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. 

Illinois launches PACE services to provide better care integration for elderly population State of Reform - Illinois News; by Maddie McCarthy; 7/2/24 The Program of All-Inclusive Care for the Elderly (PACE) officially launched in Illinois in June, and designated PACE centers have begun rolling out services to their members. ... “PACE is an integrated model of care that provides all the care and services covered by Medicare and Medicaid, as authorized by the interdisciplinary team, as well as additional medically-necessary care and services not covered by Medicare and Medicaid,” said the Illinois Department of Healthcare and Family Services (HFS) in a statement sent to State of Reform. Illinois has five regions offering PACE services: West Chicago, South Chicago, Southern Cook County, Peoria, and East St. Louis. HFS and the Centers for Medicare and Medicaid Services (CMS) awarded contracts to seven designated centers.

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.

Aligning pill burden and palliative care needs in late-stage CVD: AHA TCTMD - Cardiovascular Research Foundation; by L.A. McKeown; 7/2/24 The first scientific statement from the American Heart Association (AHA) that focuses specifically on pharmacotherapy considerations in the palliative management of patients with CVD [cardiovascular diesease] urges a patient-centered, compassionate approach to de-escalating and deprescribing. ... In addition to shedding light on how and when to start deprescribing and de-escalating common cardiovascular drugs, the statement discusses palliative drugs for pain, shortness of breath, and appetite in the context of CVD, which [Katherine E.] Di Palo [PharmD (Montefoiore Medical Center, NY)] said the committee identified as a gap in knowledge given that much of the evidence for these drugs comes from patients with serious illnesses like cancer. ... Important Takeaways: Di Palo and colleagues note that palliative care complements cardiovascular care in several important ways, including reducing physical symptom burden, managing emotional and spiritual distress, providing sufficient support for caregivers, and helping patients choose treatment in line with their goals for care. Editor's Note: Click here for the American Heart Association's statement, which we posted on 7/2/24. 

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.

Factors affecting palliative care collaboration with pain medicine specialists Clinical Pain Advisor; by James Maitlall, MD; 6/27/24 Structured collaboration between physicians working in palliative care (PC) and pain medicine (PM) may increase PC physician referral of seriously ill patients to PM specialists and potentially optimize their care, according to study results published in the Journal of Pain and Symptom Management. ... In a survey study, a multicenter team of investigators explored attitudes and beliefs among US PC physicians regarding PM specialists, as well as factors potentially impacting collaboration between physicians in these 2 areas of practice. ... The American Academy of Hospice and Palliative Medicine (AAHPM) approved the survey for distribution to 1000 of its physician members, who were selected at random. ... The investigators concluded, “Although we found that PC physicians have highly positive attitudes about the value of PM specialists, referral rates remain low, even for IDDS implantation, which has perhaps the largest body of evidence for patients with complex cancer-associated pain.”  

Q&A: What is the ID clinician’s role in end-of-life care? Healio; by Caitlyn Stulpin; 6/27/24 Patients receiving infectious diseases (ID) consultation over the past decade were increasingly complex, generally sicker and more likely to die soon after a consultation was performed, according to a study. Researchers said that the rate of infectious diseases (ID) consultation relative to hospital admissions doubled during that time, suggesting that ID physicians are more often being faced with the challenge of caring for complex patients. Because of this, Alison G.C. Smith, MD, MSC, and Jason E. Stout, MD, MHS, and colleagues aimed to assess the role of these physicians when it came to end-of-life care, leading them to conduct a retrospective cohort study of all patients with an ID consult at the Duke University Health System between Jan. 1, 2014, and Dec. 31, 2023.

End-of-life care needs in cancer patients: a qualitative study of patient and family experiences BMC Palliative Care; by Mario López-Salas, Antonio Yanes-Roldán, Ana Fernández, Ainhoa Marín, Ana I Martínez, Ana Monroy, José M Navarro, Marta Pino, Raquel Gómez, Saray Rodríguez, Sergio Garrido, Sonia Cousillas, Tatiana Navas, Víctor Lapeña, Belén Fernández; 6/21/24  Results: Four major themes emerged from the interviews that explored the needs and concerns of patients with cancer at the end of life: (1) physical well-being (2) emotional well-being (3) social well-being and (4) needs relating to information and autonomous decision-making. The interviews also shed light on the specific needs of family members during this period, namely the difficulties of managing increased caregiver burden and maintaining a healthy work-life balance.

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.

20 most socially responsible hospitals, per Lown Institute Becker's Hospital Review; by Mackenzie Bean; 6/25/24 Duke Regional Hospital in Durham, N.C., is the most socially responsible acute care hospital in the U.S., according to a June 25 ranking from Lown Institute. The nonpartisan healthcare think tank assessed more than 2,700 acute care hospitals and 800 critical access hospitals nationwide across 54 metrics related to health equity, value of care and patient outcomes. ... The 20 most socially responsible acute care hospitals in the U.S., per Lown Institute:

When victims die more than 30 days after a crash, they don’t count StreetsBlogUSA; by Kea Wilson; 6/24/24... Since it first launched in 1975, the federal Fatality Analysis and Reporting System database has excluded all car crash deaths that occur more than 30 days after the initial collision. That means people like [9-year-old] Ben — who lived with a traumatic brain injury, a severed spinal cord, an inability to speak, and other major disabilities for five years before he died — aren't included in official annual death totals. Survivors say those stats also don't capture the sheer scale of the grief, horror, and hardship suffered by victims and their families, whether they succumb to their injuries immediately or manage to hang on.