Medicare hospice use patterns among patients with Alzheimer’s disease or related dementias compared to those with other terminal diagnoses (Issue Brief)
ASPE; Frank, J., Huessard, K., Broyles, I., Frazier, L., Oliveira, I., Haltermann, W., III, Lamont, H., Okafor, M., & Blanco, M.; 9/25
Key Points:

• People living with Alzheimer’s disease and related dementias (ADRD) have unpredictable disease trajectories that raise unique challenges for end-of-life care planning and may contribute to disparities in hospice care. This study investigated whether length of stay (LOS), visit frequency, and live discharge (LD) rates differed for Medicare hospice enrollees with ADRD compared to Medicare hospice enrollees with other common terminal diagnoses (e.g., cancer). This study also investigated whether hospice agency characteristics were associated with differences in these care patterns.
• Frequency of visits from each hospice staff discipline varied by patient diagnosis, with ADRD patients receiving fewer average daily hospice visits than patients with other primary diagnoses. Patients with a secondary diagnosis of ADRD also tended to receive fewer hospice visits than patients with no primary or secondary ADRD diagnosis.
• Patients with ADRD had longer lengths of stay in hospice, spent a larger portion of their hospice stay receiving routine home care (RHC), and had the second highest rate of LD compared to patients with other primary diagnoses.
• Hospice characteristics, including ownership type, size, age, location, and proportion of patients with ADRD, were associated with differences in hospice care patterns including LOS, RHC days, and frequency of hospice visits.

Effectiveness and impact of telehealth-integrated palliative care for persons living with dementia and their caregivers
Telemedicine & e-Health; by Brooke Worster, Lizabeth Kaminoff, Amina Mason, Laura Pontiggia, Kayla Madden, Mackenzie Kemp, Amanda Guth, Nina Diamond, Allison Herens, Kristin Rising, Jeannette Kates; 12/25 
In 2024, an estimated 6.9 million Americans aged 65 and older were living with Alzheimer’s disease (AD), the most common form of dementia. Palliative care (PC) can improve quality of life (QOL) and reduce nonbeneficial care, yet persons living with dementia (PLWD) remain underserved. The intervention group [in this study] received up to two telehealth visits with a PC specialist, the patient (if able), and a caregiver (if participating). The intervention group had significantly fewer emergency department visits and hospitalizations but no differences in QOL or caregiver burden.

Hospice clinicians' approaches to terminal restlessness: A qualitative analysis
Journal of Pain & Symptom Management; by Andy Jan, Molly Turnwald, Susan Maixner, Thomas O'Neil, Lauren Gerlach; 1/26
Terminal restlessness is frequently observed in hospice, yet it lacks a consistent definition, diagnostic framework, and treatment approach. Five themes emerged [from this study]: (1) Diagnostic challenge-clinicians reported difficulty distinguishing terminal restlessness from delirium, pain, or medication side effects; (2) Common symptom profile-agitation, confusion, hallucinations, and constant movement; (3) Temporal association with active dying process-terminal restlessness was viewed as a sign of imminent death; (4) Ruling out reversible causes-pain, urinary retention, or other modifiable factors; and (5) Treatment variability-approaches varied, though most clinicians were more comfortable using sedating medications once death was perceived to be imminent.

EV0034 Palliative pain relief: A case study of high-frequency spinal cord stimulation in an end-of-life cancer patient
Neuromodulation: Technology at the Neural Interface; by P. Majedi, Dominic Bailey; 1/26
A significant proportion of patients with cancer will experience cancer-related pain at some point during their illness. The treatment approach for cancer-related pain is often multifaceted and may necessitate the use of advanced interventional methods, including spinal cord stimulation (SCS). Recent studies have demonstrated the utility and efficacy of SCS techniques in the treatment of cancer-related pain and chemotherapy induced neuropathy. Here, we present a case report on a patient receiving high frequency SCS at 10 kHz for end-stage cancer-related pain.

Researchers identify new blood markers that may detect early pancreatic cancer; NIH-funded, four-marker panel could one day help catch one of deadliest cancers at more treatable stages
NIH press release; 1/30/26
National Institutes of Health (NIH)-supported investigators have developed a blood test to find pancreatic ductal adenocarcinoma, one of the deadliest forms of cancer. The new test could improve survival rates from pancreatic cancer, which tends to be diagnosed at late stages when therapy is less likely to be effective. The findings were published in Clinical Cancer Research. Overall, only about 1 in 10 pancreatic cancer patients survive more than five years from diagnosis. However, experts expect that when the cancer is found and treated at an earlier stage, survival would improve. While finding the cancer early is key, there are no current screening methods to do so.

A scoping review on aphasia and technology: Exploring mechanisms enhancing quality of life
Quality of Life Research; by Grace E. Terry, Cassondra Wilson, Gillian Anderson, Stacy M. Harnish; 1/26 
People with aphasia are at an increased risk for reduced quality of life (QoL) because of their change in communication abilities. The present study aims to review the current evidence supporting assistive technology as a tool to improve QoL for people with aphasia, while investigating the various mechanisms technology may impact that lead to increased QoL for people with aphasia. This review emphasizes the role mechanisms such as self-management, social interaction, and virtual communication play in improving QoL for people with aphasia, while emphasizing the role technology plays in impacting the function of these mechanisms.  However, for this assistive technology to be impactful, it must be person centered and thoroughly trained based on the current body of evidence.

Preparing for the inevitable: a scoping review of death and dying education in U.S. medical schools
Academic Medicine; by Logan Patterson, Autumn Decker, Angelique King, Anna Roman, Cory Bolkan, Raven H Weaver; 1/26
There remains a sizeable gap in evidence-based medical education related to knowledge, skills, and abilities pertaining to end-of-life care. The authors offer next steps for developing, implementing, and measuring evidence-based interventions to improve end-of-life care competency. The authors advocate for continued implementation of evidence-based educational interventions, regardless of anticipated specialty area, throughout all preclinical and clinical years.

Later-life friendship in advance care planning: Variation by marital status and gender
Research on Aging; by Zheng Lian, Lucie Kalousová; 1/26
Friendship is an understudied social context in research on advance care planning (ACP). Multivariable logistic regressions show that having any friends is associated with greater odds of AD [advance directives] and EOL [end-of-life] discussions. The positive association between emotional support from friends and EOL discussions is more pronounced among never married men, compared to both married individuals and never married women. These findings highlight friendship as a salient social context associated with ACP engagement, particularly among never married men.

Medical Aid in Dying and our ethical duties—Call to action
JAMA Health Forum; by Yesne Alici, Liz Blackler, Julia Danielle Kulikowski, Amy Scharf; 1/26
Medical aid in dying (MAID) is legal in 11 US states and Washington, DC, and is being actively considered in 18 additional states ... In all jurisdictions where MAID is legal, hospital systems have the option to opt out of providing MAID services but are legally obligated to share information about where patients can access resources. We maintain that all hospital systems and individual clinicians have an ethical responsibility to go beyond simply sharing information. Patients are going to ask about MAID, and institutions are ethically obligated to establish comprehensive policies that empower and encourage their clinical staffs—primarily physicians but also nurses and advanced practice clinicians—to purposefully and thoughtfully respond. Here, we describe the experience of our institution, Memorial Sloan Kettering Cancer Center (MSK), in developing policies and procedures to fulfill this responsibility and highlight lessons for other health care organizations and oncology practices seeking to accomplish similar goals.

From the iron lung to artificial intelligence: Integrating new technology into critical care 
American Journal of Critical Care; by Seo Yoon Lee, Alvin D. Jeffery; 1/26
Artificial intelligence technology has emerged rapidly and is being incorporated into the health care delivery system as a new bedside tool. It is vital to maintain a human-centered approach, in which artificial intelligence serves as a tool to augment, not replace, the nuanced judgment of health care professionals. It is crucial to cultivate a critical mindset, continuously validating artificial intelligence outputs against clinical judgment. Integrating artificial intelligence into team workflows, developing clear ethical guidelines, and fostering collaboration between clinicians and data scientists are essential for successful implementation. By proactively preparing for the transition, the critical care community can harness artificial intelligence’s power to improve patient recovery and survival while ensuring that technology remains guided by human expertise and compassion.
Assistant Editor's note: All of us in health care, not just those working in critical care, will be faced with decisions about how to incorporate AI into our work. It will likely become an invaluable tool in our day-to-day lives. But AI can only give us ideas, suggestions and enhanced knowledge. It cannot hold the hand of a dying patient or comfort the loved ones who bear witness. Only we can offer the CARE in health care. Empathy, humanness and critical judgments can come only from us.

[Austria] Hospice nurses' views about the necessity for palliative sedation in existential suffering
Pain Management Nursing; by Dana Hagmann, Susanne Fleckinger, Piret Paal; 1/26
Disagreements between nurses and doctors regarding the assessment and management of existential suffering in terminally ill patients represent a critical challenge in palliative care, particularly in the context of inpatient adult hospices. The study highlights the limited involvement of nurses in decision-making processes regarding palliative sedation despite their critical insights into patients' existential suffering. The findings emphasize the need for interdisciplinary collaboration and the integration of nurses' perspectives to achieve more holistic and ethically sound care in inpatient hospices.

[UK] The effects of music interventions on behavioural and psychological symptoms in older adults with dementia: Systematic review
Advances in Mental Health; by Motunrayo A. Akinboye, Benjamin O. Ajibade; 12/25
Dementia, affecting over 55 million people globally, often presents with behavioural and psychological symptoms (BPSDs) such as agitation, depression, and anxiety. Pharmacological treatments can lead to adverse effects, highlighting the
need for safer, non-drug alternatives like music interventions. Findings show that music interventions significantly alleviated symptoms such as depression, anxiety, and agitation. Both active (e.g., singing, playing instruments) and
receptive (e.g., listening) music therapy formats were effective, with sessions ranging from 20–90 minutes. Interventions were most successful when personalized and culturally tailored.

The secret to life is enjoying the passage of time. ~James Taylor