Literature Review

How to choose the right hospice care - Brain & Life Magazine Brain & Life; by Hallie Levine; June/July 2024 Hospice care is designed to help patients die with dignity and provide support to their families. These tips can help ensure it does. ... [Case study examples follow.] In hospice, “the focus shifts from treating the disease to managing symptoms and maintaining quality of life,” says James Gordon, MD, FAAN, a neurologist and retired hospice and palliative care expert at the University of Washington in Seattle. “Patients and their families often get to a point where they ask themselves if the cure is causing more suffering than it's worth,” Dr. Gordon says. “If they are close to the end of life, it's often time for hospice.”Editor's Note: We chose this article because its source, Brain & Life Magazine. This can be an excellent disease-specific resource for your serious illness, palliative, hospice, and bereavement team members. "Brain & Life is powered by more than 40,000 neurologists worldwide who are committed to keeping you and your family better informed." Visit its "Disorders A-Z: Neurologic Disorders Resource Center (brainandlife.org)." 

Haven Hospice team members win three Florida Hospice and Palliative Care Association awardsPress release; 6/5/24Gainesville, FL: Three Haven Hospice team members were awarded with Florida Hospice and Palliative Care Association (FHPCA) Awards of Excellence at the 2024 FHPCA 39th Forum in Orlando, Florida.

Governor on hand for PACE openingNews-ExpressKy, Pikeville, KY; by Terry L. May; 6/7/24Mountain View PACE (Program of All-Inclusive Care for the Elderly) was created to help adults 55 years old and older with complex care needs to avoid nursing homes and to receive care and services necessary to help them be safe, comfortable, and healthy while maintaining a more independent lifestyle, Mountain View PACE Medical Director Dr. James Rummel Jr. said. ... “For those of us who have aging parents, we see this cycle of people who are having a hard time living well at home so they tend to do this circle of home to the ER to the hospital to the nursing home for rehab then back home and it keeps repeating.” ... “We are not trying to replace anybody,” Rummel said. “We are trying to augment the system to fill the gaps. We are a niche type of healthcare system.” ... “What a great day in Pikeville and Pike County,” Governor Beshear said. “How we treat our seniors says something about us and our values as a people." 

AccentCare expands hospice care business to Rhode Island HomeCare; 6/7/24 AccentCare, a nationwide provider of home health, hospice and personal care services, announced the opening of its Warwick hospice location and its expansion into Rhode Island after being awarded a Certificate of Need (CON) license in the state. “We are excited to expand our footprint in New England and to provide hospice services to more patients and families in the region,” said Andy Johnston, president of hospice & PCS, AccentCare. “We know the critical role hospice plays in extending the continuum of care to patients and adding dignity to the end of life. We are honored to begin providing high-quality, compassionate care in Rhode Island.” 

Five arrested over 'sham hospices' alleged to bilk Medicare for over $15 million Los Angeles Times; by Emily Alpert Reyes; 6/8/24 Angeles over an alleged scheme to bilk the Medicare program of more than $15 million. The U.S. Department of Justice said three of the San Fernando Valley residents who were arrested — Petros Fichidzhyan, also known as Peter; Juan Carlos Esparza; and Karpis Srapyan, also known as Tony Levy — were accused of running "sham hospice companies" and turning in fraudulent claims to Medicare for hospice services. ... As part of the alleged scheme, the three defendants misappropriated the identifying information of doctors to claim those physicians had deemed hospice services necessary for patients, federal prosecutors said. They also allegedly used the names and Social Security numbers of Russian and Ukrainian citizens who had left the U.S. to open bank accounts and sign leases, indicating that the "impersonated identities" were the owners of the hospice companies that they in fact controlled, according to the federal indictment. 

Navigating the complexities of palliative care for patients with comorbidities and complicated symptomsPharmacy Times; 6/6/24In an interview with the Pharmacy Times, Justin Kullgren, PharmD, FAAHPM, Palliative Medicine Clinical Pharmacist Specialist and PGY2 Pain Management & Palliative Care Residency Program Director at The Ohio State University Wexner Medical Center, James Cancer Hospital, shares insights into palliative care and common challenges faced by pharmacists treating patients with complicated symptoms. He discusses the complex nature of patient cases in palliative care, emphasizing the importance of effective treatment management, pain tolerance, and overcoming patient barriers to treatment.

Surprise D-Day veteran honored on anniversaryDaily Independent; by Lin Sue Flood; 6/6/24At the tender age of 18, Surprise [AZ] resident Ned Kent joined the Army. That was January 1940 — just four months into World War II — and he served faithfully through July 1945, virtually the end of the war. A hard worker, Kent rose to the rank of technical sergeant and fought on the front lines of the Battle of the Bulge in Belgium. He and his troop won a Bronze Star for their heroic actions storming Normandy while under German bombardment on D-Day 80 years ago. ... But those five years of service were difficult to talk about. It took Kent decades to open up about what he experienced, including the horrors witnessed while liberating a concentration camp. One of the people he shared openly with was Hospice of the Valley social worker Roberta Fellows. Once she learned about his time in the service, she was determined to give him some much-needed recognition for all he endured. She called upon a veteran volunteer with Hospice of the Valley’s Saluting Our Veteran’s program. ... The humble centenarian was beside himself, surrounded by son-in-law Sam, a Vietnam-era veteran, and Debi, who brought a surprise gift: 11 of his medals framed in a shadow box.

Death with dignity: 50th anniversary of America’s first hospiceYankee Institute; by Andrew Fowler; 6/7/24 ... In the late 19th century, terminally ill patients faced undignified treatment or were even “refused admission to the hospital entirely” due to “availability of space and resources” or race and socio-economic class, according to Doctors, Death, and Denial: The Origins of Hospice Care in 20th Century America by Sarah E. Pajka. ... All of this shaped the outlook of Florence Wald — a former dean of the Yale University School of Nursing, and a Branford native. Growing up in the early 20th century, she recognized the flaws and inhumane nature of medical care toward terminal patients, telling the Associated Press (AP), on Nov. 26, 1971, that death is “a period of life that can have a lot of meaning. It can be content, full of joy, with lots of reminiscing.” But death needed to be “more human and meaningful,” as she stated in the same AP article. Throughout her career, Wald’s passion for palliative care revolutionized the medical profession, with her co-founding “The Connecticut Hospice,” the first in the United States, on June 11, 1974.  Since then, more than 5,200 hospices have been established in the country and millions have sought both in-patient and home care services. This is the story of how the first hospice was founded in Connecticut 50 years ago.  ... Editor's Note: This fascinating history of hospice's beginnnings illuminate core purposes, outcomes (are we measuring the right factors?), and current 21st century challenges. This article is published by the Yankee Institute, not Connecticut Hospice. This author frames this history as a stand against "euthanasia." Whatever one's ethical, political, or religious stand on today's MAiD issues (Medical Aid in Dying)--also referred to as physician assisted suicide--we invite you to find common ground in learning from our history and celebrating Florence Wald's co-founding of The Connecticut Hospice. For readers, what do you know about your hospice organization's history? What might you research and learn? Whom can you honor? Fifty years from now, what will be said of how your organization chose to address 2024's core hospice purposes, outcomes, and challenges?

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.

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. ...

NAHC, NHPCO comment on revision of Hospice Certifying Physician Enrollment RequirementHomeCare; 6/7/24 The National Association for Home Care & Hospice (NAHC) and the National Hospice and Palliative Care Organization (NHPCO) responded to the Centers for Medicare & Medicaid Services (CMS) recently revised guidance regarding the implementation of the hospice certifying physician enrollment requirement. NAHC and NHPCO identified that some instruction provided by CMS was inconsistent with established law and regulations regarding the certification of a patient’s terminal illness for new hospice elections after the first benefit period. That instruction, if implemented, could have resulted in major negative impacts on hospices and the patients and families they serve. Both organizations requested that CMS retract the guidance to remain consistent with regulation and statute. On June 6, CMS rescinded its guidance in order to align with current regulations, offering clarity for providers. 

OKC woman charged after allegedly facilitating mother's suicide: 'Do with it what you will'The Oklahoman; by Josh Dulaney; 6/6/24A woman facing murder charges is accused of giving a firearm to her mother who then shot herself to death. In Oklahoma County District Court this week, Jaye Dee Watts, 44, was charged with first-degree murder in the commission of a crime, second-degree murder, kidnapping and aiding suicide by furnishing a weapon. Court documents reveal the shocking allegations. About 7:13 p.m. on Sept. 10 ... Oklahoma City police responded to a call about an attempted suicide involving a firearm. The caller was a hospice employee who said she had received a phone call from Watts, the victim’s daughter. According to an affidavit that was part of an arrest warrant filed by a homicide detective, Watts told the hospice employee that her mother, 72, shot herself. The hospice employee called 911 after speaking with Watts, and responding officers found Watts’ mother dead inside the home. Editor's Note: The descriptions are graphic. This is not an example of "Medical Aid in Dying" for the purpose of ending suffering, but rather an example of elder abuse paired with workplace violence.

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.