Literature Review
‘Global problem’: Numerous factors, biases contribute to overtreatment at end of life
02/27/25 at 02:00 AM‘Global problem’: Numerous factors, biases contribute to overtreatment at end of life Healio; by Josh Friedman; 2/26/25 Nathan I. Cherny, MD, has worked all around the world. At every stop — from Australia to Israel, and Memorial Sloan Kettering Cancer Center in between — he has seen people with cancer receive overly aggressive treatment at the end of life. ... In a review published in ESMO Open, Cherny and a cohort of multinational colleagues highlighted numerous reasons why overtreatment occurs among patients approaching the end of life, ... They listed more than 20 contributing factors, including desire for control of the cancer, denial and anger, family pressure and hope preservation. The two factors that contribute most to overtreatment are optimism bias and the “counterphobic determination to treat,” which involves clinicians having a difficult time introducing the suggestion of palliative care revert to offering further treatments, Cherny said. ... Responsibility for decisions does not need to fall solely on oncologists, Cherny added. Palliative care physicians, social workers, chaplains and others can be part of a team to assist patients with their choices. ... The number of patients who are overtreated differs at each institution. “Each institution has its own culture of care,” Cherny said. Editor's note: This article puts forth significant insights for all palliative and hospice clinicians, interdisciplinary teams, and palliative/hospice executive leaders. Apply Cherny's to your referral sources: "Each institution has its own culture of care." Apply these findings to your own palliative and hospice services.
North Texas doctor helps parents facing infant loss deal with the unimaginable
02/27/25 at 02:00 AMNorth Texas doctor helps parents facing infant loss deal with the unimaginableCBS News - Texas; by Andrea Lucia, Lexi Salazar, Katie Standing; 2/25/25[Background story for parents Yvette and Thoms Ngo upon dealing with the news that their in-utero baby girl Zoe was diagnosed with Trisomy 13, would likely miscarry, or die soon after birth. Dr. Terri Weinman, their neonatologist offered rich palliative care interventions and support.] "When we met Dr. Weinman and her team the first time, she would say things like, 'So, what are we going to do when Zoey is here,' which changed my mindset completely," Yvette Ngo said. ... For the first time, the Ngos began to consider what Zoey's life, short as it might be, could look like. "It made us more comfortable with the situation, I mean as comfortable as you can be," Thomas Ngo said. "She just gave us hope." Zoey was born on April 18, 2024. She met her parents, her siblings and her grandparents. She was baptized. "They made us little crafts and mementos for us to take home, like footprints, really ways to help cherish Zoey's life," Yvette Ngo said. "They took her heartbeat and recorded it for us. Little things that we wouldn't necessarily think of." Zoey even had a chance to go home. But after 36 hours of life, Zoey passed away in her father's arms. The perinatal palliative care Zoey received remains rare. But for families like the Ngos, it provides a small sense of control when it's needed most. "Being able to plan so much in advance and think about all the different scenarios and how we wanted it," Yvette Ngo said. " I think, looking back on our time with Zoey..." "We wouldn't have done anything differently," Thomas Ngo said. Editor's note: Pair this with "Improving knowledge, confidence, and skills in perinatal bereavement care through simulation in baccalaureate nursing students," posted 2/24/25.
Today's Encouragement: If they don't give you a seat at the table ...
02/26/25 at 03:00 AMIf they don’t give you a seat at the table, bring a folding chair. ~ Shirley ChisholmHonoring Black History Month 2025
Why being trustworthy is a leadership hack that drives success
02/26/25 at 03:00 AMWhy being trustworthy is a leadership hack that drives success Inc.; by Yufie Ren; 2/20/25 Leaders who cultivate trust can significantly reduce employee churn and improve organizational performance. ... In an era of rapid change, when teams look to leaders for stability and direction, trust is the invisible currency that fuels organizational success. ... Fortunately for managers – and workers – there’s a lot of research into how to be a more trustworthy leader. Here are a few insights:
CIO hiring on the rise: How to land a top tech exec role in 2025
02/26/25 at 03:00 AMCIO hiring on the rise: How to land a top tech exec role in 2025 CIO; by David Weldon; 2/25/25 Job opportunities are picking up for CIOs and other IT leaders in 2025, but so are expectations, with AI, change acceleration, and business transformation at the top of most companies’ wish lists. Early returns on 2025 hiring for IT leaders suggest a robust market. For some recruitment firms, job growth for tech executive positions is at great heights.
Candice Bergen’s caregiving journey and how estate planning can help
02/26/25 at 03:00 AMCandice Bergen’s caregiving journey and how estate planning can help FindLaw; by Catherine Hodder, Esq.; 2/20/25 Candice Bergen is a movie and television star and comedienne best known for her role as Murphy Brown. ... Bergen’s husband of over 20 years, Marshall Rose, recently passed after battling Parkinson’s disease. Her first husband, director Louis Malle, died from lymphoma. In Bergen’s memoir “A Fine Romance,” she describes the struggle of caregiving for someone who is critically ill. She writes, “It really costs you to take care of someone who is critically ill day after day.” Many caregivers can relate. According to the NIH, 50 million people care for a disabled, older adult, or chronically ill family member or friend. ... However, there are estate planning tools available that can help caregivers manage the health and support of their critically ill loved ones. ...
5 tips to determine how tech can support your physicians
02/26/25 at 03:00 AM5 tips to determine how tech can support your physicians American Medical Association (AMA); by Georgia Garvey; 2/25/25 ... Margaret Lozovatsky, MD, vice president of digital health innovations at the AMA, recently shared five important considerations—among them establishing a governance model and agreeing on shared priorities—in designing technology to support clinical practice. Dr. Lozovatsky’s presentation was part of a two-day AMA training event to help physicians eliminate unnecessary work and free up more time to focus on what matters most—patient care. ...
Relaxing licensing, training requirements during pandemic didn’t improve nursing home staffing: study
02/26/25 at 03:00 AMRelaxing licensing, training requirements during pandemic didn’t improve nursing home staffing: study McKnights Long-Term Care News; by Zee Johnson; 2/24/25 A new study of more than 15,000 nursing homes found no link between relaxed certified nurse aide training and licensing protocols during the pandemic and improved staffing levels. During COVID-19, 19 states loosened their training requirements (the “treatment” group), and 31 states did not (“control” group). However, both recorded nearly the same CNA hours per resident per day, according to the study by researchers at the University of Iowa. ... During the pandemic, direct caregivers were at extreme risk for contracting the deadly virus, which killed more than 200,000 nursing home residents and workers. But more often than not, they were left without basic benefits such as paid sick leave, Mehboob said.
Daughter indicted for killing mother with morphine in Evans
02/26/25 at 03:00 AMDaughter indicted for killing mother with morphine in Evans The Augusta Press, Augusta, GA; by Greg Rickabaugh; 2/25/25The daughter of a woman who died in an Evans assisted living home from a fatal dose of morphine has been indicted for malice murder. Rachel Elaine Waters, 41, is expected to surrender this week on murder charges in the death of 74-year-old Marsha Sprayberry Foster, according to Columbia County authorities.An indictment says that Waters administered a lethal dose of morphine on July 12, 2023, while her mother was at the Marshall Pines assisted living on North Belair Road. The cause of death was determined in an autopsy, showing that excessive use of the unprescribed morphine was the reason for her death. Foster had Alzheimer’s disease, and the morphine was reportedly left behind by hospice workers and used by the daughter without authorization.
How boomers are personalizing their last chapter
02/26/25 at 03:00 AMHow boomers are personalizing their last chapter Broadview; by Larry Krotz; 2/19/25 From death doulas to digital legacies, this generation is flipping the script on end-of-life traditions. ... I confess that I don’t generally think much about dying, though many in my generation do. Baby boomers, that great bulge in the population whose concerns for so long have dominated the culture, have moved from preoccupations with creative retirement or the adequacies of the health-care system to a fascination with death. Witness the immense popularity last year of the Royal Ontario Museum’s multisensory exhibit Death: Life’s Greatest Mystery or the growth of death cafés ... For my contemporaries, death has become the next item on the to-do list. What it will look like. How to prepare for it. How to make it your own. ...
ONA Leadership Column: The next level
02/26/25 at 03:00 AMONA Leadership Column: The next level State Nurses Associations - Oklahoma Nurses Association; by Dean Prentice, DHA, MA, BSN; 2/24/25 What is it going to take to raise the leadership ability of your staff to the next level? One of the many roles you play for your staff is encouraging their professional development. ... The future of nursing will require a well-rounded skill set that goes beyond traditional clinical training. Emotional intelligence, cultural competence, data-driven decision-making, ethical leadership, and resilience are all critical to meeting the challenges of tomorrow’s healthcare landscape. By developing these skills, nurses will not only improve patient outcomes but will also contribute to the evolution of the nursing profession, ensuring it remains relevant, compassionate, and effective in an increasingly complex world.
Interdisciplinary strategies for establishing a trusting relation as a pre-requisite for existential conversations in palliative care: a grounded theory study
02/26/25 at 03:00 AMInterdisciplinary strategies for establishing a trusting relation as a pre-requisite for existential conversations in palliative care: a grounded theory study BMC Palliative Care - Part of Springer Nature, Open Acces; by Annica Lagerin, Christina Melin-Johansson, Bodil Holmberg, Tove Godskesen, Elin Hjorth, Lena Junehag, Carina Lundh Hagelin, Anneli Ozanne, Johan Sundelöf & Camilla Udo; 2/19/25... This study aimed to gain an in-depth understanding of healthcare professionals’ (HCPs) experiences of existential conversations with patients with PC needs and their next-of-kin by generating a theoretical model. ... To emphasize the importance of ethical competence for quality patient care, particularly in PC, a combination of care ethics, clinical proficiency, relational skills and effective communication is essential. ... The potential obstacles we identified that require attention include the need for managers ... to support HCPs by allowing time for reflection, developing new routines, and providing education focused on existential conversations in PC. However, the main contribution of this study is the description of the interdisciplinary strategies HCPs used to establish meaningful, existential conversations by maintaining presence, as this paved the way for trusting conversations with patients and next-of-kin. Editor's note: Pair this with today's article "Why being trustworthy is a leadership hack that drives success."
DOJ launches probe into UnitedHealth’s Medicare billing practices after investigative reports
02/26/25 at 03:00 AMDOJ launches probe into UnitedHealth’s Medicare billing practices after investigative reports MSN; by Taylor Herzlich; 3/22/25 The Department of Justice has reportedly launched an investigation into UnitedHealth Group’s Medicare billing practices as scrutiny over the health insurance industry intensifies — sending the company’s stock plummeting.The probe is analyzing the company’s practice of frequently logging diagnoses that trigger larger payments to its Medicare Advantage plans, according to The Wall Street Journal. UnitedHealth shares plunged nearly 9% Friday. A series of Wall Street Journal reports last year found that Medicare paid UnitedHealth billions of dollars for questionable diagnoses.
Keeping cool when debate turns hot: Inaugural global Ethics Center conference features scholarship, presentations on fostering civil, productive dialogue
02/26/25 at 03:00 AMKeeping cool when debate turns hot: Inaugural global Ethics Center conference features scholarship, presentations on fostering civil, productive dialogue The Harvard Gazette; by Christy DeSmith; 2/24/25 Americans today are wrestling with how to turn down the heat when discussing politically and morally charged topics. Students, professors, and education professionals from around the globe assembled at Harvard this month to chart their way to more productive discussions — and better relations. The inaugural Challenging Barriers to Civil Discourse conference, hosted by the Edmond and Lily Safra Center for Ethics, featured scholarship on fostering open, honest exchanges across deep divides. ... [Dr. Julia] Kolak told of mediating clashes that arose ... when the family of a critically ill patient ... resisted end-of-life care. She works to unearth the principles guiding all parties, without elevating those with medical expertise. “When we treat others as capable of dialogue,” she offered, “it really changes the affective grip of conflict. ... [Jeffrey Dunn] raised the critical question: “What is the long-term goal of this work?” ...
Leading early conversations about ICD [implantable cardioverter defibrillator] use in end-of-life cancer care
02/26/25 at 03:00 AMLeading early conversations about ICD [implantable cardioverter defibrillator] use in end-of-life cancer care Cancer Network; by Megan Mullins, PhD, MPH; 2/21/25 Earlier and more frequent talks about disabling ICDs with patients receiving end-of-life care and their families may help avoid excessive pain. ... Regarding implantable cardioverter defibrillators (ICDs) in those with fatal cancers, it is critical that patients know what having a device means and how it impacts end-of-life care, according to Megan Mullins, PhD, MPH. CancerNetwork® spoke with Mullins, assistant professor in the Peter O’Donnell Jr. School of Public Health, the Harold C. Simmons Comprehensive Cancer Center, and the Department of Internal Medicine at UT Southwestern Medical Center, about how ICD deactivation prior to end-of-life care could impact clinical practice in patients with advanced cancers. ... She emphasized that device deactivation would allow the body to undergo the natural dying process without unnecessary painful shocks associated with the use of the device.
Empowering employees to drive CX [Customer eXperience] innovation: A comprehensive path to success
02/26/25 at 03:00 AMEmpowering employees to drive CX [Customer eXperience] innovation: A comprehensive path to successCustomerland; by Ricardo Saltz Gulko; 2/24/25 ... While it is widely recognized that employees play a crucial role in shaping customer experience (CX), their impact on innovation is often less clear. However, employees are the bedrock of innovation within any organization. They bring diverse perspectives, skills, and creativity that fuel the development of new products, services, and processes. This article delves into the significant ways employees influence innovation, providing a comprehensive analysis supported by ten key points. ...
[Korea] 9 in 10 Koreans support ending life-prolonging treatment: study
02/26/25 at 03:00 AM[Korea] 9 in 10 Koreans support ending life-prolonging treatment: study The Korea Times; by Kim Hyun-bin; 2/24/25 More than nine out of ten Koreans think that they would opt to forgo life-prolonging treatment if they were terminally ill, a new study has found, highlighting shifting attitudes toward end-of-life care in the country. According to a report released by the Korea Institute for Health and Social Affairs on Sunday, 91.9 percent of respondents expressed they would choose to discontinue life-sustaining treatment if they were diagnosed with a terminal illness or were nearing the end of life, based on a survey conducted last April and May on 1,021 men and women. 8.1 percent stated they would prefer to continue such treatment.
Hospice caregiver spends days with family during Arkansas winter storm
02/25/25 at 03:30 AMHospice caregiver spends days with family during Arkansas winter storm NBC News KARK - Maumelle, AR; by Neal Zeringue; 2/20/25 In icy conditions, many would not risk going up and down the steepest hills, but in-home care workers have. One in Maumelle even stayed away from home for days to be with a family on top of a dangerous hill. ... [Nelda] Michael’s husband has dementia and has had in-home care for 15 months. He needs constant attention. Because of the ice, nurses with Arkansas Hospice could not see him Wednesday, but on Thursday they were determined to give him care. However, Morgan Bartley and Michelle Kelley’s cars slid down the hill on one side of the road the Michaels live on top of. KARK 4 News found them stuck and helped them up from the other end of the road. “We were prepared to park our vehicles at the bottom and hike a mile up. Anything to get to him and to her,” Bartley said. [Click on the title's link to continue reading.]
Today's Encouragement: Not everything that is faced can be ...
02/25/25 at 03:00 AMNot everything that is faced can be changed, but nothing can be changed until it is faced. ~ James BaldwinHonoring Black History Month 2025
How OU Health's Professional Practice Model is defining nursing excellence
02/25/25 at 03:00 AMHow OU Health's Professional Practice Model is defining nursing excellence Health Leaders; by G Hatfield; 2/24/25 This model enables [Oklahoma University] OU Health to elevate nursing education, practice, and outcomes, says this CNE. ... Stefanie Beavers, DNP, RN, NEA-BC, chief nurse executive at OU Health, and HealthLeaders Exchange ... The Concept: A professional practice model, according to Beavers, is an evidence-based practice that aligns organizational values with a framework driven by research and outcomes. The goal is to elevate nursing excellence and patient outcomes, but also to solidify the identity of the organization's teams. The OU Health Nursing Professional Practice Model was developed based on the Joanne Duffy Quality Caring Model, so that the organization could take caring behaviors and integrate them into OU Health’s values.
Pennsylvania lawmaker introduces ‘No Patient Left Behind Act’
02/25/25 at 03:00 AMPennsylvania lawmaker introduces ‘No Patient Left Behind Act’ WHTM - PA Homepage; by Brady Doran; 2/19/25 A Pennsylvania lawmaker introduced a bill that would ensure hospitals have visitation policies that balance patient needs with public health protocol. According to Sen. Doug Mastriano (R-33), elderly patients left alone in hospitals experience faster physical and cognitive decline. The No Patient Left Behind Act, introduced by Mastriano, would ensure Pennsylvanians with medical treatment or end-of-life care have support by their sides. “Hospitals should be places of healing. However, for far too many, they have become places of loneliness, despair, and unnecessary suffering,” Mastriano said.
More than 900 Californians have died of the flu so far this season amid low vaccine rates, state says
02/25/25 at 03:00 AMMore than 900 Californians have died of the flu so far this season amid low vaccine rates, state saysLos Angeles Times, CA; by Lila Seidman; 2/22/25More than 900 Californians — including 15 children — have succumbed to the flu this season in what has turned out to be one of the worst surges of the respiratory illness in years, according to a report released Friday by the California Department of Public Health. Most of the influenza victims — 701 — were over 64 years old, which tracks with the conventional notion that the illness disproportionately affects older people. However, the number of children who have died has raised concerns. Four more kids died of the flu during the week ending Feb. 15, increasing the seasonal pediatric death toll by more than a third, according to the report.
US measles outbreaks: Nearly 100 people infected across two states
02/25/25 at 03:00 AMUS measles outbreaks: Nearly 100 people infected across two states MSN; by Holly Large; 2/24/25 Outbreaks of measles have been declared in both Texas and New Mexico, as health officials report that nearly 100 cases have been identified across the two states. The Texas Department of State Health Services (DSHS) has reported that as of February 21, 90 cases of measles have been identified in the South Plains region since late January, with 16 of these people having been hospitalized with the illness. According to the DSHS, the number of cases is likely to increase, “due to the highly contagious nature of this disease.”
What is death positivity?
02/25/25 at 03:00 AMWhat is death positivity? Phaneuf Funeral Homes & Crematorium, New Hampshire & Vermont; by Phaneuf; 2/19/25 Death positivity is a growing movement that challenges the long-held taboos surrounding death. Rather than shying away from the subject, death positivity encourages individuals and communities to discuss mortality openly. It’s about accepting death as a natural part of life, reducing the fear and stigma often associated with it, and using that acceptance as a foundation for better end-of-life planning and living more fully. Historically, many cultures—including those in the New England region—often treated death as a private, somber affair. Today, however, a new narrative is emerging: one that celebrates the life lived, honors the memories left behind, and helps families make informed, compassionate decisions about the future.
Patients without family or health care proxies face overtreatment or limbo in hospitals
02/25/25 at 03:00 AMPatients without family or health care proxies face overtreatment or limbo in hospitals WHYY - PBS; by Maiken Scott; 2/24/25 A program matches unrepresented patients with volunteers who can make care decisions for them during health care crises. ... [Intensive care physician David] Oxman says unrepresented patients are a small, but growing group. Some have outlived their family members, or are estranged from them. Maybe they’ve moved a lot, sometimes substance use or homelessness plays a role. The situation is especially complicated with patients who have dementia, or who can’t communicate their wishes for other reasons. ... Most states have provisions where medical guardians and medical decision makers can be appointed by a court, but that takes a long time. In the meantime, a search for relatives begins. David Sontag, director of ethics for Beth Israel Lahey Health in Massachusetts, ... created a matching program where health care professionals volunteer to represent patients, not within their own hospital systems because that could cross ethical boundaries, but at other hospitals. “This is an opportunity for us to help some of the most vulnerable members of our communities, those who have nobody to speak for them when they can no longer speak for themselves. And that allows us to respect their autonomy throughout their lives,” he said.
