Data on 71,000 US nursing home patients with advanced dementia who had trouble eating on their own showed 6% got feeding tubes to help them eat in 2014, compared with 12% in 2000, researchers reported in the Journal of the American Medical Association. A separate study in the Journal of Clinical Gastroenterology found dementia patients with feeding tubes had higher rates of rehospitalization and shorter survival times compared with patients with feeding tubes who had other neurological or medical problems.
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The 2016 Circle of Life Awards for palliative and end-of-life care innovation went to Susquehanna Health in Williamsport, Pa., Bon Secours Richmond Health System in Virginia and Cambia Palliative Care Center of Excellence in Seattle. Susquehanna Health hospice nurse Nancy Patchen, hired to work with patients at area nursing homes, said palliative care programs were introduced at the facilities one at a time, because each has its own culture, and it was necessary to determine what would work at each location.
Pediatric palliative physician Jenni Linebarger says her take-away from a study showing a trisomy 13 or trisomy 18 diagnosis is not always immediately fatal, and some interventions are beneficial, is that it is time to stop using words such as "lethal" and "futile." Linebarger says it still will be difficult to discuss a child's prognosis with parents because the conditions are filled with uncertainty and the field lacks ways to predict long-term survival.
Canadian researcher Kelli Stajduhar of the University of Victoria is studying palliative care options for homeless people at risk of dying on the street. Stajduhar, a palliative care nurse, says homeless patients often are diagnosed too late in their disease for treatment to be beneficial, and they may have had negative interactions with the health care system that led to distrust and avoidance of care.
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A law setting training standards for caregivers of Alzheimer's disease patients was signed into law by Illinois Gov. Bruce Rauner. The law includes provisions on length of training and curriculum, and creates advertising guidelines for companies that provide care to patients with Alzheimer's disease and other types of dementia.
A study in the American Journal of Geriatric Psychiatry finds depression often is underdiagnosed, untreated or inappropriately treated in adults ages 60 and older. Iqbal Ahmed, M.D., of the Uniformed Services University of Health Sciences in Maryland, commented that solutions may include efforts to reduce the stigma of mental illness, better physician education, and more widespread screening using questionnaires such as the Geriatric Depression Scale.
University of Florida researchers who used functional MRI found that patients with Parkinson's disease had reduced function in two of five brain areas involved in movement and balance one year after a baseline study, and those with multiple system atrophy and progressive supranuclear palsy had declining activity in three and all five areas, respectively, compared with no declines among healthy controls. The findings in the journal Neurology, based on imaging from 46 Parkinson's patients, suggest that the approach could be used to track disease progression and aid the development of treatments that address the causes of Parkinson's disease, researchers said.
Most health care providers participating in Medicare or the Children's Health Insurance Plan will choose to be reimbursed under the Merit-based Incentive Payment System, but some are ready to assume more financial risk and will choose an alternative payment model.
A study in Health Affairs showed that using EHR data may help reduce gaps in health care delivery driven by geographic, racial and socioeconomic disparities. Researchers found that practices have used EHR data to develop a new patient dashboard to accommodate various race populations, improve blood pressure control among African American patients, boost cardiovascular care for minority patient populations and improve care coordination.
Under MACRA, Medicare is moving from volume- to value-based reimbursement. Watch this FREE webinar as AAHPM leaders present an overview of MACRA's quality and payment provisions and discuss challenges and opportunities this law offers for our field.