Rehab and Death: Improving End-Of-Life Care for Medicare Skilled Nursing Facility Beneficiaries.

Hospitalized older adults with serious illness may be discharged to a skilled nursing facility (SNF) with the hope of improving strength to live independently and receive further disease-directed treatment, or because it is one of the few insurance-covered options for care that provides room and board coverage. For those that do not improve, discharge to a SNF can begin a cycle of costly care transitions between hospital, home with home health care, SNFs, and long-term care facilities, leading to fragmented care and missed opportunities for discussions about preferences for care, illness understanding, and to address distressing symptoms. It can also lead to dying in the emergency room and other locations that are not consistent with patient wishes.

Are we growing leaders? Exploring leadership training in hospice and palliative medicine fellowship.

Background: Although leadership competencies are recognized as critical to the practice of hospice and palliative medicine (HPM), the specific leadership content that matters most, and whether that content is taught in fellowships, remain unclear.

Objectives: The purpose of this study was to characterize the current state of leadership curricula in HPM fellowships and understand which leadership topics fellowship program directors (PDs) consider to be most important to include in a leadership curriculum for fellows.

Methods: A needs assessment survey was sent to 194 individuals identified as PDs by the American Academy of Hospice and Palliative Medicine (AAHPM).

Assessing Technical Feasibility and Acceptability of Telehealth Palliative Care in Nursing Homes.

Background: Over two-thirds of nursing home (NH) residents are eligible for palliative care (PC), yet few receive it, particularly outside of hospice. Little is known about the technical feasibility and acceptability of using telehealth for PC consultations in NHs.

Objective: To determine the technical feasibility and acceptability of PC telehealth for NH residents seen by a PC team in the hospital in the previous 30 days.

Rehabbed to Death: Breaking the Cycle.

Many older adults transfer from the hospital to a post-acute care (PAC) facility and back to the hospital in the final phase of life. This phenomenon, which we have dubbed "Rehabbing to death," is emblematic of how our healthcare system does not meet the needs of older adults and their families. Policy has driven practice in this area including seemingly benign habits such as calling PAC facilities "rehab.

Update in hospital palliative care.

Background: Seriously ill patients frequently receive care in hospitals, and palliative care is a core competency for hospitalists. We aimed to summarize and critique recent research that has the potential to impact the clinical practice of palliative care in the hospital.

Methods: We reviewed articles published between January 2012 and May 2013, identified through a hand-search of leading journals and PubMed.