Literature Review

[Australia] Overtreatment of older people near end of life: A qualitative scoping review of modalities, drivers, and solutionsOmega-Journal of Death and Dying; Samantha Fien, Emily Plunkett, Daniel Wadsworth, Magnolia Cardona; 4/24This study aimed to understand the drivers better to help minimise further risks of overtreatment for older people near the end of life (dysthanasia). Determinants included healthcare system factors, patient-centered care, family and caregiver, and clinician perspectives. This review confirms that despite almost two decades of recognition of the potential harms of overtreatment near the end of life, society, patients, and health systems have a role to play in reducing and addressing the determinants. We offer a range of solutions for clinicians, health service managers, and members of the public to consider.

Finding her strength in silence: CSU Pueblo student graduates twice, carring her mother's dream Colorado State University Pueblo, Pueblo, CO; by Soni Brinsko; 5/14/25 The porch was still new when the professors arrived that late November evening. Hand-laid tiles, each one carefully placed by a father during what should have been vacation time. He’d built it for his wife so she could sit outside, feel the Colorado breeze one more time. That night, the porch became something else entirely. It became a stage for a graduation ceremony that wasn’t supposed to happen until May. Alondra Solis Ayala is about to walk across the commencement stage at Colorado State University Pueblo this week. It will be her second graduation. The first one happened in her family’s living room, with her dying mother watching from a chair, too weak to stand but strong enough to declare “esa es mi hija”—that’s my daughter—as faculty members in full regalia handed over a diploma cover and stole in what became an impromptu, deeply personal ceremony.

Social Media Watch 5/16/25

Dying at home becomes more common for patients with history of ischemic stroke NeurologyToday; by Susan Fitzgerald; 5/15/25 In contrast to earlier studies showing a decline in stroke prevalence and mortality, a new study found that the rates are going up and more people, particularly Black Americans, are either dying at home or arriving to the hospital dead on arrival. Experts speculate that the trend may be driven by the lack of access to hospice services and care, in general.

[United Kingdom] For, against, undecided: Three GPs give their views on assisted dying BBC News; by Catherine Burns and Vicki Loader; 5/13/25 If you ask these three doctors about being GPs, their answers are remarkably similar. "It can be the best job in the world," one tells me. It's "a privilege" another says. They all talk about how they love getting to know their patients and their families. But all three have different views on assisted dying. Right now, the law here is clear: medics cannot help patients to take their own lives. But that could change. The Terminally Ill Adults (End of Life) Bill is being debated in Parliament. And if it goes through, it will give some terminally ill patients in England and Wales the option of an assisted death. Here, three doctors - Abdul Farooq, Susi Caesar and Gurpreet Khaira, who all have a different view on assisted dying - tell us how they feel about the proposals.

Kind words can be short and easy to speak, but their echoes are truly endless. ~ Mother Teresa

UnitedHealth Group is under criminal investigation for possible Medicare fraud The Wall Street Journal; by Christopher Weaver and Anna Wilde Mathews; 5/15/25 The Justice Department is investigating UnitedHealth Group for possible criminal Medicare fraud, people familiar with the matter said. The healthcare-fraud unit of the Justice Department’s criminal division is overseeing the investigation, the people said, and it has been an active probe since at least last summer. While the exact nature of the potential criminal allegations against UnitedHealth is unclear, the people said the federal investigation is focusing on the company’s Medicare Advantage business practices. UnitedHealth said in a statement it hadn’t been notified by the Justice Department of the criminal investigation. The statement said the company stands “by the integrity of our Medicare Advantage program.” A DOJ spokesman declined to comment.

A new era of healing: How home care is changing the healthcare landscape Repertoire Magazine; 5/13/25 Older adults often prefer receiving care in familiar surroundings, which enhances their comfort and quality of life. Home health services enable patients to age in place, reducing the need for institutional care, such as nursing homes. ... For the May issue, Repertoire Magazine spoke to several experts – from distributors to providers – on the current realities of the home care market and what’s in store in the years to come. ...

Family Hospice opens Dublin office to serve veterans and families in need of end-of-life care }NBC WMGT-41, Dublin, GA; by Bre'Anna Sheffield 5/13/25 Family Hospice expands to Dublin to serve the area's large veteran population and provide compassionate care for patients and families navigating end-of-life decisions. Many families face difficult decisions when it comes to hospice care. To help meet that need, Family Hospice is opening a new office in the Dublin area. The newly appointed CEO, Charles Hall, says the large veteran population in Dublin made it the right place to expand their services. 

‘Surprisingly hopeful’ story emerges about LGBTQ+ rights, efforts in senior living McKnights Senior Living; by Kimberly Bonvissuto; 5/14/25 ... The Human Rights Campaign Foundation and LGBTQ+ elder advocacy group SAGE on Tuesday released its 2025 Long-Term Care Equality Index, a national benchmarking tool focused on LGBTQ+ inclusion in senior living and care. The key takeaway, the organizations said, is the “defiant progress” occurring despite political attacks against inclusion efforts.  As cuts to the Medicaid program — which many LGBTQ+ older adults rely on — come more into focus, participation in the latest survey jumped 37% from the 2023 report, with 274 long-term care settings across 33 states expressing commitment to inclusive care for more than 29,000 residents and 18,000 staff members. Participants included independent living, assisted living, memory care, continuing care retirement / life plan and affordable housing communities, as well as skilled nursing facilities and hospice settings.

How grief transformed a psychiatrist’s approach to patient care MedPageToday's KevinMD.com [reposted in AAHPM's newsletter]; by Devina Maya Wadhawa, MD; 5/12/25It is a routine Saturday morning—I am sitting in my office, looking at the snowflakes dropping outside my window. As I sip on my cup of Earl Grey tea preparing my psyche for a busy day of managing an on-call shift on an acute care psychiatry floor, I am suddenly washed over by grief. A very similar Saturday a year ago, I was saying goodbye to my father as he was being taken off life support in the intensive care unit after suffering a massive posterior myocardial infarction and ending up with a cardiac arrest at the very young age of 62. The year has been nothing short of trying, a year of firsts. ...

No one heals himself or herself by wounding another. ~ St. Ambrose

Dementia patient discharged from hospice over Medicare requirement. Here’s why it happened WKMG-6, Deltona, FL; by Erika Briguglio and Louis Bolden; 5/14/25A Volusia County family is left scrambling after their loved one is abruptly dropped from hospice care. To qualify for hospice, patients must have a life expectancy of six months or less. However, for dementia patients, the prognosis can be unpredictable. Hospice care can be extended as long as the patient continues to meet Medicare requirements. Unfortunately, these requirements are why Amy Yates lost coverage for her 91-year-old grandmother. ... “I think it’s she hasn’t died fast enough, and it’s costing them money that they don’t want to spend,” Yates told News 6. ... What Yates’ family is dealing with is what Medicare calls live discharge, and they are not alone. The Hospice Foundation of America reports that 17% of people in 2022 who were admitted to hospice care were discharged; about 6% of the total caseload was discharged because they no longer met Medicare requirements for care under the hospice benefit.Editor's note: What are your hospice stats for live discharges? For Length of Stay (LOS)? This factor--with the face-to-face recertification requirement--is crucial. Unfortunately, many hospices misused President Jimmy Carter's extraordinarily long LOS with misleading information about hospice care. They watered down "end-of-life" care and never mentioned anything about a basic recertification process. Warm, user-friendly language can be used with integrity, authenticity, and patient/caregiver support.