Literature Review

‘Good’ death different for everyone Altoona Mirror, Altoona, PA; 7/26/24 The social and economic inequities patients suffer in life often shapes their death” was a key point of a July 13-14 article in the Review section of the Wall Street Journal. ... In the article, which was written by Dr. Sunita Puri, a palliative care physician and the author of “That Good Night: Life and Medicine in the Eleventh Hour,” Puri focuses on the conundrum many families face when dealing with the question of where to spend the final days of life. ... “New research classifies the rise in home deaths as progress,” the message immediately under the article’s headline begins, “but we need to look more closely at what these deaths look like.” ... Puri, now 10 years into her physician career, says it is now clear to her that there is much more to a “good” death than where it occurs. “Presuming a home death is a success obscures important questions about the process,” she wrote. “Did this person die comfortably? Did their caregivers have the resources and guidance they needed? Was dying at home a choice or simply the only option?” 

The bereavement care crisis in hospice facilities MedCity News; by Cara McCarty Abbott; 7/28/24 Bereavement care is an essential part of the hospice experience, designed to support those coping with loss. Bereavement care is not just a compassionate gesture; it is a critical component of the hospice care continuum. So why is it so underserved in the U.S.? ... Instead of pushing harder on hospice providers to find more ways to deliver comprehensive bereavement care with less, it's key to address the systemic forces hampering their ability to deliver quality care at the scale required and address these challenges. Editor's Note: Additionally, does your hospice still rely on the misnamed, overused "5 Stages of Grief"? These were determined from 1960's persons who were dying, not from bereaved persons who live on--surviving--the death. Extensive fresh, contemporary, hospice-designed grief resources to support bereavement counselors and the persons they serve are provided by Composing Life Out of Loss, a sponsor for our newsletter.

No One Dies Alone: a movement against isolation and loneliness in the final hours The Optimist Daily; by The Optimist Daily Ediorial Team; 7/27/24 The fear of dying alone is one of the most powerful and agonizing feelings that many harbor, especially during the COVID-19 pandemic. For some, this fear sadly becomes a reality. To address this issue, the No One Dies Alone (NODA) initiative trains and supports volunteers who provide companionship to people in their final hours. ... The NODA concept began in 1986 in Oregon, United States [by] Sandra Clarke, a nurse. ... [Alison] Bunce founded Compassionate Inverclyde (CI) in 2016 as an Ardgowan Hospice-funded project, where she worked as director of care. Starting with 20 volunteers, CI sought to sit with people who were dying alone, initially in hospices and local hospitals before extending to private homes. Today, CI has grown substantially, with over 100 volunteers available to provide companionship at a moment’s notice.

Empath Health, Trustbridge leaders are setting home health sights high after integration Home Health Care News; by Joyce Famakinwa; 7/26/24 Empath Health is a company in transition. In the spring, it completed an affiliation process with Trustbridge, which formed the largest nonprofit post-acute provider organization in the state of Florida. ... Since completion of the affiliation process, the company has focused on integration, synergistic opportunities and determining how best to deliver care to the communities it serves. One of the people at the helm of this transition is Tarrah Lowry, Empath Health’s chief operating officer and Trustbridge’s interim president. [Click on the title's link to read the recent interview by Home Health Care News' with Tarrah Lowry.]

Nursing homes ‘can’t escape’ need for increased palliative care access: researchersMcKnights Long-Term Care News; by Josh Henreckson; 7/17/24 Nursing home residents could greatly benefit from expanded access to palliative care, but providers need more access to standardized tools, staff education and relationships with clinicians to make informed decisions about care, specialists say. ... Several key “themes” could be the foundation for a more formalized method of identifying palliative care needs for nursing home patients, researchers found. They included factors such as patients with uncontrolled symptoms and otherwise serious illnesses, as well as patients with indicators of significant decline such as frequent rehospitalizations. 

Waverly nursing home put on probation, nurse suspended in connection to death of a resident, documents show ABC KETV-7, Omaha, NE; by Jake Anderson and Aaron Hegarty; 7/17/24 A nursing facility has been placed on probation by the Nebraska Department of Health and Human Services in connection to the death of a resident. Constance Glantz, 74, was mistakenly declared dead at The Mulberry at Waverly, a nursing home, in June. Glantz was then taken to a funeral home in Lincoln, which realized that she was still breathing. The 74-year-old, who was in hospice care, was declared dead hours later at a Lincoln hospital. A public records request by KETV Investigates shows that a state investigation into the facility in Waverly found the registered nurse on duty failed to take Glantz's blood pressure after it was believed she had died. That nurse was suspended, according to the state investigation. Documents show that the state also found a second case where a patient was not evaluated correctly. ... [Nebraska AARP Director Todd Stubbendieck] points to Medicare.gov's tool, which rates nursing homes, as a resource. He also points to a similar tool from ProPublica.

Senior living and care on track to set mergers and acquisitions record McKnights Senior Living; by Kathleen Steele Gaivin; 7/18/24 Mergers and acquisitions involving senior living communities and skilled nursing facilities set a new quarterly record of 183 publicly announced transactions in the second quarter, and when annualized, the sector is on track to set a new yearly record as well. That’s according to data released this week by LevinPro LTC. The number of mergers and transactions in the second quarter was 21% higher than the 151 transactions recorded in the first quarter and 49% higher than the 123 deals in the second quarter of 2023. 

Alpharetta City Council considering fee for lifting assistance calls Appen Media, Alpharetta & Roswell, GA; by Jon Wilcox; 7/16/24 The Alpharetta City Council is considering a fee for residents and assisted living homes who make multiple calls a month for emergency responders to help people who have fallen. Director of Public Safety John Robison told the council July 15 that calls for lifting assistance come at significant cost and tie up responders who may be needed for other emergencies. Last year, Robison said, 328 calls for lift assistance cost the city $78,844, almost double the cost from the previous year, which saw 190 calls at a cost of $32,275.30. ... A proposed ordinance suggests a schedule of fees for calls asking responders to assess people who have fallen and may be injured. ... Hospice patients would be exempt from the fees. 

Palliative care is underutilized in nursing homes EurekAlert! AAAS; by Regenstrief Institute; 7/16/2O Palliative care, specialized medical care focusing on providing relief from the symptoms -- including pain -- and the stress of serious illness, is underutilized in nursing homes, despite the large number of nursing home residents living with a serious illness such as cancer, dementia, Parkinson’s disease, heart failure or chronic obstructive pulmonary disease. A qualitative study, published in the Journal of the American Geriatrics Society, analyzes lack of palliative care referrals for nursing home residents and proposes ways to address this healthcare gap. In addition to examining existing referral patterns, the authors explore recommendations for ideal criteria and create a substantive framework for palliative care referrals in nursing homes. Editor's Note: You can access the article here, “Palliative care in nursing homes: A qualitative study on referral criteria and implications for research and practice” is published in Journal of the American Geriatrics Society.

Senior living providers embrace role in CMS dementia care pilot program McKnights Senior Living; by Kimberly Bonvissuto; 7/11/24 Senior living providers named participants in the federal government’s new dementia care pilot program said they are excited to be part of a new effort to support people living with dementia and their family caregivers. The Center for Medicare and Medicaid Innovation, CMMI, announced the Guiding an Improved Dementia Experience, or GUIDE, model last summer. The Centers for Medicare & Medicaid Services launched the eight-year GUIDE model on July 1 and published the program participant list on Monday [7/8]. Eligible model participants are Medicare Part B-enrolled providers eligible to bill for Medicare services and that provide, or will provide, ongoing care to people living with dementia. Eligible organizations include accountable care organizations, home health and hospice agencies, Programs of All-Inclusive Care for the Elderly, and physician practices. Additional long-term care providers and other healthcare providers, however, can participate as partner organizations by contract with another Medicare provider/supplier to meet the program care delivery requirements. Assisted living residents who are Medicare beneficiaries may be part of the model. Editor's Note: Adding to our previously published posts about the new CMS GUIDE Program (7/10/24 and 7/11/24) and its use by hospice organizations, this article describes its use by senior living care providers. 

Provider of in-home imaging services and 24/7 radiologist access raises $200M Radiology Business; by Marty Stempniak; 7/9/24 HarmonyCares, a provider of in-home X-ray services that spans 15 states, has raised $200 million in new capital, leaders announced Monday. Based in Nashville, Tennessee, the company is focused on physician-led care for vulnerable patients who cannot travel to a traditional healthcare facility. HarmonyCare Diagnostics brings the latest digital X-ray technology to patients’ homes or long-term care facilities, offering rapid results with board certified radiologists “available 24/7.”

A professional’s perspective: Ageism within the healthcare system; does it exist? Northern Kentucky Tribune; by Jeff Rubin; 7/6/24 A friend of mine named Dee recently shared with me a particularly unpleasant experience she had with a young hospital discharge planner regarding her 97-year-old mom in California. It appears Dee had a heck of a time trying to get her mom discharged to home health care rather than hospice, even though the particular care she needed could have been better delivered at home. A geriatrician by training, Dee ... recognized the invaluable role of hospice in providing end-of-life care. However, the situation she found herself in was less a question of end-of-life and more of palliative care. ...  A recent study in the US sampling 2,035 individuals between 50 and 80 years of age revealed that 93.4% experienced ageism firsthand. Their perception extended to professionals like doctors, nurses, therapists, social workers, and psychologists whose services included working with older people. [Click on the title's link for significant data, descriptions, and resources.]

Cooper University Health acquires New Jersey system Becker's Hospital Reivew; by Alan Condon; 7/1/24 Cooper University Health Care on July 1 completed the acquisition of  Cape May, NJ-based Cape Regional Health System. As part of the closing, Cape Regional Medical Center has been renamed Cooper University Hospital Cape Regional. The combined health system comprises two hospitals with more than 900 beds, 130 ambulatory sites and almost 11,000 employees, including over 1,000 physicians. It is projected to have revenue exceeding $2.2 billion a year. The transaction unlocks significant growth opportunities, particularly in the outpatient market, as healthcare continues its shift away from inpatient settings, Camden, N.J.-based Cooper CFO Brian Reilly told Becker's.