Latest news with #Ellen
Medscape
13 hours ago
- Health
- Medscape
Nurse Practitioners Fill Gaps as Geriatricians Decline
On Fridays, Stephanie Johnson has a busy schedule, driving her navy-blue Jeep from one patient's home to the next, seeing eight in all. Pregnant with her second child, she schleps a backpack instead of a traditional black bag to carry a laptop and essential medical supplies — stethoscope, blood pressure cuff, and pulse oximeter. Forget a lunch break; she often eats a sandwich or some nuts as she heads to her next patient visit. On a gloomy Friday in January, Johnson, a nurse practitioner who treats older adults, had a hospice consult with Ellen, a patient in her 90s in declining health. To protect Ellen's identity, KFF Health News is not using her last name. 'Hello. How are you feeling?' Johnson asked as she entered Ellen's bedroom and inquired about her pain. The blinds were drawn. Ellen was in a wheelchair, wearing a white sweater, gray sweatpants, and fuzzy socks. A headband was tied around her white hair. As usual, the TV was playing loudly in the background. 'It's fine, except this cough I've had since junior high,' Ellen said. Ellen had been diagnosed with vascular dementia, peripheral vascular disease, and type 2 diabetes. Last fall, doctors made the difficult decision to operate on her foot. Before the surgery, Ellen was always colorful, wearing purple, yellow, blue, pink, and chunky necklaces. She enjoyed talking with the half dozen other residents at her adult family home in Washington state. She had a hearty appetite that brought her to the breakfast table early. But lately, her enthusiasm for meals and socializing had waned. Johnson got down to eye level with Ellen to examine her, assessing her joints and range of motion, checking her blood pressure, and listening to her heart and lungs. Carefully, Johnson removed the bandage to examine Ellen's toes. Her lower legs were red but cold to the touch, which indicated her condition wasn't improving. Ellen's two younger sisters had power of attorney for her and made it clear that, above all, they wanted her to be comfortable. Now, Johnson thought it was time to have that difficult conversation with them about Ellen's prognosis, recommending her for hospice. 'Our patient isn't just the older adult,' Johnson said. 'It's also often the family member or the person helping to manage them.' Nurse practitioners are having those conversations more and more as their patient base trends older. They are increasingly filling a gap that is expected to widen as the senior population explodes and the number of geriatricians declines. The Health Resources and Services Administration projects a 50% increase in demand for geriatricians from 2018 to 2030, when the entire baby boom generation will be older than 65. By then, hundreds of geriatricians are expected to retire or leave the specialty, reducing their number to fewer than 7600, with relatively few young doctors joining the field. That means many older adults will be relying on other primary care physicians, who already can't keep up with demand, and nurse practitioners, whose ranks are booming. The number of nurse practitioners specializing in geriatrics has more than tripled since 2010, increasing the availability of care to the current population of seniors, a recent study in JAMA Network Open found. According to a 2024 survey, of the roughly 431,000 licensed nurse practitioners, 15% are, like Johnson, certified to treat older adults. Johnson and her husband, Dustin, operate an NP-led private practice in greater Seattle, Washington, a state where she can practice independently. She and her team, which includes five additional nurse practitioners, each try to see about 10 patients a day, visiting each one every 5-6 weeks. Visits typically last 30 minutes to an hour, depending on the case. 'There are so many housebound older adults, and we're barely reaching them,' Johnson said. 'For those still in their private homes, there's such a huge need.' Laura Wagner, a professor of nursing and community health systems at the University of California, San Francisco, stressed that nurse practitioners are not trying to replace doctors; they're trying to meet patients' needs, wherever they may be. 'One of the things I'm most proud of is the role of nurse practitioners,' she said. 'We step into places where other providers may not, and geriatrics is a prime example of that.' Practice Limits Nurse practitioners are registered nurses with advanced training that enables them to diagnose diseases, analyze diagnostic tests, and prescribe medicine. Their growth has bolstered primary care, and, like doctors, they can specialize in particular branches of medicine. Johnson, for example, has advanced training in gerontology. 'If we have a geriatrician shortage, then hiring more nurse practitioners trained in geriatrics is an ideal solution,' Wagner said, 'but there are a lot of barriers in place.' In 27 states and Washington, DC, nurse practitioners can practice independently. But in the rest of the country, they need to have a collaborative agreement with or be under the supervision of another health care provider to provide care to older adults. Medicare generally reimburses for nurse practitioner services at 85% of the amount it pays physicians. Last year, in more than 40 states, the American Medical Association and its partners lobbied against what they see as 'scope creep' in the expanded roles of nurse practitioners and other health workers. The AMA points out that doctors must have more schooling and significantly more clinical experience than nurse practitioners. While the AMA says physician-led teams keep costs lower, a study published in 2020 in Health Services Research found similar patient outcomes and lower costs for nurse practitioner patients. Other studies, including one published in 2023 in the journal Medical Care Research and Review , have found healthcare models including nurse practitioners had better outcomes for patients with multiple chronic conditions than teams without an NP. Five states have granted NPs full practice authority since 2021, with Utah the most recent state to remove physician supervision requirements, in 2023. In March, however, Mississippi House Bill 849, which would have increased NP independence, failed. Meanwhile, 30 Texas physicians rallied to tamp down full-scope efforts in Austin. 'I would fully disagree that we're invading their scope of practice and shouldn't have full scope of our own,' Johnson said. She has worked under the supervision of physicians in Pennsylvania and Washington state but started seeing patients at her own practice in 2021. Like many nurse practitioners, she sees her patients in their homes. The first thing she does when she gets a new patient is manage their prescriptions, getting rid of unnecessary medications, especially those with harsh side effects. She works with the patient and a family member who often has power of attorney. She keeps them informed of subtle changes, such as whether a person was verbal and eating and whether their medical conditions have changed. While there is some overlap in expertise between geriatricians and nurse practitioners, there are areas where nurses typically excel, said Elizabeth White, an assistant professor of health services, policy, and practice at Brown University. 'We tend to be a little stronger in care coordination, family and patient education, and integrating care and social and medical needs. That's very much in the nursing domain,' she said. That care coordination will become even more critical as the US ages. Today, about 18% of the US population is 65 or over. In the next 30 years, the share of seniors is expected to reach 23%, as medical and technological advances enable people to live longer. Patient and Family In an office next to Ellen's bedroom, Johnson called Ellen's younger sister Margaret Watt to recommend that Ellen enter hospice care. Johnson told her that Ellen had developed pneumonia and her body wasn't coping. Watt appreciated that Johnson had kept the family apprised of Ellen's condition for several years, saying she was a good communicator. 'She was accurate,' Watt said. 'What she said would happen, happened.' A month after the consult, Ellen died peacefully in her sleep. 'I do feel sadness,' Johnson said, 'but there's also a sense of relief that I've been with her through her suffering to try to alleviate it, and I've helped her meet her and her family's priorities in that time.'
Metro
a day ago
- Entertainment
- Metro
Ellen DeGeneres shares rare look at sprawling UK home after leaving US
To view this video please enable JavaScript, and consider upgrading to a web browser that supports HTML5 video Ellen DeGeneres has given fans a glimpse into her sprawling Cotswolds home after moving to England at the end of 2024. When Donald Trump was set to be re-elected as US President at the end of 2024, many A-listers claimed they'd be moving out of the US. Ellen and her wife, Portia de Rossi, made the leap and ditched their life in Montecito and set themselves up in the ultra-luxury English countryside, the Cotswolds. The Wrap reported that the duo told friends that Trump's coming to power was the 'primary motivation' and that they planned to 'never return' to the US. Since their move, the pair has shared snaps of their slower lifestyle, which focuses on their chickens, sheep, and gardening adventures. In a sweet video shared on social media, the couple revealed that some of their sheep have made a habit of entering their home and making themselves comfortable. 'Our sheep keep coming inside. To be fair, we do have a piece of furniture that looks like a sheep, but that one doesn't try to eat our rugs,' Ellen captioned the video. In the video Portia could be heard encouraging the sheep to plod back through the kitchen doors to the garden, and not make themselves too comfortable in their home. The compiled videos of the sheep wandering into their home showed off different angles of their sunlit property with impressive glass doors facing the incredible view of their land. The home had various rugs laid upon the concrete floor and an industrial style throughout, which included the black metal-framed bifold doors. This contrasted with the country-style brown leather of the sofas and armchairs and patterned warm-toned rugs. On social media, the star has shared videos of the sheep on her 43-acre property where her 'farmhouse' is situated, but has rarely let fans see inside this home. Many of her videos detail the sheep managing to escape from their pen and end up wherever they fancy, such as in the garden, or even evicting the chickens from their coop. More Trending Other video snapshots on their property reveal that the couple also has a lake, swimming pool, and expansive fields surrounding their country home. Since settling into the country lifestyle, the star has even been spotted making friends with the A-list locals. A video shared by Jeremy Clarkson's girlfriend Lisa Hogan on Instagram, showed that Ellen and Portia were singing along and enjoying their drinks, sitting by the balcony of The Farmer's Dog, Clarkson's latest venture. '@thecorrsofficial thanks for the acoustic check & for swooping by on your night off the tour! Trilled to confirm @thefarmersdogpub sounds great. @jeremyclarkson1 @natalie_imbruglia @jamesblunt @ellendegeneres @portiaderossi,' Lisa captioned the post on social media. Got a story? If you've got a celebrity story, video or pictures get in touch with the entertainment team by emailing us celebtips@ calling 020 3615 2145 or by visiting our Submit Stuff page – we'd love to hear from you. MORE: Donald Trump stuns Juventus players with dig at transgender footballers MORE: US 'Doomsday Plane' spotted near DC: Everything you need to know about the Boeing E-4B MORE: R Kelly begged for Trump's help before 'murder plot' that saw him overdose in prison
Newsweek
2 days ago
- General
- Newsweek
Juneteenth Is Under Attack Because It Tells the Truth About Power
On Dec. 21, 1848, two people boarded a train in Macon, Ga., beginning a journey to Philadelphia. They were traveling together, but laws, particularly slave codes, made it so they needed to sit in separate cars. To others on the train, everything seemed relatively normal. In their eyes, a white man with an injured arm and bandages on his face had boarded the train with his dark-skinned slave. He sat down in the comfortable "whites only" section while his devoted slave, assured that his "master" was relaxed, proceeded to the crowded "negro" car to find his seat. On a surface level, the traveling pair symbolized differences in the life experiences of Black men versus white men. At each stop on their four-day journey, the Black man was degraded and sent away to eat and sleep where he would not be seen and where conditions would be subpar. The white man, on the other hand, traveled in luxury, welcomed with sympathy. In other words, one of the two travelers was seen as a human being with rights to live freely and make their own decisions, to be treated with dignity and care; the other was either infantilized at best or completely dehumanized. A Juneteenth flag waves in front of the main door of the Department of Commerce, on June 21, 2024. A Juneteenth flag waves in front of the main door of the Department of Commerce, on June 21, 2024. Getty Images What the people they encountered were unaware of was that this duo was relying on the assumptions of their time, the prejudices of their contemporaries, and the dictates of the status quo for far more than a medical trip. They were heading to Philadelphia in search of freedom from it all, to release the chains of captivity that bound them, and to escape the cruel, inhumane practice of slavery. This quest was not solely for the liberation of William Craft, the Black man. It was also for his wife, an enslaved woman named Ellen, who cut her hair to neck length, sewed herself a pair of men's trousers, and wore a hat and glasses to conceal her identity. The couple knew that if Ellen were to pose as a white man she would be required to sign documents on behalf of her "slave," but because both of them had been restricted by law from learning to read or write, they wrapped her arm in bandages and feigned an injury. As we celebrate Juneteenth this year, all while facing the attempted erasure of this important day on behalf of our current administration, the true story of Ellen and William Craft reveals far more than historical injustice. It shows us how the desire to eliminate the day that commemorates Black American freedom is an attempt to uphold a social order that relies on categorizing human beings based on skin color and sex, a social order that I refer to as American patriarchy. American patriarchy is a system that has long defined national identity by the dominance of white, cisgender, straight, able-bodied men. This ideology has always relied on the exclusion, suppression, and erasure of other histories. Their story reminds us that understanding and resisting American patriarchy is essential if we hope to create something new. The Craft's ability to run to freedom in this way displayed a mastery of a book they had been forced to study all their life. Ellen knew her character well because her survival had already depended on it long before she cut her hair and sewed her pants. She had picked up the knowledge she needed to turn American patriarchy into her escape, by observing those who called themselves her masters. She had been forced to learn the intricacies of American patriarchy from the moment she was born, to examine those who aimed to oppress her down to the smallest of details. Once fluent in their ways, with the story of American patriarchy memorized, she transferred it beautifully into her four-day journey as a white man. This is why knowledge of Juneteenth, Black Independence Day, is under attack: it threatens the story that power must remain unchallenged. When we know stories like those of Ellen and William Craft, we know how far we have come, we know we cannot ever stop being keenly aware of what we are facing, and we know we must use that knowledge to escape the traps of American patriarchy. When Juneteenth and all the stories it carries are erased from our institutions, it is not because they are unimportant; it is because they threaten a narrative that insists power must remain concentrated and historical accountability avoided. Juneteenth is a reminder of a different legacy, one of resistance, survival, and the persistent redefinition of what this country can become. Recognizing Juneteenth, defending its place in our national consciousness, is not just about honoring the past. It is about being fully aware of what we are up against and choosing the kind of future we are willing to fight for. Anna Malaika Tubbs is a scholar, advocate, and two time bestselling author currently making headlines for her newest release Erased: What American Patriarchy Has Hidden from Us. The views expressed in this article are the writer's own.
Irish Independent
7 days ago
- Sport
- Irish Independent
Barretstown the benefactors as friends and family remember the late Ellen Kinch
She died in 2007 following a brave battle against cancer, but the community in Tinahely and its surrounds had long rallied behind her and her family by then. This helped her to get the very most from her 16 years, and 18 years on from her passing, her family still feels that support locally and from further afield. We see it every year at the Ellen Kinch Memorial competitions, which have become something of a festival of Ladies Football since their foundation in 2008. In the interim, the event has raised north of €40,000 for Barretstown, a cause that's close to the Kinch family's heart for good reason. 'When Ellen attended Crumlin Children's Hospital, they organised for us, as a family, to go up to Barretstown,' Ellen's sister, Jackie Kinch, a former Wicklow footballer, told The Wicklow People and The Bray People. 'We spent a weekend there, and it was one of the standout moments during her illness for us as a family; they were all very, very good to us above there, they gave us a nice memory to hold on to, and the care they gave her was second to none.' Jackie was speaking ahead of her family's cheque presentation to Barretstown, proceeds raised from yet another successful staging of this fantastic event. Those funds clocked in at approximately €5,000 on this occasion. But while the competitive side of things is very much secondary to what the tournaments raise for charity, there are titles up for grabs nonetheless. Host club Tinahely's second team lost out to An Tóchar in the B Division final in 2025, but Jackie and her team-mates couldn't be denied in a competitive A Final against Wexford side Baile Dubh. It wasn't Jackie's first time claiming the trophy bearing her sister's name, but the high of doing so has not diminished one bit. 'We had previously won it in the past, but we have won it the last couple of years, and we've been lucky to be able to retain the cup!' she said. 'But it's very important, and it's nice to be able to bring it back to the club, there is a sense of pride in it, and it's important to us as a family.' Jackie thanked everyone involved in making the day a success yet again, including volunteers, referees, and Tinahely for making their facilities available. There was, also, a world of gratitude for the 15 participant teams, which included four 'Mothers and Others' outfits. 'You could never thank people enough for the support they give us every year,' Jackie said. 'The same faces keep coming back, year in, year out, and it's great to have their support and their help.'
Miami Herald
12-06-2025
- Entertainment
- Miami Herald
Ellen DeGeneres and Portia de Rossi's move to the UK has been ‘difficult' amid renovation
Ellen DeGeneres and Portia de Rossi have had a few bumps in the road to deal with as they settle into their new life in England, but a source exclusively tells In Touch that they're committed to making the most of their adventure and not letting any setbacks get them down. 'They knew going into this that it wasn't going to be totally smooth sailing, it was always going to be a challenge,' the source says of the U.K. move. 'Taking on a big renovation in a foreign country is not easy. But they're both very skilled at renovation. It's one of their passions.' After decades of calling California home, Ellen, 67, and Portia, 52, quietly packed up in 2024 and moved more than 5,000 miles to a new 43-acre property nestled in Cotswolds, the heart of the British countryside about 90 minutes outside of London. The Cotswolds' celebrity residents include David and Victoria Beckham, Kate Moss and Simon Cowell. Ellen and Portia sold their Carpinteria, California, estate — which they purchased for $70 million in 2022 — to Singapore-based tycoon Robert Friedland for a whopping $96 million. Unfortunately, their new $15 million Cotswolds home was plagued with floods, resulting in expensive damage, and the couple has since moved to a new mansion which is about 30 minutes from their original property. The source says the couple — who have been married since 2008 — have 'navigated plenty of hiccups' in the past with other projects, adding, 'So they weren't all that thrown off by the stumbling blocks they've faced in the U.K.' 'It's been difficult at times because they do miss the comfort of things back in America, but more than anything they're pleased to be embracing this new start,' the insider explains. 'They're getting to know the people around them and loving the property and the area. They take long walks in the woods every day, build roaring fires at night, all that stuff that's so typical of the English countryside. Ultimately, it is proving to be a very good move for their souls and for their marriage.' The bumps in the road come after In Touch reported that the couple moved overseas in late 2024 because Ellen was 'just done' with the United States, while her wife was equally ready to 'turn the page' and begin a new chapter in their lives. Ellen had gone into isolation over the years following reports that she was mean to her staff on The Ellen DeGeneres Show. In light of the scandal, the former host chose to end her long-running talk show in May 2021 after 19 seasons. She opened up in a rare comment about being canceled during her Ellen's Last Stand … Up tour stop at Radio City Music Hall in New York City before her move in August 2024. During her set, Ellen recalled being dubbed the 'most hated person in America' after years of being the celebrity personality that fans 'most want to babysit' their children. She then recounted turning to professional help in light of the backlash and was advised to 'avoid all media.' After she seemed to hit rock bottom, Ellen recalled how she eventually regained the strength to 'heal' when she started writing jokes again. She then credited getting out of the 'bubble in Hollywood' for helping her realize the 'amount of support' she was still receiving from her loved ones. Copyright 2025 Us Weekly. All rights reserved.
