Literature Review

Illness, and poetry, can transform usJAMA; Rafael Campo, MD, MA; 1/25... just as illness may alter our bodies and minds in unknowable ways, so can poetry subject us to the unexpected—through metaphor, imagery, and form—and thus can be indispensable as a guide to those in medicine seeking to provide empathetic care. Poetry becomes transformational, the shape-shifting text itself embodying the seemingly incomprehensible, making the father’s dementia and the speaker’s sense of grief, anger, and loss ultimately palpably human. Though perhaps readers can’t fully grasp the experience of Alzheimer disease, or losing one’s parent to its ravages, through poetry we can feel restored and heartened by its transformative power, “saying yes yes/we could live anywhere.”

Medicaid unwinding experiences in dual-eligible older adultsJAMA Health Forum; Renuka Tipirneni, MD, MSc; Wendy Furst, MA; Dominic A. Ruggiero, MPH; Dianne C. Singer, MPH; Erica Solway, PhD, MSW, MPH; Erin Beathard, MPH, MSW; Syama R. Patel, MPH; Andrei R. Stefanescu, PhD, MS; Jeffrey T. Kullgren, MD, MS, MPH; John Z. Ayanian, MD, MPP; Eric T. Roberts, PhD; 1/25This US national survey of low-income older adults found varying awareness of and experiences with the Medicaid unwinding process and identified cost-related access barriers among those who recently lost Medicaid. By 9 to 10 months into the unwinding process, few older adults reported hearing a lot about Medicaid unwinding and many reported not receiving any communication about needing to renew Medicaid eligibility. By the time of our survey, slightly less than half of respondents had completed a Medicaid renewal. Although the proportion of respondents who said they lost Medicaid in the last 6 months was relatively low, those who lost Medicaid were more likely to report cost-related difficulty getting care. These findings highlight the importance of addressing informational and navigational barriers among dual-eligible older adults to avoid disruptions in Medicaid coverage that may contribute to difficulties accessing care. 

Interoception, cardiac health, and heart failure: The potential for artificial intelligence (AI)-driven diagnosis and treatmentPhysiological Reports; Mahavir Singh, Anmol Babbarwal, Sathnur Pushpakumar, Suresh C Tyagi; 1/25"I see, I forget, I read aloud, I remember, and when I do read purposefully by writing it, I do not forget it." This phenomenon is known as "interoception" and refers to the sensing and interpretation of internal body signals, allowing the brain to communicate with various body systems. Dysfunction in interoception is associated with cardiovascular disorders. In the context of HF [heart failure], AI algorithms can analyze and interpret complex interoceptive data, providing valuable insights for diagnosis and treatment. By leveraging patient data, AI can personalize therapeutic interventions.

The role of health care stereotype threat in end-of-life planning among older sexual minority adultsInnovation in Aging; Meki Singleton; 12/24Healthcare stereotype threat (HCST), defined as “the threat of being reduced to group stereotypes within healthcare encounters”, may occur when social identities negatively impact healthcare experiences. Prior research has shown that individuals report experiencing HCST related to age, gender, weight, race/ethnicity, HIV status, and sexual orientation. Findings demonstrate that HCST may negatively impact comfort in healthcare decision-making while also potentially motivating older SM [sexual minority] adults to formally engage in ACP [advance care planning]. Research is needed to investigate the barriers and challenges to engaging in ACP among older SM adults and interventions to reduce HCST. 

Disproportionate use of aid in dying among people with ALS: Why ALS aid-in-dying requests are common while ALS is rareJournal of Aid-in-Dying Medicine; Carolyn Rennels, MD; Steven Z. Pantilat, MD FAAHPM, MHM; Ambereen K. Mehta, MD, MPH, FAAHPM; Allison Kestenbaum, MA, MPA, BCC-PCHAC, ACPE; Kelsey Noble, DO; Jessica Besbris, MD; Ali Mendelson, MD; Kara Bischoff, MD; 12/24People with amyotrophic lateral sclerosis (ALS) disproportionately use aid in dying. We explore aspects of the ALS experience that may help explain the higher rates of aid-in-dying requests in this disease relative to others. In particular, the desire to maintain control is prominent in the face of a relentlessly progressive disease that results in substantial disability. We also describe how the requirement for self-administration of aid-in-dying medications impacts people with ALS.

Requests for medical assistance in dying by young Dutch people with psychiatric disordersJAMA Psychiatry; Lizanne J.S. Schweren, PhD; Sanne P.A. Rasing, PhD; Monique Kammeraat, BSc; Leah A. Middelkoop, MSc; Ruthie Werner, MSc; Saskia Y.M. Mérelle, PhD; Julian M. Garcia, MD; Daan H.M. Creemers, PhD; Sisco M.P. van Veen, MD, PhD; 1/25This cohort study found that the number of young psychiatric patients in the Netherlands who requested MAID-PS [medical assistance in dying based on psychiatric suffering] increased between 2012 and 2021 and that applications were retracted or rejected for most. Those who died by MAID or suicide were mostly female and had long treatment histories and prominent suicidality. These findings suggest that there is an urgent need for more knowledge about persistent death wishes and effective suicide prevention strategies for this high-risk group.

[Sweden] The process of pain assessment in people with dementia living in nursing homes: A scoping reviewPalliative Care and Social Practice; Caroline Kreppen Overen, Maria Larsson, Adelheid Hummelvoll Hillestad, Ingela Karlsson, Siren Eriksen; 1/25Studies have documented a pain prevalence in people with dementia living in nursing homes of 35%–43%, but a possible prevalence of 60%–80%. This scoping review provides a comprehensive description of pain assessment in people with dementia living in nursing homes as a process in three steps. Self-reported information is the most appropriate when assessing pain, as symptom experience is subjective and highly personal. However, for people with dementia living in nursing homes, self-reporting represents a challenge due to cognitive impairment, including difficulties with language and communication. People with dementia might express pain with different behavioural expressions or signs, such as agitation, apathy, restlessness or wandering. Numerous observational assessment tools targeting pain in people with dementia have been developed and evaluated and systematic use of standardized observational tools has been recommended.

Clarinda health center honors Fulks for family donation Maryville Forum, Clarinda, IO; 1/22/25 The Clarinda Regional Health Center announced last week that the recent remodel of its hospice suite and family room was made possible through a donation from the Jimmy and Lora Lea Fulk family. According to a news release from the hospital, the transformed space is a lasting tribute to the Fulks, reflecting on their values of faith, family and perseverance. The renovation, funded by Joyce Fulk Whitney, Dale Fulk, Alice Fulk Wisner and Nancy Fulk McKinnon in honor of their parents, ensures that the hospice suite and family room are not only more functional, but also provides a sanctuary for those in need of comfort and solace, the news release stated. 

Executive Personnel Changes - 1/24/25

Health policy at a crossroads: What to watch in 2025Health Affairs; by Katie Keith; 1/21/25This article is the first in a new Health Affairs Forefront featured topic, “Health Policy at a Crossroads.” Articles in this topic will offer timely analysis of prominent regulatory, legislative, and judicial developments in health policy... 2025 could mark a major inflection point in health policy. Over the past four years, among many other changes, the nation rebounded from a once-in-a-generation pandemic; the uninsured rate reached a record low—with record enrollment across Medicare, Medicaid, and the Affordable Care Act marketplaces; Medicare beneficiaries began to see savings on prescription drugs; overdose deaths dropped; and women lost the right to reproductive choice under the US Constitution, leading to abortion bans in more than 20 states less than three years since the Supreme Court overturned Roe v. Wade.

Caring for communities in needHospice Foundation of America email; 1/22/25Hospices can play a significant role in supporting communities in the aftermath of natural disasters and other tragic situations. This program will feature speakers from western North Carolina, who will share lessons learned and response strategies they employed to support families, patients, staff, and first responders while faced with death, flooding, mudslides, property destruction, and communication and power outages caused by Hurricane Helene.Presenters include Chris Comeaux, Vern Grindstaff, and Sheila Crane.

Barry Goldberg, blues-rock keyboardist whose work with Bob Dylan included controversial Newport '65 Concert, dies at 83 [with hospice care] Variety; by Chris Willman; 1/23/25 Barry Goldberg, a blues-rock keyboard player whose work with the Paul Butterfield Blues Band led to playing with Bob Dylan in the 1960s, including the notorious 1965 Newport Folk Festival concert dramatized in "A Complete Unknown," died Wednesday [1/23] at 83. Bob Merlis, a representative, said that Goldberg died in hospice care after a 10-year struggle with non-Hodgkin lymphoma, with his wife of 53 years, Gail Goldberg, and son, Aram, at his bedside.