Literature Review

Discontinuation of medications with limited benefit at end of life in community-dwelling older veteransJournal of the American Geriatrics Society; by Joshua M Thorpe, Kelvin A Tran, Sherrie L Aspinall, Shelli L Feder, Brystana G Kaufman, Ann Kutney-Lee, Maria K Mor, Loren J Schleiden, Florentina E Sileanu, Carolyn T Thorpe, Courtney H Van Houtven; 4/26Discontinuation of medications with limited benefits (LBM) in patients nearing the end of life can reduce burden, adverse events, and costs, and enhance quality of life. However, most research on end-of-life prescribing has focused on nursing homes or hospice settings. [This study setting was] community-residing, non-hospice older veterans. Among community-dwelling older veterans in their final year of life, 73% were receiving at least one LBM at the start of that year, and 78% of these individuals continued LBM use until death. These rates parallel those reported in long-term care populations and underscore the need for community-based healthcare providers to routinely screen for LBMs and support appropriate medication discontinuation in older patients with advanced illnesses and limited life expectancy.

NPHI statement on “Protecting Patients and Taxpayers: Cracking Down on Medicare Fraud” hearingNational Partnership for Healthcare and Hospice Innovation, Washington, DC; Press Release; 4/22/26 The National Partnership for Healthcare and Hospice Innovation (NPHI) supports the continued focus by Congress and the Administration on addressing fraud, waste, and abuse within the Medicare hospice benefit. NPHI’s policy team, led by Ethan McChesney and joined by Quin Lyons, attended the House Ways & Means Full Committee hearing titled “Protecting Patients and Taxpayers: Cracking Down on Medicare Fraud,” on April 21, reinforcing NPHI’s active engagement on this issue. ... “Fraud in hospice is not a theoretical concern – it is happening in real time, and patients and families are paying the price,” said Tom Koutsoumpas, Founder and CEO of NPHI. “We are seeing entire markets impacted by actors who have no connection to the communities they claim to serve. These fraudulent actors must be rooted out of the system — at once."

[Canada] Palliative Care Coalition of Canada (PCCC) Blueprint for Action 2025-2030 Palliative Care Coalition of Canada (PCCC); 4/24/26 The Palliative Care Coalition of Canada (PCCC) released the Blueprint for Action 2025–2030, a national roadmap that identifies key priorities needed to ensure that more people in Canada have access to high-quality, culturally safer, and affordable palliative care. 

Not just California: A national hospice ‘Blue Book’ is needed to fight fraudThe Hill; by Robin Heffernan; 4/22/26Congress has finally decided to wade into the deep waters of hospice fraud in California. That is a good thing. But what members need to know is that this problem is not new, and it is not confined to one state. What’s more, enforcement alone will not solve it — what is desperately needed is more prevention... What is missing is a so-called “Blue Book” for the hospice industry — an ongoing, up-to-date reference of providers and their quality performance, to distinguish high-quality providers from those that should not be in the program. The data for this already exists. Claims patterns, visit reliability, length of stay, revocation rates and patient experience can make outliers visible early. Unfortunately, that information is not consistently surfaced or used at the point where decisions are made.Publisher's note: I wholeheartedly agree with Robin’s insightful article and strongly encourage everyone to explore the National Hospice Locator. This valuable resource represents a meaningful step forward in improving access to compassionate end-of-life care. Also, Robin has participated in several Teleios Collaborative Network TCNtalks podcasts. [Robin Heffernan is co-founder and chief executive of Empassion Health.]

1520ai and Hospice Analytics announce strategic combination to advance data-driven hospice care and AI innovation1520ai & Hospice Analytics press release; by Mark Cohen, Ernesto Lopez, Cordt Kassner; 4/28/261520ai and Hospice Analytics today announced that Hospice Analytics will become part of 1520ai and the broader simPAL Solutions family, bringing together Hospice Analytics’ hospice data expertise with 1520ai’s vision for a new generation of hospice-native AI capabilities designed to help providers turn data into better decisions and improved care. Hospice Analytics will maintain its core branding, products, and services while operating as part of 1520ai. Founder and longtime leader Cordt Kassner will continue to lead operations and guide the organization’s ongoing work with hospice providers across the country. “This builds on Hospice Analytics’ long-established foundation of innovation, expertise, and reliability,” said Ernesto Lopez, CEO of 1520ai. “Cordt and his team have earned deep trust in the hospice community by turning complex data into meaningful, actionable insights. Together, we have an opportunity to integrate AI into that work and create tools that help hospice leaders make better decisions, improve operations, and support better care for patients and families.”

No debt, ideal weight, 8 hours of sleep, mental health on track, right nutrition, zero alcohol. This was my peak. I was 8. ~Unknown

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!

Interventions for bereavement-What works, what does not, and what mightJAMA Psychiatry; by Charles F. Reynolds III, Holly G. Prigerson, M. Katherine Shear, Sidney Zisook; 4/26The 2025 publication commissioned by the Agency for Healthcare Research and Quality (AHRQ) of a systematic review of “Interventions to Improve Care of Bereaved Persons” provides a timely opportunity to continue—and to deepen—a conversation of great importance about the universal experience of grief and its burdens, both personal and related to public health. The report was prepared at the Southern California Evidence-Based Practice Center in Los Angeles; it aimed to review available evidence on screening, diagnosing, and treating children and adults with grief disorders related to bereavement. The Substance Abuse and Mental Health Services Administration convened an independent subject matter advisory panel to assess the feasibility of developing standards for high-quality bereavement and grief care.  

Communication processes and priorities in Medical Aid in Dying conversations: A cross-sectional qualitative study of multidisciplinary cancer cliniciansCancer Medicine; by Meghan McDarby, Alix Youngblood, Megan Miller, William E Rosa, Haley Buller, Betty R Ferrell; 4/26Medical aid in dying (MAiD) is a practice that enables eligible individuals with a terminal, life-limiting illness to end their lives in a self-directed way. Multidisciplinary care teams play a vital role in facilitating discussions and patient decision making about MAiD in cancer care settings. Four themes were identified as communication priorities and processes critical for multidisciplinary teams when discussing MAiD with cancer patients: (1) addressing complexity of MAiD ... ; (2) thorough palliative care assessment; (3) strategies for clinicians and healthcare systems to optimize MAiD discussions; and (4) person-centered care that de-stigmatizes MAiD. Findings underscore the distinct complexity of MAiD discussions in oncology and highlight the need for tailored, person-centered approaches that go beyond standard end-of-life communication.

[Singapore] Factors associated with caregiver burden among family caregivers of patients on home-based palliative care: A systematic reviewPalliative Medicine; by Wei-Ling Koh, Jerrald Lau, Chermaine Ang, Choon Meng Yee, Sara Ho, Ker-Kan Tan; 4/26Home hospice services are increasingly central to palliative care as more patients express preference for care or death at home. In these settings, the role of family caregivers becomes crucial.  Heterogeneity across studies highlighted uniqueness of patient-caregiver dyads on caregiver burden - for instance, family caregivers with multiple social roles may face heightened pressure from meeting patients' care demands. Other factors include logistical, financial or care arrangement matters. Caregiver burden interventions should adopt multi-pronged approaches to ensure holistic support for patients and family caregivers, such as incorporating both medical and psychosocial support to enhance wellbeing of both parties.

Saturday newsletters focus on headlines and research - enjoy!

[New Zealand and Australia] Most palliative care doctors back research into psychedelic medicines for end of life careNews Wire; 4/12/26A survey of palliative care doctors in New Zealand and Australia has found overwhelming support for more research into psychedelic medicines for patients facing terminal illness, adding weight to growing calls for a regulated pathway that would allow clinicians to explore what some researchers describe as transformative treatments. The study, which surveyed 93 palliative care physicians across both countries, found 88 per cent agreed that clinical use of psychedelic medicines for palliative patients warranted further investigation. [The source article referenced is Perceptions of Australasian palliative care physicians regarding the safety and efficacy of psychedelic medicines: An exploratory mixed-methods study; Psychedelics; by Nicholas Sawers, Michael Billingsley, David B. Menkes; 6/1/26.]