Literature Review

HHS faces $31B cuts in proposed FY ’26 budget: 6 notes Becker's Hospital Review; by Madeline Ashley; 6/2/25 President Donald Trump’s proposed fiscal 2026 budget slashes funding for the National Institutes of Health by $18 billion to $27.5 billion as part of a sweeping overhaul to realign federal healthcare spending.  The NIH received $46.4 billion in program level funding in 2024 and just over $46 billion in 2025, according to the budget proposal. [Continue reading for this article's lists of (1) consolidated institutes and centers; and (2) "six things to know."]

7 Brutal truths about leadership no one tells you at 29Forbes; by Nirmal Chhabria; 5/29/25At 29, I was handed my first leadership role. Six months later, I was drowning—my inbox was overflowing with problems, top performers were quitting and morale was plummeting. "What am I doing wrong?" I asked my mentor. "You're trying to be the hero instead of creating heroes," she replied. That conversation began my real leadership education—years of failures that revealed truths I wish I'd known from day one. Here are seven leadership insights that only experience taught me:

LeadingAge, Hospice Associations seek delay in HOPE implementation LeadingAge; Press Release; 5/28/25 LeadingAge, along with the National Alliance for Care at Home and the National Partnership for Healthcare and Hospice Innovation, on May 19 urged the Centers for Medicare and Medicaid Services (CMS) to delay implementation of the Hospice Outcomes and Patient Evaluation, or HOPE tool. In the letter to CMS Administrator Dr. Mehmet Oz the associations outline concerns with technology implementation in preparation for the HOPE tool. The letter specifically asks CMS to waive the HOPE timeliness submission requirement for two calendar quarters post implementation. The letter further requests that CMS delay the HOPE implementation date until at least six months after CMS education, training, and final validation specifications are available and the application for iQIES access has been opened for hospices. 

Remove barriers that restrict hospice care, Alliance offers in new report McKnights Home Care; by Adam Healy; 5/28/25 Hospice providers can boost quality and patient satisfaction with a focus on transparent, culturally sensitive communication with clients, according to a new report by the National Alliance for Care at Home. ... For the report, the Alliance surveyed 2,000 adults who either recently experienced the death of a loved one or have been involved in healthcare decisionmaking for a person with a serious illness. Respondents included individuals of a variety of ages, income levels, ethnicities and educational backgrounds. ... . For many seniors, one of the largest barriers to care is ineffective communication, the survey found. Language barriers are a significant hurdle for non-English speaking older adults, particularly those who are first generation immigrants, it noted. Many seniors are also less comfortable with technology-based communication than younger people, and prefer face-to-face conversation over text messages.

Jewish hospice volunteer goes beyond ‘Shabbat blessings’ with ‘Froth and Bubble’ Jewish News; by Shannon Levitt; 5/20/25 Jeff Lewis, 71, had about 100 boxes of books with him when he moved to the Valley from California more than a decade ago. Surprisingly, those books became his first link to Hospice of the Valley (HOV), an organization that would become very important to him through the years. ... Thus, when he decided to retire from his photography business but wanted to stay busy, his friend again nudged him toward HOV and its Shabbat Blessings volunteer program. ... As a Shabbat Blessings volunteer, Lewis, a member of Temple Solel in Paradise Valley, offers hospice patients a small Shabbat service, including lighting Shabbat candles, saying the Hamotzi and Kiddush blessings and offering small prayers. [Story of patient financially choosing between medicine and food.]  ... [Lewis} started buying $75 grocery gift cards to give away. [This developed into] The Froth and Bubble Foundation for Food Assistance. Editor's note: This inspirational Shabbat blessings story tells the rich background behind our 3rd top-read story from last week, Hospice volunteer donates 10,000 gift cards to cancer patients. Scroll to the end of this story for the meaning behind the name "Froth and Bubble." 

Don't aim at success. The more you aim at it and make it a target, the more you are going to miss it... success will follow you precisely because you had forgotten to think about it. ~Viktor Frankl, Man's Search for Meaning

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!

If you have knowledge, let others light their candles in it. ~Margaret Fuller

A single academic site study of five years evaluating pharmacy students’ palliative care clinical reasoning using Script Concordance TestingAmerican Journal of Hospice ad Palliative Medicine; Florence Labrador, PharmD-c; Kyle P. Edmonds, MD, FAAHPM; Toluwalase A. Ajayi, MD, FAAP, FAAHPM; Rabia S. Atayee, PharmD, BCPS, APh, FAAHPM; 5/25This study aimed to evaluate the impact of a Pain and Palliative Care elective didactic course on enhancing clinical reasoning skills among Doctor of Pharmacy (PharmD) students using the Script Concordance Test (SCT). The elective course was offered six times, covering various palliative care topics such as opioid management, procedural pain, and end-of-life care. The study found a statistically significant improvement in SCT scores from pre- to post-course assessments ... This study demonstrates the effectiveness of a targeted palliative care elective in improving clinical reasoning skills among pharmacy students.

Palliative care for patients with end-stage renal disease-An examination of unmet needs and experiencing problemsJournal of Hospice & Palliative Nursing; Darawad, Muhammad W. PhD, RN; Reinke, Lynn F. PhD, ANP-BC, FPCN, FAAN; Khalil, Amani PhD, RN; Melhem, Ghaith Bani PhD, RN; Alnajar, Malek MSN, CNS, RN; June 2025Patients with end-stage renal disease face numerous physical, emotional, and financial burdens, necessitating palliative care (PC) interventions. This cross-sectional study ... revealed that 64.7% of participants experienced significant challenges, primarily financial difficulties (78.5%), autonomy concerns (68.8%), and a need for information (68.0%). More than half (51.9%) reported needing PC [palliative care], particularly for managing fatigue (78.3%), pain (79.8%), and depression (72.9%). Unmet needs were common (47.6%), with the most notable gaps in financial support (52.5%) and information provision (50%). These findings underscored the urgent need for tailored PC interventions for end-stage renal disease patients, particularly in addressing symptom management, psychosocial and spiritual support, financial support, and information deficits, to enhance their quality of life.

Describing the impact of physician end-of-life communication training on simulated stress using a novel stress marker American Journal of Hospice and Palliative Medicine; by Amy H. J. Wolfe, MD, MEd, Pamela S. Hinds, PhD, RN, FAAN, Adre J. du Plessis, MD, Heather Gordish-Dressman, PhD, and Lamia Soghier, MD, MEd-2; 3/25/25 Introduction: Empathetic end-of-life (EOL) communication is important for high quality pediatric patient and family outcomes. Trainees may have limited exposure and training in caring for patients at EOL which may impact communication-related stress. ...  Conclusions: Pediatric residents report limited opportunities to communicate with patients/families at EOL, which may impact stress responses when communicating life-altering news to families. Simulated communication encounters can be designed to evoke subjective and objective stress which can be measured using novel technology and may help address limited EOL opportunities.

Avoidant and approach-oriented coping strategies, meaning making, and mental health among adults bereaved by suicide and fatal overdose: A prospective path analysisBehavioral Sciences; Jamison S. Bottomley, Robert A. Neimeyer; 5/25The current study shed light on the role of avoidance- and approach-oriented coping strategies in aggravating or ameliorating the longer-term distress of the survivors of such losses, roughly half of whom showed continued clinical-level elevations of prolonged grief, posttraumatic stress, and depressive symptomatology two years following the death. The results provided cautionary evidence that avoidant coping through denial, distraction, and behavioral disengagement prospectively predicted higher levels of prolonged grief and posttraumatic stress, with the impairment of meaning making about the loss accounting for much of the variance in the former outcome. In contrast, actively approaching others for support and attempting to confront and surmount the problems posed by bereavement consistently predicted a reduction in prolonged grief, posttraumatic stress, and depression symptoms in the months that followed. The latter impacts were found to be fully mediated by the enhancement of meaning making about the loss, carrying practical implications for bereavement support and grief therapy for this vulnerable population of mourners.

Live hospice discharge of individuals with cognitive disabilities: A systematic reviewJournal of the American Medical Directors Association; by Victoria M Winogora, Christine E DeForge, Kimberlee Grier, Patricia W Stone; 4/25This systematic review is the first to focus on live discharge from hospice for individuals with cognitive disabilities. All studies focused exclusively on individuals with dementias. Although the term cognitive disability was absent from the literature reviewed, cognitive disability was associated with live discharge. Future research should aim to include the greater cognitive disability community to assess hospice and other end-of-life outcomes to identify potential targets for future intervention.