A study found that hospice patients experience multiple care transitions near the end of life, with more than half going to hospitals. These transitions are often associated with younger or non-white patients, those with multiple chronic conditions, or in-patient hospice care. The number of transitions varies widely by state.
Hospice programs vary significantly in their visitation rates for Medicare patients nearing death, with black patients and those in nursing homes receiving fewer visits. Analysis of Medicare claims data reveals that hospices with smaller patient volumes and those based in nursing homes were less likely to provide visits.
A University of Missouri researcher found only 10 clinical trials conducted in U.S. hospices since 1985, highlighting a need for more evidence-based care.
A study by Dana-Farber Cancer Institute researchers found that factors such as hospice care duration, ICU admissions, and death location are associated with excellent end-of-life care. Expanding hospice access and revising Medicare provisions could improve quality of life for terminally ill patients.
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A study found that African American and Native American dialysis patients were 43-44% less likely to use hospice before dying compared to white patients. The research highlights the need for high-quality research into the benefits of dialysis therapy in older and sicker segments of society.
A hospital surveillance program utilizing a two-stage Clinical Decision Support (CDS) system reduced the risk of adverse outcomes, such as death and hospice discharge for sepsis patients, by 30%. The study found that 61% of patients who first activated the alert had SIRS syndrome, an early physiologic response to infection.
Researchers found that video conferencing can facilitate shared decision-making among terminally ill patients and family caregivers in hospice care. The study highlights the need for more research on shared decision-making in hospice care to improve patient-centered care.
Despite rapid expansion of palliative care programs in US hospitals, access remains uneven, with smaller hospitals and for-profit institutions being less likely to offer services. Variables associated with a greater likelihood of providing palliative care include presence of a residency training program and links to a medical school.
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A recent study published in Journal of Palliative Medicine found variations in hospice use patterns between states, highlighting the need for improved end-of-life care. Researchers identified differences in the timing and duration of hospice enrollment, which could mask issues requiring attention.
Researchers found key differences between people receiving hospice care in ALFs versus those cared for at home. People in ALFs were more likely to be older and female, and received help from the hospice team earlier, leading to a higher quality of life before death.
New research from Brigham and Women's Hospital found that individual physicians are the strongest predictor of whether a patient will be referred to hospice care. Patients with poor-prognosis cancer diagnoses were more likely to enroll in hospice if seen by a physician in the top 10% of hospice use.
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Researchers found a modest reduction in depressive symptoms among some surviving spouses of hospice users compared with non-hospice users. Hospice care was associated with improved depression scores for a subgroup of surviving spouses, particularly those who were primary caregivers.
A study found that hospice use was linked to fewer depressive symptoms in surviving spouses, with benefits lasting a year after death. The research team analyzed data from over 1,000 deceased patients and their surviving spouses, suggesting high-quality care can have a positive impact on caregivers as well.
A new study by King's College London found nearly double the proportion of people dying in hospices since 1993, with most deaths from cancer. The gap between those living in affluent and deprived areas is increasing, with hospice deaths becoming more age-related.
A new study found that expanded hospice care improved indicators of care quality, including reduced reliance on intensive care and feeding tubes. However, it also led to increased costs to Medicare of $6,761 per patient on average due to longer stays and increased provider numbers.
A new study reveals that the perception of quality care for the dying in the US has worsened over the last decade, with loved ones reporting a decrease in satisfaction. Despite efforts to improve end-of-life care, significant gaps remain between patient and provider preferences.
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Researchers found that nursing home hospice patients have longer stays, are more likely to be women and have dementia, and often receive higher Medicare spending compared to those living in the community. The study also identified a 'crossover' group with significantly longer hospice stays.
A study found that Medicare patients with poor-prognosis cancers who received hospice care had significantly lower rates of hospitalizations, ICU admissions, and invasive procedures at the end of life. Hospice beneficiaries also had lower health care expenditures during the last year of life.
Researchers at Brigham and Women's Hospital found that patients without hospice care had significantly higher rates of health care utilization and costs during their last year of life. Hospice care was associated with lower rates of hospitalizations and intensive procedures.
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A new Penn Medicine study reveals that certain patient characteristics, such as being male, married, and younger than 65, may be associated with shorter hospice stays. The study also found that patients with blood cancers and Medicaid or uninsured status tend to enroll in hospice earlier in their illness
A study examining Medicare hospice discharges found that nearly 1 in 5 patients were discharged alive, sparking concerns about cost-saving measures. The researchers also discovered significant variation in live discharge rates across states and individual hospices.
Despite limited evidence, antibiotics are still widely prescribed to terminal hospice patients, with 27% continuing use in final week of life. This raises concerns about unnecessary side effects, adverse events, and antibiotic resistance.
For-profit hospices tend to provide fewer community benefits, serve more patients with longer stays, and exceed Medicare's cap on length of stay. In contrast, nonprofit hospices are more likely to partner with oncology centers and address disparities in hospice use.
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A new study reveals a complex system of perspectives among hospice organizations and workers regarding physician-assisted death. Despite being historically opposed, many caregivers now struggle to balance their core beliefs with the new laws, leading to varied reactions and approaches.
A study found that high spiritual support from religious communities is associated with reduced aggressive treatment in patients with advanced cancer. Patients receiving spiritual support from the medical team had higher rates of hospice use, fewer aggressive treatments, and fewer ICU deaths.
A study published in Health Affairs found that Medicare patients who enrolled in hospice received better care at a significantly lower cost to the government. The study, led by researchers at Mount Sinai, showed annual savings of $2.4 million to $6.4 million for the government.
A study by University of Kentucky researcher Elaine Wittenberg-Lyles found that hospice team members often respond to caregiver empathic opportunities with perfunctory responses, rather than addressing emotional needs. This highlights the need for better communication about psychosocial issues and emotional losses for caregivers.
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A study by Case Western Reserve University researchers explores how family members cope with anger toward God during a loved one's death. The findings show that lower levels of religiosity and spiritual connection are associated with increased anger, while prayer and seeking forgiveness can be effective coping strategies.
A study analyzing Medicare claims data found a decrease in hospital deaths, but increased ICU stays and healthcare transitions in the last months of life. Hospice use increased from 21.6% to 42.2%, while short hospice stays grew, suggesting that increasing hospice use may not lead to reduced resource utilization.
A recent study found that while more seniors are dying with hospice care than a decade ago, they are increasingly doing so for very few days right after being in intensive care. This suggests that palliative care often happens as an afterthought, and patients may not receive the full measure of comfort and psychological support they need.
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A survey of US hospices found that restrictive policies limit access to hospice care for patients requiring costly treatments. Reforming Medicare reimbursement rates and eligibility requirements is necessary to support patients and their providers.
A new analysis found that the Medicare rule blocking simultaneous hospice and skilled nursing facility care at the end of life results in patients receiving less aggressive treatments and dying outside of hospitals. Residents with concurrent hospice and SNF care were 87% less likely to die in the hospital compared to those without hosp...
A study by Indiana University School of Medicine found that nonwhite Medicare patients with heart failure are less likely to enroll in hospice, but more likely to experience hospitalizations and increased costs when they do. Racial disparities persisted over time, highlighting the need for improved end-of-life care options.
A multidisciplinary group of healthcare experts share their experiences on integrating palliative care into the ICU setting. The discussion highlights the potential benefits of palliative care in easing suffering and improving quality of life for critically ill patients.
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A study led by the University of Kentucky found that hospice family caregivers experience 'second-order patient' stress due to caregiving tasks and emotional impact. Researchers recommend routine care interventions to address these unique needs and improve caregiver outcomes.
Patients with advance directives specifying limits in treatment had significantly lower end-of-life Medicare spending and greater odds of hospice use than those without, particularly in high-spending regions. The study suggests that advance directives may be most impactful in regions where treatment norms are more aggressive.
A survey of 538 family members found that hospice care significantly improved the provision of care and support for nursing home patients with dementia and their families. Family members of hospice recipients reported lower levels of unmet needs, pain management concerns, and emotional support needs.
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A study published in the Journal of Pain and Symptom Management found that counties with higher median household incomes have a greater supply of hospice services. This suggests that wealthier communities are more likely to have access to these life-sustaining programs, which can improve pain control, maintain independence, and even ex...
A study found that for-profit hospices tend to have more patients with dementia and other diagnoses requiring less intense care, as well as longer hospital stays. This may be due to financial incentives tied to Medicare reimbursement rates.
A recent study by Beth Israel Deaconess Medical Center researchers found that nonprofit hospice agencies disproportionately care for patients with diagnoses associated with less skilled care and longer lengths of stay. This may lead to financial obstacles in providing appropriate care for the neediest patients.
A large proportion of Medicare expenditures for nursing home residents with advanced dementia is spent on aggressive treatments that may be avoidable and of limited clinical benefit. Strategies that promote palliative care may reduce costs at the end of life by shifting from aggressive to comfort care approaches.
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A new study finds that the proportion of nursing home residents with dementia benefiting from Medicare hospice care nearly tripled between 1999 and 2006, with duration of care more than doubling. This trend has implications for policymakers seeking to control Medicare costs while preserving access to essential end-of-life care.
Researchers found that 98% of the US population lives within 60 minutes of a hospice provider, suggesting access is not a barrier to enrollment. However, more research is needed to determine why many patients and families avoid hospice care at end-of-life.
A new study published in the Journal of the American Medical Association recommends prioritizing palliative care over life expectancy when determining hospice eligibility for advanced dementia patients. The study found that a clinical tool assessing mortality risk can improve accuracy and expand access to hospice services.
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Studies examine resource use and costs in the last six months of life for Medicare beneficiaries with heart failure and Canadian patients who died of heart failure, revealing increased hospice use but high hospitalization rates. Increasing availability of alternative care venues may help reduce hospitalizations and contain costs.
Briefings will present practical, clinical case studies encountered by callers to PAL-MED CONNECT, focusing on topics such as pain management, opioid safety, and neuropathic pain symptoms. The collaboration aims to provide valuable resources for healthcare professionals seeking expertise in palliative care.
Researchers found that patients disenrolling from hospice care had nearly five times the healthcare costs of those remaining with hospice. This is due to increased hospitalizations and emergency department visits.
A recent survey found that most Oregon hospices have limited participation in the Death with Dignity Act, which allows terminally ill patients to request physician-assisted death. Hospices' role is largely confined to providing neutral information about the law, leaving patients to seek assistance from physicians themselves.
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The study found that Medicare-certified hospice stays in nursing homes have doubled in the last 10 years, with average treatment times increasing from 46 to 93 days. The researchers attribute this growth to increased Medicare services and reimbursement policies that incentivize longer stays.
A recent study published in Journal of Palliative Medicine found that living wills often do not accurately reflect patients' actual treatment preferences at the end of life. The authors propose revising living wills to include more realistic scenarios and estimates of treatment effectiveness to guide advance care decisions.
A new study from the Institute for Aging Research found that blacks and Hispanics have significantly lower odds of receiving hospice care for advanced heart failure compared to whites. The study highlights the need to ensure equal access to and education about hospice services, particularly for racial and ethnic minorities.
A study of Medicare beneficiaries with heart failure found that Black and Hispanic patients were less likely to use hospice care compared to white patients. Cultural differences, lack of trust between patients and physicians, and access issues may contribute to these disparities.
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A study found that nearly 60% of hospice patients with implantable cardioverter defibrillators (ICDs) have the shocking function deactivated, despite potential benefits for their quality of life. ICDs can cause physical and psychological distress for patients and their families.
Groundbreaking studies will help hospice patients and families address unresolved issues before and after a loved one passes away. The research focuses on marshaling patients' inner strengths, such as hope, optimism, and connectedness, to improve psychological outlooks.
The article outlines seven key areas for improving spiritual care, including Spiritual Care Models and Training/Certification. The guidelines provide practical recommendations for implementing spiritual care in palliative care settings.
A new study found that expanded insurance benefits and comprehensive case management increased hospice care use among patients with advanced illnesses. The study, published in Journal of Palliative Medicine, reported a 70% increase in hospice use and mean number of days in hospice care.
A study published in Current Biology confirms that our brains temporarily represent used tools as part of our body schema. This phenomenon affects how we move and perform tasks, with participants exhibiting altered arm movements and perception after tool use.
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A study published in Archives of Internal Medicine found that only half of patients diagnosed with metastatic lung cancer discuss hospice options with their physicians. The study also revealed disparities in hospice discussions among different racial and marital groups, highlighting the need for improved end-of-life care conversations.
A study exploring hospice availability in the US found that communities with higher proportions of wealthy and educated residents have greater availability. Hospices also struggle to deactivate implantable defibrillators for end-of-life patients, with few formal policies in place.
A Brown University researcher has developed a user-friendly guide for doctors and patients on choosing high-quality hospice care. The guide emphasizes the importance of
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