A National Hospice and Palliative Care Organization report on diversity says that "the business challenge of hospice care is to transform care and services to meet a more dynamic mix of people of various races, cultures and backgrounds." Increasing hospice awareness among minorities and promoting greater workforce diversity may help open hospice care to more people.

A report from Avalere Health says Medicare Advantage patients are more likely to be affected by social determinants of health, which may affect hospices preparing for a carve-in demonstration in 2021. "Information on social determinants of health will be essential for strategic planning of services and providing the appropriate end-of-life care," report author Christie Teigland said.

Dr. Melissa Walton-Shirley writes about being shocked to learn that a hospitalized patient, a vibrant and active 73-year-old, was wearing a do-not-resuscitate bracelet without understanding what it meant. After talking with the man about his wishes, they changed his status, and clinicians should be prepared to explore and talk about orders that don't appear to make sense, Walton-Shirley writes.

Because time is limited, hospice patients may be hyper-focused on what they have left of it, hospice social worker Lizzy Miles writes. Showing patients and families respect for their time, being mindful of how the hospice team uses our time with them, and setting reasonable expectations are some of the ways to help patients and families feel good about the time spent with them.

Employers should consider policies and benefits aimed at helping Generation X workers who increasingly are responsible for caregiver duties at home and are the least financially secure, compared with baby boomers and millennials, said MetLife's Bradd Chignoli. Caregiver leave, flexible work schedules and locations, disability insurance, financial wellness programs and voluntary benefits are some of the options for helping caregivers in the workplace.

Researchers found that compared with the general population, patients with chronic myeloid leukemia were at greater risk of developing a second hematologic malignancy. Among 13,276 people with chronic myeloid leukemia in the National Cancer Institute's Surveillance, Epidemiology, and End Results Program, 4.5% developed a second malignancy, according to the study in the International Journal of Hematology.

An analysis of data for 12,099 octogenarians newly diagnosed with acute myeloid leukemia found a one-month mortality rate of 41% and median overall survival of 1.5 months. Forty-one percent received chemotherapy within a median of seven days, and 0.07% received hematopoietic stem cell transplants, according to a research letter in the American Journal of Hematology.

New York is leading a coalition of 23 states suing to strike down a Trump administration regulation that allows health care providers to refuse to provide services to patients based on religious or moral grounds. The rule, scheduled to go into effect in July, would allow providers to "openly discriminate" against patients, New York Attorney General Letitia James said.

Candida auris could become a serious health threat across the globe, according to the CDC. The fungus is difficult to identify with standard methods, is often multidrug resistant and inflicts serious damage to those with weakened immune systems.

Health care facilities are seeking alternatives to electronic health record processes that have led to burnout among physicians. Many industry veterans say that open interoperability guidelines, rather than frameworks tailored to individual vendors or platforms, are the solution.

US adults ages 45 to 64 were more likely to die from cancer than heart disease between 1999 and 2017, but cancer mortality among that group fell 19% during the study period, according to a study in the CDC's National Vital Statistics Reports. Meanwhile, the prevalence of heart disease-related deaths decreased by 22% from 1999 to 2011, then increased 4% from 2011 to 2017, with the greatest increase found among white women.

The number of consumers who want to engage with health care providers using digital methods is increasing, and practices can use the technology to improve patient engagement, write Matt Henry and Susan Kanvik, health care consultants with Point B. They recommend that practices should decide what their pain points are before finding the technology needed.

AAHPM's video series called HPMQ, Hospice and Palliative Medicine Question, has released its newest video help addressed difficult topics that you may face in your organization. This month's video asks "If I block his dopamine and stimulate his serotonin, will he feel better?," presented by Allison E. Jordan.

The 2019 Virtual Conference: Overcoming the Challenges of Community-Based Palliative Care, hosted by NHPCO, HPNA and AAHPM is coming July 17-18. This conference will address key clinical practice and program development challenges, providing practical solutions to ensure the delivery of exceptional quality care and the success of community-based palliative care. If you are an AAHPM member, be sure to register at the AAHPM member rate! Learn more.