Literature Review
Pacemaker and defibrillator deactivation in competent hospice patients: an ethical consideration
04/19/25 at 03:05 AMPacemaker and defibrillator deactivation in competent hospice patients: an ethical considerationAmerican Journal of Hospice and Palliative Care; by Jennifer M Ballentine; 1/05In 2003, a Colorado hospice provider asked the DCBC for assistance in developing a policy on deactivation of pacemakers and defibrillators in competent hospice patients. The hospice had encountered concerns from some physicians and cardiac care clinicians that deactivating such devices treads the fine line between legitimate withdrawal of burdensome treatment and assisted death... This article summarizes contributions from the committee's discussion, as well as independent research undertaken by the author.Publisher's note: This older, yet still relevant and helpful, article recently came across my desk.
Quality of nonprofit hospice affiliated with integrated healthcare systems
04/19/25 at 03:00 AMQuality of nonprofit hospice affiliated with integrated healthcare systemsJournal of Pain & Symptom Management; Gulmeena Khan, Emmanuelle Belanger, Joan Teno; 4/25Research shows hospice primary caregivers report better quality of care at Nonprofit (NP) than For-Profit (FP) hospices, but there is variation in quality across NP hospices. CAHPs hospice scores did not differ if a hospice was part of integrated healthcare system or not. Further research is needed on variation in quality in NP hospices.
Concordance of 30-day mortality and in-hospital mortality or hospice discharge after sepsis
04/19/25 at 03:00 AMConcordance of 30-day mortality and in-hospital mortality or hospice discharge after sepsisJAMA Network; by Hallie C. Prescott, Megan Heath, Namita Jayaprakash, Raymund B. Dantes, Chanu Rhee, Patricia J. Posa, Scott A. Flanders; 4/9/25In this all-payer, multihospital cohort of patients with community-onset sepsis, the proportion of hospitalizations ending in death or hospice discharge was similar to 30-day mortality and substantially higher than in-hospital mortality alone. Concordance between this composite outcome and 30-day mortality was high and greater than in-hospital mortality alone at the encounter level. These data suggest that the composite outcome of in-hospital mortality or hospice discharge may be a useful measure for national benchmarking of sepsis outcomes. While not identical to 30-day mortality, this composite outcome is available in real time for all patients and appears to have minimal systematic bias from variable hospital discharge practices.Publisher's note: An interesting study that includes "hospital discharge to hospice" as an important variable for consideration.
[Netherlands] A care ethical perspective on family caregiver burden and support
04/19/25 at 03:00 AM[Netherlands] A care ethical perspective on family caregiver burden and supportNursing Ethics; Maaike Haan, Jelle van Gurp, Marianne Boenink, Gert Olthuis; 3/25Family care-when partners, relatives, or other proxies care for each other in case of illness, disability, or frailty-is increasingly considered an important pillar for the sustainability of care systems. Especially in a palliative care context, however, family care can be challenging. Witnessing caregivers' challenges may prompt compassionate nurses to undertake actions to reduce burden by adjusting tasks or activities. The question is then whether self-sacrifice is a problem that nurses should immediately solve. Therefore, we suggest that caregiver experiences should always be interpreted in an explorative dialogue, focused on what caring means to a particular family caregiver. Nurses do not have to liberate family caregivers from the situation but should support them in whatever overwhelms or drives them in standing-by their loved ones until the end.
Saturday newsletters
04/19/25 at 03:00 AMSaturday newsletters focus on headlines and research - enjoy!
Death matters: Is there really no place like home when it comes to dying?
04/18/25 at 03:20 AMDeath matters: Is there really no place like home when it comes to dying? Sequim Gazette, Sequim, WA; by Jeanette Stehr-Green Volunteer Hospice of Clallam County; 4/16/25 While not everyone has the chance to decide where they will die, most Americans say that given the choice, they would prefer to die at home. For most people, home is familiar and comfortable. It is more private than a room in a hospital or nursing facility, and more likely to allow intimate gatherings with family and friends. In the home, the dying person and their caregivers are more in control, deciding when to have visitors, eat, drink, or take medications. ... Planning, realistic expectations, and adequate support are key to keeping a dying person at home. Consider the following steps: ... Home might not be best ...
Without support, seniors aging in place may elect facility-based care, study finds
04/18/25 at 03:00 AMWithout support, seniors aging in place may elect facility-based care, study finds McKnights Home Care; by Adam Healy; 4/16/25 Older adults aging in place may rethink whether they want to receive care at home if they do not receive certain aging-in-place supports from their care providers and loved ones, according to a new study published in the Journal of the American Geriatrics Society. The researchers interviewed nearly 300 older adults receiving care at home and in long-term care facilities. ... The first theme was participants’ personal health experiences. ... Similarly, loss of health of loved ones and friends may also influence where patients want to receive care. ... The final factor influencing older adults’ aging preferences was time, the study found.
This weekend: Passover and Easter with hospice patients and families
04/18/25 at 03:00 AMThis weekend: Passover and Easter with hospice patients and familiesHospice & Palliative Care Today; by Joy Berger, DMA, FT, BCC, MT-BC, editor in chief; 4/17/25 This weekend brings a confluence of the Jewish Passover and Christian Easter holy days. Whatever your faith system, understanding at least a bit about the diverse faith systems of those you serve matters. We provide these hospice-specific resources as references:
Cybersecurity contracts at risk as HHS cuts 150 IT workers: Report
04/18/25 at 03:00 AMCybersecurity contracts at risk as HHS cuts 150 IT workers: Report Becker's Health IT; by Naomi Diaz; 4/15/25 The Department of Health and Human Services could face a critical breakdown in its IT and cybersecurity systems after a sweeping reduction in force that eliminated key staff and leadership, Wired reported April 14, citing four current and former agency employees. More than 150 workers in HHS’ Office of the Chief Information Officer were among hundreds of administrative staff laid off April 1, according to the report. These employees were responsible for contract renewals and cybersecurity licenses and oversaw operations at the department’s Computer Security Incident Response Center — the hub for detecting and responding to cyberthreats across the department. Sources told Wired the cuts left no one in place to renew critical cybersecurity contracts, some of which are set to expire as soon as June.
Carolina Caring Foundation’s “Flights & Bites” fundraiser raises over $45,000 for compassionate care
04/18/25 at 03:00 AMCarolina Caring Foundation’s “Flights & Bites” fundraiser raises over $45,000 for compassionate care Carolina Caring, Hickory, NC; 4/17/25 The Carolina Caring Foundation is celebrating the remarkable success of its 4th annual Flights & Bites fundraiser, which took place on Thursday, April 3rd, 2025, at Moretz Mills in Hickory, NC. This year’s event exceeded expectations, raising over $45,000 to support Carolina Caring’s mission of providing compassionate care to patients and families. Guests at the fundraiser were treated to an exquisite culinary experience titled “Passport to Flavor,” featuring tastes from around the world. “Carolina Caring Foundation expresses heartfelt gratitude to all sponsors and donors for their generous support in making our fundraiser a tremendous success,” stated Tara Bland, CFRE, Executive Director of the Carolina Caring Foundation.
Today's Encouragement: You must let suffering speak, if you want ...
04/18/25 at 03:00 AMYou must let suffering speak, if you want to hear the truth. ~ Cornel West
Palliative care and advanced cardiovascular disease in adults: Not just end-of-life care: A scientific statement from the American Heart Association
04/18/25 at 03:00 AMPalliative care and advanced cardiovascular disease in adults: Not just end-of-life care: A scientific statement from the American Heart Association AHAIASA Journals - American Heart Association; by Lucinda J. Graven, PhD, APRN, FAHA, Lisa Kitko, PhD, RN, FAHA, Martha Abshire Saylor, PhD, MSN, BA, RN, Larry Allen, MD, MHS, FAHA, Angela Durante, PhD, RN, Lorraine S. Evangelista, PhD, RN, CNS, WAN, FAHA, Amy Fiedler, MD, James Kirkpatrick, MD, Lakeisha Mixon, MSW, and Rachel Wells, PhD, MSN, BA on behalf of the American Heart Association Complex Cardiovascular Nursing Care Science Committee of the Council on Cardiovascular and Stroke Nursing; and Council on Cardiovascular Surgery and Anesthesia; 4/17/25 ... This scientific statement (1) discusses the application of effective communication, shared decision-making, age-friendly care, and advance care planning in advanced cardiovascular disease palliative care; (2) provides a summary of recent evidence related to palliative care and symptom management, quality of life, spiritual and psychological support, and bereavement support in individuals with advanced cardiovascular disease and their care partners; (3) discusses issues involving diversity, equity, and inclusion in cardiovascular disease palliative care; (4) highlights the ethical and legal concerns surrounding palliative care and implanted cardiac devices; and (5) provides strategies for palliative care engagement in adults with advanced cardiovascular disease for the care team.
HHS cuts pose threat to older Americans' health and safety
04/18/25 at 03:00 AMHHS cuts pose threat to older Americans' health and safety Newsweek; by Kristin Lees Haggerty and Scott Bane - The National Collaboratory to Address Elder Mistreatment at Education Development Center (EDC); The John A. Hartford Foundation; 4/17/2 On March 27, 2025, the federal government announced major cuts to the department of Health and Human Services (HHS). ... Sounding the Alarm for Elder Justice: The population of older adults is rapidly growing, and one in 10 experience abuse, neglect, and/or exploitation—a risk that is even higher for those living with dementia. ... Cutting services to older adults will increase these risks and costs. Moreover, ... 11.5 million family and friend caregivers provide over 80 percent of help needed for people living with dementia in the U.S. Without access to services like Meal on Wheels, adult day care, and respite care, we can expect caregiver burden and strain to increase significantly and with it, rates of elder abuse, emergency department visits, hospitalizations, and nursing home placements. We know this because of the abuse spike seen clearly during the COVID-19 pandemic, which doubled to over 20 percent of older adults, as services were limited, and older adults were socially isolated. HHS cuts are also likely to result in loss of specialized expertise in identifying and addressing elder mistreatment, so that when elder abuse does occur, we won't have the services to stop it and make sure it won't happen again.
Regulatory leaked HHS budget signals $40B in cuts, assumes ACA subsidies expire
04/18/25 at 03:00 AMRegulatory leaked HHS budget signals $40B in cuts, assumes ACA subsidies expire Fierce Healthcare; by Noah Tong; 4/17/25 Department of Health and Human Services (HHS) reorganization plans appear to have been revealed through a leaked Office of Management and Budget (OMB) document. The 64-page PDF with HHS’ plans were first reported by Inside Medicine and later reported by The Washington Post and other news publications. In an update, Inside Medicine said the entire document was authenticated by The Washington Post. ... While the restructuring was broadly announced, and individual offices have been reportedly axed in recent weeks, the leak provides greater insight into how the reorganization, firings, reductions in force and office eliminations and consolidations will fundamentally alter the agency.
Executive Personnel Changes - 4/18/25
04/18/25 at 03:00 AMExecutive Personnel Changes - 4/18/25
Integrating social determinants into palliative care
04/18/25 at 03:00 AMIntegrating social determinants into palliative care Hospice News; by Holly Vossel; 4/16/25 Strong staff education and reimbursement are among the keys to successfully integrating social determinants of health within a palliative care program. Screening tools developed by the U.S. Centers for Medicare & Medicaid Services’ (CMS) include five areas of social determinants of health: food and housing insecurity, transportation needs, utility difficulties and interpersonal safety. Supplemental domains include financial stability, employment and family and social support, among others.
One last game: student builds virtual reality experience for hospice patients
04/18/25 at 03:00 AMOne last game: student builds virtual reality experience for hospice patients Clemson News; by Sam Cannon; 4/15/25 At Clemson, a dedication to innovating health care and fostering wellness means more than just training the next generation of doctors and nurses. For Class of 2025 student Rob Martin, it has meant curating meaningful moments for members of his community. ... [Rob] joined the Tandem VR™ team, a concept invented by Olivia McAnirlin, Virtual Reality and Nature Lab co-director at Clemson, which helps people connect to past experiences and complete “bucket lists” with their loved ones. As part of this project, local hospice care patients were asked what they would want the chance to experience one more time before they pass. When the overwhelming response from patients was a Clemson football game, a research team of undergraduate and graduate students, practitioners and faculty got to work.
Inside Amazon's strategy to partner with digital health companies
04/18/25 at 03:00 AMInside Amazon's strategy to partner with digital health companies Modern Healthcare; by Brock E.W. Turner; 4/15/25 While Amazon's splashy acquisitions have generated significant buzz, a foundational piece of the technology and e-commerce giant's healthcare business is focused on partnerships with digital health companies. Amazon launched its Health Benefits Connector in January 2024 with digital health unicorn Omada Health for patients with high blood pressure and diabetes. The service allows users to input information about their insurance plan and potentially identify covered services from Amazon’s partners.
8 health system CEOs on the turbulence defining 2025
04/18/25 at 02:00 AM8 health system CEOs on the turbulence defining 2025 Becker's Hospital Review; by Kelly Gooch and Kristin Kuchno; 4/16/25 From capacity constraints to reimbursement pressures, health system CEOs are navigating a changing healthcare landscape. One of the top concerns in 2025 is the potential for Medicaid funding cuts. A recent report estimates hospitals could face a $31.9 billion loss in revenue if federal proposals to scale back Medicaid expansion move forward. CEOs from across the country — including safety-net systems, academic medical centers and expanding regional providers — recently shared how they are preparing for continued uncertainty and what strategies they are prioritizing in response.
Ahead of National Volunteer Week and in celebration of National Volunteer Month, NPHI CEO urges Americans: “Step forward. Be present. Volunteer with your local hospice.”
04/17/25 at 03:10 AMAhead of National Volunteer Week and in celebration of National Volunteer Month, NPHI CEO urges Americans: “Step forward. Be present. Volunteer with your local hospice.” National Partnership for Healthcare and Hospice Innovation (NPHI), Washington, DC; by Matthew Wilkinson; 4/16/25 Ahead of National Volunteer Week next week, and in celebration of National Volunteer Month this April, the National Partnership for Healthcare and Hospice Innovation (NPHI) is shining a light on the often-unsung heroes of hospice: volunteers. These compassionate individuals are central to the mission of NPHI’s member providers nationwide, offering their time, energy, and hearts to patients and families during life’s most tender and vulnerable moments. NPHI member organizations rely on nearly 30,000 volunteers to keep their programs running—almost matching the number of full- and part-time staff employed across its national member network. Nationwide, hundreds of thousands of hospice volunteers contribute millions of hours of service annually. This deep tradition of volunteerism isn’t just symbolic—it’s built into the very structure of hospice care. All Medicare-certified hospices are required to have volunteers actively involved in patient and family support, reflecting the core values of compassion and community care that define the field.Editor's note: Throughout the year, find this and more national observances on our newsletters "Healthcare Observances" tab at the top of our website, https://www.hospicepalliativecaretoday.com/resources/healthcare-observances.
Patient-centered communication drives supportive care needs in incurable cancer
04/17/25 at 03:00 AMPatient-centered communication drives supportive care needs in incurable cancer Oncology Nursing News; by Kristie L. Kahl; 4/16/25 The Primary Palliative Care Communication Intervention (PRECURSOR) may improve the psychosocial experiences of patients with incurable gynecologic cancer and their caregivers in the outpatient setting, according to results of a pilot study presented at the 50th Annual ONS Congress. ... Currently, most of the conversation around supportive care is provider-driven, and clinical tendency is to insert palliative care in the terminal setting. However, the study investigators aimed to integrate supportive care across the cancer continuum.
Why good palliative care clinicians get fired
04/17/25 at 03:00 AMWhy good palliative care clinicians get fired JAMA Network - Viewpoint; by Abby R. Rosenberg, MD, MS, MA; Elliot Rabinowitz, MD; and Robert M. Arnold; 4/14/25 Even the most seasoned palliative care clinician gets fired. In the past year, one of us was fired after asking whether a patient endorsing suicidal ideation had access to a gun; the patient requested not to see the palliative care team because we asked intrusive questions and documented the encounter. One of us was fired after supporting a family’s decision to discontinue life-sustaining therapies for their loved one with multisystem organ failure; the primary intensivist suggested palliative care overstepped in discussing options for which the family (and clinical teams) was not ready. And one of us was fired after sharing the impression that a patient with cancer was dying; the family suggested they preferred the oncologist’s version of a more hopeful future.
Join Rebecca Ramsey and Chris Comeaux in exploring the future of home care
04/17/25 at 03:00 AMJoin Rebecca Ramsey and Chris Comeaux in exploring the future of home care Teleios Collaborative Network (TCN); podcast by Chris Comeaux with Rebecca Ramsey; 4/16/25 In this episode of TCNtalks, host Chris Comeaux interviews Rebecca Ramsay, CEO of Housecall Providers. Rebecca shares her unique journey in healthcare and emphasizes the importance of nonprofit organizations in delivering quality care. Rebecca discusses the evolution of Housecall Providers, the significance of home-based primary care, and the interdisciplinary approach required to meet the needs of patients with complex conditions. She also advocates for Hospice organizations to expand into home-based primary care, highlighting the growing demand and the gaps in current services. Chris and Rebecca explore the challenges of maintaining a stable workforce, the complexities of payment structures, and the importance of a steady referral stream for viable home-based primary care.
CMS to withdraw federal Medicaid match for workforce, social needs, and infrastructure: What states, health care providers and community organizations need to know
04/17/25 at 03:00 AMCMS to withdraw federal Medicaid match for workforce, social needs, and infrastructure: What states, health care providers and community organizations need to know The National Law Review; by Margia Corner, Adam Herbst of Sheppard, Mullin, Richter & Hampton LLP; 4/16/25 In a move signaling a major shift in federal priorities, the Centers for Medicare & Medicaid Services (“CMS”) recently announced it will limit federal funding for state Medicaid initiatives that support services beyond direct medical care. ... On April 10, CMS notified states that it will no longer approve new, or renew existing, state proposals for Section 1115(a) Demonstration Project expenditure authority to provide federal matching funds for state expenditures for designated state health programs (“DSHP”) and designated state investment programs (“DSIP”).