Literature Review
"Ask us anything": A framework for understanding bereaved children's questions about illness, dying, and grief
08/08/26 at 03:40 AM"Ask us anything": A framework for understanding bereaved children's questions about illness, dying, and griefPalliative Care & Social Practice; by Ceilidh Eaton Russell, Liana Bailey, Ashwini Pugazhendhi, Karleigh Sutton, Sandra Twiner Ross, Joanna Humphreys; 7/26Grieving children may wonder about questions of illness, dying, and death as they navigate the death of, or grief for, someone who matters to them. Parents and caregivers, as well as health and psychosocial clinicians frequently report feeling uncertain and unprepared to engage in these conversations even if they are aware of their helpfulness. Interested in examining the questions bereaved children wonder about, this study analyzed 710 anonymous questions submitted by children aged 5-17 during Ask Us Anything sessions at a bereavement camp in Ontario, Canada between 2009 and 2024. Question focuses (i.e., what it says about the core topic) spanned across: Body, Condition, Dying and Death, Grief, while question functions (i.e., what it says about what the person seeks to understand about the topic) spanned: How it Works, Catch, Cause, Cure, Care, Connect. Children's questions can be helpful windows into what their grief experiences are like and what their emotional, existential, and/or informational needs are within this experience.
Ethical implementation of organ donation following medical assistance in dying: Recommendations of the ethics committee of the Transplantation Society
08/08/26 at 03:35 AMEthical implementation of organ donation following medical assistance in dying: Recommendations of the ethics committee of the Transplantation SocietyTransplantation; by Kristof Van Assche, Johannes Mulder, Curie Ahn, Richard D M Allen, Jan Bollen, Katrina A Bramstedt, Patrizia Burra, Patrick Cras, Kumud Dhital, Ian Dittmer, Beatriz Domínguez-Gil, James Downar, Riadh A S Fadhil, Patrick Ferdinande, John L R Forsythe, Marie-Chantal Fortin, Michael A Freeman, Rik T Gerritsen, Kim E Grayson, Andrew Healey, Alex Kazemi, Vivek B Kute, Dominique E Martin, Diethard Monbaliu, Elmi Muller, Alejandro Nino-Murcia, Gert Olthuis, Helen I Opdam, Brendan Parent, Alicia Pérez Blanco, Sam D Shemie, Marion Siebelink, Amina Silva, Vanessa Silva E Silva, Hans P Sonneveld, Peter G Stock, Rankie Ten Hoopen, Carrie Thiessen, Walther van Mook, Dirk Van Raemdonck, Anji E Wall, Matthew J Weiss, Larna Woodyatt, Dirk Ysebaert, David Thomson; 7/26Medical assistance in dying (MAiD) is legally permitted in a growing number of jurisdictions ... Organ donation following MAiD offers patients an opportunity to address transplant needs as a final act of altruism, but it also raises complex ethical questions that require strong safeguards to protect patients, professionals, and public trust.We identified key ethical issues and safeguards by analyzing guidelines and protocols from the 6 countries where organ donation following MAiD is performed: Australia, Belgium, Canada, the Netherlands, New Zealand, and Spain. Three domains of ethical concern emerged: (1) safeguarding the integrity of patients' decision-making (voluntariness, informed consent, and how and when information is presented); (2) ethical governance of donation following MAiD (adherence to the Dead Donor Rule, death determination, and consent for premortem interventions); and (3) implications for care relationships and professional practice (end-of-life impacts, recipient information and donor anonymity, and professional support, including conscientious objection). Key recommendations include clear and consistent policies; a patient-centered, nondirective approach; rigorous eligibility and voluntariness assessments; and strict separation between MAiD and donation/transplantation teams.
Aging and end-of-life care planning among transgender and nonbinary individuals: A systematic review
08/08/26 at 03:30 AMAging and end-of-life care planning among transgender and nonbinary individuals: A systematic reviewLGBT Health; by Ginger H Kwak, G Nic Rider, Emily A Paine, Walter O Bockting, Steven A John; 7/26The objective of this review was to identify perceptions of end-of-life (EOL) care needs among transgender and nonbinary (TNB) individuals. We identified five major themes during thematic analysis: fear of discrimination in long-term care facilities, fear of loss of independence, maintaining social circles with aging, obstacles to EOL logistics, and what defines successful aging. Additional subthemes included fear about loss of identity, preference for euthanasia versus loss of identity, participation in EOL planning, and advance care plan/will completion. Psychosocial aspects were the most substantial barriers to successful EOL planning.
Short-term and long-term opioid prescribing by specialty, 2010 to 2024
08/08/26 at 03:25 AMAn objective trigger for early palliative care in severely injured trauma patients
08/08/26 at 03:20 AMMandatory mortality surprise question screening in the ED: Identification and associations with end-of-life care outcomes
08/08/26 at 03:15 AMMandatory mortality surprise question screening in the ED: Identification and associations with end-of-life care outcomesJournal of Palliative Medicine; by Nancy Kim, Karen Jubanyik, Peiyuan Liu, Giselle O'Connor, Ling Han, Rohit B Sangal, R Lynn Fiellin, Jennifer Kapo, Elizabeth Prsic, Shelli Feder; 7/26Early identification of patients with serious illness remains challenging in the emergency department (ED), where clinical decisions are made under time constraints. The mortality surprise question (MSQ) is a brief prognostic screen that may help identify patients needing end-of-life services. Results: Among 113,397 admissions (74,816 patients), MSQ completion was 100%; 7.8% received a "No" response. A "No" response was strongly associated with increased palliative care consultation ... , ACP documentation ... , hospice referral ... , comfort-measures-only orders ... , hospice disposition ... , higher inpatient mortality ... , and increased 30-day readmission ... Palliative care consultation occurred earlier among MSQ "No" than MSQ "Yes" encounters.
Opportunities for improving end-of-life care for veterans receiving hospice in community nursing homes
08/08/26 at 03:10 AM"It felt like throwing in the towel": Family caregiver perspectives on end-of-life decision making in chronic obstructive pulmonary disease
08/08/26 at 03:00 AM"It felt like throwing in the towel": Family caregiver perspectives on end-of-life decision making in chronic obstructive pulmonary diseaseJournal of Palliative Medicine; by Natalia Smirnova, Tivona Batieste, Sarah H Cross, Samir Jamdar, Catherine S Peterson, Camille P Vaughan, Dio Kavalieratos; 7/26Chronic obstructive pulmonary disease (COPD) has an unpredictable trajectory and high symptom burden, complicating end-of-life (EOL) decisions around place of death and hospice use. We conducted semi-structured interviews with bereaved caregivers of people with COPD who received pulmonary care at a U.S. academic center and died within 12 months. Fifty-six percent of decedents received hospice; 33% died at home. Caregivers described five themes: missed prognostic cues and poor communication; hospice as both loss and relief; home as ideal but hospital as default; financial influences on decisions; and mismatch between hospice and COPD needs. Caregivers identified a readiness gap driven by prognostic uncertainty, communication challenges, and financial constraints.
Private equity ownership in hospice care: a systematic review (2012-2026)
08/08/26 at 03:00 AMPrivate equity ownership in hospice care: a systematic review (2012-2026) American Journal of Hospice and Palliative Medicine; by Denise D. Quigley, PhD, MA, Shannon Walsh, MPP, Cordt T. Kassner, PhD, Lara Dhingra, PhD, and Andrew W. Dick, PhD; 7/28/26 Hospice care is associated with improved end-of-life outcomes. Recent shifts in hospice utilization highlight several key trends. Alzheimer’s disease and related dementias (ADRD) (25%) have surpassed cancer (23%) as the leading primary diagnosis. Concurrently, industry ownership has transitioned from predominantly nonprofit to for-profit (70%) and private equity (PE) ownership has grown dramatically from 3% to 15%. To date, no study has synthesized evidence on PE ownership in hospice care. We conducted a systematic review of English-language, peer-reviewed studies published 2012-2026, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
[Greece] Patient-reported outcome measures in palliative care: A systematic review to inform health policy and health system performance
08/08/26 at 03:00 AM[Greece] Patient-reported outcome measures in palliative care: A systematic review to inform health policy and health system performanceHealth Policy; by Maria Katharaki, Christos Triantafyllou, Julie Ling, Joao Breda; 7/26Health systems increasingly recognise palliative care as an essential component of universal health coverage. Assessing palliative care quality and value remains challenging, as key outcomes are often missed by routine indicators. Patient-reported outcome measures (PROMs) can address this gap, but their use remains fragmented. Seventy studies were included. The most commonly used PROMs were the Integrated Palliative Care Outcome Scale (IPOS), Edmonton Symptom Assessment Scale (ESAS), and the EORTC QLQ-C15-PAL instrument. Implementation challenges included patient frailty, workload and time constraints, limited standardisation, and poor integration into clinical workflows and health information systems.
Saturday newsletters
08/08/26 at 03:00 AMSaturday newsletters focus on headlines and research - enjoy!
When I was a boy and I would see scary things in the news, my mother would say to me...
08/08/26 at 03:00 AMWhen I was a boy and I would see scary things in the news, my mother would say to me, "Look for the helpers. You will always find people who are helping.” ~Fred Rogers
LATE vs Alzheimer’s: Biomarkers, Mixed Dementia, and Clinical Realities with Nate Chin and Sterling Johnson
08/07/26 at 03:00 AMLATE vs Alzheimer’s: Biomarkers, Mixed Dementia, and Clinical Realities with Nate Chin and Sterling Johnson GeriPal; podcast by GeriPal with Sterling Johnson and Nate Chin; 8/6/26 Up until just a couple years ago, an 85-year-old patient presenting with gradual, amnestic memory loss was almost automatically presumed to have Alzheimer’s disease. However, new biomarkers and the recognition of conditions like Limbic-predominant age-related TDP-43 encephalopathy (LATE) are reshaping our understanding of cognitive decline in older adults. It’s looking more clear that pure Alzheimer's dementia is rare in older adults, and co-occurring pathologies that may include Alzheimer’s, LATE, Lewy Body, and vascular neuropatholigies, are the rule rather than the exception. ... Sterling Johnson is a clinical neuropsychologist and researcher who leads the CLARiTI study, which is attempting to uncover the intersecting causes of dementia. Nate Chin is the medical director and Clinical Core Co-Leader for the Wisconsin Alzheimer’s Disease Research Center (ADRC), the host of the Dementia Matters podcast, and author of a new book When Memory Fades.
Hospice Coalition Questions and Answers: June 25, 2026
08/07/26 at 03:00 AMHospice Coalition Questions and Answers: June 25, 2026Palmetto GBA; 8/4/26Includes Coalition questions, Hospice Appeals Reports, and Hospice CAP Updates.
If you think you are too small to make a difference, try ...
08/07/26 at 03:00 AMIf you think you are too small to make a difference, try sleeping with a mosquito. ~ Dalai Lama
Additional CMS website information for the Hospice Wage Index Final Rule
08/07/26 at 03:00 AMAdditional CMS website information for the Hospice Wage Index Final RuleCMS
Executive Personnel Changes - 8/7/26
08/07/26 at 03:00 AMExecutive Personnel Changes - 8/7/26
Why you should care about the shakeup at NIH: Sean Morrison, Ken Covinsky, Stacy Fischer
08/07/26 at 03:00 AMWhy you should care about the shakeup at NIH: Sean Morrison, Ken Covinsky, Stacy FischerGeriPal podcast; by Alex Smith, Eric Widera, Sean Morrison, Ken Covinsky, Stacy Fischer; 6/18/26Emergency Podcast! Our guests Sean Morrison, Ken Covinsky, and Stacy Fischer believe that you should care deeply about the proposed shakeup at the National Institutes of Health. Major proposed rules changes at the Office of Management and Budget, would affect a huge range of government grants, from Headstart to Transportation to the National Science Foundation, as well as the National Institutes of Health (NIH), the subject of today’s podcast.
Chapters Health finalizes Housecall Providers affiliation
08/07/26 at 03:00 AMChapters Health finalizes Housecall Providers affiliation Hospice News; by Holly Vossel; 8/5/26Chapters Health System has recently completed its affiliation with Oregon-based Housecall Providers. The two organizations penned an agreement to affiliate in February. The move will allow Chapters to significantly expand geographically and grow its value-based services, the organization indicated. Housecall Providers offers hospice, advanced illness care and home-based primary care. ... Chapters Health System has recently completed its affiliation with Oregon-based Housecall Providers. The two organizations penned an agreement to affiliate in February. The move will allow Chapters to significantly expand geographically and grow its value-based services, the organization indicated. Housecall Providers offers hospice, advanced illness care and home-based primary care.
CMS offers guidance on expanding PACE program to rural areas
08/07/26 at 03:00 AMCMS offers guidance on expanding PACE program to rural areas McKnights Home Care; by Marissa Fernandez; 5/3/26 The National PACE Association praised recent guidance from the Centers for Medicare & Medicaid Services, which offered up mobile health clinics and using funding from the Rural Health Transformation Program as two main ways to expand the Program of All-Inclusive Care for the Elderly to rural areas. ... Mobile health clinics were identified as acceptable alternative care settings as long as they meet applicable local, state and federal health care facility regulations and documentation clearly labels it a mobile unit. CMS also offered guidance to states on using RHT funding for PACE organizations.
Elder mistreatment prevention and solutions: Carrie Rubenstein, Julia Hiner, & Tony Rosen
08/07/26 at 03:00 AMElder mistreatment prevention and solutions: Carrie Rubenstein, Julia Hiner, & Tony RosenGeriPal podcast; by Alex Smith, Eric Widera, Carrie Rubenstein, Julia Hiner, Tony Rosen; 6/4/26Today we revisit a topic we last discussed in a 2020 podcast with Laura Mosqueda: elder mistreatment. Our guests today are geriatricians Carrie Rubenstein and Julia Hiner, and Tony Rosen, an emergency medicine doctor. They talk about where we are now, in 2026, with elder mistreatment...
Elisabeth Kübler-Ross at 100: a legacy that changed how the world faces death
08/07/26 at 03:00 AMElisabeth Kübler-Ross at 100: a legacy that changed how the world faces deathe-hospice; by Ken Ross and Stephen Connor; 7/13/26 On July 8, the world marked the 100th anniversary of the birth of Dr. Elisabeth Kübler-Ross, the Swiss American psychiatrist whose work helped transform how clinicians, families, faith communities, and societies understand death, dying, grief, and compassionate care. Born in Zurich in 1926, Kübler-Ross entered medicine at a time when dying patients were often kept at the margins of care—physically present in hospitals, yet too often emotionally abandoned. She challenged that silence with a simple but radical act: she listened. Sitting at the bedside of people facing the end of life, she heard their fears, hopes, anger, questions, and need for honesty. In doing so, she insisted that dying people were not medical failures, but human beings with voices, wisdom, and dignity. Her landmark 1969 book, On Death and Dying, grew from interviews with seriously ill patients and introduced a language that reshaped modern conversations about loss.
VITAS Healthcare enhances mobile app to simplify hospice referrals and improve access to care
08/07/26 at 03:00 AMVITAS Healthcare enhances mobile app to simplify hospice referrals and improve access to carePR Newswire, Miramar FL; by VITAS Healthcare; 8/5/26VITAS Healthcare announced the launch of its enhanced mobile app, a digital platform designed to streamline hospice referrals and expand access to trusted hospice care resources for healthcare professionals, patients and families across the country. The VITAS Healthcare mobile app brings hospice referrals, eligibility tools and expert-developed education into one secure, mobile-friendly experience. By making it easier to submit referrals and access hospice guidance anytime, anywhere, the app helps support timely, informed decision-making in moments that matter most.