Literature Review

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

Complications of gastrostomy tube placement in patients with dementia: A national inpatient analysisSurgical Endoscopy; Spencer R. Goble, Thomas M. Leventhal; 6/25Gastrostomy tubes have not been shown to improve long-term outcomes in patients with dementia, yet the risk of short-term complications have not been well characterized in this population. Conclusions: Gastrostomy tube placement complications do not appear to be increased in patients with dementia. However, those who undergo gastrostomy tube placement are less likely to discharge to home which has important quality of life implications.

Physician Orders for Life-Sustaining Treatment in rural VirginiaSage Open Aging; Pamela B Teaster, E Carlisle Shealy; 6/25Physician Orders for Life-Sustaining Treatment (POLST) arose in 1991 to improve end-of life-care for patients with advanced, chronic, and progressive illnesses whose death is imminent within a year. POLST attempted to address problems inherent in advance directives (e.g., poor completion rates, confusing form language, dismal communication with a surrogate). POLST exists in all U.S. states, although each is unique and uptake is inconsistent, particularly in rural areas. The purpose of this study was to investigate current practices and barriers around POLST in a rural area using an online survey and interviews with practitioners. Findings included the need for consistent funding, clarification of goals, and greater and varied opportunities for staff training.

Parental authority and the weight of assent: Navigating moral dilemmas in adolescent end of life careJournal of Bioethical Inquiry; A. L. Heifner, M. M. Ortiz, T. L. Major-Kincade, C. O’Connor; 6/25 In the current era of moral pluralism, medical decisions must account for much more than clinical considerations: they must abide by legal standards of decision-making which usually prioritize parental preferences. Conflict abounds between the parent or other legal decision-maker and healthcare team in situations where the parent prefers not to disclose the severity of the adolescent’s illness or the healthcare team believes continuing lifesaving therapies are not in the adolescent’s best interest. These dilemmas challenge how we solicit adolescents’ preferences (assent) and their options for refusal (dissent). We explore the moral distress healthcare workers face navigating conflict amongst various stakeholders involved in the adolescent’s end-of-life care. Strategies to minimize moral distress are also provided.

Quality indicators and patient outcome measures for palliative care in cancer patients: A systematic reviewEcancermedicalscience; Chase Peng Yun Ng, Moira Hegyi, Grant Lewison, Tania Pastrana, Eve Namisango, James Cleary, Barbara Hasties, Eric Kabisa, Helena Musau, Kathryn Spangenberg, Paola Ruiz, Zipporah Ali, Mertixell Mallafre-Larrosa, Alfredo Polo, Julie Torode, Ajay Aggarwal, Richard Sullivan, Mevhibe Hocaoglu; 6/25With the exponential rise in global cancer incidence, the surge in demand for palliative care has outstripped capacity, limiting patients' access to quality and holistic palliative care, especially in low- and middle-income countries. There is an overall lack of standardisation of QIs [quality indicators] and POMs [patient outcome measure], as well as variability in evidence of palliative care research. We recommend that stakeholders collaborate to develop a standardised repository of metrics for monitoring and evaluating palliative care services at both individual and system levels, with a particular focus on structural and process indicators. Incorporating validated, patient-centred measures and selecting key items as quality indicators will enable meaningful tracking of changes, guiding resource allocation and driving improvements in patient-centred care.

[Canada] Electronic decision support for deprescribing in older adults living in long-term care-A stepped-wedge cluster randomized trialJAMA Network Open; Emily G. McDonald, MD, MSc; Justine L. Estey, MSc; Cody Davenport, MSc; Émilie Bortolussi-Courval, RN; Jeffrey Gaudet, MSc; Pierre Philippe Wilson Registe, MSc, MPH; Todd C. Lee, MD, MPH; Carole Goodine, PharmD; 5/25Potentially inappropriate prescribing (PIP) occurs when medications that carry a higher risk of harm than benefit are prescribed. It occurs more often among older adults in the setting of polypharmacy (taking multiple medications) and is costly and harmful. PIP and potentially inappropriate medications (PIMs) contribute to excess adverse drug events, such as falls, fractures, cognitive decline, hospitalization, and death [and] the problem is more pronounced for older adults living in nursing homes (long-term care [LTC] homes). Depending on the screening criteria used, in some studies, the prevalence ranges from 67.8% to 87.7% of nursing home residents. Electronically generated, individualized reports that contained prioritized opportunities for deprescribing in older adults were paired with preexisting quarterly medication reviews [and] this study found that electronic decision support paired with the usual workflow could render the deprescribing process scalable and effective.

Saturday newsletters focus on headlines and research - enjoy!

[Norway] iLIVE volunteer study: Volunteer and healthcare professional perceptions of newly developed hospital end-of-life-care volunteer services, in five countriesPalliative Medicine; Tamsin McGlinchey, Stephen Mason, Grethe Skorpen Iversen, Dagny Faksvåg Haugen, Inmaculada Ruiz Torreras, Pilar Barnestein Fonseca, Miša Bakan, Berivan Yildiz, Ruthmarijke Smeding, Anne Goossensen, Agnes van der Heide, John Ellershaw; 5/25Volunteer services that provide direct support to patients receiving palliative and end-of-life care in hospitals are new and developing, but little is known about the use and experience of such services from key stakeholders. 20 Volunteers and 20 healthcare professionals were recruited. Three overall themes were generated: (1) Volunteers provided 'unique, distinct, 'community' support' bringing familiarity to an unfamiliar, medically focussed environment. (2) Volunteers were able to 'establish a connection centred on 'being there' within the acute hospital environment' despite the fast paced and highly changeable environment. (3) Through 'relational interactions adapted to the individual person' volunteers attended to patients' existential and emotional needs. These services confer benefits that are transferrable across cultures and countries, 'fusing' formal care with the informal visiting of family or friends, attending to patients' existential needs.

Executive Personnel Changes - 7/16/25 

Medicare telehealth trends: Information on telehealth use by Medicare Fee-for-Service beneficiaries Data.CMS.gov; Centers for Medicaree & Medicaid Services; 7/16/25 Data update frequency: Quarterly Latest data available: Q4 2025The Medicare Telehealth Trends dataset provides information about people with Medicare who used telehealth services between January 1, 2020 and December 31, 2024. The data were used to generate the Medicare Telehealth Trends Report.

Charlie’s Angels Quilting Group donates 2,000th quilt to hospice MIdland Daily News, Midland, MI; by Jhyrah DeLapp; 7/17/25 Charlie’s Angels Quilting Group has donated its 2,000th handmade quilt to United Hospice Service of Aspire Rural Health System. Since 2007, every quilt made by the group has been uniquely designed, featuring a wide variety of colors, patterns and textures. Each quilt bears a thoughtful label that reads: “May this blanket bring you peace and comfort.” ... The group is made up of dedicated men and women from Huron, Sanilac and Tuscola counties. It was founded 18 years ago by Brenda Miller of Bad Axe in memory of her brother, Charlie Kiehl, who received care at the Hospice Residence in Marlette. After Charlie’s passing in 2007, Brenda and her family were deeply touched to receive a handmade quilt from the hospice team. Inspired by that act of kindness, she began gathering friends and family to create quilts for future patients, launching what would become Charlie’s Angels Quilting Group.

Silver tsunami brings new challenges for end-of-life care NPR Network, KANW New Mexico Public Radio; by Jenny Kinsey; 7/16/25 ... Inhora isn’t a hospice but it describes itself as a social model hospice house that provides a place to be. The nonprofit opened in April and contracts with several local hospice providers to provide end of life support. ... Inhora gets its support through donations and volunteer help which enables their guests to stay for free. That’s the idea behind Inhora, said Miles Gloetzner, RN, Inhora’s founder and Executive Director. ... Investigating the idea led him to the Omega Home Network, a national network of comfort care homes, and other communities with the same mission bringing comfort and caring to those at the end of life . That’s when he realized his dream was not his alone. A comfort care home or social model hospice house provides free room and board for patient/guests and a family member or friend while they receive hospice care. ... Comfort homes like Inhora are found across Mountain West states, including Colorado, Nevada, Utah, Idaho, and Wyoming. The idea isn’t new. For instance, the Omega Home Network was founded in 2003 in Tulsa, Oklahoma. It is a national organization of 50 comfort care homes – and growing rapidly with 79 in development.

Agrace opens western Wisconsin office in La Crosse WisBusiness, La Crosse, WI; Press Release; 7/16/25 Agrace continues its rapid growth across the state of Wisconsin with the opening of a new office in La Crosse, a western-Wisconsin city of 52,000 located along the Mississippi River. Since its founding in Madison, Wis., in 1978, Agrace has provided exceptional care for the state’s residents who are in the final months of life. The new Agrace location gives residents of La Crosse County greater choice for high-quality, in-home hospice care. County residents can enroll with Wisconsin’s largest nonprofit hospice to receive hospice care that comes to them where they live—in private homes, long-term care facilities or any other place they call home.