Literature Review

AMA ‘disappointed’ in MedPAC for backing off deeper Medicare pay reform Becker's Hospital Review; by Alan Condon; 1/15/26 The American Medical Association expressed disappointment after the Medicare Payment Advisory Commission voted Jan. 15 to recommend only a modest update to Medicare physician payments for 2027, backing away from more robust reforms it had previously supported. ... “The AMA appreciates that last year’s reconciliation bill provided a temporary 2.5 percent update for 2026; however, that increase expires in 2027,” David Aizuss, MD, chair of the AMA Board of Trustees,” said in a news release shared with Becker’s. Editor's Note: Pair this with another post in today's newsletter, Alliance responds to MedPAC vote on home health and hospice payment recommendations.

Life is like riding a bicycle. To keep your balance, you must keep moving. ~Albert Einstein

"The lack of preparation compounds provider grief": Results from a needs assessment on grief training delivered to pediatric residentsClinical Pediatrics; by Erin Hickey, Erica L Jamro; 12/25Educational interventions to prepare pediatric residents to care for grieving people are rare.  Pediatric residents completed a survey conducted from March to April 2022 that assessed their experience, attitudes, skills, and knowledge of organizational support related to caring for grieving patients and families.  Despite improvements in competence with delivering difficult news with years in residency ... , only 35.7% felt competent by PGY3/4 [post-graduate year 3]. Only 19.5% of residents overall believe adequate grief support exists within their training program. Opportunities for residents to receive formal grief training are inadequate.

[Italy] End of life with psylocibin: Research, data and experienceEmerging Trends in Drugs, Addictions, and Health; by T. Re, A. Metastasio; 12/25Throughout history, mushrooms have served as a bridge for ancient populations, guiding human beings from earthly life to the "Beyond" and allowing them to "taste" this passage during their lifetime, thereby alleviating the fear of death. Recent scientific research has revealed that these ancient practices are supported by research done by leading world universities showing the effectiveness of psilocybin mushrooms in addressing fear of death, anxiety, and existential stress. The experience of guiding a person across the bridge between life and death raises intriguing questions about the nature of consciousness, the potential for communication in "non-ordinary states of consciousness" between different realms of nature, and the possibility of transcending space and time, thereby creating a new experience and continuity between life and death. Although we advocate for a wider and more accessible of use of psylocibin in the end of life we believe that more studies are necessary to identify the subjects that would benefit the most from this practice.

Integrating compassion and policy: Highlights from IAHPC Advocacy, 2025Palliative Medicine in Practice: by Katherine Irene PettusIn 2025, the International Association for Hospice and Palliative Care (IAHPC) advanced advocacy for palliative care as an ethical, clinical, and human rights imperative. As a non-state actor in official relations with the World Health Organization (WHO), the association worked across policy, faith, and professional domains to integrate palliative care into universal health coverage frameworks. This report summarizes IAHPC’s global activities from February to November 2025, including engagement at the 78th World Health Assembly (WHA), collaboration with WHO and the International Narcotics Control Board (INCB), the launch of the Leadership and Advocacy Development (LEAD2) program, and new interfaith and educational initiatives.Assistant Editor's note: As I peruse peer reviewed journals to bring you relevant and current summaries of research, I am amazed at the large number of articles published now about palliative care. It wasn't this way just a few years ago. As a long-time hospice and palliative care nurse, I am delighted to see the ground swell of interest in the principles, the need, the value, and the effectiveness of palliative care. I feel like 'We Have Arrived' (finally!). Kudos to all of you who have worked tirelessly over many years to educate professionals and the public at large, about palliative care and its virtues. I know we are not done; there is more to do. But we've come a long way baby!

Video conversation aids to assist in goals-of-care discussions with older adults in a medical setting: A systematic reviewAmerican Journal of Hospice & Palliative Care; Ashna S Karpe, Mokunfayo O Fajemisin, Stephanie Martinez Ugarte, Lara Ouellette, Martin L Blakely, Gina H Khraish, Shreyans V Sanghvi, Min J Kwak, Jessica L Lee, Lillian S Kao, Thaddeus J Puzio; 12/25Goals-of-care (GOC) discussions align medical treatment with older adults' preferences, yet are hindered by communication barriers, provider discomfort, and misinformation. Video-based decision aids improve understanding and reduce decision conflict, though data on their use in older populations remain limited. Video variability and differences in measured outcomes limited comparisons and generalizability. Video-based decision aids show promise for improving knowledge and aligning treatment preferences. Further studies are needed to investigate the impact of video-based decision aids on GOC conversations in older adults in acute care settings.

Expanding the boundaries of palliative care: Diseases of the nervous system and survival prognosis in home-based programsAmerican Journal of Hospice & Palliative Medicine; by Mônica Isaura Corrêa, Igor de Oliveira Claber Siqueira, Sonia  Souza, Eduardo Bruera, Ana Paula Drummond-Lage; 12/25Home-based palliative care (HBPC) is increasingly recognized as an essential strategy for managing patients with non-oncologic and life-limiting conditions. However, prognostic factors influencing survival in this population remain underexplored. Diseases of the nervous system (DNS) were the most frequent referral diagnoses [in this study] (32.3%). Patients with Alzheimer’s disease and related dementias demonstrated longer survival than those with other DNS or no DNS diagnoses ... While PPS [Palliative Performance Scale] remains a useful tool, its discriminatory capacity was modest, underscoring the need for refined prognostic models in non-oncologic palliative care.

Why asking about “critical abilities” is misguided: Lessons learned from the updated Serious Illness Conversation Guide Journal of General Internal Medicine; by Joel Michael Reynolds, PhD and Michael Pottash, MD, MPH; 1/20/26 The Ariadne Labs’ Serious Illness Care Program is a care delivery model that aims to improve conversations between patients and their clinicians about serious illness. This is accomplished through its foundational tool: the serious illness conversation guide. ... As of 2022, the Serious Illness Care Program has a footprint in over 44 countries and in all 50 states. The conversation guide had been translated into over 13 languages and nearly 18,000 clinicians had been trained on its use. In 2023, the Serious Illness Care Program released an updated conversation guide. ... Gone was the future-oriented question about critical abilities: “What abilities are so critical to your life that you can’t imagine living without them?” A more present-focused question about activities replaced it: “What activities bring joy and meaning to your life?” ... The revision of the Serious Illness Conversation Guide signals more than a semantic change. Its revision of the critical abilities question instead reflects a deeper reckoning with the ethical limitations of traditional advance care planning and with the import of disability bioethics. 

Winter weekend storms: Off the grid United States power outage tracker USAToday.com; real-time data map; updated every 15 minutes  USA Today provides a real-time U.S. Power Outage Tracker that aggregates data from more than 1,000 utility companies nationwide. This interactive map updates automatically every 15 minutes, offering near–real-time visibility into outages as severe weather and blizzard conditions unfold. Editor's Note: Share, save, and bookmark this resource. Use it to stay ahead of power disruptions in your service areas. For leaders in affected or high-risk regions, final preparations today can reduce harm this weekend. Assess and review with your leaders and teams (especially newer employees): 

‘Death Cafe’ will explore end-of-life issues, over refreshments OC Register, Orange County, CA; by Teri Sforza; 1/21/26 The Orange County Deathworkers Alliance wants to chat about your inevitable demise. Yes, members say, they’re a blast at parties! The Alliance is not a grief support group exactly, but a collection of caregivers, doulas, doctors, organizers and the like who help folks get a grip on the details attendant to their own mortality, and/or the mortality of loved ones. ... Death Cafés are a global movement, allowing people to discuss the oft-taboo thoughts and questions they have about the end of life. Organizers say the format encourages folks to share personal stories, explore their feelings and/or simply listen to other perspectives in a supportive atmosphere.

Patients' perceptions of autonomy in palliative care: Two patient interview exemplars Palliative Care and Social Practice; by Kristen Tulloch, Julia Acordi Steffen, John P Rosenberg; 1/19/26 Results: Four themes were identified: (a) my involvement in healthcare decisions, (b) change to my autonomy during illness progression, (c) self-assessing my abilities to exercise autonomy and (d) my coping mechanisms for loss of autonomy. Palliative care patients perceived and managed their autonomy amidst their illnesses, revealing a sense of loss of autonomy extending beyond healthcare into many daily activities. Participants wished to exercise autonomy in nuanced ways, varying in intensity across many aspects of their lives, underscoring the importance of recognising and respecting individuals' wishes for autonomy.Editor's Note: The authors’ focus on coping with loss of autonomy is essential. As illness progresses, autonomy can erode not only in medical decisions but across daily life, identity, and meaning—losses that are too often overlooked in clinical care. The frequently misapplied “Five Stages of Grief” can further blur this reality, reducing complex, personal experiences to linear expectations not supported by contemporary grief research. Understanding how patients adapt to loss of autonomy is foundational to truly person-centered palliative care.