Literature Review

Emergency physicians and hospice & palliative medicine: A growing trend in fellowship trainingJournal of Pain and Symptom Management; by Alexander Zirulnik, Caroline Meehan, Daniel Markwalter, Jennifer Gabbard, Alyssa Tilly, Paul Zimmerman, Jensy Stafford, Justin Brooten; 9/25Emergency Medicine (EM) has played a foundational role in Hospice and Palliative Medicine (HPM) since the subspecialty's formal recognition. EM is one of the fastest-growing sources of applicants to HPM fellowships, reflecting rising recognition of palliative care's value in acute care. This trend has important implications for workforce planning, specialty integration, and the future of dual-trained EM-HPM clinicians.

Communication surrounding treatment preferences for older adults with dementia during emergency medical services responseJournal of the American Geriatrics Society; by Lauren R. Pollack, Danae G. Dotolo, Anna L. Condella, Whitney A. Kiker, Jamie T. Nomitch, Elizabeth Dzeng, Nicholas J. Johnson, Thomas D. Rea, May J. Reed, Michael R. Sayre, Erin K. Kross; 9/25Emergency Medical Services (EMS) providers, capable of rapidly delivering life-prolonging interventions, are often first to respond to acute health concerns for older adults in the United States. Prior work has shown a preference among many people with dementia for comfort-focused care near end-of-life. EMS providers treating critically ill older adults with dementia face challenges that may hinder their ability to elicit treatment preferences, in particular when responding to calls from professional caregivers. Direct communication with surrogate decision-makers may facilitate goal-concordant care.Assistant Editor's note: Being an RN for over 40 years, I have seen many changes in health care, especially in what is expected now of patients/families. I remember the day when nurses were not permitted to share with the patient his/her own BP reading; instead, we were to tell patients to "ask the doctor". Back then the doctor controlled almost all aspects of the patient's care, as well as the sharing of information with the patient about his/her own medical condition. I am glad those days are gone. Now, patients are expected to engage in ongoing discussions regarding advance care planning, execute written advance directives, and are expected to share their care preferences with health providers and loved ones and/or caregivers. It would be an ideal world where health care providers were continuously aware of evolving patient preferences and could always deliver goal concordant care. I believe we need to keep working toward this goal, but I also understand that this expectation can add burden to patients who are already extremely burdened with the many difficult aspects of serious illness. I believe that, as health care providers, we need to appreciate that some people simply cannot or will not share their preferences; it is simply too scary, too foreign, too difficult to do so.

Landmark verdict awards over $510 million to Saint Mary’s Health Network Business Wire, Reno, NV; by Noel True and Mark Reece; 10/2/25 In a historic decision with national implications for healthcare, a Washoe County jury awarded Saint Mary’s Health Network, affiliate of Prime Healthcare, over $510 million in damages, including punitive damages, after finding Universal Health Services of Delaware, Inc. (UHS) and affiliated defendants liable for fraud, malice, and oppression in a coordinated scheme against Saint Mary’s Health Network during the height of the COVID-19 pandemic. ... “This verdict delivers a resounding message for all of healthcare: integrity and compassion must guide every decision we make,” said Sunny Bhatia, M.D., President of Prime Healthcare. 

Welcome to fall top news stories September 2025 Teleios News Stories (TCN); pod/videocast hosted by Chris Comeaux with Cordt Kassner; 10/1/25As the seasons shift, so do the conversations shaping Hospice and Palliative Care.  In this week’s episode, host Chris Comeaux and Hospice data expert and co-host Cordt Kassner explore the latest headlines, challenges, and innovations impacting Hospice and Palliative Care. ... Covering a range of topics, including the impact of AI on Hospice Care, the importance of end-of-life visits, and the challenges of Hospice utilization trends.  Also highlights significant events and stories from the Hospice community, such as the launch of a new nursing scholarship program and the impact of Hurricane Helene one year later.

Grieving someone who’s still here Psychology Today; by Bob Uslander, MD; 10/2/25 Grief does not always begin after death. For many families facing dementia, terminal illness, or a slow decline, it arrives before the final goodbye—quietly, persistently, and often without recognition. This is known as anticipatory grief: the emotional process of mourning a loved one who is still alive. As a palliative care physician, I see this every day. Spouses tell me they feel like they have already lost their partner. Adult children struggle with the reversal of roles, becoming the caregiver to the parent who once cared for them. Caregivers often oscillate between love, exhaustion, guilt, and detachment. None of this means they are doing it wrong. It means they are grieving.

Visiting Nurse Association rejects Cape Cod Healthcare's latest contract proposal Cape Cod Times, Hyannis, MA; by Desiree Nikfardjam; 10/2/25 Visiting Nurse Association of Cape Cod registered nurses have voted "overwhelmingly" to reject Cape Cod Healthcare's contract offer that was proposed on Sept. 11, according to a press release. The offer was the "last, best, and final" from Cape Cod Healthcare, according to the statement. The nurse association members are represented by the Massachusetts Nurses Association. ... The Visiting Nurse Association's nurses provide essential home health and hospice care to patients across Cape Cod and the Islands and had previously voted 96% in favor of authorizing a three-day strike if progress at the bargaining table was not made.

Chico nurses at Enloe Health to hold rally to protest closure of home health and hospice units National Nurses United; Press Release by the California Nurses Association/National Nurses United; 10/1/25 ... Nurses are calling on the hospital to protect the health of some of Chico’s most vulnerable patients and maintain the essential services and end-of-life care provided by these units.  “For years, Enloe hospice stood alone in providing care for underserved Medi-Cal patients and for our youngest, most fragile patients—children at the end of life,” said Ruby Khoury, registered nurse in the hospice unit. “A vital, compassionate service is being taken away, and a hospital that once led with dignity and inclusivity in hospice care now faces a painful void. We nurses demand that the home health and hospice units remain open. Otherwise, the most vulnerable will suffer first: children, Medi-Cal patients, families without resources.”

Awards and Recognitions: September 2025

CMS issues memo with contingency plans for state survey & certification activities in the event of federal government shutdown CMS - Center for Clinical Standards and Quality; by CMS Directors, Quality, Safety & Oversight Group (QSOG) and Survey & Operations Group (SOG); 10/1/25 On October 1, 2025, CMS issued QSO-26-01-ALL identifying State Survey and Certification functions that (a) are not affected by a Federal shutdown, (b) excepted functions that are to be continued in the event of a shutdown (also referred to as “essential functions”), and (c) other activities that are directly affected and therefore should not be operational during a Federal shutdown. CMS also clarified that Hospice Surveys funded through the Consolidated Appropriations Act (CAA) of 2021are considered mandatory and are not impacted by the Federal Government shutdown. Work funded under these sources should continue.

Confidential conversations in palliative care: An ethnographic exploration of trust and interpersonal relationship between nurse and patient Journal of Clinical Nursing; by Tove Stenman, Bodil Holmberg, Ylva Rönngren, Ulla Näppä, Christina Melin Johansson; 9/30/25 Confidential conversations in palliative care are grounded in fragile, dynamic trust, necessitating ongoing presence, sensitivity and adaptability from RN. To support these interactions, healthcare environments must prioritise privacy, relational continuity and communication training. Future research should investigate how organisational structures and clinical settings influence confidential conversations. ... Healthcare environments should facilitate confidential conversations by ensuring relational continuity and minimising distractions. Communication training that emphasises presence and management of silence can strengthen nurse–patient relationships, enhancing patient care and emotional support.

Home health industry welcomes CMS’ repeal of nursing home staffing mandate Home Health Care News; by Joyce Famakinwa; 9/20/25 Earlier this month, the Centers for Medicare & Medicaid Services (CMS) drafted a rule that would repeal the federal staffing mandate for nursing homes – a move that would send ripple effects through the home health industry. The rule was controversial among nursing home operators, but it also received pushback from home health providers who were concerned that the mandate would lead to further staffing scarcity. “The repeal is positive for home health agencies,” Katy Barnett, director of home care and hospice operations and policy at LeadingAge, told HHCN in an email. 

Human judgment: The magic ingredient for making AI work across aging services disciplines McKnights Senior Living; by Kimberly Marselas; 9/29/25 From tackling a scabies outbreak in a long-term care facility to scheduling shifts and helping write plans of correction that satisfy regulators, a range of aging services providers are eagerly already putting artificial intelligence to work. But what is it not doing for them? Taking the place of human staff members, their workplace knowledge or their clinical judgment. That was a resounding takeaway of a recent McKnight’s Tech Summit webinar exploring how AI technologies are supporting care teams role by role.