Literature Review

American Academy of Hospice and Palliative Medicine Announces Pierre M. Désy, MPH, CAE, as New Chief Executive OfficerIn late July, Pierre Désy, MPH, CAE became the new CEO of the American Academy of Hospice and Palliative Medicine. Désy recently served as CEO of the Society of Gynecologic Oncology (SGO) and the Foundation for Women's Cancer (FWC), where he led the development and implementation of strategic plans, revised bylaws, improved governance models, and advanced diversity and inclusion initiatives. Désy previously held executive leadership roles with the International Association of Oral and Maxillofacial Surgeons (IAOMS) and the Emergency Nurses Association (ENA). He has also served as a management consultant and coach, supporting healthcare associations and professionals in improving performance and achieving excellence. Désy said, "I am particularly energized to be part of an organization where I can bring together my public health background and decades of association management experience, and work alongside a team that shares my passion for building partnerships, advancing health equity, and supporting interdisciplinary collaboration to expand access to quality care. I am impressed by the work that has been accomplished by the Academy and look forward to working together to further its mission."Guest Editor Note, Ira Byock, MD: Mr. Désy’s public health background and substantial experience in executive roles of national specialty groups positions him well to lead AAHPM during this turbulent period in American healthcare. Hopefully, with his guidance the Academy will find ways to respond to the variability in access to and quality of hospice and palliative services and the widespread persistence of unmet needs among seriously ill and dying Americans.

Guest Voice: What ‘It’s a Wonderful Life’ teaches us about living with MS Multiple Sclerosis News Today; by Donald Kushner, MD; 8/15/25 Donald Kushner, MD, is a retired physician, board certified in internal medicine and hospice and palliative care. He has been living with multiple sclerosis (MS) for more than 20 years and draws on his dual perspective as both doctor and patient to explore illness, identity, and adaptation. He’s writing a book about how people with chronic illness and their support systems can better understand — and talk to — each other. ... George’s story reminds me that resilience often shows up in ordinary moments. That the life we’ve built — even with detours — is still a life of worth.

Black and white older adults’ end-of-life experiences: Does hospice use mitigate racial disparities?The Journals of Gerontology; by Clifford Ross, Brina Ratangee, Emily Schuler, Zheng Lian, Benmun Damul, Deborah Carr, Lucie Kalousová; 7/25Racial disparities in end-of-life care are well documented, but less is known about how these inequalities shape assessments of death quality. Proxies for Black decedents reported higher perceived death quality than those for White decedents, despite evidence of greater structural disadvantage. However, perceived care concordance was significantly lower among Black decedents. Hospice care was associated with improved perceived death quality for Black decedents but not for Whites. When accounting for socioeconomic and death experience controls, hospice care did not moderate perceived care concordance.

Do you care about your legacy? 54% of Americans want to leave mark on the world Study Finds, New York, NY; by StudyFindsAnalysis, reviewed by Steve Fink; 8/15/25 Getting older changes everything, including what we care about most. A new survey of 2,000 Americans reveals ...

How to estimate your EHR implementation cost: Factors that impact your budget Joyrulez; by RickD32; 8/14/25 Implementing an EHR (Electronic Health Record) system is one of the most significant investments a healthcare organization can make. Beyond the obvious benefits of digital recordkeeping—such as improved patient care, streamlined workflows, and regulatory compliance—the financial implications of EHR implementation are considerable. Understanding the factors that influence costs is essential for accurate budgeting and successful project execution. This guide will break down the key considerations, providing insights into an ehr implementation cost breakdown, the roles involved, and hidden expenses that organizations often overlook.

YoloCares: A caring coalition for California The Davis Enterprise; by Craig Dresang; 8/15/25 In his closing remarks at a 2016 stakeholder meeting, hosted by the National Academy of Medicine, Dr. Victor Dzau (academy president) said, “We need a coalition, a movement, a critical mass. We need to work together so that the whole is greater than the sum of its parts. We need to come together to develop resources for policy and communication. We need to improve our communication — to patients and families, healthcare providers, government, and the public.” His words perfectly captured the founding spirit of the Coalition for Compassionate Care of California. ... The group is a small but mighty powerhouse that works closely with healthcare systems and providers, patient advocacy groups, professional associations and policy — and lawmakers to promote high-quality care for seriously ill Californians.Publisher's note: Thanks for your editorial Craig - and a shout out to Jennifer Ballentine and the strong work she and the Coalition are doing!

Make a habit of two things - to help, or at least, to do no harm. ~Hippocrates

350 health groups urge Congress to extend Medicare telehealth MedCityNews; by Marissa Plescia; 8/14/25 A group of 350 organizations, including the American Academy of Hospice and Palliative Medicine, are urging Congress to make Medicare telehealth flexibilities introduced during the COVID-19 pandemic permanent, or at least extend them for two years. In a letter to congressional leaders, the organizations emphasize the importance of telehealth for Medicare beneficiaries, particularly those with chronic conditions or in rural areas, and highlight the potential impact on health care access and infrastructure. Guest Editor’s Note, Judi Lund Person: Unless there is Congressional action after the August recess to extend the hospice face-to-face requirement through telehealth, that option will conclude on September 30, 2025.

Ethical obligations to inform patients about use of AI toolsJAMA; by Michelle M. Mello, Danton Char, Sonnet H. Xu2; 7/25When a health care organization decides to deploy an AI tool, it should decide whether notification or consent is ethically required. To decide that disclosure is not required at the point of care is not to conclude that organizations have no transparency obligations concerning their use of AI. Two complementary steps can help discharge these obligations. First, health care organizations’ websites and written materials distributed to patients should explain how the organization uses AI to deliver better, safer, more efficient care and protect staff well-being. This kind of transparency honors patients’ desire to know how their care may be affected by AI and may help some make decisions about where to seek care. 

Improved outcomes and cost with palliative care in the Emergency Department: Case-control studyThe Western Journal of Emergency Medicine; Brandon Chalfin, Spencer M Salazar, Regina Laico, Susan Hughes, Patrick J Macmillan; 7/25This small pilot case-control study included a subset of all patients referred by emergency physicians and hospitalists for palliative care within 24 hours of registration, physically present in the ED. CONCLUSION: Embedding hybrid physicians in the ED significantly shortened hospital stays and reduced charges for seriously ill patients. A notable secondary outcome was that 26.5% of ED visits in the case group did not result in hospital admission, compared to all controls being admitted ... In addition, more cases than controls had a code status of comfort care at discharge ... These findings support the further exploration of integrating such physicians into ED settings to enhance patient care and optimize hospital resources.

Behavioral symptoms in patients with dementia are associated with care partner abusive behaviorsJournal of Elder Abuse & Neglect; by Emily LeRolland, Francesca Falzarano, Karen L. Siedlecki; 8/25Abuse of older adults with dementia is an increasingly prevalent public health concern in the United States. The current study examined whether care recipient behavioral symptoms (e.g. aggressive or agitated behaviors) predicted abusive behaviors by care partners. Results indicate that most participants reported engaging in at least one abusive behavior toward their care recipient. Behavioral symptoms in care recipients were a significant predictor of abusive behavior perpetrated by the care partner, even after controlling for a large number of covariates. Care partner depressive symptoms significantly mediated the relationship between care recipient behavioral symptoms and care partner abusive behavior. Our results suggest that physician screening for depression in care partners and referral to appropriate resources may be one avenue for decreasing the risk of abuse toward care recipients. 

Clinician and caregiver perspectives on managing dementia behaviors in hospiceMedpage Today; by Elethia W. Tillman; 7/25New research reveals a gap in training and resources for managing behavioral and psychological symptoms of dementia (BPSD) in hospice settings, impacting both patient well-being and caregiver burden. Key points include:

Proportional sedation for persistent agitated delirium in palliative care-A randomized clinical trialJAMA Oncology; David Hui, Allison De La Rosa, Jaw-Shiun Tsai, Shao-Yi Cheng, Egidio Del Fabbro, Anita Thankam Thomas Kuzhiyil, Kendra Rowe, Ahsan Azhar, Thuc Nguyen, Michael Tang, Chien-An Yao, Hsien-Liang Huang, Jen-Kuei Peng, Wen-Yu Hu, Sonal Admane, Rony Dev, Minxing Chen, Patricia Bramati, Sanjay Shete, Eduardo Bruera; 7/25Neuroleptic and benzodiazepine medications are often considered for patients with persistent agitated delirium in the last days of life; however, the risk-to-benefit ratio of these medications is ill-defined and benzodiazepine medications have not been compared to placebo. The results of this randomized clinical trial indicate that proactive use of scheduled sedatives, particularly lorazepam-based regimens, may reduce persistent restlessness and/or agitation in patients with advanced cancer and delirium in the palliative care setting.