Literature Review
Hospice was meant to offer dignity in death - but it fails the most marginalized. We need hospice programs that go to the streets, into shelters, behind bars
12/25/25 at 03:10 AMHospice was meant to offer dignity in death - but it fails the most marginalized. We need hospice programs that go to the streets, into shelters, behind barsSTAT; by Christopher M. Smith; 8/26/25I’ve spent more than a decade in hospice care, sitting at the bedsides of people facing the final days of their lives. I’ve held hands in hospital rooms, in tents, in prison cells, and in homes that barely qualify as such. And over time, I’ve come to see that dying in America is not just a medical event - it’s a mirror. It reflects everything we’ve failed to do for the living. Hospice was created to bring dignity to the dying - to manage pain, provide emotional and spiritual support, and ease the final passage for people with terminal illness. But the systems surrounding hospice care are riddled with inequity. The very people most in need of compassion - the unhoused, the incarcerated, people of color, LGBTQ+ individuals, and people with disabilities - are systematically excluded, underserved, or erased. Access to a good death is too often reserved for the privileged, while everyone else is left to navigate a system that wasn’t built for them - or worse, actively works against them... The truth is, hospice care cannot achieve its mission unless it actively addresses the inequities built into the structures around it. We need hospice programs that go to the streets, into shelters, behind bars. We need training rooted in cultural humility, in antiracism, in trauma-informed care. We need to reimagine what it means to offer dignity to someone whose life has been defined by abandonment. That work won’t come from quarterly board meetings or compliance audits. It will come from listening - really listening - to those most affected. It will come from rethinking how we define “home,” “caregiver,” and “worthy.” It will come from a shift in focus: from profits to people, from efficiency to empathy, from “standard of care” to standard of justice... Because dying is universal. But justice, even at the end of life, is still not.Publisher's note: STAT also references Dr. Ira Byock's article "The hospice industry needs major reforms. It should start with apologies, 8/22/23".
A doctor’s tumor rupture upends all she thought she knew
12/25/25 at 03:05 AMA doctor’s tumor rupture upends all she thought she knewMedscape Nurses; by Rana Awdish as told to Sarah Yahr Tucker; 3/17/25At some point, every doctor becomes a patient. For many physicians, experiencing serious illness and treatment is humbling, eye-opening, and, in the end, transformative. Dr. Patient is a Medscape series telling these stories... I was 7 months pregnant and it was my last day of fellowship. I went to dinner with my best friend to celebrate, and at the table I had excruciating abdominal pain that led me to present to my hospital. I didn’t know yet, but I had a noncancerous tumor in my liver that ruptured... There’s a lot of good evidence that when physicians communicate with empathy, a patient is less likely to come back to the ER for the same complaint... It’s as effective as any drug we have. I learned this from one of the surgeons who operated on me... He looked at me and said, “I want you to tell me what you’re most afraid of.” I said, “I’m afraid of having an ostomy bag when I leave the operating room.” And he said, “I can’t tell you how much I don’t want that to happen to you. I’m going to do everything I can to make sure that doesn’t happen.” With that one question and answer, I understood that our work for our patients is to hold their fear. I didn’t know that my fear couldn’t be bludgeoned to death with data. I thought if I had the right data, I would feel better. But nothing was ever going to make that better except him acknowledging my fear and holding it for me.Publisher's note: I recently experienced how healthcare, including hospice, is very different when we are the patient - or in my case, the son. So much to be thankful for; so much to learn. Also see the author's article Never-Words: What not to say to patients with serious illness.
The return of the prodigal son...
12/25/25 at 03:00 AMPeople who have come to know the joy of God do not deny the darkness, but they choose not to live in it. They claim that the light that shines in the darkness can be trusted more than the darkness itself and that a little bit of light can dispel a lot of darkness. They point each other to flashes of light here and there, and remind each other that they reveal the hidden but real presence of God. ~Henri Nouwen, “The Return of the Prodigal Son”, as discussed by Philip Yancey
A strategic path forward for hospice and palliative care: A white paper on the potential future of the field
12/25/25 at 03:00 AMA strategic path forward for hospice and palliative care: A white paper on the potential future of the fieldPalliative Medicine Reports; by Ira Byock; 6/5/25The field of hospice and palliative care in the United States is experiencing serious problems and faces an uncertain future. Quality of hospice care is highly variable. Unethical hospice business practices are common in some regions. Palliative care’s integration within American health care has stalled, despite demonstrating that much better care for seriously ill and dying people is both feasible and affordable... Efforts must start with zero tolerance of fraudulent business and clinical practices that harm vulnerable patients. The four components of this strategic approach are:
The quiet note: Music, the language of compassion at life's end
12/24/25 at 03:30 AMThe quiet note: Music, the language of compassion at life's end Psychology Today; by Sara Leila Sherman and Morton Sherman; 7/14/25 Music plays a vital role in the quieter, more tender, more difficult moments of life, especially near the end. We’ve seen how a single note, played or remembered, can become a bridge between worlds, between a person and their memories, a caregiver and a patient, a life lived and a life letting go. In those final moments of life, where silence often speaks louder than words, music and mindful action offer something medicine cannot: presence.
A dying wish: Man with terminal cancer travels to volunteer in all 50 states
12/24/25 at 02:00 AMA dying wish: Man with terminal cancer travels to volunteer in all 50 states ABC-7 News, Bay Area, CA; by 4/6/25 When Doug Ruch was told he had just 12 to 18 months to live, he didn't choose to stay home. Instead, he hit the road - on a mission to help as many people as possible while he still can. "I thought to myself, I have two choices. I can sit at home and wait to die, or I can go out and live," he told ABC7 News. [Continue reading ...] Editor's note: For more, visit Doug's website, www.dyingtoserve.com.
A woman in hospice granted a wish of one last swim
12/24/25 at 01:50 AMA woman in hospice granted a wish of one last swim WEAU-13 News, Bloomer, WI; by Danile Gomez; 7/16/25 Often times the small things are taken for granted. Like a dip in the pool. For Barbara Melby, it was on the final list of things to do as she lives out her time in hospice care. “Barbara has been doing pretty well. She has had some fatigue and some tiredness,” said Leah Grace, the registered nurse with St. Croix Hospice assigned to Melby’s case. ... Grace worked hard to make sure Melby’s last dip in the pool would come to fruition. She cleared it with Melby, her family and the managers at the hospice center. The aquatic center helped in granting the wish too. ... “The way the chair put me in down the water was very nice,” said Melby. Of those in Melby’s family that jumped in the pool with her included Stoll and her kids Colby, Sydney and Brody. “I grew up swimming in my grandmother’s pool. ...” said Stoll. She is happy to be there for her grandmother’s last swim. “Just a pretty special memory we will all hold on to for a pretty long time.” Melby was a swim instructor, ... It was something she always loved and it made her happy to have had her wish granted.
Terminally ill Stanford professor teaches class about dying from cancer
12/24/25 at 01:45 AMTerminally ill Stanford professor teaches class about dying from cancerCBS News, Bay Area, CA; by Elizabeth Cook; 3/13/25 A Stanford University professor's new curriculum explores the multiple aspects and phases of a person dying of cancer, and it comes from a person with first-hand knowledge. Dr. Bryant Lin has been a professor for almost two decades. He's used to being the teacher, not the subject of his classes. But that all changed in 2024 when he was diagnosed with stage 4 lung cancer. ... The diagnosis was a dose of cruel irony. Lin co-founded the Center for Asian Health Research and Education. One of the priorities for the foundation is researching non-small cell adenocarcinoma, also known as "never-smoker lung cancer," the same cancer diagnosis that Lin received. ... The class is called "From diagnosis to dialogue: A doctor's real-time battle with cancer." Within minutes of being posted, the class and the waitlist were full. ... The 10-week course covers the entire spectrum of cancer as seen through the eyes of someone who is living it. ... Stanford University recorded every session of the class so that they could live on for future physicians. If you would like to watch them, they can be found on YouTube.
Jan. 27, 2025, International Holocaust Remembrance Day [link 1]--paired with--A little-known story about a Jewish refugee and Cicely Saunders [link 2]
12/24/25 at 01:40 AMRemembering the Holocaust with little-known story about a Jewish refugee and Cicely Saunders: Honoring the International Holocaust Remembrance Day - 80th Anniversary of the liberation of Auschwitz
The dying man who gave me flowers changed how I see care
12/24/25 at 01:35 AMThe dying man who gave me flowers changed how I see care MedPageToday's KevinMD.com; by Augusta Uwah, MD; 9/2/25 Today for the first time, I got flowers from a grateful patient. And I reflect on how rough the week has been, all the things that seemed impossible and insurmountable, and everything that has brought me to this point. The patient is going on hospice, he’s going to die, yet he felt that I made a significant impact that he wanted to show his gratitude. And that almost brought me to tears. ...
City forced him to cut the oak tree tied to his late wife, so he found a way to save it forever
12/24/25 at 01:30 AMCity forced him to cut the oak tree tied to his late wife, so he found a way to save it forever Scoop Upworthy; by Prachi Mallick; 11/4/25 It was where he had proposed to her, where they carved their initials 30 years earlier, where their love had taken root. In a recent post, one husband shared how a city order forced him to say goodbye to the oak tree that had been central to his marriage, and how, instead of letting that final link vanish, he found a way to rebuild it into something he could carry with him forever. ... "For two years, I couldn’t touch it. Then, one day, I saw someone who had turned wood from his grandfather’s barn into furniture. Something clicked inside me. I taught myself woodworking through YouTube videos and practicing at night. Every cut, every curve of that tree became part of a door. The branches that once bore our initials are now the frame for all who enter our home."Editor's Note: Click here and scroll down for a photo of this husband's beautiful artistry.
Hands
12/24/25 at 01:20 AMHands Journal of the American Medical Association (JAMA); by R. Jordan Williams, MD, MPH; 8/13/25Lend me your hand Callused or calaminedWrinkled or plump,Nails bittenNails extendedSplintered and pittedNails neatly or never cropped.Lend me your hand Strong or weak Cold or warmingSwollen and swanned; Gnarled in knots ...Editor's Note: Continue reading this powerful poem. Additionally, JAMA published this description of the poem, "Poetry and the Medicine of Touch" by Rafael Campo, MD, MA: "In this deeply felt poem, the hand becomes a potent metaphor for our shared humanity ... Aspiring clinicians are still taught to assess, to palpate, to diagnose through touch. Yet, as “Hands” reminds us, patients’ hands hold far more than clinical signs—they reflect stories, histories, fears, and hopes. ..."
Father of 3 stages 'Grief Photo Shoot' to remember wife who died of cancer (exclusive)
12/24/25 at 01:15 AMFather of 3 stages 'Grief Photo Shoot' to remember wife who died of cancer (exclusive): CJ Infantino and his late wife Ariana were high school sweethearts People; by Jordan Greene; 2/13/25 There are many moments forever etched in CJ Infantino’s memory, but one stands out above the rest. It was Sept. 5, 2020, when CJ and his wife, Ariana, sat their three kids down at the kitchen table in their California home and told them that Ariana, 35, was going to die. ... Ariana was diagnosed with stage 4 breast cancer in 2015 — coincidentally, on CJ’s 30th birthday. "We spent the next five-and-a-half years trying to live as much life as we could. We wanted to pack 30 years into 10," CJ says. ... After her last breath, he recalls that everyone "just went silent." ... Right away, the father of three felt isolated, as if no one could relate to his experience. He found that the things people said were often unhelpful and, at times, unintentionally harmful. ... "I really just wanted to show my kids that, even though she’s not physically here, it’s okay to talk about her. We’re still allowed to laugh, even when we’re in so much pain," he says. "I remember the first moment I laughed or felt a hint of joy, and I thought, 'Are we allowed to do this?' " ... [Click on the title's link for the inspirational story and family photos before and after Ariana's death.]
Elderly people look at their younger reflections in this beautiful photo series by Tom Hussey
12/24/25 at 01:00 AMElderly people look at their younger reflections in this beautiful photo series by Tom Hussey Digital Synopsis; photos by Tom Hussey; retrieved from the internet 7/10/25 'Reflections of the Past' is an award-winning photo series by commercial advertising photographer Tom Hussey. The photographs show an elderly person looking pensively at the reflection of his/her younger self in the mirror. Hussey was inspired by a World War II veteran who said "I can't believe I'm going to be 80. I feel like I just came back from the war. I look in the mirror and see this old guy." It's beautiful, touching ... Editor's Note: Click here to view this touching series. The phrases "every photo tells a story" and "a picture is worth a thousand words" come to life. This award-winning campaign was used in a marketing campaign by Novartis for a treatment of Alzheimer's disease. [Our newsletter has no disclosures to report.] These photos are under strict copyright laws with strict enforcement. They can be shared easily via social media links at the top of its webpage.
My Dad was a professional Santa for 49 years — until tragedy struck. Then a group of strangers gave us a miracle.
12/24/25 at 12:45 AMMy Dad was a professional Santa for 49 years — until tragedy struck. Then a group of strangers gave us a miracle. HuffPost | Personal; by Melissa Melnick; 12/7/25 "When they told us their idea, I felt something crack open in me." I grew up knowing that Christmas magic wasn’t something you waited for — it was something you made. And I learned that from my dad. Most people think they know about Santa, but my sister and I were lucky enough to grow up with him. My father, Ray, started playing Santa when he was just 21 years old. ... Knowing my dad, I suspected he’d never actually stop. Then, just a few months later, our world got turned upside down. ... Within 24 hours of the story airing on TV, more than 120,000 people had viewed the clip online. Photos poured in. Old letters. Messages from parents whose children had visited my dad over the years. Stories about how Santa Ray had given their kids confidence, comfort, or joy. ... Editor's Note: Continue reading this beautiful, inspiring story.
Redmond family honors late husband with holiday trees for cancer patients
12/23/25 at 03:30 AMRedmond family honors late husband with holiday trees for cancer patients NBC KING-5, Redmond, WA; by Anne Erickson; 12/15/25 Every December, Linda Pankow's Redmond home fills with volunteers, friends and family for a 25-year tradition born from loss. "I like the mayhem," Pankow said with a smile. The group decorates more than 100 small holiday trees destined for cancer and hospice patients at Evergreen Health. "It's hard around holidays when you've lost somebody," Pankow said. Her husband, Rick, a nursery owner, died from non-Hodgkin's lymphoma at age 43. The tree-decorating project became a way to honor his memory and his love of trees. "Doing this and knowing my husband loved trees because he was a nursery person, it just kind of brings me joy," Pankow said. "It's a good memory of him and a tribute to him." The tradition has grown to include multiple generations. This year, Rick's two-month-old great-nephew Milar joined the effort.
To have more does not mean to ...
12/23/25 at 03:00 AMTo have more does not mean to be more. ~ Abraham Joshua Heschel
Refuge: How people experiencing homelessness spend their final days
12/23/25 at 03:00 AMRefuge: How people experiencing homelessness spend their final days NBC News, KUSA-9, Denver, CO; by Chris Vanderveen and Chris Hansen; 12/21/25 If few cities and states know how to effectively deal with their unhoused populations, far fewer know what to do when the unhoused enter the final days, weeks, and months of their lives. The 9NEWS documentary “Refuge” represents a deeply personal examination of one of the more invisible crises of American life today: hospice care for the unhoused. “People like to think somehow, some way it’s being taken care of, but it’s not,” said James “JP” Hall, founder of Denver’s Rocky Mountain Refuge, one of a handful of places around the country that offers custodial end-of-life care for people experiencing homelessness.
Hospice News’ 10 most-read stories of 2025
12/23/25 at 03:00 AMHospice News’ 10 most-read stories of 2025 Hospice News; by Jim Parker; 12/19/25 Large acquisitions, regulatory headwinds and the fate of COVID-era telehealth flexibilities were top-of-mind issues for hospice providers in 2025, as evidenced by the 10 most-read Hospice News stories of the year. ... The following are the 10 most-read Hospice News articles of 2025.
Community comes together for hospice patient’s motorcycle ride wish
12/23/25 at 03:00 AMCommunity comes together for hospice patient’s motorcycle ride wish 29 News, Charlottesville, VA; by Gabby Womak; 12/18/25 A 41-year-old hospice patient got his wish Thursday, December 18, when Hospice of the Piedmont and Stonewall Harley-Davidson helped arrange for him to ride a motorcycle one more time. Kevin Olague, a patient with Hospice of the Piedmont, had one simple request: to feel the road again. “Even in the middle of dying, I’ve never felt so alive than when I’m on a bike,” Olague said. “I don’t know. It’s just freedom. It’s somewhere between flying a plane and skydiving. There’s just nothing like it.” Hospice of the Piedmont worked with Stonewall Harley-Davidson in Ruckersville to make the ride happen, with Olague’s loved ones watching.
Medicare Final Rule changes that home health providers need to know
12/23/25 at 03:00 AMMedicare Final Rule changes that home health providers need to know Home Health Care News; by Morgan Gonzales; 12/17/25 The Medicare home health final payment rule for calendar year 2026 has been most discussed for its methodology and its 1.3% aggregate rate cut, but other aspects of the final rule require home health providers to carefully strategize for the upcoming year. ... In 2026, it will be key for providers to determine their case-mix weights and how to work with different PDGM groups, according to Cindy Campbell, senior director of advisory services at WellSky.
Palliative care staff attitudes toward music therapy for hospitalized adult patients
12/23/25 at 03:00 AMPalliative care staff attitudes toward music therapy for hospitalized adult patients American Journal of Hospice and Palliative Medicine (AJHPM); by Katherine A. Carney, APRN, CNP, MS, Rachel M. Wiste, APRN, CNP, MSN, Susanne M. Cutshall, APRN, CNS, DNP, MS, Christina Wood, MA, MT-BC, Rachel C. Gentes, APRN, CNP, MSN, Brianna E. Larsen, MA, MT-BC, Nana A. Tiwaa, MAS, Amelia E. Tetlie, APRN, CNP, DNP, and Regina M. Mackey, MD; 12/18/25 ... Top reasons for music therapy (MT) referral were psychosocial support, pain and symptom management, and coping. The most common symptom-focused indications were anxiety, mood, and existential distress. A variety of factors influenced decisions to refer for MT. Most felt that at least half of their patients could benefit from MT, and nearly all rated MT as “extremely” or “very” effective for improving patients’ quality of life.Editor's Note: Visit stories about music therapy the American Music Therapy Association. For extensive uses of music therapy in hospice and bereavement care, I invite you to explore my book, Music of the Soul - Composing Life Out of Loss, published in Routledge's Series in Death, Dying and Bereavement, 2006.