 9: Hospice Services"

Book Review: The Journey’s EndAmerican Journal of Medical Quality, by Casey, Donald E. Jr MD, MPH, MBA; 3/24.Michael Connelly's "The Journey's End" is a highly engaging and insightful guide for bouth ourselves and our loved ones on how we ought to face death with dignity.

Transitions between skilled home health and hospice for persons living with dementia: a systematic review of literatureAnnals of Palliative Medicine, by Sharon E. Bigger, Robin Ann Foreman, Christiana Keinath, Gail L. Towsley; 3/24We found that persons living with dementia are at higher risk for early, unsuccessful discharge from-and readmission to-skilled skilled home health; and persons living with dementia are at higher risk for being discharged alive from hospice.

Empowering young voices: Navigating the complexities of minors in healthcare decisionsEuropean Journal of Pediatrics, by J Peter de Winter, Jaan Toelen, Gregorio Paolo Milani; 3/24The inclusion of children in healthcare decisions is a crucial element that requires attention to ethical, legal, and psychological considerations. Balancing autonomy with welfare interests and parental involvement is a significant challenge in pediatric healthcare ethics.

Courage is what it takes to stand up and speak; courage is also what it takes to sit down and listen. ~Winston Churchill