Literature Review

Early electronic advance directives reduce burdensome end-of-life care News Medical & Life Sciences | Wiley; 5/20/26 Advance directives document patient preferences for future care, including end-of-life. An analysis in the Journal of the American Geriatrics Society found that older patients with an advance directive that had been uploaded into the electronic health record at least six months before death were 25% less likely to experience potentially burdensome end-of-life care (19.9% versus 26.8%) and 31% less likely to have died in the hospital (23.2% versus 32.1%).

CMS enrollment moratoria: CHOW implications for home health and hospice transactions JD Supra; by Arnall Golden Gregory LLP; 5/22/26 ... Although the announcement has significant implications for new HHA and hospice entrants, the practical impact on change of ownership (“CHOW”) transactions is narrower: the moratoria should affect only those CHOWs that are treated as new initial enrollment under the Medicare “36-month rule.” ...Key Takeaways

Van Duyne introduces the "Protecting Seniors and Stopping Fraudsters Act" to enact mandatory oversight requirements to combat hospice and home healthcare fraud Congresswoman Beth Van Duyne, Washington, DC; Press Release; 5/19/26 ... Since 2023, Rep. Van Duyne (TX-24) has been a recognized leader on the issue of exposing and stopping hospice and home healthcare fraud. ... This week, Rep. Van Duyne introduced new legislation, the Protecting Seniors and Stopping Fraudsters Act, to strengthen Medicare oversight, crack down on bad actors, protect seniors from fraudulent enrollments, and improve accountability across the hospice and home health system. ... [Read the full bill]Summary and Key Provisions: ... The bill is designed to move Medicare oversight from a reactive model to a proactive one by identifying bad actors earlier, particularly in geographic hotspots where provider growth far exceeds patient growth. It targets providers with aberrant billing, discharge, enrollment, or low-quality reporting patterns rather than imposing blanket burdens across the industry. ... [Continue reading] ...

Ways and Means: Approved policies fight fraud in critical safety net programs United States House Committee on Ways & Means - Chairman Jason Smith, Washington, DC; Press Release; 5/22/26 Ways and Means Republicans advanced anti-fraud legislation after months of hearings that revealed the extent of fraud and mismanagement in vital programs like Medicare, Temporary Assistance for Needy Families (TANF), and unemployment insurance. ... [Go directly to the Ways & Committee press release on Friday 5/22/26, with information and links below to their Fact Sheet for each newly approved policy.] 

Veterans Day 2026: recent articles in the newsHospice & Palliative Care Today; compilation by Joy Berger; 5/22/26

Voluntarily stopping eating and drinking (VSED) with hospice support in America: A case seriesJournal of Pain and Symptom Management; by Hope A Wechkin, Elizabeth T Loggers; 5/26Despite increasing public awareness of voluntary stopping of eating and drinking (VSED), there are no descriptions of the clinical course of US patients who pursue VSED, with or without hospice support... We employed retrospective chart review methodology to review a consecutive case series of 20 patients who requested and received hospice support for VSED... While this study has significant limitations, VSED was completed by all who initiated the process and death generally occurred within 10 days. Therefore, those initiating VSED should be considered eligible for hospice care, with care initiated quickly. Symptoms during VSED were typical of hospice patients and can be managed using common hospice techniques and medications.

Ketamine for depression in serious illness: Evidence, safety, and practical approachesJournal of Pain & Symptom Management; by Paul Noufi, Joshua B. Borris, Danielle Chammas, Cara L. McDermott, Nneka N. Ufere, Jason A. Webb, Daniel Shalev; 4/26Patients with serious illness and short prognoses often experience depression and suicidal ideation. Traditional antidepressants are limited by delayed onset, creating a need for rapidly acting therapies. Ketamine and esketamine [nasal spray] offer the strongest evidence among rapid-acting antidepressants and may be preferred when urgent symptom relief is needed. However, rigorous psychiatric trials in serious illness are lacking. Clinicians should consider prognosis, access to Risk Evaluation and Mitigation Strategies-certified esketamine programs or equivalent regulatory frameworks outside the US, and the need for an appropriate maintenance regimen when integrating ketamine into palliative care depression management.

[Ireland] Developing a reflective practice program to support oncology and palliative care staff with patient deathJournal of Palliative Medicine; by Geena Kelly; 4/26Oncology and palliative care staff frequently encounter death yet often lack structured opportunities for reflection following these experiences. Oncology and palliative care staff in an Irish acute hospital collaboratively developed a structured reflective practice program to support coping with patient death. Using insider-action research, this pilot study demonstrates a feasible, staff-led approach to embedding reflective practice into routine clinical practice.  The project has contributed an adaptable model for structured reflection in the acute hospital setting and underscores the importance of acknowledging the emotional toll of caring for patients at the end of life. This is an important step towards embedding reflective practice into the culture of health care, with potential for future AR cycles to build on this work even more, involving greater numbers of staff and further evaluating the intervention’s effectiveness.  

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