Literature Review

HSPN Staffing Summit: Leveraging technology for person-centered care Hospice News; by Sophie Knoelke; 12/9/24 This article is sponsored by CareXM. This article is based on a virtual discussion with Kathleen Benton, President and CEO of Hospice Savannah. ... Dr. Benton has a master’s degree in medical ethics and a doctorate in public health. She has offered and reviewed many publications relevant to the topics of palliative care, ethics, hospice, and communication. [Dr. Benton:] I was schooled in clinical ethics and really mediating ethical dilemmas in health care. Looking at, is this in the best interest of the patient? Are we truly following the patient’s wishes? Many of the dilemmas, I would say a good 90%, occur at the end of life. ... [At] the root of [really trending] cases was one missing element. That element was the lacking area of communication. What do I mean by that? I believe that health care does the worst job of probably all other areas of communicating with folks. We have really taken what it is to be human out of what it is to treat a patient and a person. [Click on the title's link to continue reading this insightful discussion.]

Homebound seniors living alone often slip through health system’s cracks KFF Health News; by Judith Graham; 12/2/24 Carolyn Dickens, 76, was sitting at her dining room table, struggling to catch her breath as her physician looked on with concern. “What’s going on with your breathing?” asked Peter Gliatto, director of Mount Sinai’s Visiting Doctors Program. “I don’t know,” she answered, so softly it was hard to hear. “Going from here to the bathroom or the door, I get really winded. I don’t know when it’s going to be my last breath.” Dickens, a lung cancer survivor, lives in central Harlem, barely getting by. She has serious lung disease and high blood pressure and suffers regular fainting spells. In the past year, she’s fallen several times and dropped to 85 pounds, a dangerously low weight. And she lives alone, without any help — a highly perilous situation. Across the country, about 2 million adults 65 and older are completely or mostly homebound, while an additional 5.5 million seniors can get out only with significant difficulty or assistance. ... It’s a population whose numbers far exceed those living in nursing homes — about 1.2 million — and yet it receives much less attention from policymakers, legislators, and academics who study aging.

Health system C-suites channel 'hospitality energy' for next year Becker's Hospital Review; by Laura Dyrda; 11/27/24 Health system C-suites are taking their organizations "back to the basics" next year to focus on improving quality outcomes and creating an elite patient experience. This means prioritizing a culture of service and training staff in hospitality. Cliff Megerian, MD, CEO of University Hospitals in Cleveland, said the system has focused on reducing variation in care pathways and optimizing clinical services for maximum quality, safety and efficiency this year, an effort that will continue into 2025. University Hospitals is also doubling down on its reputation for compassionate care, said Dr. Megerian. "The goal is for our patients – our guests – to feel truly cared for at each touchpoint along the patient journey, with clinical and non-clinical caregivers alike both bearing the responsibility to make this happen," he said. "The word 'hospitality' has at its root the word 'hospital' — it's our goal to work to bring that 'hospitality' energy to our work in healthcare, always informed by world-class science."Editor's note: The Latin root word described is "hospitium," which branched into contemporary words "hospitality," European "hostels" for travelers, "host," "hotels," and yes, "hospice." At its core, hospitium refers to travelers on a significant life journey, tended by compassionate hosts who provide rest and nourishment. Click here for more information, which emphasizes the relationship between the host and the guest.

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. 

New Health Equity Guide from Center to Advance Palliative Care provides a roadmap to transform care for black patients with serious illness Cision PRWeb; by Center to Advance Palliative Care; 11/13/24 Having medical concerns dismissed, not being believed when reporting pain, and facing multiple barriers to care are just three of the experiences reported to Center to Advance Palliative Care (CAPC) in a focus group of Black patients with serious illness. In fact, when Black people in the United States are living with a serious illness like cancer, heart failure, or dementia, they experience disproportionately high suffering compared to white patients—often due to poor pain management, low-quality communication from their care teams, and high family caregiver burden. To address these inequities, CAPC has released a new, comprehensive guide, Advancing Equity for Black Patients with Serious Illness, to equip palliative care leaders and health equity change agents with practical tools to implement meaningful change. Drawn from research, examples of health equity initiatives from across the country, and the wisdom of health equity leaders, the guide provides a practical roadmap for transforming care for Black patients, and their families and caregivers.

“I’m 68 and totally alone”: 50 people share what it’s like being seniors AOL.com - Bored Panda; by Dominyka; 11/9/24 People are different in their upbringing, in their tastes, even in their looks. But all people do have one thing in common: we're all heading towards the same end. With the exception of Bryan Johnson, maybe. Still, we're all aging, whether we like it or not. And with aging comes social isolation; according to a 2024 Medicare report, 57% of adults aged 65 and older report feeling lonely. The users of Quora recently tackled this problem when one person wrote: "I'm 63 years old and so lonely. Does it matter to anyone?" Many older people rushed to the comments to share their stories, highlighting the sad realities they face today. Bored Panda sought the expertise of the anti-ageism activist Jacynth Bassett, Founder and CEO of Ageism Is Never In Style about how important social connections are to us as we age. We also spoke with her about the right terminology when referring to older people and how we can all spot ageist attitudes in ourselves. 

Study: People with dementia more apt to be admitted to nursing homes with lower star ratings McKnights Long-Term News; by Kristen Fischer; 11/5/24 People living with dementia are less likely to be admitted to high-rated nursing homes compared to people who don’t have the disease, a new study finds. Researchers looked at admission to nursing homes with higher staffing ratings after hospitalization and how individuals fared in the nursing homes based on having or not having dementia. The report was published on Oct. 29 in Alzheimer’s & Dementia. The team evaluated traditional Medicare beneficiaries discharged to nursing homes between 2011 and 2017 along with the relationship between facility staffing star-ratings, short-term readmission and mortality. The number of vacant beds in nursing homes with high ratings was also considered. Data was derived from 5.6 million people who were discharged to nursing homes; 23.1% of the people had dementia.

As IV shortage continues after hurricane, U.S. invokes wartime power to speed recovery CBS News; by Alexander Tin; 10/15/24 The Biden administration says it has invoked the wartime powers of the Defense Production Act to speed rebuilding of a major American factory of intravenous fluids that was wrecked by Hurricane Helene last month. Damage to the plant in North Carolina has worsened a nationwide shortage of IV fluids, and hospitals say they are still postponing some surgeries and other procedures as a result. Some 60% of the nation's IV supplies had relied on production from the plant, run by medical supplier Baxter, before it was damaged by the storm. "Ensuring people have medical supplies they need is a top priority of the Administration. It's exactly why we are working closely with Baxter to support cleanup and restoration of the facility, including invoking the Defense Production Act to help production resume as quickly as possible," an official with the Department of Health and Human Services told CBS News on Tuesday.

Hospital-at-home care’s future still hangs in the balance Home Health Care News; by Joyce Famakinwa; 10/7/24 Even with a proven track record for clinical effectiveness and cost savings, the hospital-at-home model’s future hangs in the balance. “The data suggests that, for the populations that have been studied in multiple different places, it’s a very safe service to be done and with high-quality care, low readmission rates, low escalation rates, low infection rates,” Dr. Adam Groff, co-founder Maribel Health, told Home Health Care News. “The bottom line is people love it, patients love it and it’s a high-quality care experience.” ... In 2020, the hospital-at-home model had its breakthrough. Though the model was common internationally, it was considered niche in the U.S. This changed with the introduction of the Centers for Medicare & Medicaid Services’ (CMS) Acute Hospital Care At Home program. A recent report from CMS found that the program has been largely successful. ... Despite the momentum the model has seen in recent years, challenges still exist when it comes to operations and scalability. Specifically, less than 9% of waiver-approved hospitals accounted for more than 70% of all U.S. admissions, according to data from MedPAC’s June 2024 report to Congress. ... 

Why hospital-at-home, other providers are pressing worker safety Modern Healthcare; by Diane Eastabrook; 9/24/24 At-home care providers are testing strategies to better protect workers who are raising the alarm on workplace safety. A new survey of more than 400 home healthcare workers found more than half said they experienced or witnessed at least one act of violence or harassment in the workplace, according to Transcend Strategy Group, which conducted the poll on behalf of home care providers. The report, which echoes similar findings from a National Nurses United survey, comes as hospital-at-home programs expand and more care moves to where patients live. ... Home-based care providers are trying to address the issue because concerns about personal safety could make it harder to recruit and retain workers in a competitive job market. The concerns are also coming up in contract negotiations between unions and providers.

House call: Hospital care at home is about to explode in New Jersey mycentraljersey; by Scott Fallon; 9/11/24 Delia Halpin was being treated for a lung infection at Hackensack University Medical Center over three days in July when doctors came to her room with a suggestion: You can go home if you’d like. Halpin, 80, wasn’t being discharged. She was returning to her Maywood house with a load of medical equipment, a tablet to let her keep in touch with doctors, and a team of nurses who would visit every day until she recovered. “No one wants to be in the hospital,” she said. “It was great to be home, be around family, be around the things you’re comfortable with.” Halpin is among the first wave of patients who received care under Hackensack’s new “Hospital from Home” program — but she is far from the last. ...

Factors associated with Do Not Resuscitate status and palliative care in hospitalized patients: A national inpatient sample analysis Palliative Medicine Reports; by Jean-Sebastien Rachoin, Nicole Debski, Krystal Hunter, Elizabeth CerceoIn the United States, the proportion of hospitalized patients with DNR, PC, and DNR with PC increased from 2016 to 2019. Overall, inpatient mortality and LOS fell, but hospital charges per patient increased. Significant gender and ethnic differences emerged. Black patients and males were less likely to have DNR status and had higher inpatient mortality, LOS, and hospital charges.