Literature Review

Faith is taking the first step even when you don’t see the whole staircase. ~ Martin Luther King Jr. Honoring Black History Month 2025

HHS job cuts mount: 4 notes Becker's Hospital Review; Madeline Ashley; 2/18/25 HHS saw further job cuts on Feb. 15 across agencies including the CDC, FDA and National Institutes of Health, including around 1,000 NIH terminations, after a Trump administration order to eliminate "nearly all" HHS probationary employees, Bloomberg reported Feb. 16. Here are four things to know: [click on the title's link to continue reading]

The case for a 4-day workweek for nurse managers Becker's Clinical Leadership; by Kelly Gooch: 2/18/25 Four-day workweeks lead to an improved work-life balance for nurse managers, nurse leaders at Philadelphia-based Fox Chase Cancer Center argue in a new paper shared with Becker's. "A 4-Day Workweek for Nurse Leaders: Unveiling the Lessons Learned" is based on a study conducted at the 100-bed specialty cancer center. The study aims to evaluate the influence of a four-day workweek on nurse leaders' perceptions of workload and job satisfaction. Results of the study were published Feb. 17, and included 24 care delivery units and 43 nursing directors, managers and assistant nurse managers.

Wilton’sTurnover Shop surpasses historic milestone — $1 million in donations to Visiting Nurse & Hospice  Good Morning Wilton, Wilton, CN; by Reader Contributed to GMW; 2/7/25 A legacy of generosity has reached a historic milestone — the Turnover Shop of Wilton has surpassed $1 million in lifetime donations to Waveny LifeCare Network’s Visiting Nurse and Hospice. This extraordinary achievement, 80 years in the making, continues to fuel the Network’s Patient Care Fund, ensuring that home care and hospice services remain accessible to those in need, regardless of financial circumstances. “This milestone is a powerful testament to the impact of community-driven generosity,” Homecare at Waveny Vice President Carol Smith said. ... As two deeply rooted nonprofit organizations, Waveny’s Visiting Nurse & Hospice and the Turnover Shop share a mission of service, dedication and heartfelt support for their community. 

Reimagining care and research for Amyotrophic Lateral SclerosisJAMA Neurology; Suma Babu, MBBS, MPH; Joshua M. Sharfstein, MD; Eva L. Feldman, MD, PhD; 1/25Amyotrophic lateral sclerosis (ALS) is a fatal neurological disease involving progressive motor neuron degeneration. In 2022, US Congress and the National Institutes of Health (NIH) commissioned the National Academies of Science, Engineering and Medicine (NASEM) to identify priorities to make ALS a livable disease within a decade. After extensive deliberations and input from the public, researchers, and persons with lived experience, the committee released its report, Living With ALS. To accelerate progress in patient care and therapeutics, one of the report’s major recommendations was for the National Institute of Neurological Disorders and Stroke (NINDS) to fund a clinical trials network dedicated to ALS that is distributed across diverse geographic regions and integrated within a novel hub-and-spoke system of care and research for ALS. The hubs are ALS Centers of Excellence that provide patient care and research, both basic and clinical, while the spokes represent a large number of community and regional ALS clinics that provide care and link to hubs for research. By integrating ALS clinical trials within this structure, we have the potential to transform ALS care, drive innovation in ALS therapeutic development, and pave the way for breakthroughs in other neurodegenerative diseases. 

[Updated] Trump administration suspends hospice Special Focus Program Hospice News; by Jim Parker; 2/14/25 The Trump Administration has suspended implementation of the hospice Special Focus Program. Finalized in the 2024 home health payment rule, the program is designed to identify poor performing hospices, mandate quality improvement and in some cases impose additional penalties. However, stakeholders in the hospice space have contended that the agency’s methodology for selecting hospices for the program is deeply flawed. Notice of the suspension appeared [Friday, 2/14] on the U.S. Centers for Medicare & Medicaid Services (CMS) website.Editor's note: Click here for "Hospice leaders applaud CMS’s decision to reevaluate Special Focus Program, call for meaningful reforms," posted 2/17/25.

Teleios announces completion of Boomer End-of-Life Care Survey Teleios Collaborative Network (TCN), Hendersonville, NC; by Tina Gentry; 2/12/25 Teleios Collaborative Network (TCN) announced the completion of its survey titled “What Baby Boomers Want in End-of-Life Care.” This survey aimed to gain insights into the healthcare preferences and needs of the Baby Boomer generation as they age, transition into retirement and seek end-of-life care. On February 5th, TCN’s Visioneering Council, which comprises member CEOs, C-Suite staff, and marketing managers, gathered to discuss the survey results and explore the best ways to utilize this information to enhance patient care. Before reviewing TCN’s survey findings, Matthew Wilkinson from NPHI and Bill Keane from Emergence presented results from NPHI’s “Aging and End of Life Care Survey.” Additionally, Dr. Terry Fulmer provided insights from the John A. Hartford Foundation’s survey titled “What Older Adults Want from Health Care.” TCN President and CEO Chris Comeaux said, “Over my career, we have been honored to care for the greatest generation. Now that we are at the dawn of the baby boomers being the majority of those we will be honored to care for as they enter their twilight years. Knowing what they expect, what they care about, what they do not want to worry about, all of this is such important data to ensure hospice over the next 30 years is providing an even greater service to patients and families. That’s what this study was looking to accomplish. It’s a great start in that direction.” 

Hospice advocates push bill for a third time despite two Hochul vetoes Spectrum News 1, New York State; by susan Arbetter; 2/12/25 Last spring, Capital Tonight sounded an alarm about for-profit hospice care. The Federal Bureau of Investigation (FBI) had just issued public warnings about for-profit hospice fraud in four states; it was alerting consumers to a scam in which patients were being enrolled without their knowledge by recruiters who were “selling” hospice to people who weren’t eligible. Hospice fraud like this has also been extensively reported by The New Yorker and Pro Publica. After Gov. Kathy Hochul twice vetoed a bill preventing the expansion of for-profit hospice in New York, a new bill (S.3437/ A. 565) is being introduced by the chair of the state Senate Finance Committee, Liz Krueger, and chair of the state Assembly Health Committee, Amy Paulin. “If a family is faced with a loved one that is dying, they should not also be faced with the possible incentive of money,” Assembly member Paulin told Capital Tonight. There are a variety of drawbacks to for-profit care, and there is clear data that shows profit motives drive for-profit hospice to neglect patient care and prioritize volume over quality.

[Turkey] Actual roles of Occupational Therapists in palliative and hospice care: A scoping reviewAmerican Journal of Hospice and Palliative Medicine; Güleser Güney Yılmaz, PhD, OT; Hülya Yücel, PT, PhD; Milda Gintiliene, MD; 1/25 Occupational therapists play a crucial role in coordinating and facilitating safe transitions from the hospital to home, aiming to improve the overall quality of life and reduce hospital stays. Various roles of occupational therapists have been defined in palliative care: discovering occupational meaning in the last periods of life and supporting occupational participation, management of persistent physical and psychological symptoms, especially pain and fatigue, improving or supporting the quality of life for individuals under palliative care, supporting mental well-being, supporting social participation, use of adaptive technologies, providing individuals with confidence and comfort. Occupational therapists also have various duties in maintaining palliative-hospice care at home include evaluating the individual at home and supporting home care and rehabilitation after discharge. Interventions for caregivers or supporting caregivers who have lost their roles, occupations or jobs in the care process are also among the roles of occupational therapists.

Proposed framework for setting practical and ethical boundaries in medicineJAMA Internal Medicine; Sarah C. Hull, MD, MBE; Nancy R. Angoff, MD, MPH, MEd; 2/25At a national conference session addressing challenges for women in cardiology, one of us (S.C.H.) was struck by a junior attending physician’s account of her struggle to establish boundaries, expressing her desire to be helpful and collaborative as well as her reticence to decline requests lest she appear unkind. Reflecting on my own experience, I realized that women are often socialized to avoid saying no for fear of disappointing others or appearing selfish, but this socialization has not served us well. Indeed, this is a common refrain we have heard from young women entering the medical profession. Our anecdotal experience matches data suggesting that, compared with men, women are more likely to be asked and less likely to decline low-promotability task requests.

Health policy challenges for 2025 and beyondJAMA Health Forum; Lanhee J. Chen, JD, PhD; 1/25Despite multiple reform attempts, the US health care system is still burdened by high costs, limited access to quality care, and policies that have resulted in the inefficient delivery of care. However, technological advances, insights from the COVID-19 pandemic, and approaching policy deadlines, such as expiration at the end of 2025 of enhanced coverage subsidies available through the Affordable Care Act (ACA), offer policymakers a reason to act. The next few years will present policymakers with opportunities to address key health care challenges, including the future of Medicare, the continuing implementation of the ACA, and the health care provisions included in the federal tax code. The new administration and Congress will have their hands full in 2025 because the expiring tax and subsidy provisions are action-forcing events. Lawmakers will face a unique opportunity to reform the system in a way that improves accessibility and affordability and enforces some measure of fiscal discipline, and to make decisions that could positively affect the future of health care for millions of individuals in the US.

Risk factors for and health status of socially isolated adultsJAMA Network Open; Tarun Ramesh, BS; Kushal Kadakia, MSc; Marcela Horvitz-Lennon, MD, MPH; Joshua Breslau, PhD, ScD; Hao Yu, PhD; 1/25In 2023, the Surgeon General issued an advisory on the epidemic of loneliness and social isolation, calling for more research and policy interventions to address these challenges. The overall prevalence of social isolation in our study was 3%, which is lower than other determinants of health, such as smoking, poverty, and inadequate health insurance. Our results indicate 3 broad and likely interrelated populations at risk for social isolation, including racial and ethnic minority groups, those with financial insecurity (ie, unemployed, uninsured, lower income), and those with chronic health conditions, with depression being a large factor. We also found that the socially isolated adults reported worse health status compared with those without social isolation.