Literature Review

Navigating Aging: Lack of affordability tops older americans’ list of health care worries KFF Health News - Northern Kentucky Tribune; by Judith Graham, KFF News; 7/5/24 What weighs most heavily on older adults’ minds when it comes to health care? The cost of services and therapies, and their ability to pay. ... A new wave of research highlights the reach of these anxieties. When the University of Michigan’s National Poll on Healthy Aging asked people 50 and older about 26 health-related issues, their top three areas of concern had to do with costs: of medical care in general, of long-term care, and of prescription drugs. More than half of 3,300 people surveyed in February and March reported being “very concerned” about these issues. 

Medicare Program: End-Stage Renal Disease Prospective Payment System, Payment for Renal Dialysis Services Furnished to Individuals with Acute Kidney Injury, etc. Federal Register; Proposed Rule by the Centers for Medicare & Medicaid Services; 7/5/24

Clinician- and patient-directed communication strategies for patients with cancer at high mortality risk JAMA Network Open - Oncology; by Samuel U. Takvorian, MD, MSHP; Peter Gabriel, MD, MSE; E. Paul Wileyto, PhD; Daniel Blumenthal, BA; Sharon Tejada, MS; Alicia B. W. Clifton, MDP; David A. Asch, MD, MBA; Alison M. Buttenheim, PhD, MBA; Katharine A. Rendle, PhD, MSW, MPH; Rachel C. Shelton, ScD, MPH; Krisda H. Chaiyachati, MD, MPH, MSHP; Oluwadamilola M. Fayanju, MD, MA, MPHS; Susan Ware, BS; Lynn M. Schuchter, MD; Pallavi Kumar, MD, MPH; Tasnim Salam, MBE, MPH; Adina Lieberman, MPH; Daniel Ragusano, MPH; Anna-Marika Bauer, MRA; Callie A. Scott, MSc; Lawrence N. Shulman, MD; Robert Schnoll, PhD; Rinad S. Beidas, PhD; Justin E. Bekelman, MD; Ravi B. Parikh, MD, MPP; 7/1/24 Serious illness conversations (SICs) that elicit patients’ values, goals, and care preferences reduce anxiety and depression and improve quality of life, but occur infrequently for patients with cancer. Behavioral economic implementation strategies (nudges) directed at clinicians and/or patients may increase SIC completion. ... In this cluster randomized trial, nudges combining clinician peer comparisons with patient priming questionnaires were associated with a marginal increase in documented SICs compared with an active control. Combining clinician- and patient-directed nudges may help to promote SICs in routine cancer care.

[Certificate of Need] Diagnosis for 6.26.24: Checking the pulse of Florida health care news and policy Florida Politics, scroll down to "Death and Dying"; 6/26/24 Florida health care regulators this week announced they tentatively denied 21 Certificate of Need (CON) applications for new hospice programs and approved 9 others. Heavily populated Broward and Hillsborough counties drew the most interest, with seven providers wanting to establish new hospice programs in each area. [For details, click on the title's link and scroll down to "Death and Dying."]

Pasadena Hindu Temple offers health planning series for seniors: Interactive session to cover advance care, palliative care, and hospice services Pasadena Now; 7/2/24 The Pasadena Hindu Temple is hosting a health and wellbeing series for seniors, focusing on future healthcare planning. ... Doctors Alka and Pradeep Kapoor, both board-certified in internal medicine, hospice, and palliative medicine, will present on topics including advance care planning, palliative care, and hospice care. The doctors, who have over 45 years of medical experience, are also certified in Post Acute and Long-term care medicine. ... Established in 2002, the Pasadena Hindu Temple has evolved into a hub for Indian heritage and Hindu worship in Southern California. Now operating as the Hindu Temple and Heritage Foundation (HTHF), the nonprofit organization offers various community services. Editor's Note: What cultures and faith communities are in your service areas? Do you reach out to all? Does your staffing reflect your community? Click here for U.S. Census information and search for your geographical areas. 

Empowering ‘deeply undervalued’ caregivers would improve ‘lifeline for older adults’ McKnights Senior Living; by Kimberly Bonvissuto; 6/28/24 Direct care workers and family caregivers remain “deeply undervalued” and often overlooked despite calls for investment in the care economy, according to the authors of a new report. “These caregivers provide a lifeline for older adults, people with disabilities, and people living with chronic conditions,” PHI and the National Alliance for Caregiving said in an issue brief released Wednesday. “Empowering them in their roles will help to ensure high quality, responsive care to meet the needs and preferences of millions of Americans now and in the future.” The organizations called on providers, Congress, the Department of Labor, the Centers for Medicare & Medicaid Services, the federal Health Resources and Services Administration, states, managed care plans and advocates to invest in the “essential partnership” between direct care workers and family caregivers. The new brief includes insights from a variety of stakeholders ...  The result is a list of recommendations that prioritize improvements to direct care jobs.Editor's Note: Our sponsor, Composing Life Out of Loss, equips hospice and palliative care organizations with caregiver education and support video libraries to strengthen relationships between the direct care professional and the family caregiver, with timely information for the entire family. Contents are written to CMS CoPs, CAHPS, and contemporary grief research; English and Spanish.

Evaluating palliative care impact: Insights from Tennessee Oncology's OCM participation The American Journal of Managed Care (AJMC); by Mary Caffrey and Pearl Steinzor; 6/27/24 A study finds limited changes in hospice utilization, highlighting challenges in real-world implementation. In an interview at the 2024 American Society of Clinical Oncology annual meeting, Ravi Parikh, MD, MPP, assistant professor of medicine and health policy, Perelman School of Medicine, University of Pennsylvania, discussed the outcomes of a palliative care study at Tennessee Oncology, providing insights into the challenges and limitations of evaluating hospice utilization and quality-of-life improvements in the real-world setting. 

The Program of All-Inclusive Care for the Elderly will begin in July at Jordan Valley Community Health Center KSMU Ozarks Public Radio; by Michele Skalicky; 6/24/24 A new program at Jordan Valley Community Health Center in Springfield will allow those 55 and older to age in their own homes. The Program of All-Inclusive Care for the Elderly is the first PACE program in southwest Missouri. "We'll do home assessments to make improvements that will allow them to live in their homes safely so we don't have potentials for trips and falls or if somebody has a need to have a built, we'll take care of all of that through our home assessment and allow them to have the safest possible home," said Ryan Kruger, vice-president of operations for PACE and pharmacy at the health center. The PACE model uses an interdisciplinary team of professionals that provide coordinated care. PACE care includes medical and personal care, rehabilitation, social interaction, medications, transportation and more.

Chronic loneliness can raise stroke risk in older adults, findings show McKnights Long-Term Care News; by Kristen Fischer; 6/24/24 A new study links loneliness to stroke risk, showing that those who are regularly lonesome have a 56% higher risk for stroke than those who are more socially connected. Situational loneliness wasn’t linked to a higher risk for stroke, which indicates that the stroke risk stems from chronic loneliness. Investigators led by a team from Harvard T.H. Chan School of Public Health published their report Monday in eClinicalMedicine. Research has already linked loneliness to an increased risk for cardiovascular disease. The new report is one of the first to evaluate the association between loneliness and stroke risk.

Dementia decisions: Making tough choices about hospice, palliative care Being Patient; by Katy Koop; 6/25/24 In the later stages of Alzheimer's, palliative and hospice care can be necessary. But how do you find a facility designed for dementia patients? ... Dr. Maribeth Gallagher, director of Arizona’s Hospice of the Valley dementia program, joins Being Patient video reporter Mark Niu to discuss how to make these difficult decisions and what makes a palliative or hospice care program “dementia-capable.” Gallagher’s work directing the Hospice of the Valley’s dementia program has received national and international awards for its innovative approaches. Her focus on dementia care was initially inspired by her personal experiences as a family caregiver, sharing the journey with her loved one from diagnosis to death. [Click on the title's link for the full conversation, in both audio and text.]

Column: Hospice offers redirection of care The Andalusia Star News; by Vickie Wacaster; 6/22/24 Watching someone you love grow weaker and weaker with each passing day is challenging. Yet, sadly, many of us experience this. In my own life, when my late husband was diagnosed with a terminal, non-curable, yet treatable disease, I felt we were living on a roller coaster of emotions, appointments, and treatment options. ... Every day was a journey into uncharted territory for both of us. ... It was only during the last few days that we found the strength to say “no more treatments” and asked for hospice. ... Physicians recognize that hospice is not a withdrawal of care but a redirection of care to meet the needs of patients with an advanced terminal illness/disease. ...Editor's Note: The word "redirection" powerfully, easily shifts the course of care. The person remains at the center, with the focus being the person, not the disease. This is not a denial of dying and death, but rather a signpost, a gentle way to open the difficult conversation for providing information and asking "what matters most to you, now?" 

Research uncovers racial disparities in hospice discharge outcomesMcKnight's Clinical Daily News; by Kristen Fischer; 6/20/24When Black patients leave hospice care alive, they have a higher risk for being admitted to a hospital, according to a study published on May 16 in JAMA Network Open. About 15% of patients who enter hospice actually wind up being discharged from it before they die. That can happen for various reasons such as unplanned hospitalization, getting other treatment for a terminal condition, transferring to another hospice service, or if their condition improves. The transition to hospice can be hard, but moving to a different care setting can be challenging as well.

ASTHO and NAMD call on Congress to fully fund Medicaid and CHIP in U.S. territories ASTHO - Association of State and Territorial Health Officials; by Jane Esworthy and Stephanie Rhodes; 6/20/24 In a joint letter to Congress, the Association of State and Territorial Health Officials (ASTHO) and the National Association of Medicaid Directors (NAMD) urged Congress to fully fund Medicaid and Children's Health Insurance Programs (CHIP) in the U.S. territories. ASTHO and NAMD request that Congress lift the annual Section 1108(g) allotment cap for all territories and authorize a permanent 83% Federal Medical Assistance Percentage (FMAP) for Puerto Rico. ... “ASTHO recognizes the importance of permanent, sustainable, and equitable Medicaid financing for all U.S. territories,” says Joseph Kanter, MD, MPH, ASTHO CEO. ... “Unlike the states, the U.S. territories face an annual cap on their Medicaid funding,” says Kate McEvoy, Executive Director of NAMD. “This has impaired the territories’ capacity to provide needed health care to Medicaid-eligible U.S. citizens and nationals. It has also held the territories back from making the structural investments in care delivery and value-based payment reform, workforce, IT systems, and program integrity that are crucial to high performing and innovative Medicaid programs.”