Literature Review

Blessed is the season which engages the whole world in a conspiracy of love. ~Hamilton Wright Mabie

When the nurse becomes the daughter: Lessons from my father's final daysAmerican Journal of Hospice & Palliative Care; by Keshia R Brown; 11/25Military service demands sacrifice, but no professional challenge prepared me for the deeply personal experience of caring for my father at the end of his life. This experience transformed my understanding of nursing by revealing the profound impact of presence, love, and dignity-centered care. Caring for my father illuminated the intersection of professional skill and personal devotion, demonstrating that the heart of nursing extends beyond clinical interventions. It resides in honoring the whole person and offering unwavering compassion in their most vulnerable moments. This narrative reflects on the emotional, ethical, and spiritual lessons learned as I walked my father through his final chapter-an unexpected gift and the greatest honor of my nursing career.

Staying connected: A longitudinal, multisite, interprofessional rural fellowship collaborationJournal of Pain & Symptom Management; by Rhianon R. Liu, Rebecca N. Hutchinson, Stephen H. Berns, Nastasha Stitham, Jackie Fournier, John W. Wax MD , Lisa A. Stephens, Jonathan S. Jolin, Maxwell T. Vergo; 11/25Four interprofessional Hospice and Palliative Medicine (HPM) fellowship programs in rural northern New England states created an in-person educational retreat series. The goal of the series was to maximize shared educational resources and foster community amongst faculty and fellows, in an upstream attempt to improve recruitment/retention of clinicians in three rural states with inadequate access to specialty palliative care. At least 88% of fellows rated the retreats effective in strengthening their clinical, communication, teamwork, and leadership skills. Over four-fifths of faculty and fellows felt the retreats increased their sense of belonging and decreased professional isolation. The retreats were a top factor influencing fellowship choice for 29% of fellows, as well as a major incentive to remain practicing in the region for 32% of faculty.

Self-efficacy change among diverse family caregivers in dementia care The Journals of Gerontology Series B; by Deborah M Oyeyemi, Erich J Greene, Yunshan Xu, David R Lee, Rafael Samper-Ternent, Maya L Lichtenstein, Alan Stevens, Jeff D Williamson, Arun S Karlamangla, Debra Saliba, David B Reuben; 11/25Objectives: to determine whether changes in caregiver self-efficacy (beliefs about one’s ability to manage dementia-related problems and access help) differed by caregiver race and ethnicity across all participants enrolled in a large pragmatic trial of comprehensive dementia care. Black, Latino, and White dementia caregivers reported similar improvements in caregiver self-efficacy after participating in a comprehensive dementia care trial. Caregiver self-efficacy change did not differ significantly by caregiver race and ethnicity. Personalized aspects of comprehensive dementia care appear to address the needs of diverse caregiver populations.

Palliative care specialist use among Medicare decedents who had poor-prognosis cancersJAMA Network; by Isaac S. Chua, Haiden A. Huskamp, Ateev Mehrotra, Andrew D. Wilcock; 7/25Has specialty palliative care (PC) use among Medicare decedents who had cancers with poor prognoses changed in the context of greater telehealth use and more advanced practice clinicians in the field? In this cohort study..., the proportion with specialty PC use increased 24% from 2018 to 2023 [from 30% to 37%], largely driven by outpatient encounters and care by advanced practice clinicians. Decedents who were older, had lower incomes, and were living in nonmetropolitan areas remained less likely to receive any PC... These findings suggest that different strategies are needed to increase PC use among some disadvantaged subpopulations.Publisher's Note: Similar to Hua's article (Validation of a claims-based algorithm for specialist palliative care delivery in metastatic cancer), palliative care specialists were defined as those with NPI provider specialty code 17 or those who  included an ICD-10 Z51.5 code on at least 80% of their evaluation and management encounters.

Validation of a claims-based algorithm for specialist palliative care delivery in metastatic cancerJournal of Pain and Symptom Management; by May Hua, Zhixin Yang, Ling Guo, J Brian Cassel, R Sean Morrison, Guohua Li; 11/25The lack of valid methods to identify specialist palliative care (PC) delivery in population-level data impedes comprehensive understanding of its use... We developed a claims-based algorithm to identify specialist PC, using a physician billing claim from a known PC clinician as the gold standard, retaining candidate variables with a positive predictive value (PPV) >60%... A simple algorithm can identify receipt of specialist PC care in Medicare claims for patients with metastatic cancer with reasonable accuracy.Publisher's Note: While this is a statistically sophisticated article, findings support use of the palliative care provider specialty code (Provider Specialty Code 17) and encounter for palliative care code (ICD-10 Z51.5) to identify specialist palliative care delivery in a specific population (Medicare beneficiaries with metastatic cancer claims).

Clarification: Dr. Byock reached out to clarify that the fee-for-service performance margins he cited are from 2020. He regrets not making that clear in the paper. He’s been made aware of recently updated figures from 2023 that reflect significantly diminished margins of 13.7% for for-profits and -1.3% for non-profits (MedPAC 12/5/25). This reflects a serious downward trend that obviously threatens non-profits hospice providers. This dangerous trend highlights the need for strenuous efforts to shift to quality-based competition, making success in the marketplace dependent on demonstrated quality of care and outcomes, particularly patient-family experience.

Hospice Savannah launches Certified Nursing Assistant Training Program Savannah Tribune, Savannah, GA; Press Release; 12/17/25 Hospice Savannah is proud to partner with Senior Citizens, Inc. and Savannah Technical College to launch the Edel Caregiver Institute’s Weekend Certified Nursing Assistant Training Program. ...  Open to all community members, the program provides full CNA accreditation through Savannah Tech and will include specialized dementia and elder-care skills training. For those who qualify, scholarships are available offering tuition assistance, CAT Bus vouchers, childcare support, discounted meals, and immediate employment opportunities with Hospice Savannah or Senior Citizens, Inc. upon successful completion and certification.Editor's Note: This innovative CNA Training Program was awarded a $50,000 grand from Savannah Philanthropic Partners, under the leadership of President/CEO Kathleen Benton.

MAID: Medical Aid in Dying - Should Medical Aid in Dying be legal? Britannica; by The Editors of ProCon; 12/16/25

The real holiday miracle is fitting everything into one suitcase and still finding the Wi‑Fi password.

25 years of progress: ELNEC and AACN transforming palliative nursing education Journal of Hospice & Palliative Nursing - JHPN / HPNA; by Cassandra Godzik, PhD, APRN, CNE, Deborah Trautman, PhD, RN, FAAN, Robert Rosseter, MBA, MS, FAAN, Pamela Malloy, MN, RN, FPCN,Jennifer DiBenedetto, PhD, APRN, Polly Mazanec, PhD, AOCN, ACHPN, FPCN, FAAN; 12/25 In the year 2000, leaders with the American Association of Colleges of Nursing joined with Dr. Betty Ferrell and her colleagues at City of Hope to address gaps in how nurses are educated to care for patients at the end-of-life and their families. ... To date, more than 1.7 million nurses have been educated with the ELNEC curriculum, and more than 1200 undergraduate and 440 graduate schools of nursing offer ELNEC training in palliative end-of-life care. The remarkable academic-practice partnership at the heart of ELNEC has dramatically changed nursing care for patients with serious illnesses and their families in the United States and globally. ... Editor's Note: As ELNEC celebrates its 25th anniversary, we honor a leadership legacy that has transformed nursing education and elevated end-of-life care worldwide. What began as a visionary collaboration between AACN and Dr. Betty Ferrell at City of Hope has become a global standard—preparing nurses for clinical excellence, compassionate presence, and interdisciplinary care. With deep appreciation, we celebrate Dr. Betty Ferrell, ELNEC, AACN, City of Hope, and the leaders who continue to champion this vital work forward.