Literature Review

Health gap at end of life is now wider in US than any other country Science Alert - Health; by Carly Cassella; 12/16/24 A data-crunching survey covering 183 member nations of the World Health Organization has now confirmed what some scientists feared: while years are being added to most people's lives, healthy life is not being added to most people's year. Researchers at the Mayo Clinic found that people around the world in 2019 were living 9.6 years of life burdened by disability or disease – an increase of 13 percent from 2000. In that same time frame, global life expectancy has increased 6.5 years, and yet health-adjusted life expectancy has only increased 5.4 years. In the US, the gap between lifespan and 'healthspan' is growing particularly wide. Between 2000 and 2019, life expectancy in the US increased from 79.2 to 80.7 years for women, and from 74.1 to 76.3 years for men. When adjusting for healthy years of added life, however, the span only increased by 0.6 years among men. And among women, while health-adjusted life expectancy fluctuated slightly over time, in 2019 it matched the figure seen in 2000. The expanding gap means if an American woman lived to the expected 80.7 years of age, the last 12.4 years of her life would on average be impacted by disease or disability.

'A blessing': Hospital beds find new homes in families who had been praying for them Austin American-Statesman, Austin, TX; by Nicole Villalpando; 12/13/24 Ron McDaniel had been trying to find a place for the hospital bed both his dad, Robert, and brother, Gary, had used in the assisted living facility where they were before they died. His father was a Navy veteran who was burned over 30% of his body during World War II. His brother had severe brain damage from a car accident in 1976 and was a quadriplegic. The electronic hospital bed with the extra comfortable mattress and the trapeze bar needed a new home. Ron McDaniel wanted it to go to a veteran or a veteran's family because it originally came from the Veterans Affairs, but he tried organization after organization with no luck. Meanwhile, Sandra Daniels was in desperate need of a hospital bed for her mother, Bertha Woodward, 87, who has heart failure, problems with her kidneys and limited mobility caused in part by neuropathy in her feet. Daniels could not afford a hospital bed but had been trying organization after organization for a year and came up empty. She had recently called AGE of Central Texas to see if they might have a hospital bed. ...Editor's note: Organizations who helped include 26th Statesman Season for Caring, Austin Palliative Care, ATX Firefighter Moving, AGE of Central Texas.

A centenarian thrives living alone, active and engaged California Healthline - originally published by The Washington Post; by Judith Graham; 12/10/24 “The future is here,” the email announced. Hilda Jaffe, then 88, was letting her children know she planned to sell the family home in Verona, New Jersey. She’d decided to begin life anew — on her own — in a one-bedroom apartment in Hell’s Kitchen in Manhattan. Fourteen years later, Jaffe, now 102, still lives alone — just a few blocks away from the frenetic flashing lights and crowds that course through Times Square. ... She’s an extraordinary example of an older adult living by herself and thriving. ... I’ve spoken with dozens of seniors this past year for a series of columns on older Americans living alone. Many struggle with health issues. Many are isolated and vulnerable. But a noteworthy slice of this growing group of seniors maintain a high degree of well-being. What might account for this, particularly among people in the farthest reaches of old age? [Click on the title's link to continue reading.]

Why repeat offender nursing homes elude accountability Modern Healthcare; by Diane Eastabrook and Tim Broderick; 12/10/24 Fallbrook Rehabilitation and Care Center stands out as one of the worst among the more than 1,200 nursing homes in Texas and the nearly 15,000 facilities nationwide. Over a three-year period at the skilled nursing facility in Houston, one patient died after staff did not notice her ventilator had disconnected.  ... The Texas Department of Health and Human Services cited Fallbrook for more than 50 other health and safety violations. Fallbrook was fined about $640,000 between April 2021 and July 2023, according to Modern Healthcare analysis of April 2024 CMS data. The amount was among the top 30 fines paid by nursing homes nationally and was more than six times the average fine other Texas nursing homes with CMS one-star ratings were assessed during that period. Yet the 200-bed nursing home collected more than $20 million in reimbursements from Medicare, Medicaid and health insurance companies in 2021 and 2022, ... The ownership groups can control facilities through convoluted webs of individuals, private equity investors, limited liability companies, real estate investment trusts and other trusts that often transfer money to related companies or third parties with ownership interests in the nursing homes. The Human and Human Services Department Office of Inspector General has identified this as a problem.

From sleeping in cars to having an apartment: Season for Caring helps once-homeless families Austin American-Statesman; Austin, TX; by Nicole Villalpando; 12/8/24 When Thamairis Canales Yanez learned this year that she had been selected for the Austin-American Statesman's Season for Caring program, "what I did was thank God," she said. ... The 45-year-old and her 14-year-old daughter, Ivanna, came to the U.S. from Venezuela after Yanez's dental business was taken away by the government, and she feared for her daughter's life. She is trying to rebuild her life in America, but it has been difficult. At one point, she and Ivanna were living in her car. She has breast cancer that has spread to her brain. She is unable to work. Often when Season for Caring comes into the lives of the featured families, it is during one of their darkest times.  ...  "I have seen the impact on families," said Robin Clemons, chief development officer at Hospice Austin. "Imagine facing the end of life, and they can't pay their rent. (With Season for Caring funds) they don't have to worry about those types of needs. The stress for the caregiver, it relieves that burden."

Resources are expanding for older adults on their own California Healthline; by Judith Graham; 12/9/24 Jeff Kromrey, 69, will sit down with his daughter the next time she visits and show her how to access his online accounts if he has an unexpected health crisis. Gayle Williams-Brett, 69, plans to tackle a project she’s been putting off for months: organizing all her financial information. ... Until a few years ago, few resources were available for this growing slice of the older population. Now, there are several Facebook groups for solo agers, as well as in-person groups springing up around the country, conferences and webinars, a national clearinghouse of resources, and an expanding array of books on the topic. [Click on the title's link to read more.]

All-inclusive elder care for aging at home: This nursing home alternative is on the rise Caring.com; by Dom DiFurio; 11/25/2024 ... PACE centers, or Programs of All-Inclusive Care for the Elderly. As of August 2024, 177 programs across 33 states and the District of Columbia are in operation, allowing aging people to stay within their home communities while still receiving the elevated care they would need as older adults living with disabilities or chronic illnesses. A PACE facility is a kind of "one-stop shop" that offers services like dental care, social services, occupational therapy, prescription medication, and nutritional counseling. ... Caring.com examined data maintained by the National PACE Association to see which states have the most programs available to serve their aging populations and how they can impact the quality of care for adults who want to live independently outside a clinical setting for as long as possible. ... Several states are also undergoing trials, expansion, or establishing new PACE programs for their aging residents. Minnesota and South Dakota are considering starting PACE programs. Nevada is in the process of establishing its own program after using COVID-19 funding to experiment with the system to address the health needs of people ages 55 and older who need nursing facility-level care but can still live safely in their communities. Georgia's governor also signed a bill into law earlier this year creating the state's first PACE.

Michael Dowling: We've revolutionized care for aging adults, but is America's health system ready for the senior population boom? Becker's Hospital Review; by Michael J. Dowling, President and CEO, Northwell Health; 12/2/24 Like many baby boomers and those from earlier generations, I have vivid memories from my younger years of my grandparents and other aging adults struggling with an assortment of ailments that their doctors told them were just an inevitable part of growing old. ... The transformative advancements made over the past half-century in meeting the physical and emotional health needs of the nation's rapidly aging population are remarkable — and that's especially important because more Americans are turning age 65 now than in any other time in our history (4.1 million in 2024, or 11,200 a day). And as we move toward a new year, every healthcare executive must examine whether we are collectively prepared to care for them in the years and decades ahead and take steps to recruit the medical specialists we need to meet burgeoning demand. ... Lastly, all clinicians must embrace palliative care as part of their standard practice in managing the health of aging adults with serious illness. ... 

This Scottsdale art class helps adults with memory loss 'live in the moment' AZCentral, Scottsdale, AZ; by Alexandra Hardle; 12/1/24 ... Anne Halvorson and her mother, Nancy Halvorson, have been attending Memory Lounge since 2022. Nancy was diagnosed with Alzheimer's the year prior, Anne said. Nancy lives in an assisted living facility, but she spent much of her career as a music therapist working with children with special needs in the public school system, Anne said. Since her mother was already naturally drawn to art, the two became frequent attendees of Memory Lounge after hearing of the program through Hospice of the Valley. "It's been a lifesaver for us. It has given my mother an outlet for all of her creativity, which she has in abundance," Anne said. Memory Lounge also allows Anne's mother the chance to use a different part of her brain and to learn something new. It's also a space for her to simply socialize and talk about something other than her doctor's appointments and where she's living, Anne said.

Seen Health invests $22m for PACE Care Centers HomeCare, Los Angeles, CA; by Seen Health; 11/26/24 Seen Health, a health care organization focusing on aging-in-place services and culturally-focused care models, announced it has invested $22 million in funding to expand access to its culturally-focused care centers for eligible seniors. The company said [its] first center is set to open in California and will be built upon the Program of All-Inclusive Care for the Elderly (PACE) model. The PACE model aims to deliver comprehensive medical and social support for seniors with chronic conditions who are covered by Medicaid or Medicare. The care model intends to provide an alternative method of care to nursing homes by enabling seniors to stay in their homes and age in place. ... The first Seen Health center, which is set to open in Los Angeles County's San Gabriel Valley, intends to serve the local Asian and Pacific Islander community.

Be a Santa to a Senior helps homebound seniors during holiday season The Joplin Glove; 11/26/24 Home Instead Senior Care is offering a chance to play Santa this year to homebound seniors who might be overlooked during the holidays. The Be a Santa to a Senior is a national program with Home Instead, a company that offers services for homebound seniors. These seniors might not have a family member close by or might not be able to travel to see family. Adam Bokker, owner of Home Instead in Joplin, said hundreds of thousands of gifts have been collected and given to seniors nationally during the holiday season over the years. "It's an opportunity for them to have a little gift, a little joy, some companionship even with someone delivering that gift," Bokker said. "We call it Be a Santa to a Senior because our seniors really benefit from having that extra gift, extra companionship when many times they're not able to go see their families."

Hospital at home saves lives and money: CMS report American Medical Association; by Jennifer Lubell; 11/22/24 A federal report to Congress on the Acute Hospital Care at Home initiative shows that at-home acute care produces lower mortality rates and post-discharge spending than traditional inpatient care while also yielding positive feedback from patients and caregivers. The Centers for Medicare & Medicaid Services (CMS) launched the home-care initiative in response to the COVID-19 public health emergency, granting waivers to individual hospitals to provide Medicare patients with inpatient-level home care. With 358 approved hospitals across 137 health systems in 39 states since its start in November 2020, this innovation in care delivery has become an important feature of the Medicare program. ... Importantly, these programs demonstrate clinically, and often more cost-effective care. “Numerous studies have demonstrated that many types of care that are currently delivered in an office or facility could be provided at home, with clinically appropriate, high quality, and cost-effective outcomes,” wrote the authors of the AMA report. About 15–20% of emergency and urgent care services and up to 35% of hospice services are capable of being administered at home. As home care continues to evolve, this service could provide up to 25% of post-acute and long-term care in the home. 

Nursing homes with more black residents lag in care goal discussions Medical Xpress; by Columbia University Irving Medical Center; 11/20/24 New research from Columbia University School of Nursing published in the American Journal of Hospice and Palliative Medicine shows that timely goals of care discussions are less likely to take place in nursing homes with a higher percentage of Black residents. These discussions are crucial to ensuring that nursing home residents receive care that aligns with their wishes, postdoctoral research fellow Jung A. "Chloe" Kang, Ph.D. '24, Professor Patricia Stone, Ph.D., and their colleagues note in the report, published online September 15, 2024. But these conversations are often delayed until patients experience life-threatening events, the authors add, which can lead to unwanted therapies and unnecessary hospitalizations. ...