Literature Review

‘Change in air’ for senior living and care industry in 2025 McKnights Senior Living; by Kimberly Bonvissuto; 12/20/24 “Change is in the air” heading into 2025 for the senior living and care industry, particularly evidenced in regulatory shifts, dementia care, technology expansion and market rebounds, according to the Health Dimensions Group’s annual white paper outlining key issues expected to affect providers in the future.

The top long-term care stories of 2024 McKnights Long-Term Care News; by James M. Berklan; 12/20/24 Workforce issues dominated the long-term care provider landscape in 2024 — but in far more ways than just coping with the finalization of the nation’s first-ever nursing home staffing mandate. As new legal and political winds may eventually push that controversial regulation off providers’ desks anyway, it was clearly apparent this year that McKnight’s Long-Term Care News readers’ interests span a wide array of personnel and workplace issues. Below are the top stories, topics and issues that our readers showed they were most intrigued about when it came to doing their jobs better, and about the sector in which they spend so much daily energy.

Sierra Hills employees strike for safer conditions to live and work Wyoming Tribune-Eagle, Cheyenne, WY; by Noah Zahn; 12/26/24 Employees at Sierra Hills Assisted Living protested Thursday outside the facility after Edgewood Healthcare, which owns Sierra Hills, has refused to budge in negotiations for safer working conditions for employees and residents after more than 10 months of negotiation. “We did include many things in our contract proposal that we feel will really benefit the residents,” said Taylor Ewig, who has been a CNA at Sierra Hills for around 10 years. ... There are currently between 70 and 80 residents at the facility and around eight under hospice care. Ewig and other CNAs participating in the strike said that many of the Sierra Hills residents are supportive of the strike. The issues began at the facility when Sierra Hills implemented a hospice care service a few years ago, shortly after the onset of the COVID-19 pandemic. ... The company hires hospice nurses who are only on the facility about two hours per week, according to Sierra Hills staff. The rest of that time, the burden of care for the resident falls to the staffed CNAs and RNs.

U.S. health care spending reaches $4.9 trillion Hospice News; by Jim Parker; 12/20/24 The nation’s total health expenditures rose 7.5% to $4.9 trillion in 2023, a new analysis by the U.S. Centers for Medicare & Medicaid Services (CMS) found. This growth took place at a faster pace in 2023 than prior years. In 2022, health care spending rose at a rate of 4.6%. Total Medicare hospice spending accounted for $25.7 billion last year, according to a separate report from the Medicare Payment Advisory Commission (MedPAC). ... About 21% of U.S. health care spending in 2023 was via Medicare, with private insurance representing a 30% share. Medicaid accounted for 21%, and the remaining 10% were out-of-pocket costs. “Hospital care, physician and clinical services, and nursing care facilities and continuing care retirement communities, which collectively accounted for 33% of all out-of-pocket spending in 2023, were the main contributors to the faster growth in 2023,” CMS indicated.

Sierra Hills assisted living employees in Cheyenne to strike over staffing issues' Wyoming Tribune-Eagle, Cheyenne, WY; by Noah Zahn; 12/18/24 In March, a resident at Sierra Hills Assisted Living in Cheyenne fell and hurt their hip and shoulder. A CNA at the facility reported that the resident could not be moved without causing shoulder pain, noting that they had likely broken their shoulder and hip, according to a report from the Wyoming Department of Health. The resident was bed-bound, in “excruciating pain” and screamed for hours, which frightened the other residents. The CNA stated this was “the worst thing she had ever experienced.” At the time, the resident was one of six hospice patients at the assisted-living facility. Sierra Hills made hospice care available at the facility shortly after the COVID-19 pandemic. When hospice nurses were unavailable, the burden of care fell to the CNAs and RNs on staff. The CNA caring for this resident in March stated it was difficult to get hospice to respond on the weekends, saying that there was an 80% chance hospice would answer a phone call and a 50% chance a hospice nurse would come to the facility. Six days later, the resident died. Editor's note: Click on the title's link to continue reading. This strike--reportedly related to staffing--appears to be related extra responsibilities on the staff, because of the hospice's limited responses on weekends. This is 2024; not 1974. How does this scenario relate to your hospice triage, hours, staffing, incident reports, community partnerships? 

Characteristics of patients enrolled in hospice presenting to the emergency department American Journal of Emergency Medicine; by Kayla P Carpenter, Fernanda Bellolio, Cory Ingram, Aaron B Klassen, Sarayna S McGuire, Alisha A Morgan, Aidan F Mullan, Alexander D Ginsburg; 12/9/24, online ahead of print Emergency Departments (EDs) frequently care for patients with life-limiting illnesses, with nearly 1 in 5 patients enrolled in hospice presenting to an ED during their hospice enrollment. This study investigates the reasons patients enrolled in hospice seek care in the ED, the interventions they receive, and their outcomes. ... Patients enrolled in hospice most frequently presented to the ED for trauma [36%; with 15% for pain, 12% for catheter/tube malfunction]. Most received laboratory studies and imaging. Nearly half of patients were admitted to the hospital and short-term mortality was high, particularly for patients enrolled in hospice for needs for ED care? Ie.,

Weekly US Map: Influenza summary updateCDC - U.S. Centers for Disease Control and Prevention; ongoing, retrieved from the internet 12/16/24A Weekly Influenza Surveillance Report Prepared by the Influenza Division Editor's note: Bookmark this page to your web browser to monitor flu activity in your service areas through these more vulnerable winter months. Click on the map's "State" button for macro data at the state level. Click on the map's "CBSA" to drill down to counties.

'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.

How innovative designs can help ease ethical tension in good dementia caregiving and decision-makingAMA Journal of Ethics; Emily Roberts, PhD; 12/24The European dementia village is a pioneering health care site: 4 acres of integrated housing and amenities that include large exterior walkways around gardens, restaurants, and shops. A US-based conceptual model is the dementia friendly city center [DFCC], which integrates health care service delivery into adaptive reuse and urban revitalization. Separately and together, we can work to deliver new interventions that can make a difference for those living with dementia and their families. Further exploration of the DFCC model is required to address possible financial and regulatory constraints that accompany the development of necessary public health infrastructure.

UConn John Dempsey Hospital joins National Age-Friendly Health System Movement UConn Today; by Jennifer Walker; 12/12/24 UConn John Dempsey Hospital was recently accepted for participation in the national Age-Friendly Healthy Systems Movement to improve health care for older adults. The Age-Friendly Health Systems Movement, sponsored by The John A. Hartford Foundation and the Institute for Healthcare Improvement in partnership with the American Hospital Association and the Catholic Health Association of the United States​, is a national collaboration of hospitals and health systems implementing a set of evidence-based interventions to make the care of all older adults equitable and age-friendly. This initiative addresses the reality that a growing proportion of the US population is elderly and has complex healthcare needs which challenge many institutions. This movement is built upon a framework of a set of four best practice interventions known as the 4Ms.

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.]

‘Reimagining Hope’ podcast shines a light on the conversation of serious illness The Baltimore Times, Pasadena, MD; podcast hosted by Rachel Jordan; 12/6/24 As families and their loved ones struggle with serious progressive illness, finding information, resources and support is more critical than ever before in our history. In response, Hospice of the Chesapeake and Chesapeake Supportive Care are introducing a new, innovative and informative podcast series, “Reimagining Hope.”  Hosted by Rachel Jordan, Director of Advocacy & Legislative Affairs, the series will feature guests who can provide valuable insight and help you reimagine the hope you may be missing. The podcast will provide quick, easy-to-understand information while giving you the critical skills and real-time tools you can use today to navigate advanced illness.