English

Vivian Sarpong

Felbry College School of Nursing

Department of General Education

English Composition ll

Ms. Karissa Doughty

March 8, 2021

Annotated Bibliography

Home-Base Palliative Care

Hayes, K. (2017, May 31). Home-based palliative caregiving is gaining popularity.

https://www.aarp.org/caregiving/home-care/info-2017/home-based-palliative-care-fd.html.

Provides a broad look at palliative care combined with traditional care. This resource also looks to the support palliative care has, as well as some of the challenges that it faces. Payment is mentioned, but specifically Medicare and how it plays an important role for patients and families looking to cover palliative services. Just as importantly, at- home based palliative care generally receives a good response and that is part of the reason why it is expanding; California appears to be leading this newfound expansion. At-home based palliative care allows for the prevention of caregiver burnout. Social workers, chaplains, and others are able to contribute towards this type of care which lessens the burnout that this article talks about.

Gomes, B., Calanzani, N., Curiale, V., McCrone, P., & Higginson, I. J. (2013, June 6). Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers. The Cochrane database of systematic reviews. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4473359/.

This article aims to address the services that palliative care offers to adult patients with advanced illness and comparing this type of patient with their “odds” of dying at home. This article also considers how effective palliative care is in regard to symptom control, the quality of life a patient has, and the caregiver’s challenges and satisfaction with providing this type of care at home. The cost-effectiveness of palliative care is also looked into. The determinations made in this article come from a mixture of resources covering palliative care which include including: 12 electronic databases; 49 reviews’ four textbooks; 17 experts and researchers.

Home-Based Palliative Care Program Found to Reduce Costs, Hospital Admissions. AJMC. https://www.ajmc.com/view/home-based-palliative-care-program-found-to- reduce-costs-hospital-admissions.

This article’s main focus is on how cost-effective home-based palliative care is. A study based on patients in New York who died while in usual care and compared to patients who died while enrolled in home-based palliative care. According to the article, 596 out of the 651 patients died in usual care, while 82 died while in home-based care. This article goes on to address the decrease in hospital admissions due to the increase in at- home palliative care as well. Based on the information in this article, hospital admissions decreased by 34% for home-based patients in their final month of life— emergency department visits were also decreased. The type of caregivers who play a role in home-based palliative care are registered nurses, social workers, doctors, data analyst, administrative staff, and volunteers.

October 31, 2016, & Apps, S. G. linkF. T. P. E. O. Aligning Quality and Cost Savings Through Home Based Palliative Care. GeriPal. https://www.geripal.org/2016/10/cost-savings-of-home-based-palliative-care.html.

This resource takes a closer look at the numbers that support the idea of palliative care being cost-effective. It takes into consideration the rapid number of palliative care programs that are spreading around the country; and it also considers the number of patients who prefer at-home based care. Medicaid costs and hospital admissions are some of the topics that this case-study looks to. A graph is provided to show the difference in cost between usual care and home-based care as patients near the end of

their lives. The graph reflects that HBPC is relatively cheaper at o months prior to death through eleven months prior to death.

Why Some Patients Aren't Getting Palliative Care. Why Some Patients Arent Getting Palliative Care | The Pew Charitable Trusts. https://www.pewtrusts.org/en/research- and-analysis/blogs/stateline/2017/07/10/why-some-patients-arent-getting-palliative- care.

This particular article sets its focus on the health insurance aspect of palliative care. It addresses Medicare and what it does and does not cover. Insurance plans tend to cover some palliative care services, but don’t cover services delivered by palliative caregivers. According to the article, it is difficult to obtain palliative care when you are not terminally ill. Prior articles have stated that palliative care is expanding, and while that is true, it still is not as accessible to many patients. One reason for this is because palliative care is ma fairly new field within health care and there are not enough specialists.

MediLexicon International. Does Medicare cover palliative care? Costs, rules, and more. Medical News Today. https://www.medicalnewstoday.com/articles/does-medicare- cover-palliative-care#are-there-palliative-care-benefits.

This article defines what palliative care is and then continues on to discussing Medicare and Medicare Advantage plans that cover inpatient care, outpatient care, and mental health counseling that contribute towards palliative care services. It outlines the types of conditions that could lead to palliative care and further breaks down the parts of Medicare that cover what: ex. Drugs, special needs plans, doctor’s visits, inpatient care, etc. This article does a nice job lay out the different types of financial support if covering for expenses out-of-pocket prove to be difficult. Possible financial support can come from Medicaid, hospital benefit programs that agencies provide; an example would be the Veterans Administration.

Madsen, K. (2019, July 2). The Hidden Costs of Dying in America. Medium. https://tincture.io/the-hidden-costs-of-dying-in-america-2da0b81bbcd1.

This source takes a look at the types of expenses patients and families will face in regard to end of life. This article addresses not only palliative care cost, but hospital care, hospice care, legal costs, funeral and burial costs and much more. The numbers for each topic are mentioned and are compared to one another. Just like the other sources mentioned above, palliative care seems to be less than the other types of care

and services provided for patients who are at the end of the life. Again, like the other articles, it mentions how Medicaid and Medicare play vital roles in the types of coverage patients and families will not have to worry about.

Stringfellow, A. Palliative Care vs. Hospice: Key Differences, Coverage Options, and Benefits. https://www.seniorlink.com/blog/palliativecare-hospice.

This article focuses on the differences between palliative care and hospice care. It addresses the costs between the two types of care and also addresses the benefits of each type of care—specifically, who pays for either palliative care or hospice care. Medicare and Medicaid have been mentioned in the above sources, but this source takes a closer look at what is covered for hospice care and palliative care separately. Both palliative care and hospice care focus on the patient whose life is about to end, but they are essentially different in terms of the benefits that come with each. Joseph M (2017) Palliative Care - A Noble and Holistic Specialty. J Palliative Care Med 7:322. doi:10.4172/2165-7386.1000322 Joseph M. reports on patient's who are having unpleasant bodily sensations associated with illness and believes it is with their entire physical and emotional state. Their whole being is attached in the process. Patient's who are acutely experiencing disease that cannot be cured, for example, cancer or an organ wasting away. Physicians have only addressed the dominion of physical aspect, but not on psychological aspect. Palliative Care aims at the highest quality of life, and offers comfort and dignity in the dying moment of the patient. Also, it provides pain management paired with empathy in patient care. The patient's families are also considered to be part of the whole care process. Palliative Care is "holistic" (Joseph, 2017) because the whole being is connected to physical, emotional, spiritual, and social wellbeing. (Joseph, 2017). Palliative Care is also considered collaboration care provided by professionals. Dumanovsky, R., N. Christakis, E., JS. Kutner, J., KE. Steinhauser, N., D. Selby, A., A. Viganȯ, M., . . . CD. Manning, P. (2017, January 01). Improving palliative care with deep learning.

Palliative care unfortunately has been a stage where most family members don’t want to deal with due to the pains their loved ones go through. According to BMC Medical Informatics and Decision Making, physicians give too much information about the likely course of a disease have a few palliative staff. The Institutional Review Board

agreement, electronic health record (EHR) date was introduced to predict mortality of patients.

Since all patients were going through EHR data, patients with positive prediction for palliative care was not overlooked by physicians, and patients were able to receive palliative care they deserved. The staff shortage for palliative care patients were also resolved.