Articles Posted in End of Life

caring-150x150A glaring gap in the U.S. health care system — the giving of care at home — is burgeoning into a costly chasm.  Pretty much everybody involved needs to pay close attention and finally act to deal with the nation’s failure to support home caregiving for the sick, injured, debilitated, and aged.

The consequences of inaction already are becoming clear, as the dearth of home care is smacking the recovering economy, “contributing to labor shortages around the country and playing a role in overall inflation,” the Washington Post reported, finding:

“At least 6.6 million people who weren’t working in early March said it was because they were caring for someone else, according to the most recent Household Pulse Survey from the Census Bureau. Whether — and when — they return to work will play a role in the continued recovery and could reshape the post-Covid labor force. For all the attention on parents — and mothers in particular — who stopped working to care for children during the pandemic, four times as many people are out of the work force, caring for spouses, siblings, aging parents, and grandchildren, according to the Federal Reserve’s latest Monetary Policy Report.

grief-150x150Death has not taken a holiday in this country. It has, instead, had a field day, with 2021 breaking records, recording 3.465 million American lives lost — 80,000 more than in history-setting 2020, federal statisticians say.

The coronavirus pandemic gets much of the blame for the nation’s grim toll, which was made all the worse because many of the deaths last year, as opposed to the year before, were preventable because safe, effective vaccines became widely available and could have averted debilitating and deadly illnesses for so many.

But Covid-19 was not alone as a killer that rose up to take American lives and to slash a fundamental measure of public health — life expectancy rates. The Associated Press reported, citing information from the federal Centers for Disease Control and Prevention:

academies-300x90The nation’s nursing homes and other long-term care facilities are in dire need of drastic overhaul to dramatically improve the quality and safety of their treatment of the aged, sick, and disabled. They too often now get what one expert has described as “ineffective, inefficient, inequitable, fragmented, and unsustainable” care.

To repair the glaring, longstanding wrongs in these facilities — problems that critics say contributed to 150,000 resident deaths during the coronavirus pandemic — requires sweeping practical, regulatory, and financial changes in an industry focused on profits and resistant to change, according to newly published expert research report by the National Academies of Sciences, Engineering, and Medicine.

The academies, with members who are leaders in their fields, are private, nonprofit institutions that work outside of government to provide objective advice on matters of science, technology, and health.

weedn-150x150It’s a grim issue that too many of us would want to ignore in the best of times. But the coronavirus pandemic and its collateral harms have pushed beyond their  limits the medical experts who study death, locally and nationally.

In Maryland, the chief medical examiner has resigned, and a deputy has been designated as the interim head of one of the nation’s busiest morgues, the Washington Post reported. Victor Weedn (shown right), who had served as the operation’s head since 2019, stepped down as the facility has gotten stuck in such snafus that it has more than 200 bodies awaiting autopsy, “the biggest backlog the office has seen.” The nightmarish mess matters, the Washington Post reported:

 “The logjam has left families distraught as they experience extended delays in funerals. It has also created problems with some [criminal] prosecutions, with holdups in courts obtaining autopsy reports and getting stand-in medical examiners for murder trials. In the past couple of months, the caseload in Maryland has increased by nearly 400%. There were 50 bodies awaiting autopsies in late December. The number swelled to 240 last week. Weedn recently estimated that the office would have a backlog of 300 this month. He and other medical examiners across the country have blamed backlogs on a combination of staffing shortages and rising deaths because of violence, Covid-19, and drug overdoses.”

calmattersnhomestrandcover-300x256As experts drill down to discover why nursing homes and other long-term care facilities are not playing a vital role in the U.S. health system by admitting improving patients from costly care in overwhelmed hospitals, a disconcerting explanation is emerging on who is filling some of the invaluable institutional space.

They might be called system hostages of sorts, poorer residents of nursing homes and other facilities whose condition has gotten better but who are trapped in institutions for distinct reasons, including the grim reality that they owe money they cannot pay, according to Jesse Bedayn of the nonprofit news site CalMatters. As he reported of the situation in the Golden State and nationally:

“While elder care advocates sound the alarm about patient ‘dumping’ by some California nursing homes — kicking out their mentally ill or bereft patients who need stable housing and care — a parallel dilemma is also threatening vulnerable residents: how to get out of a nursing home. The vast majority of people admitted to California skilled nursing facilities stay for less than three months to rehabilitate a broken limb or recover from a stroke or other ailment, according to the California Association of Health Facilities, an industry trade group. After these short-term stays, residents typically return home. But for thousands of poor nursing home residents … a temporary stay can become indefinite. Saddled with hefty Medicare copayments that can reach $5,000 a month — and later stripped of Social Security income, diverted to pay ongoing nursing home costs — they are often unable to hang onto their former housing. They become effectively stranded, with Medi-Cal and Social Security paying for housing and daily living in the facility.”

aduhelm-300x250As the nomination of Dr. Robert Califf to head the federal Food and Drug Administration advances, he and the agency already are confronting a major regulatory crisis over Aduhelm, a prescription drug targeted for Alzheimer’s treatment and approved on the thinnest of evidence.

An FDA sister agency, the Centers for Medicare and Medicaid Services (CMS), has joined the Department of Veterans Affairs in sharply restricting Aduhelm’s use and coverage for payment.

Quickly after the FDA approved the drug made by Biogen and the maker priced it at $56,000 annually for patients, the VA said it would consider Aduhelm for use in one of the nation’s largest health systems only on a case-by-case basis.

hospitalbedhospice-300x200Profit-raking private investors, aka hedge funders, have taken aim at operations intended to help the elderly, desperately ill, and grievously injured experience a dignified death. The rapacious takeover of the hospice industry nationwide ought to be setting off political and regulatory alarms in a rapidly graying nation.

As is typically the case when MBA-driven interests buy up different kinds of enterprises, they not only don’t exhibit much concern about the whys or wherefores of a business. They focus, instead, on how they can build volume, while cutting services, staff, and costs, the Huffington Post reported, describing what private equity firms have targeted for hospices. As the online news site found:

“Today, private equity firms are acquiring American hospices at an astonishing rate. From 2012 to 2019, the number of hospices owned by private equity companies tripled. The pace of acquisitions seems to have only gotten faster during the Covid-19 pandemic. Industry brokers who have never before put together a deal involving private equity say they now field calls from private equity buyers multiple times a week. Tempted by a wave of retiring baby boomers, the-sky’s-the-limit Medicare payments, the mom-and-pop nature of the industry and a lack of regulation that is pretty startling even by U.S. standards, private equity now accounts for three out of every five new hospice acquisitions.”

nhomehall-300x200The battle to safeguard the elderly, sick, and injured residents of the nation’s nursing homes and other long-term care facilities is far from over — and the fight may be even tougher than advocates for the vulnerable may have imagined.

That’s because the facilities employ aggressive tactics to contest safety and other violations found by state and federal regulators in a system that favors them and shuts out the aggrieved while also keeping crucial information hidden from the public, the New York Times reported.

The newspaper said it investigated what happens when inspectors write up homes, finding a little-known system that owners and operators play to the max to protect a financially lucrative aspect of their operations: the “stars” awarded by the Centers for Medicare and Medicaid Services on its web site.

coviddeathspreventable-300x140
The coronavirus pandemic is nearing another grim mark: 800,000 deaths in this country in its two-year run, with 1 in 100 of the fatalities occurring among those 65 and older.

The pandemic toll exceeds the population of cities like Washington, D.C., Seattle, Denver, Boston, and Memphis, and is heading toward the equivalent of spots like Charlotte and Fort Worth. The virus for some time now has proven to be deadlier than the military casualties the country experienced combined in World War II plus the Vietnam and Korean wars.

Still, millions of shoppers are cramming into stores and malls seeking seasonal bargains and gift-giving wonders. Tens of millions of travelers are ready to jump into cars, trains, buses, and planes for holiday and year-end journeys,  to gather with friends and family.

aduhelm-300x250Taxpayers and patients are suffering the rising negative consequences of the federal Food and Drug Administration’s dubious decision to overrule its own independent expert advisors and to approve on scant evidence Aduhelm. It is a prescription drug targeting Alzheimer’s disease, and concerns are rising about the medication’s safety and costs, not to mention whether it really works.

FDA advisors had argued against the drug, cautioning  that it carries significant potential side effects including swelling and bleeding in the brain. Those taking Aduhelm have been warned to undergo frequent, regular, and pricey brain scans as safeguards.

Still, experts have been startled by a much-discussed death of a 75-year-old Canadian woman, who was taking the drug as part of a clinical trial. She suffered seizures, was hospitalized, had brain scans, and was diagnosed with brain swelling shortly before she died.

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