A new assessment tool provides comprehensive data on home care quality, identifying areas for improvement. The 22 measures cover processes and outcomes, revealing that no single provider excels in all aspects.
Experts recommend improving government reimbursement rates, increasing staffing levels, and providing better training for nursing home staff. Family members share stories of inadequate care, including unneeded tests and treatments, but also praise compassionate gestures from attentive aides.
The NIH panel's statement highlights the need for enhanced communication among patients, families, and providers, as well as recruitment of under-represented populations in end-of-life research. The panel also recommends creating networks of researchers and patient cohorts to facilitate coordinated studies.
Dementia patients experience a long, slow decline with sudden changes, making optimal care challenging. The healthcare system's focus on acute illness treatment hinders end-of-life care, resulting in poorly trained providers, systems, and patients.
Patients with dementia face significant barriers to optimal care, including lack of education, poor prognostic tools, and conflicting financial incentives. The authors propose solutions, such as improved hospice access, better quality-assessment tools, and changes in the healthcare system.
A study of 2,220 patients with acute coronary artery disease found that early invasive treatment showed a benefit in preventing heart attack or death, especially for older patients. A survey also revealed significant salary disparities between female and male medical faculty members in the US.
A survey of 73 social workers in the Carolinas found that over a quarter reported similar comments from patient family members. The study suggests that hospice patients considering hastening death may differ from typical patients, with higher rates of cancer. Social workers can provide assessment and intervention to address these needs.
A study by the University of Toronto Joint Center for Bioethics found that patients' perceptions of care improved when medical staff solicited their concerns, with significant gains in symptom control, support, and pain management. The research suggests a simple yet effective approach to addressing subpar end-of-life care.
Since 1991, end-of-life care has seen significant improvements in palliative care and hospice availability. Timothy Quill's father's death provided a unique opportunity to illustrate the good and bad in end-of-life care, highlighting the need for consistent availability of care options.
Researchers at UNC Chapel Hill are working on a new program to improve employment in long-term care facilities, focusing on recruitment and retention strategies, including better pay, recognition, and training. The project aims to address staffing shortages and improve the quality of life for nursing home residents.
A Northwestern University study found that death rate after hospital discharge increased up to 72 percent for patients with DNR orders. Despite this, the researchers suggest that shorter lengths of stay can be achieved without compromising patient health through improvements in therapies and end-of-life care.
Physicians can help family caregivers by promoting good communication, facilitating advance care planning, and providing emotional support. They can also attend to family grief and bereavement, improving outcomes for both patients and caregivers.
The American Academy of Family Physicians proposes a palliative care model for elderly patients, focusing on proactive and team-oriented care. The TLC model aims to relieve physical and emotional suffering throughout the aging process.
A study of Medicare-eligible patients with lung, breast, colorectal, and gastrointestinal tumors found a rise in chemotherapy use and emergency room admissions near death. However, an increase in hospice care usage suggests that improved palliative services may reduce aggressive end-of-life treatment.
A study found that family members reported high rates of unmet needs for symptom management, emotional support, and physician communication. Patients receiving home hospice services had better quality care outcomes compared to those in institutional settings.
A large US multistate study found that end-of-life care is often woefully inadequate, with many patients receiving insufficient pain medication, emotional support, and respectful treatment. The study recommends expanding access to hospice care, growing palliative medicine training, and improving nursing home end-of-life care.
The HealthGrades study found that hospital care quality differs markedly by state, with better-performing hospitals concentrated in northern states. States such as Florida, Colorado, Ohio, Pennsylvania, and Michigan consistently ranked high across various procedures and diagnoses.
A new system allows for continuous monitoring of mortality rates in general practices, helping identify unusual trends and potential areas for improvement. The tool can aid in spotting high-quality care by highlighting low mortality rates.
After passage of the Balanced Budget Act, length of stay in Medicare home care decreased among patients, particularly those in for-profit agencies. This decrease may have been a result of fraud and abuse control measures.
Researchers found exponential killing of tuberculosis bacteria was more rapid with isoniazid, followed by rifampin's dominance. A study of acute monocytic leukemia revealed rapidly progressive respiratory distress, highlighting the need for early ICU admission and management.
A study of 917 patients found that functional decline was steady and not marked by a sharp point in time, challenging the Medicare hospice model. The researchers suggest that alternative care systems are needed to provide adequate support for frail elderly individuals with progressive decline.
A new study found that patients in higher-spending regions receive more care, but it does not translate to better outcomes, patient satisfaction, or access to care. Removing liver tumors by ethanol injection therapy followed by interferon therapy may reduce the risk of tumor recurrence in patients with chronic hepatitis C virus.
A study of 213 terminally-ill cancer patients found that only 7% expressed concern over losing dignity. The majority reported psychological distress and symptom distress instead. This highlights the need for dignity-conserving care in palliative care.
A ESMO survey found that almost all oncologists (92%) believe dying patients should receive anti-tumor therapy alongside end-of-life care. However, less than half routinely coordinate patient care or collaborate with support teams.
A study by UC Davis researchers found that cancer patients receiving both investigational chemotherapy treatments and palliative care outperformed those who received only treatment. This approach improved quality-of-life assessments and increased completion of chemotherapy cycles.
A study published in the American Journal of Clinical Nutrition reveals that 67% of convalescent home patients have low serum albumin levels indicative of severe malnutrition. Malnourished patients are also more likely to experience depression and dehydration, highlighting the need for improved nutrition care.
A review article highlights ethnic differences in access to medical services, particularly end-of-life care, among minority groups. Cultural mistrust and lack of awareness about individual patient preferences also hinder effective care.
The study aims to determine the effectiveness of meditation and/or massage in improving patients' perceived quality of life. Researchers hope to find ways to improve quality of life, particularly in the spiritual domain, for patients dying with AIDS.
The aging inmate population in Pennsylvania's prisons requires increased long-term care services due to growing numbers of inmates needing daily living assistance. The study found that nearly 24% of inmates 65 years and older need assistance, and the cost of care can reach up to $70,000 per person per year.
The American College of Physicians-American Society of Internal Medicine opposes physician-assisted suicide, considering it a threat to the patient-physician relationship. Instead, they suggest improving access to hospice care, palliative care, and pain management.
A study found that elderly nursing home residents receiving hospice care through Medicare are less likely to be hospitalized in their last days of life compared to those without such care. Hospice care improves the quality of life and reduces costs for the federal government.
A home-based primary care intervention program by the Department of Veterans Affairs significantly improved health-related quality of life and satisfaction for patients and their caregivers. The study found that Team-Managed Home-Based Primary Care (TM/HBPC) improved HR-QoL scales, caregiver outcomes, and reduced hospital readmissions.
A new JAMA series aims to teach doctors and nurses how to manage end-of-life care issues, as physicians are not adequately trained in this area. The series will cover topics such as symptom management, hospice care, and cross-cultural differences in dealing with death.
A study found that earlier recognition of a child's prognosis by both parents and physicians can lead to stronger emphasis on treatment aimed at lessening suffering. The study also revealed that high-quality palliative care is more likely when both parties recognize the child's prognosis.
A Northwestern University study collects data from nearly 1,000 dying patients to provide new insights into the care of terminally ill individuals. The research reveals that good communication with physicians and nurses, as well as spiritual/religious practices, contribute to a greater sense of purpose and personal acceptance.
A study found that 24% of elderly individuals experienced recurring dizziness, with factors like anxiety, depression, and taking five or more medications contributing to the issue. Two last-resort options for end-of-life suffering are discussed: terminal sedation and voluntary refusal of food and fluids.
A study by University of Chicago researchers found that doctors predict their terminally ill patients will live 5.3 times longer than they actually do, leading to unsatisfactory end-of-life care. The study suggests that some improvements may be made by having disinterested doctors provide predictive second opinions.
A new analysis of the SUPPORT study found that less aggressive treatment for seriously ill elderly adults does not explain their higher short-term mortality rates. In contrast, reporting HIV-infected patients by name had a limited impact on timely care and partner notification.
The Palliative Care Project challenges the current model of medical care, which forces terminally ill patients to choose between continued medical treatment and hospice care. The new program integrates both services, allowing patients to receive cutting-edge medical therapy while also benefiting from palliative care.
A study by OHSU found that patients who completed the bright pink POLST form had high levels of comfort care and low rates of aggressive life-extending treatment. The form, which enables patients to state wishes on specific treatments, was designed to record patients' wishes in the present, not just future healthcare.
The new Moore Options program uses AIDS specialists as primary care providers and coordinators, focusing on complex patient needs. Published studies show improved outcomes and lower costs for patients treated by experienced care providers.
Hospice care is underused in the US, with most patients enrolling too late to benefit from it. Short stays can lessen the effectiveness of hospice care, leaving little time for caregivers to learn about the patient's needs and arrange optimal care.