Article
Geriatrics & Gerontology
Dallas Mindo-Panusis, Rebecca. L. L. Sudore, Irena Cenzer, Alexander. K. K. Smith, Ashwin. A. A. Kotwal
Summary: Despite known racial disparities, little is known about ACP disparities experienced by US immigrants. This study found that US immigrants have lower ACP engagement compared to US-born older adults, especially for recent immigrants.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2023)
Article
Geriatrics & Gerontology
Patience Moyo, Lacey Loomer, Joan M. Teno, Roee Gutman, Ellen M. McCreedy, Emmanuelle Belanger, Angelo E. Volandes, Susan L. Mitchell, Vincent Mor
Summary: This study examined the relationship between an advance care planning (ACP) video intervention and end-of-life health care transitions. The results showed that video-assisted ACP was associated with a significant reduction in hospital transfers in the last 90 days of life among nursing home residents with advanced illness. However, the intervention did not have a significant impact on late health care transitions and multiple hospital transfers.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Health Care Sciences & Services
Lauren Jodi Van Scoy, Michael J. Green, Pamela D. Witt, Cindy Bramble, Christopher Richardson, Irene Putzig, Olubukola Toyobo, Emily Wasserman, Vernon M. Chinchilli, Amy Tucci, Benjamin H. Levi
Summary: The study found that African American communities in the USA have positive attitudes towards advance care planning (ACP) with most participants considering further engagement in ACP worthwhile. There were no significant differences in values and beliefs across different geographical regions, but rural areas were slightly more skeptical than urban areas. Themes from focus groups supported the survey data, highlighting the value and need for ACP.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2021)
Article
Oncology
Sarah S. Nouri, Deborah E. Barnes, Ying Shi, Aiesha M. Volow, Nikita Shirsat, Anne L. Kinderman, Heather A. Harris, Rebecca L. Sudore
Summary: The study found that among older adults, using an interactive multimedia web-based ACP program along with an easy-to-read advance directive can increase ACP documentation and engagement, regardless of cancer diagnosis. This approach did not lead to increased depression or anxiety.
Article
Geriatrics & Gerontology
Yifan Lou, Deborah Carr
Summary: This study investigates the impact of race and subjective life expectancy on advance care planning (ACP) among older adults. The findings suggest that racial disparities exist in ACP, and subjective beliefs about future survival can influence individuals' ACP decisions.
JOURNALS OF GERONTOLOGY SERIES B-PSYCHOLOGICAL SCIENCES AND SOCIAL SCIENCES
(2022)
Article
Health Care Sciences & Services
Sarah Nouri, Lingsheng Li, Carrie Huang, Anni Chung, Sandy Chen Stokes, Shirley Pan, Elizabeth C. Wong, Jeffrey Newman, Joseph W. Woo, Joyce Cheng, Charissa H. Tan, Molly Wertz, Elyse Wood-Hughes, Mara Quinn, Steven Z. Pantilat, Courtney R. Lyles, Christine S. Ritchie, Rebecca L. Sudore
Summary: This study explored the facilitators and barriers to advance care planning (ACP) in the Chinese community in San Francisco and aimed to increase ACP engagement through co-designing and implementing pilot events. The study found that ACP was highly valued in the Chinese community but faced barriers such as lack of tools for younger generations to discuss ACP with elders. Based on focus group findings, the Chinese Community Committee developed a novel ACP tool and designed intergenerational events. These events significantly increased participants' readiness for ACP and were highly accepted by the community.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
(2023)
Article
Geriatrics & Gerontology
Michelle J. Berning, Emily Palmer, Timothy Tsai, Susan L. Mitchell, Sarah D. Berry
Summary: A systematic approach to advance care planning during the COVID-19 outbreak led to a significant increase in the proportion of LTC residents with do-not-hospitalize orders. The majority of residents maintained their new directives to avoid hospitalizations beyond the peak of the pandemic, highlighting the effectiveness of the initiative in sustaining preferences for end-of-life care.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2021)
Review
Health Care Sciences & Services
Tessa Jones, Elizabeth A. Luth, Shih-Yin Lin, Abraham A. Brody
Summary: The study evaluated interventions aimed at improving outcomes for racial and ethnic underrepresented populations in palliative and end-of-life care in the United States. Results indicated that educational interventions had significant positive effects on advance care planning and advance directive completion for underrepresented racial or ethnic groups.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
(2021)
Article
Geriatrics & Gerontology
Hiroshi Gotanda, Anne M. Walling, David B. Reuben, Marie Lauzon, Yusuke Tsugawa
Summary: This study examined the trends in advance care planning (ACP) and end-of-life (EOL) care among persons living with dementia. The results showed that the completion rates of ACP did not increase over time, and the use of life-prolonging treatments in EOL care has increased.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2022)
Article
Geriatrics & Gerontology
Rheda Adekpedjou, George A. Heckman, Paul C. Hebert, Andrew P. Costa, John Hirdes
Summary: Advance care directives (DNAR and DNH) for residents in long-term care homes are associated with increased health instability and death, and decreased hospitalization. DNH directives are not commonly used and are often overturned, suggesting a need for re-evaluation of policies.
Article
Surgery
Henry Davies, Marie -Jose Vleugels, Jing Yi Kwan, Alexander Aerden, Lucy Wyld, Lee -Ellen Fawcett, Rebecca Anthony, Assad Khan, Tom Wallace, Marieke Van Den Beuken-Van Everdingen, Geert Willem Schurink, Barend M. E. Mees, D. Julian A. Scott
Summary: A significant proportion of patients with abdominal and thoracic aortic aneurysms do not receive intervention after reaching the treatment threshold, leading to high mortality. This retrospective multicenter cohort study investigated the end-of-life care received by conservatively managed patients and found low rates of palliative care consultation and advance care planning.
JOURNAL OF VASCULAR SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
Hiroki Kitakata, Takashi Kohno, Shun Kohsaka, Daisuke Fujisawa, Naomi Nakano, Yasuyuki Shiraishi, Yoshinori Katsumata, Yuji Nagatomo, Shinsuke Yuasa, Keiichi Fukuda
Summary: The study found that patients with heart failure have positive attitudes towards advance care planning but low actual engagement rates, with a discrepancy between preferences and participation. Patients have different preferences for end-of-life care, and doctors need to consider appropriate care planning methods that align with patients' care goals.
Article
Cardiac & Cardiovascular Systems
Hiroki Kitakata, Takashi Kohno, Shun Kohsaka, Daisuke Fujisawa, Naomi Nakano, Yasuyuki Shiraishi, Yoshinori Katsumata, Yuji Nagatomo, Shinsuke Yuasa, Keiichi Fukuda
Summary: Most patients with heart failure recognize the importance of advance care planning (ACP) but have not engaged in ACP conversations before. Preferences for end-of-life (EOL) care vary among patients, highlighting the need for physicians to align ACP approaches with individual care goals.
Article
Geriatrics & Gerontology
Deepshikha Charan Ashana, Noah D'Arcangelo, Priscilla K. Gazarian, Avni Gupta, Stephen Perez, Amanda J. Reich, Jennifer Tjia, Scott D. Halpern, Joel S. Weissman, Keren Ladin
Summary: This study examines the barriers and facilitators to advance care planning (ACP) among clinicians. The findings show that most clinicians avoid discussing ACP with certain racial/ethnic groups, those with limited English fluency, and individuals with specific religious beliefs. The study suggests the need for interventions at the clinician and institutional levels to reduce disparities in ACP.
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES
(2022)
Article
Nursing
John W. Collins, Rick Zoucha, Joan Such Lockhart, Sandra J. Mixer
Summary: This study identified that African Americans have cultural beliefs and traditions that influence end-of-life advance care planning and decision making, including faith in God, belief in life after death, a strong matriarchal family structure, fear of discussing death, and mistrust of the U.S. health care system. These cultural factors must be taken into consideration when providing culturally congruent care.
JOURNAL OF TRANSCULTURAL NURSING
(2021)
Article
Health Care Sciences & Services
Lacey Loomer, Ashvin Gandhi, Fangli Geng, David C. Grabowski
Summary: This study used a new data source, Caregiverlist, to collect private-pay prices for 12,000 nursing homes nationwide and found factors that affect prices.
MEDICAL CARE RESEARCH AND REVIEW
(2021)
Article
Health Care Sciences & Services
Tamra Keeney, Nina R. Joyce, David J. Meyers, Vincent Mor, Emmanuelle Belanger
Summary: Administrative claims data can be used to identify high-need Medicare beneficiaries, but their persistence in high-need status and subsequent variation in outcomes are unknown. A study using national-level claims data found longitudinal variability of high-need status among Fee-for-Service beneficiaries and revealed the pervasiveness of poor outcomes associated with even transient high-need status over time.
MEDICAL CARE RESEARCH AND REVIEW
(2021)
Article
Health Care Sciences & Services
Vinay B. Rao, Emmanuelle Belanger, Pamela C. Egan, Thomas W. LeBlanc, Adam J. Olszewski
Summary: Among patients with hematologic malignancies, the use of palliative care services is increasing, and early palliative care services are associated with less aggressive end-of-life care. This suggests the need for prospective trials of early palliative care in hematologic malignancies.
JOURNAL OF PALLIATIVE MEDICINE
(2021)
Article
Health Care Sciences & Services
Leanna Jean Travis, Kali S. Thomas, Melissa A. Clark, Emmanuelle Belanger
Summary: The study found that a majority of residential care facilities admit and retain residents in need of end-of-life care, despite low levels of skilled nursing care. Characteristics such as skilled nursing, hands-on contact hours from personal care aides, and policies allowing exemptions to self-evacuation rules were associated with increased likelihood of admitting and retaining residents in need of end-of-life care in RC/AL communities.
AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE
(2021)
Article
Health Care Sciences & Services
Lacey Loomer, Cyrus M. Kosar, David J. Meyers, Kali S. Thomas
Summary: Analysis of Medicare beneficiary data shows that MA enrollees are less likely to receive prescribed post-acute HH compared to TM enrollees. In MA plans, those with cost sharing, referrals, and pre-authorization are less likely to receive prescribed HH.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2021)
Article
Health Care Sciences & Services
Kim Nichols Dauner, Lacey Loomer
Summary: This study focused on how collaborative provider organizations in rural Northeastern Minnesota and Northwestern Wisconsin address social determinants of health. Findings revealed challenges for rural providers in terms of financial, labor, resources, and social services, as well as policy barriers, indicating the need for policy change and collaboration efforts to promote the development of rural health systems.
BMC HEALTH SERVICES RESEARCH
(2021)
Article
Health Care Sciences & Services
Lacey Loomer, David C. Grabowski, Huizi Yu, Ashvin Gandhi
Summary: Staff turnover is positively associated with the probability of infection control citations, indicating that staff turnover plays a role in the spread of infections within nursing homes.
HEALTH SERVICES RESEARCH
(2022)
Article
Medicine, General & Internal
Karen Shen, Lacey Loomer, Hannah Abrams, David C. Grabowski, Ashvin Gandhi
Summary: The study found a significant number of unreported COVID-19 cases and deaths in US nursing homes reported to the NHSN, indicating a potential underestimation of the total cases and deaths in nursing homes. Failure to account for this issue may lead to misleading conclusions about the role of different facility characteristics and state or federal policies in explaining COVID outbreaks.
Article
Geriatrics & Gerontology
Patience Moyo, Lacey Loomer, Joan M. Teno, Roee Gutman, Ellen M. McCreedy, Emmanuelle Belanger, Angelo E. Volandes, Susan L. Mitchell, Vincent Mor
Summary: This study examined the relationship between an advance care planning (ACP) video intervention and end-of-life health care transitions. The results showed that video-assisted ACP was associated with a significant reduction in hospital transfers in the last 90 days of life among nursing home residents with advanced illness. However, the intervention did not have a significant impact on late health care transitions and multiple hospital transfers.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Geriatrics & Gerontology
Ellen M. McCreedy, Xiaofei Yang, Susan L. Mitchell, Roee Gutman, Joan Teno, Lacey Loomer, Patience Moyo, Angelo Volandes, Pedro L. Gozalo, Emmanuelle Belanger, Jessica Ogarek, Vincent Mor
Summary: The purpose of the study was to evaluate the impact of an ACP Video Program on documented DNH orders among nursing home residents with advanced illness. The results showed that compared to usual care, the ACP Video Program intervention increased the proportion of residents with new DNH orders, but did not significantly reduce hospitalizations.
Article
Health Care Sciences & Services
Lacey Loomer, Momotazur Rahman, Tracy M. Mroz, Pedro L. Gozalo, Vincent Mor
Summary: Home health agencies in rural areas face unique challenges in providing care to older adults, and increasing payments have resulted in a reduction in rehospitalizations for rural postacute home health episodes.
JOURNAL OF RURAL HEALTH
(2023)
Article
Health Care Sciences & Services
Lacey Loomer, Kim Nichols Dauner, Jennifer Schultz
Summary: Minnesota implemented a new pay-for-performance reimbursement scheme, known as Value-Based Reimbursement (VBR), for nursing homes in 2016. This study examines the association between VBR and quality improvement. The data from 2013 to 2019, including Centers for Medicare and Medicaid Services, Nursing Home Compare, and Long-term care Facts, are analyzed using multivariate regression with commuting zone fixed effects. The findings show minimal significant changes in quality in Minnesota nursing homes after the implementation of VBR, suggesting the need for reconsideration of the pay-for-performance efforts.
MEDICAL CARE RESEARCH AND REVIEW
(2023)
Letter
Geriatrics & Gerontology
Lacey Loomer
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2023)
Article
Geriatrics & Gerontology
Lacey Loomer, Jessica A. Ogarek, Susan L. Mitchell, Angelo E. Volandes, Roee Gutman, Pedro L. Gozalo, Ellen M. McCreedy, Vincent Mor
Summary: The study results showed that the use of ACP video program did not significantly reduce hospital transfers, burdensome treatment, or hospice enrollment among short-stay nursing home patients, and the fidelity to the intervention was low.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2021)
Article
Gerontology
Megan Shepherd-Banigan, Hailey J. James, Valerie A. Smith, Brenda L. Plassman, Eric Jutkowitz, Emmanuelle Belanger, Courtney H. Van Houtven
Summary: Place of care consideration is crucial in long-term care planning, with factors such as consulting with a financial planner and patient demographics playing important roles. While traditional drivers like care partner burden were not identified, understanding these drivers can help clinicians guide patients and families in LTC planning.
JOURNAL OF APPLIED GERONTOLOGY
(2021)