Literature Review
VA announces expanded burial benefits for those under VA-provided hospice care
07/20/25 at 03:25 AMVA announces expanded burial benefits for those under VA-provided hospice care Tri-State Alert; by Staff Report; 7/11/25 The Department of Veterans Affairs announced today it has temporarily expanded burial benefits for certain Veterans, per the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act. The new law specifies eligible Veterans are those who are discharged from VA-provided medical or nursing care to receive VA-provided hospice care at their home and who pass away between July 1, 2025, and Oct. 1, 2026. Previously, Veterans who died at home under VA hospice care after discharge from VA-provided medical or nursing care were not always eligible for a full VA burial allowance. The Dole Act addresses that gap.
With new facility, Mourning Dove Grief Care expands help for survivors of loss
07/20/25 at 03:20 AMWith new facility, Mourning Dove Grief Care expands help for survivors of loss Oil City News, Casper, WY; by Dan Cepe; 7/16/25 Death can be natural, or it can be cruel and unexpected. It is, however, an inevitable part of the human experience that can affect survivors in countless ways possibly for the remainder of their lives. ... Mourning Dove Grief Care, a service by Central Wyoming Hospice & Transitions, aims to provide that help to members of the community. ... The [new] facility will allow anyone in the community suffering from loss to walk in and schedule appointments or join a support group, whether they’ve gone through Hospice or not. The program itself started when Hospice noted the need for grief care in the community, particularly for people suffering from sudden losses. “Interestingly enough, we found that even therapists and counselors were referring to us when they had clients dealing with loss,” she said.
Hosparus Health plans to create end-of-life care center
07/20/25 at 03:10 AMHosparus Health plans to create end-of-life care center Spectrum News 1, Louisville/Lexington, KY; by Destinee Flowers; 7/16/25 Plans for Louisville’s first inpatient, standalone hospice care center are underway, as a part of Hosparus Health’s ongoing efforts to provide comfortable end-of-life care for seniors and their loved ones. ... Tawanda Owsley, Hosparus Health chief development and marketing officer [described], "We will have a 21-bed, 10,000-square-foot unit ... [and that] the new facility will replace a traditional hospital setting with a warmer one while still providing high-level clinical care. It will have private rooms to accommodate family members, bathrooms in each care room, a chapel, kitchen, children’s room and an outdoor garden area. “[Our] healing garden will be a pathway from our inpatient care center to our grief counseling center," she said. ... This end-of-life care center is the third project in Hosparus Health’s “Places of Compassion” initiative, an action to modernize hospice care in anticipation of the aging Baby Boomer population.
HOPE Summer School
07/20/25 at 03:05 AMHOPE Summer SchoolProvider Insights communication; by Annette Lee; 7/11/25Provider Insights Inc. has created a "HOPE Summer School" series, an 8-course microlearning program for our busy hospice professionals. This series is specifically designed to help hospice teams master the upcoming CMS HOPE Data Set, ensuring staff are confident and compliant. The program covers four core objectives: understanding HOPE's purpose and structure, navigating CMS documentation and reporting, building confidence in completing HOPE items with real-life examples, and meeting the Symptom Follow-Up Visit Measure. The 8 bite-sized modules (5-20 minutes each), interactive quizzes, a post -test, and 14 downloadable tools, this mobile-friendly training is perfect for busy nurses on the go. Download the HOPE Section A tool for a free sneak peek of the simple tool kit, and head over to providerinsights.com for more information and to get your organization enrolled.
Today's Encouragement - Be kind...
07/20/25 at 03:00 AMIt's embarrassing that after 45 years of research and study, the best advice I can give to people is to be a little kinder to each other. ~Aldous Huxley
Medicare fraud has gone global. It’ll take a nationwide effort to stop it
07/20/25 at 03:00 AMMedicare fraud has gone global. It’ll take a nationwide effort to stop itLos Angeles Times; by Mehmet Oz, Kim Brandt; 7/15/25Federal law enforcement recently announced a $14-billion fraud takedown — the largest healthcare fraud action in U.S. history, involving many crimes orchestrated by foreign nationals. Every American taxpayer should be alarmed not just because of the dollars at stake, but also because it reveals how vulnerable Medicare and Medicaid have become to large-scale, international exploitation... Fraud is a national problem, but it starts locally. Drive around certain neighborhoods in Los Angeles and you’ll pass what appear to be empty office buildings, which unbeknownst to neighbors could serve as hubs of criminal activity. There are more than 1,000 potentially fraudulent hospice operations identified in Los Angeles.Publisher's note: Medicare fraud is tragic - and that hospice is the highlighted provider in this story is also tragic. This article includes steps that can be taken to stop this fraud. Also, thanks to Sheila Clark, President-CEO of the California Hospice & Palliative Care Association (CHAPCA) for forwarding this article.
Sunday newsletters
07/20/25 at 03:00 AMSunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!
The Alliance’s CaringInfo Program launches new “Planning for In-Home Care” section
07/20/25 at 03:00 AMThe Alliance’s CaringInfo Program launches new “Planning for In-Home Care” section National Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 7/16/25 CaringInfo.org, a program of the National Alliance for Care at Home (the Alliance), is expanding its resources with a new website section – “Planning for In-Home Care” – as well as a brand refresh to align with its growing audience. CaringInfo provides free resources to educate and empower patients and caregivers to make informed decisions about home, serious illness, and end-of-life care and services. While CaringInfo began with a focus on serious illness and end-of-life care and support, the program’s content is expanding to provide information and resources on the full spectrum of home-based care services. ... Visit CaringInfo.org, which is free and available to all, to explore the full site as well as the new content.
Today's Encouragement
07/19/25 at 03:55 AMBe yourself; everyone else is already taken. ~Oscar Wilde
Complications of gastrostomy tube placement in patients with dementia: A national inpatient analysis
07/19/25 at 03:45 AMComplications 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.
Exploring a collective grief experience in the U.S.: Qualitative findings from older parents whose only child has died
07/19/25 at 03:40 AMExploring a collective grief experience in the U.S.: Qualitative findings from older parents whose only child has diedOmega; Yongqiang Zheng, Leslie G Wuest, Jeongah Kim, Rebecca A Rodriguez; 6/25Despite its profound physical and mental health impacts, research on the loss of an only child in later life among older U.S. adults remains scarce. This phenomenological qualitative study explores the lived experiences and meanings older bereaved parents attribute to their loss. Inductive thematic analysis revealed 6 themes: the enduring intensity of grief, significant secondary losses, feelings of isolation and alienation, the role of social support in coping, and spirituality and religion's influence on their journey. By amplifying these parents' voices, the study lays a foundation for understanding their unique grief and underscores the gaps in U.S. policy and mental health services. These findings deepen insight into an understudied population, highlighting the need for enhanced resources for older bereaved parents.
Physician Orders for Life-Sustaining Treatment in rural Virginia
07/19/25 at 03:35 AMPhysician 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.
Effectiveness of an educational intervention in enhancing end-of-life care understanding and decision-making in African Americans
07/19/25 at 03:30 AMEffectiveness of an educational intervention in enhancing end-of-life care understanding and decision-making in African AmericansPalliative & Supportive Care; Delicia Pruitt, Megan Reilly, Stephen Zyzanski, Neli Ragina; 7/25AA [African American] patients are more likely than other ethnic groups to choose life-sustaining measures at the end of their lives, leading to patients not receiving care to help them die peacefully. This decision is partly based on lack of knowledge of the available EOL [end of life] care options. An educational tool like the one developed in this study may be helpful and lessen the time of education so that physicians can answer questions at the end of the session and empower individuals and communities to take an active role in creating a culture of wellness at the EOL and decreasing morbidity.
Parental authority and the weight of assent: Navigating moral dilemmas in adolescent end of life care
07/19/25 at 03:25 AMParental 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.
Palliative video consultation and symptom distress among rural inpatients-A randomized clinical trial
07/19/25 at 03:20 AMPalliative video consultation and symptom distress among rural inpatients-A randomized clinical trialCritical Care Medicine; Marie A. Bakitas, DNSc, RN; Shena Gazaway, PhD, RN; Felicia Underwood, MSW, MPS, LICSW-S; Christiana Ekelem, BS; Vantrice T. Heard, PhD; Richard Kennedy, MD, PhD; Andres Azuero, PhD; Rodney Tucker, MD, MMM; Susan McCammon, MD, PhD; Joshua M. Hauser, MD; Lucas McElwain, MD; Ronit Elk, PhD; 7/25The triple threat of rural geography, racial inequities, and older age has hindered access to high-quality palliative care for many people in the US. Only 70% of the deep South vs 85% to 94% of the rest of the US has palliative care despite the deep South having the greatest needs due to suboptimal health care access and elevated morbidity and mortality. In this RCT [randomized clinical trial] among Black or African American and White chronically ill hospitalized adults, culturally based specialist palliative care video consultation was not associated with statistically significant reduced symptom distress compared with usual care, but there was a clinically meaningful difference ... between groups. Contrary to our hypotheses, intervention participants’ QOL [quality of life] and resource use (secondary outcomes) also were not improved. Assistant Editor's note: This study reminds us that palliative care delivered virtually, as opposed to in-person, may not be of benefit to some individuals. It also reminds us that palliative care, at its best, is delivered on an ongoing basis by a known, trusted professional, as opposed to a one-time session with a consultant.
Quality indicators and patient outcome measures for palliative care in cancer patients: A systematic review
07/19/25 at 03:15 AMQuality 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.
Collective leadership in home-based palliative care: Advancing APRN roles to enhance success
07/19/25 at 03:10 AMCollective leadership in home-based palliative care: Advancing APRN roles to enhance successHome Health Care Management & Practice; Nicole DePace, MS, APRN, GNP-BC, ACHPN; Rebecca Souza, DNP, ANP-BC, ACHPN; Therese Rochon, MA, MS, FNP-C; Paula Rego, DNP, AGPCNP-BC; Constance Dahlin, MSN, ANP-BC, ACHPN, FPCN, FAAN; 6/25Palliative advanced practice registered nurses are instrumental in responding to the opportunities and challenges in home-based palliative care through advocacy, practice, education, program development, and leading interprofessional teams. Collective leadership is proposed as a framework to address these tensions in home-based palliative care. Two cases are presented to compare and contrast collective and traditional leadership models, illustrate the role of the palliative advanced practice registered nurse leader, demonstrate how to avoid the pitfalls of a traditional leadership model, and build sustainable success through collective leadership principles. Finally, strategies to engage advanced practice registered nurses in leadership roles and address the tensions of the policy gaps in home-based palliative care are provided.
[Canada] Electronic decision support for deprescribing in older adults living in long-term care-A stepped-wedge cluster randomized trial
07/19/25 at 03:05 AM[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.
End-of-life symptoms in persons dying with advanced dementia in the community setting: Findings from IN-PEACE
07/19/25 at 03:05 AMEnd-of-life symptoms in persons dying with advanced dementia in the community setting: Findings from IN-PEACEJournal of Pain and Symptom Management; by Kurt Kroenke, Sujuan Gao, Susan E. Hickman, Alexia M. Torke, Nina M. Johnson, Amy Pemberton, Andrea Vrobel, Minmin Pan, Laura R. Holtz, Greg A. Sachs; 8/25This article characterizes symptom burden in persons with advanced dementia dying in the community who were enrolled in a 2-year trial of home-based palliative care. Symptoms did not generally worsen from enrollment to time of death and symptom severity was similar to persons with dementia dying in a nursing home.
Saturday newsletters
07/19/25 at 03:00 AMSaturday 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 countries
07/19/25 at 03:00 AM[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.
Utilization of antibiotics for the treatment of urinary tract infections in end-of-life patients
07/19/25 at 03:00 AMUtilization of antibiotics for the treatment of urinary tract infections in end-of-life patientsAmerican Journal of Hospice and Palliative Medicine; by Abigail Thomas, Lacey Davis, Allie Dolan, Rebecca Prewett; 8/25The use of antibiotics for end-of-life patients is controversial; currently there is limited guidance on the use of antibiotics in hospice patients... The purpose of this project is to examine the utilization of antibiotics for urinary tract infections (UTIs) in hospice patients... The prescribing of antibiotics in end-of-life patients is not always appropriate regardless of the PPS. This may indicate that antibiotics are initiated in asymptomatic hospice patients, and the utilization of unnecessary medications presents the risk of adverse effects.
Agrace opens western Wisconsin office in La Crosse
07/18/25 at 03:00 AMAgrace 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.
Executive Personnel Changes - 7/18/25
07/18/25 at 03:00 AMExecutive Personnel Changes - 7/16/25