Articles tagged with Hospices
The new guideline recommends full-time infection prevention staff, comprehensive training, and support for all staff, as well as partnerships with hospitals and public health agencies. This guidance aims to reduce the risk of infections in nursing homes, saving lives and money.
A new study finds that benzodiazepines and antipsychotics prescribed to patients with dementia receiving hospice care may carry major unintended risks, including increased mortality. The study highlights two policy issues: lack of oversight of medication use in hospice and a mismatch between hospice policy and dementia care.
A special issue of Journal of Intensive Medicine provides key insights into selecting optimal non-invasive respiratory support strategies for AHRF, featuring review articles and original research. The collection offers guidance on the efficacy of HFNC, CPAP, NIV, and awake prone positioning to improve patient outcomes.
A retrospective study found that only one-quarter of patients diagnosed with advanced cancer received palliative care in the last six months of life. The study also showed that 45% of decedents experienced potentially aggressive care, highlighting the need for interventions to improve quality of care.
A recent study published in JAMA found that for-profit hospices, which care for nearly 75% of Medicare patients, performed substantially worse than not-for-profit hospices. The study highlights the need for policy interventions to increase transparency and accountability in hospice ownership.
A new study by MIT scholars finds that hospice care generates substantial savings for the US Medicare system, with $29,000 in cost savings over five years for patients with Alzheimer's Disease. Hospice care provides palliative-type care at a lower cost than elaborate medical procedures, saving lives and reducing suffering.
A new article in Journal of Palliative Medicine highlights the growing role of for-profit entities in home health and hospice care, which can compromise care quality and patient welfare. The authors emphasize the need for research and regulatory responses to address these trends and ensure better care for seriously ill older adults.
Black patients with short hospice stays and those from for-profit hospice services are at higher risk of hospitalization after discharge. Researchers found that uninterrupted hospice care may be suitable for many individuals discharged from hospice, while inpatient respite and general inpatient care can lower hospitalization odds.
A stepped-care model integrating palliative care at key points in patients' cancer trajectories shows reduced palliative care visits without compromising quality of life. The approach enables more efficient delivery of early palliative care, enhancing patient-reported outcomes.
This study reveals racial and ethnic differences in hospice use, with Hispanic and non-Hispanic Black individuals having lower odds of receiving hospice care. Hispanic individuals had the highest odds of a short hospice stay, highlighting potential barriers to access and acceptance among low-income populations.
Researchers found that a small fraction of eligible patients are being approached to consider eye donation, despite both healthcare professionals and patients having favorable views towards it. The study highlights the need for practice change to offer patients who wish to donate as part of routine end-of-life care.
A new study reveals that the COVID-19 pandemic has significantly impacted end-of-life care, with a growing burden on first-time carers and reduced formal care support services. Researchers advocate for improved resources for wider end-of-life care education, health and social care staff, and identification and assessment of carers.
State palliative care laws are associated with an increased likelihood of dying at home or in hospice among decedents from cancer. Passage of these laws may be an effective policy intervention to increase the number of seriously ill patients who experience their death in such locations.
A national cohort study found that early dexamethasone administration reduced odds of mortality in hospitalized COVID-19 patients needing supplemental oxygen or mechanical ventilation. The treatment was not associated with improved outcomes for those without such needs.
A new study by the RAND Corporation found that patients receiving care from for-profit hospices have worse care experiences than those in non-profit hospices. Family caregivers reported lower quality care across all domains, including pain management and timely care.
A retrospective cross-sectional study found that VA-financed hospice services were associated with higher rates of concurrent dialysis among veterans with end-stage kidney disease. Patients who received VA-financed hospice services lived approximately 43 days after stopping dialysis, compared to just four days for those who stopped dia...
Non-Hispanic Black and Hispanic decedents with dementia used less hospice but more emergency department and inpatient services. They incurred higher Medicare inpatient expenditures, with a 60% increase compared to white decedents.
A new study reveals massive variations in hospice medication prescriptions, with treatment agency being the primary factor. Patients in agencies with high prescription rates were up to 50 times more likely to receive benzodiazepines or antipsychotics.
A study analyzing Medicare claims data found that policy changes reduced the share of patients receiving hospice care for Alzheimer's disease and related dementias. The changes also slowed growth in hospice care use by these patients.
Researchers at Rutgers University found disparities in palliative care and hospice referrals among minority patient groups, highlighting the need for standardized policies to improve access. The studies revealed that language barriers, economic status, and cultural differences contribute to these gaps in care.
A study ranking 81 countries on end-of-life care found that only six earned an A grade, while 36 received Ds or Fs. The US ranked 43rd, highlighting the need for improvement in palliative care globally. Experts emphasize the importance of making advance care plans and discussing wishes with loved ones.
A new medical records analysis found that Black patients in the US pursue more intensive treatments than white Americans in the last six months of life. White people are more likely to use hospice care, which reduces emergency department visits and invasive procedures.
A recent study by Oregon State University researchers found that patients referred to hospice care from hospitals tend to spend less time on hospice and receive fewer pain management medications than those referred from other locations. This difference highlights the need for specialized interventions to improve patient care during tra...
A Northwestern University study found that COVID-19 patients are 12 times more likely to die in a medical facility than patients who died from any cause in 2018. The high rate of deaths in hospitals and nursing homes highlights the need for improved end-of-life care, including access to virtual communication with families.
Researchers found that a dying brain can respond to sound even in an unconscious state, up to the last hours of life. The study used EEG to analyze brain activity from hospice patients and healthy controls, revealing similar responses to common and rare sounds.
A randomized trial of a hospice video educational tool found that patients who viewed the video were more likely to prefer hospice at end-of-life and had longer hospice use compared to those receiving verbal descriptions. Caregivers also reported greater knowledge and preferences for hospice care after viewing the video.
A study found that UK hospices provide some form of support before and after parental death, but the type and timing vary widely. Hospices report funding difficulties in training staff for bereavement services, despite national guidelines recommending tailored support.
The new staffing model emphasizes three key interdependent roles: palliative care physician, resource nurse, and social worker. This approach aims to deliver an optimal, integrated palliative care program, and collaboration among team members is crucial for success.
A new case study published in the Journal of Palliative Medicine reports a unique example of a patient with ALS who overcame nausea and vomiting linked to chronic cannabis use by reducing, but not discontinuing, cannabis use. This finding adds to clinicians' ability to respond to rare adverse effects of medical cannabis use.
Researchers found that early documentation of end-of-life wishes in health records can prevent hospitalizations, especially if noted at least six months prior to death. This helps respect the patient's priorities and focus on quality of life and pain management.
A study published in Supportive Care in Cancer examines the experiences of providers offering concurrent cancer therapy and hospice care to veterans. The findings highlight the importance of preserving hope while transitioning into end-of-life care, as well as the need for dedicated liaisons between VA and hospice systems.
A new white paper from the Pontifical Academy for Life recommends 43 strategies to improve global palliative care, aiming to alleviate the suffering of millions. The report was developed by an expert group representing different faiths and was published in Journal of Palliative Medicine.
A new study by Brigham and Women's Hospital found that only 20% of Medicare patients with end-stage renal disease used hospice, and those who did were more likely to have short stays. This can limit access to palliative care services and increase costs.
A study found subtle but significant differences in perceived hospice quality among patients in different settings. Family members of patients at home rated hospice quality as excellent, while those in nursing homes reported the least. The findings suggest that tailoring communication to patient setting is crucial.
Researchers identified common bucket-list themes among patients with chronic and serious illnesses, including travel, personal goals, and quality time with friends and family. This knowledge can serve as a roadmap for clinicians to provide tailored care that respects patients' preferences and values.
Researchers studied hospice patients' perceptions of wisdom, finding it to be a continuous recalibration between accepting illness and wanting to grow and change. Participants emphasized the importance of acceptance, gratitude, and positivity in their final days.
A study by Massachusetts General Hospital found that almost 40% of malignant glioma patients never enrolled in hospice, and a quarter of those who did may have enrolled too late. This highlights the need for improved end-of-life care for this patient group.
Researchers discovered significant racial disparities in hospital admission, emergency department visits, and hospice disenrollment among African American and white patients at the end of life. Black patients were more likely to experience higher-intensity care, which may negatively impact their quality of life and caregiver burden.
The Innovation Accelerator program has announced funding for four new projects aimed at addressing disparities in healthcare delivery and patient outcomes. The projects focus on improving symptom management for heart failure patients, reimagining primary care doctor visits and payment models with telemedicine, and developing a multidis...
Patients with advanced leukemia who rely on blood transfusions face barriers to quality end-of-life care, including limited hospice services and higher hospital deaths. Research suggests that improving access to blood transfusions could increase hospice care use among these patients.
Research found that leukemia patients who rely on blood transfusions face difficulties enrolling in hospice care, leading to shorter hospice stays and delayed access to palliative care. The study suggests that adding support for transfusions to the Medicare hospice benefit could maximize its benefits.
A study of 562 older adults found that those admitted to hospice care during the last year of life were slightly older and more likely to have cognitive impairments. The most common conditions leading to death were frailty, organ failure, advanced dementia, and cancer.
A Yale-led study found that nearly half of older adults admitted to hospice during their last year of life experienced symptoms for months prior to admission. The most common conditions leading to hospice admission were cancer and advanced dementia.
A new study found that the Service Intensity Add-on payment for in-person routine home hospice care can increase visits by nurses or social workers during a patient's last week of life. The payment, added to Medicare/Medicaid coverage in 2016, led to a 21.6% increase in average SIA payments and potential disparities reduction.
A new study found that a V.A. initiative to improve end-of-life care led to a substantial increase in the use of hospice among U.S. veterans. Hospice use grew at a rate twice as fast as the general Medicare population, with an estimated additional 17,046 veterans receiving hospice care between 2010 and 2014.
A new RAND Corporation study reveals that black and Hispanic patients are more likely to receive care from poorer quality hospices. In contrast, caregivers of these patients report similar or better experiences within the same hospice compared to white patients.
Research shows that blood cancer patients are less likely to enroll in hospice care compared to solid cancer patients. However, a survey of hematologic oncologists found that 68% agree that hospice care is helpful for blood cancer patients, and most would refer patients if red blood cell transfusions were available.
A new study from Indiana University Center for Aging Research and Regenstrief Institute found that the intensity of hospice services was similar across nursing homes, assisted living facilities, and patient homes, but with variations in service mix based on diagnosis and location.
A study reveals significant variation in palliative care services across England, with some regions failing to provide standardised information and patient choice being hindered. Experts recommend a national framework to ensure fair access to palliative care, citing the Welsh Palliative Care Strategy as a best practice model.
A study by University of Missouri researchers found nearly one-quarter of hospice caregivers experience moderate to severe depression and nearly one-third experience moderate to severe anxiety. Younger caregivers are more likely to be depressed or anxious.
A new study found that people with higher BMIs are less likely to receive hospice care, die at home, or receive high-quality end-of-life care. Those who did use hospice services spent fewer days in hospice due to differences in home hospice usage.
Greater primary care physician involvement at the end of life is associated with less costly and less intensive care. Regions with more primary care involvement have lower Medicare spending in the last two years of life and fewer ICU days in the last six months.
Vincent Mor, PhD, of Brown University, received the 2016 Robert W. Kleemeier Award for his outstanding research on aging and care quality. He has conducted extensive work on hospice and palliative care, including a study on National Hospice Study's effect on patients' quality of life.
Researchers found that patients who were asked about their preferred site of death and those in hospices with frequent symptom monitoring had lower hospitalization rates. For-profit hospices, however, showed persistently high hospitalization rates regardless of practice implementation.
A study found that only 52% of cancer patients received palliative care as recommended, highlighting the need for improvement in end-of-life care. Hospice care was more accessible to veterans than non-veterans, but disparities persisted.
A pilot program using video decision aids increased the documented incidence of advance care planning conversations and hospice discharges in Hilo, Hawaii. The program improved end-of-life care by allowing doctors to have critical conversations with patients about their individual preferences.
Physicians use more hospice care, spend more time in Intensive Care Units (ICUs) and just as much time in hospitals compared to the rest of the population. Doctors used an average of 2.4 days longer in hospice care at the end of life.
Research reveals US physicians utilize hospice and intensive care more frequently than non-physicians at the end of life, contradicting common assumptions. This finding raises concerns about a larger systems issue contributing to high utilization rates.
Researchers found that hospice services don't lead to higher care costs for long-stay nursing home residents, despite concerns about cost shifting. Instead, avoidance of costly hospitalization and post-acute care offsets hospice costs.
A new editorial emphasizes the need for proper pain assessment and opioid prescribing to balance treatment effectiveness with addiction risks. Experts call for physicians to speak out as a voice of reason in their communities, advocating for safe and effective pain relief when medically indicated.