Literature Review
Updated guidance on workplace harassment covers misgendering pronouns, bias over bathroom use, more
05/12/24 at 03:20 AMUpdated guidance on workplace harassment covers misgendering pronouns, bias over bathroom use, more McKnights Senior Living; by Kathleen Steele Gaivin; 5/2/24 Final guidance published last week by the Equal Opportunity Employment Commission aims to clarify for employers, employees and others their obligations related to harassment in the workplace. ... This is the first update to the guidance in 25 years, aimed at enforcing more recent changes in federal law. EEOC clarified that harassment by any person — including employers, coworkers, customers and clients — can violate federal law. ... According to the EEOC, the new guidance “updates, consolidates and replaces the agency’s five guidance documents issued between 1987 and 1999 and serves as a single, unified agency resource on EEOC-enforced workplace harassment law.” Among other guidance, the EEOC calls out asking intrusive questions about a person’s sexual orientation, gender identity, gender transition or intimate body parts as forms of harassment.
Elara Caring, cited in death of visiting nurse Joyce Grayson, vows to contest violation
05/12/24 at 03:15 AMElara Caring, cited in death of visiting nurse Joyce Grayson, vows to contest violation McKnights Home Care; by Adam Healy; 5/3/24 The Department of Labor’s Occupational Safety and Health Administration (OSHA) has cited home health, hospice and personal care provider Elara Caring for failing to provide adequate safeguards to protect visiting nurse Joyce Grayson from workplace violence. Grayson, a licensed practical nurse, was killed last Oct. 28 while providing a home health visit for a client living in a halfway house in Willimantic, CT. The DOL disclosed this week that its OSHA division cited New England Home Care, where Grayson worked, and Jordan Health Care Inc., which both do business as Elara Caring, with a “Willful-Serious” citation. Elara Caring faces up to $163,627 in penalties resulting from the citation. ...
[Australia] Palliative patients can die peacefully at home with paramedic support, claims proposed framework
05/12/24 at 03:10 AM[Australia] Palliative patients can die peacefully at home with paramedic support, claims proposed frameworkRiotack - Australia; by James Day; 5/6/24A proposed national framework suggests paramedics could help ease pressure on emergency departments by supporting palliative care patients who wish to die at home. Published in the leading international peer reviewed journal Palliative Medicine, the framework seeks to embed palliative care into paramedics’ core business and reduce needless transports to hospital. ... Lead author and trained paramedic Dr. Madeleine Juhrmann developed the framework in consultation with paramedics, palliative care doctors, GPs, carers with lived experience and others. The expert group – representing six countries and all the states of Australia – agreed on the framework’s 32 service changes to standardise best practice for paramedics delivering palliative care in community-based settings.Editor's Note: Pair this solution with related articles in today's newsletter, "Stranded in the ER, seniors await hospital care and suffer avoidable harm" and "How Mass General Brigham provides emergency care at home" (both are in our "Post-Acute" section).
Maddy Baloy had only 1 year to live after cancer diagnosis — and chose joy: 'Didn’t let anything defy her’
05/12/24 at 03:05 AMMaddy Baloy had only 1 year to live after cancer diagnosis — and chose joy: 'Didn’t let anything defy her’ People; by Lizzie Hyman; 5/8/24 Even surrounded by loved ones in hospice care at her Florida home, Maddy Baloy craved adventure. “She kept saying, ‘I want to go outside and go swimming,’ ” her fiancé Louis Risher tells PEOPLE in this week’s issue. It was how Baloy had approached each day from the time she was diagnosed with terminal cancer in February 2023, to the end of her life on May 2, 2024. In just over one year, the 26 year old gained the admiration and support of millions who followed her journey on TikTok as she worked her way through a 19-item bucket list of skills to learn, people to meet and places to go. “Maddy did not let anything defy her,” Risher, 27, says. “She was always just about love.”
Sunday newsletters
05/12/24 at 03:00 AMSunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!
TCN News Stories of the Month, April 2024
05/12/24 at 03:00 AMTCN News Stories of the Month, April 2024TCN Talks; by Chris Comeaux and Mark Cohen; 5/1/24In this podcast Chris and Mark discuss our newsletter's top news stories for the month of April as reported in Hospice and Palliative Care Today. You can subscribe for free here: https://www.hospicepalliativecaretoday.com/registration.
How to become a great boss
05/12/24 at 03:00 AMHow to become a great bossBy Jeffrey J. Fox; 2002The Great Boss Simple Success Formula:
Retraumatization when an adult child cares for the parent who harmed them through serious illness or the end of life
05/11/24 at 03:00 AMRetraumatization when an adult child cares for the parent who harmed them through serious illness or the end of lifeJournal of Pain and Symptom Management; by Jaime Goldberg, Jooyoung Kong; 5/24Adult children caring for a parent who harmed them through the parent's serious illness or the end of life are at high risk for experiencing retraumatization. This session will offer trauma-informed, culturally responsive, person-centered tools and techniques hospice and palliative care professionals can use to effectively identify, assess, and intervene with this often-overlooked population of caregivers.Publisher's note: This current article summary is for an upcoming AAHPM conference workshop. The study was previously published in JPSM 5/24 here.
Associations between Certificate of Need policies and hospice quality outcomes
05/11/24 at 03:00 AMAssociations between Certificate of Need policies and hospice quality outcomesAmerican Journal of Hospice & Palliative Medicine; by Arlen G. Gaines, John G. Cagle; 5/24Approximately 86% of hospices are in states without a hospice CON provision. The unadjusted mean HIS scores for all measures were higher in CON states (M range 94.40-99.59) than Non-CON (M range 90.50-99.53) with significant differences in all except treatment preferences. ... The study suggests that CON regulations may have a modest, but beneficial impact on hospice-reported quality outcomes, particularly for small and medium-sized hospices.
The role of mindfulness and resilience in Navy SEAL training
05/11/24 at 03:00 AMThe role of mindfulness and resilience in Navy SEAL trainingMilitary Psychology; by Andrew Ledford, Celeste Raver Luning, Deirdre P. Dixon, Patti Miles, Scott M. Lynch; 5/24Mindfulness and resilience are thought to be essential qualities of the military’s special operations community. Both are tested daily in Special Operations Forces (SOF) assessment and selection efforts to prepare candidates to persist through grueling training and complex combat situations; but these qualities are rarely measured. While military leadership places value on the concepts of mindfulness and resilience, there is minimal empirical research examining the role that they play in the completion of training. This longitudinal study followed three classes of SEAL candidates at Basic Underwater Demolition/SEAL (BUD/S) training over their six-month selection program. We estimated logit models predicting successful completion of BUD/S and specific types of failure in that training environment with indexes of mindfulness and resilience at the start of the program as predictors of completion. The results indicate that mindfulness is generally unrelated to completion, while resilience generally predicts completion.Publisher's note: A leadership-oriented article from another field (the military) that can be applied to healthcare.
Does assisted living provide assistance and promote living?
05/11/24 at 03:00 AMDoes assisted living provide assistance and promote living?Health Affairs; by Sheryl Zimmerman, Robyn Stone, Paula Carder, Kali Thomas; 5/24Assisted living has promised assistance and quality of living to older adults for more than eighty years. ... As assisted living has evolved, the needs of residents have become more challenging; staffing shortages have worsened; regulations have become complex; the need for consumer support, education, and advocacy has grown; and financing and accessibility have become insufficient. Together, these factors have limited the extent to which today’s assisted living adequately provides assistance and promotes living, with negative consequences for aging in place and well-being. This Commentary provides recommendations in four areas to help assisted living meet its promise: workforce; regulations and government; consumer needs and roles; and financing and accessibility. Policies that may be helpful include those that would increase staffing and boost wages and training; establish staffing standards with appropriate skill mix; promulgate state regulations that enable greater use of third-party services; encourage uniform data reporting; provide funds supporting family involvement; make community disclosure statements more accessible; and offer owners and operators incentives to facilitate access for consumers with fewer resources. Attention to these and other recommendations may help assisted living live up to its name.Publisher's note: Many of these ALF recommendations may be helpful in hospice, too...
Today's Encouragement
05/11/24 at 03:00 AMSuccess is stumbling from failure to failure with no loss of enthusiasm. ~Winston Churchill
Reflective learning: A new leadership development framework driving engineering innovation
05/11/24 at 03:00 AMReflective learning: A new leadership development framework driving engineering innovationReflective Practice; by Jeremy Wei; 2/18/24Innovation is an organizational learning process that demands a reflexive perspective to take on uncertainties and question deeply held assumptions, propelling leadership and organizational structures forward. ... A reflexive-learning-based leadership development program is a set of collective actions comprising four fundamental steps: acknowledging problems, reassessing assumptions, thinking of alternatives, and developing new perspectives. This study demonstrates its effectiveness in developing collective reflexivity within an engineering organization by repurposing the After-Action Review (AAR) as reflexive learning training.Publisher's note: A leadership model applied in the engineering field that could be translated to healthcare.
The value of screening for a history of incarceration in the palliative care setting
05/11/24 at 03:00 AMThe value of screening for a history of incarceration in the palliative care settingAmerican Journal of Hospice and Palliative Medicine; by Joseph Michael Schnitter, Joshua Hauser; 5/24In this article, we explore existing literature that highlights the unique physical, cognitive, and psychosocial challenges that formerly incarcerated patients face. We proceed to argue that palliative care providers should screen for a history of incarceration to identify and address the needs of this patient population. We also offer strategies to create a safe, welcoming environment to discuss past traumas related to these patients’ time in prison.
Inpatient palliative care and healthcare utilization among older patients with Alzheimer's Disease and Related Dementia (ADRD) and high risk of mortality in U.S. hospitals
05/11/24 at 03:00 AMInpatient palliative care and healthcare utilization among older patients with Alzheimer's Disease and Related Dementia (ADRD) and high risk of mortality in U.S. hospitalsAmerican Journal of Hospice and Palliative Care; by Zhigang Xie, Guanming Chen, Oluwadamilola T Oladeru, Hanadi Y Hamadi, Lucinda Montgomery, Maisha T Robinson, Young-Rock Hong; 5/24PC substantially reduced hospital expenditures for older patients with ADRD-HRM, but the prevalence remained low at 14.6% in the study period. Future studies should explore the unmet needs of patients with lower sociodemographic status and those in rural hospitals to further increase their PC consultation utilization.
Saturday newsletters
05/11/24 at 03:00 AMSaturday newsletters focus on headlines and research - enjoy!
In praise of hospice
05/11/24 at 03:00 AMIn praise of hospiceJAMA; by James R. Nicholas, MD; 4/24... Joan did what she wanted to do: she, with the help of hospice, made her dying as easy as possible for me and our children. I have the same wish for myself. I doubt if I will achieve it as well as did Joan, but I will have her as a guide. And I hope I will have the kind of hospice team that Joan had.
End-of-life ethics content in the ten residencies offering Hospice and Palliative Medicine Fellowship
05/11/24 at 03:00 AMEnd-of-life ethics content in the ten residencies offering Hospice and Palliative Medicine FellowshipJournal of Pain and Symptom Management; by Sara W. Youssef, Lauren E. Berninger, Danielle J. Doberman; 5/24Ethics training is essential to hospice and palliative medicine (HPM) training. Ten residencies feed into HPM fellowship, but clinical ethics tested on board certification exams vary in content and weight across specialties. Given this variance, standardizing end of life ethics training for HPM fellowship programs presents an opportunity for educational improvement.
Oregon Death with Dignity Act access: 25 year analysis
05/11/24 at 03:00 AMOregon Death with Dignity Act access: 25 year analysisBMJ Supportive & Palliative Care; by Claud Regnard, Ana Worthington, Ilora Finlay; 5/24[UK] The number of assisted deaths in Oregon increased from 16 in 1998 to 278 in 2022. Over this time, patients’ health funding status changed from predominantly private (65%) to predominantly government support (79.5%), and there was an increase in patients feeling a burden and describing financial concerns as reasons for choosing an assisted death. There has been a reduction in the length of the physician–patient relationship from 18 weeks in 2010 to 5 weeks in 2022, and the proportion referred for psychiatric assessment remains low (1%). Data are frequently missing, particularly around complications.
[Honoring Nurses Week] Too many nurses are being assaulted. Some say they are being blamed for the attacks.
05/10/24 at 03:05 AM[Honoring Nurses Week] Too many nurses are being assaulted. Some say they are being blamed for the attacks. Chief Healthcare Executive; by Ron Southwick; 5/9/24 With disturbing regularity, nurses in hospitals and other healthcare settings are being physically assaulted and verbally harassed. More than half of emergency nurses say they’ve been assaulted or threatened within the past 30 days, according to the Emergency Nurses Association. In a separate study, researchers found that healthcare workers faced at least one violent or aggressive incident for every 40 hours worked, according to findings published by The Joint Commission Journal on Quality and Patient Safety. With the observance of National Nursing Week, the increased violence in healthcare can’t be ignored. Nursing leaders say the regular exposure to violence or threatening behavior is one factor adding to stress and burnout of nurses and, in some cases, spurring them to seek new jobs.
Teeing it up for Hospice of the Valley: Over $53k raised
05/10/24 at 03:00 AMTeeing it up for Hospice of the Valley: Over $53k raisedCity Sun Times; by Lin Sue Flood; 5/6/24It was a picture-perfect day out at Grayhawk Golf Club for Hospice of the Valley’s 2024 Pro-Am Golf Tournament, presented by Cigna Healthcare. The March 28 event in Scottsdale raised over $53,000 for the nonprofit’s charity care programs. “It’s a tournament that is meaningful for all players,” said sponsor Tim Louis, who competes every year with wife Amy in memory of his parents. “It’s a mission of love, it’s a mission of dignity and I love to support it.”
Financial strain on nursing homes sparks buying binge
05/10/24 at 03:00 AMFinancial strain on nursing homes sparks buying binge Modern Healthcare; by Diane Eastabrook; 5/8/24Skilled nursing facility deals increased more than 80% in the first quarter of 2024 compared with the same period in 2023. There were 57 nursing home acquisitions valued at nearly $1.4 billion in the first quarter of this year compared with 31 deals valued at $448 million during the same period last year, according to Levin Associates, which tracks healthcare mergers and acquisitions. ... Last year was the worst year for healthcare bankruptcies in five years, according to restructuring and consulting firm Gibbins Advisors. Senior living and pharmaceuticals accounted for half of the 79 Chapter 11 filings in healthcare in 2023, the company said. It predicted continued distress for the senior care industry this year in a January research report.
Amedisys to sell 100 locations to advance UnitedHealth group deal
05/10/24 at 03:00 AMAmedisys to sell 100 locations to advance UnitedHealth group deal Hospice News; by Holly Vossel; 5/8/24 Amedisys Inc. has agreed to divest upwards of 100 home health and hospice locations to an undisclosed private equity buyer as the company addresses regulators’ antitrust concerns in its pending acquisition by the UnitedHealth Group’s (UNH) health care services arm Optum. The news came in a recent social media post from The Capitol Forum. Selling off some of Amedisys’ locations in overlapping markets within Optum’s service region may help push the transaction forward amid mounting regulatory concerns. The U.S. Department of Justice (DOJ) is mulling a possible lawsuit to block the acquisition, citing potential antitrust issues related to the deal. The concerns center around the ability for other providers to compete if Optum and Amedisy combine their geographic footprints.
Today's Encouragement: For Mother's Day, "I wonder ..."
05/10/24 at 03:00 AM“I wonder if my first breath was as soul-stirring to my mother as her last breath was to me.” - Lisa Goich-Andreadis, 14 Days: A Mother, A Daughter, A Two-Week GoodbyeEditor's Note: Remembering my mom, Jane.