Literature Review

Older Americans living alone often rely on neighbors or others willing to help California Healthline; by Judith Graham; 11/12/24Donald Hammen, 80, and his longtime next-door neighbor in south Minneapolis, Julie McMahon, have an understanding. Every morning, she checks to see whether he’s raised the blinds in his dining room window. If not, she’ll call Hammen or let herself into his house to see what’s going on. Should McMahon find Hammen in a bad way, she plans to contact his sister-in-law, who lives in a suburb of Des Moines. That’s his closest relative. Hammen never married or had children, and his younger brother died in 2022. Although Hammen lives alone, a web of relationships binds him to his city and his community — neighbors, friends, former co-workers, fellow volunteers with an advocacy group for seniors, and fellow members of a group of solo agers. ... American society rests on an assumption that families take care of their own. But 15 million Americans 50 and older didn’t have any close family — spouses, partners, or children — in 2015, the latest year for which reliable estimates are available. Most lived alone. By 2060, that number is expected to swell to 21 million. ... [Click on the title's link to continue reading.]Editor's note: This important article references (1) "a noteworthy study published by researchers at Emory University" titled "Solo but not alone," which we will include in a Saturday research issue and (2) an AAPR survey that gives the name "solo agers." I give a shout-out to the visionary "Living Alone Program" back in 1993 at Hospice of Louisville (now Hosparus), and to all hospices who deliver creative, quality care to persons who live alone.

Solo but not alone: An examination of social and help networks among community-dwelling older adults without close familyJournal of Applied Gerontology (J Appl Gerontol); by Jane Lowers, Duzhi Zhao, Evan Bollens-Lund, Dio Kavalieratos, Katherine A Ornstein; 11/31/2022... Nearly one in four adults is at high risk for aging without a spouse or children ... Previous descriptions of adults aging solo have focused on social isolation (Chamberlain et al., 2018; Roofeh et al., 2020), yet diverse, non-kin social networks can provide robust emotional and instrumental (task-oriented) support and such networks are becoming more common over time (Suanet & Antonucci, 2016; Verdery et al., 2019), although the type and intensity of support may vary by the type of relationship (e.g., kin vs non-kin) and factors including frequency of interaction (Wellman 1990). ... Therefore, as a first step, we sought to define the population of adults aging solo and compare its social networks and sources of help to adults with close family nearby. Editor's note: Though this article is from 2022, we are posting it due to our post on 11/13/24, Older Americans living alone often rely on neighbors or others willing to help, and our readers' frequent "most read" articles about seniors' challenges with isolation, depression, and caregiving challenges. 

Hospice organizations honor veterans for Veterans Day

Pennsylvania LPNs will now be able to make death pronouncements Tri-State Alert; 11/4/24 A bill sponsored by Sen. Lynda Schlegel Culver (R-27) was signed into law this week to enable licensed practical nurses (LPNs) working in a hospice setting to make death pronouncements. “I am grateful for the governor’s support of this important legislation,” Culver said. “LPNs are with patients and their families until the moment of death, providing essential care during emotional times. Allowing LPNs to make death pronouncements, which was previously only a function of doctors, RNs, physician assistants, and coroners, can alleviate wait times that grieving families often experience.” The bill was amended in the House of Representatives to also provide needed clarification on the waiver of birth and death certificate fees for members of the armed services, veterans, and their families. The law now outlines specifically whose documents qualify for the waiver, as well as applicants and scenarios for which the fee may be waived. 

Asian American diversity and representation in the health care workforce, 2007 to 2022JAMA Network Open; Michelle Ko, MD, PhD; Kevin Dinh, MS; Sarah Iv, BS; Monica Hahn, MD; 10/24In this serial cross-sectional study of American Community Survey 1-year estimates from 2007 to 2022, Filipinx Americans had consistently high representation among registered nurses and nursing assistants; Indian, Pakistani, and Chinese Americans predominated among physicians, whereas Hmong and Cambodian American representation in medicine remained substantially below general population representation. Bangladeshi and Chinese American representation grew among home health aides over the study period. These findings suggest that aggregation of Asian American subgroups into a single racialized group erases substantial inequities in health workforce diversity.

Morphomics, survival, and metabolites in patients with metastatic pancreatic cancerJAMA Network Open; Valerie Gunchick, MS; Edward Brown, MS; Juan Liu, PhD; Jason W. Locasale, PhD; Philip A. Philip, MD, PhD; Stewart C. Wang, MD, PhD; Grace L. Su, MD; Vaibhav Sahai, MBBS, MS; 10/24In this large cohort study, we observed no association of BMI [body mass index] with survival for patients with metastatic PDA [pancreatic ductal adenocarcinoma]. However, longer survival was associated with more subcutaneous fat and a higher muscle-to-fascia ratio, whereas shorter survival was associated with more dense visceral fat. In addition, we observed large-magnitude associations of subcutaneous fat and muscle-to-fascia ratio with several metabolites, which provide key biological insight.

Emergency department visits among patients with dementia before and after diagnosisJAMA Network Open; Cameron J. Gettel, MD, MHS; Yuxiao Song, MS; Craig Rothenberg, MPH; Courtney Kitchen, BA; Andrea Gilmore-Bykovskyi, PhD, RN; Terri R. Fried, MD; Abraham A. Brody, PhD, RN; Stephanie Nothelle, MD; Jennifer L. Wolff, PhD; Arjun K. Venkatesh, MD, MBA, MHS; 10/24Emergency department (ED) visits among persons living with dementia represent a substantial health care challenge, often necessitating targeted interventions to optimize care and support. We assessed changes in ED use before and after incident dementia diagnosis among Medicare beneficiaries aged 65 years and older. Within the entirety of the 12-month period assessed, having a diagnosis of dementia was associated with a 40% increase in the likelihood of having an ED visit. The observed changes in ED use, with peaks before and after dementia diagnosis, suggest that the diagnostic process may precipitate acute health care crises and increased health care–seeking behavior among individuals with dementia and their caregivers.

Person-centered care planning for people living with or at risk for multiple chronic conditionsJAMA Network Open; Brittany N. Watson, MD, MPH; Lilly Estenson, MSW; Aimee R. Eden, PhD, MPH; Maya T. Gerstein, DrPH; Maria Torroella Carney, MD; Vonetta M. Dotson, PhD; Trisha Milnes, AuD, MHA; Arlene S. Bierman, MD, MS; 10/24This qualitative study identified 9 themes for strategies for, as well as facilitators and barriers to implementation of PCCP [person-centered care planning]: (1) suboptimal quality of care; (2) person-centered, goal-concordant care; (3) multidisciplinary team–based care and care coordination; (4) prevention across the life course; (5) digital health solutions; (6) workflow; (7) education and self-management support; (8) payment; and (9) achieving community, health system, and payer goals. These themes identified reforms needed and components of care delivery models to support PCCP.

VITAS touts significant Q3 success, projects future growth McKnights Home Care; by Adam Healy; 10/31/24 VITAS, the home care and hospice subsidiary of Chemed, achieved robust financial results in the third quarter of 2024 and is poised for continued growth, company leadership said Wednesday during an earnings-related conference call. “We are excited about the continued strong results of VITAS,” Kevin McNamara, president and chief executive officer of Chemed, said, according to a transcript. “We are very bullish on the prospects for VITAS for the remainder of 2024 and beyond.” In the quarter ended Sept. 31, VITAS generated $53.4 million in profits, a 20.6% increase compared with the prior year quarter. Revenues rose 17.2% to $391.4 million. Chemed as a whole produced $75.7 million in net profit, a 1% increase year-over-year, behind revenues that increased nearly 7.4% to $606.1 million, according to an earnings report.

Veterans Day 2024 Events (parades, celebrations, concerts) – listed by state VeteranOwnedBusiness.com; retrieved from the internet 11/6/24Here is a list of events being held in each state (also virtual) for Veterans Day 2024. Some of these events (parades, speeches, tributes and more) take place before, on and after Veterans Day (Monday, November 11, 2024).Editor's note: Veterans Day is Monday, November 11th. What are you doing for the patients you serve who are veterans? For your employees and volunteers who are veterans? For hospice-specific resources, click here for NHPCO/The Alliance's "News and Information from We Honor Veterans." For more generic location-specific event and resources click here for this list (by state) of Veterans Weekend events in your area.  

Statement from NPHI on US election results National Partnership for Healthcare and Hospice Innovation (NPHI); Press Release; 11/6/24On November 6th, the Associated Press declared that Donald Trump is the new president-elect of the United States. In response to this news, the National Partnership for Healthcare and Hospice Innovation (NPHI) issued the following statement from Tom Koutsoumpas, our CEO: "Following the election of President-Elect Donald Trump, the National Partnership for Healthcare and Hospice Innovation (NPHI) reiterates its dedication to advocating for high-quality, compassionate care for all patients and families facing serious illness. NPHI looks forward to collaborating with the incoming administration and new Congress to address critical needs in healthcare policy, expand support for advanced illness care, and work toward a stronger healthcare future for patients, families, and caregivers alike. ... [Click here to read the full statement.] ... At NPHI, we are committed to ensuring that every American has access to dignified, high-quality care. We will work with the new administration to protect and enhance the Medicare hospice benefit, expand access to high-quality care at home, and advance policy solutions that center on patient needs and community well-being."

National Partnership for Healthcare and Hospice Innovation celebrates National Hospice and Palliative Care Month National Partnership for Healthcare and Hospice Innovation (NPHI); 10/31/24 In honor of National Hospice and Palliative Care Month, NPHI also shines a spotlight on the true Care Heroes—the dedicated professionals and volunteers who provide compassionate care to those facing terminal or serious illnesses. Their dedication to ensuring comfort, dignity, and quality of life is the foundation of hospice and palliative care. These Care Heroes make a profound impact on the lives of patients and their families, offering essential support during some of life’s most challenging moments. “We celebrate and recognize the invaluable contributions of these Care Heroes—the extraordinary individuals who are delivering exceptional quality care each and every day,” stated Tom Koutsoumpas, CEO. “We invite everyone to join us in sharing their positive experiences of working, volunteering, or caring for those at the end of life.” “This November is a time to recognize the essential role of hospice and palliative care providers in our communities,” stated Carole Fisher, president. “We invite everyone to join us in spreading the word about the impact of these services and in celebrating the dedicated professionals who provide this critical care. To participate in National Hospice and Palliative Care Month, NPHI encourages everyone to join the conversation online using the hashtags #CareHeroes, #HAPCM, #HospiceCare, and #PalliativeCare. You can also explore our Public Outreach Toolkit for more guidance.

Mortality and function after widowhood among older adults with dementia, cancer, or organ failureJAMA Network Open; Rebecca Rodin, MD, MSc; Alexander K. Smith, MD, MS, MPH; Edie Espejo, MPH; Siqi Gan, MPH; W. John Boscardin, PhD; Lauren J. Hunt, PhD, RN; Katherine A. Ornstein, PhD, MPH; R. Sean Morrison, MD; 9/24In this cohort study including 13,824 participants in the Health and Retirement Study, widowhood was associated with functional decline and increased 1-year mortality in functionally impaired older adults with dementia and cancer. The study findings suggest that older adults with functional impairment and cancer or dementia are at risk of adverse outcomes following widowhood, including functional decline and a marked elevation in the risk of death, in the year after widowhood.