Literature Review

The iatrogenic consequences of medicalising grief: Resetting the research agenda Sociology of Health & Illness: by Sarah Gurley-Green, Lisa Cosgrove, Milutin Kostic, Lauren Koa, and Susan McPherson; published 11/28/25, distributed via Evermore 1/28/25When the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in 2013, there was a firestorm of controversy about the elimination of the bereavement exclusion. Proponents of this change and of the proposed “complicated grief” designation believed that this change would help clinicians recognise major depression in the context of recent bereavement. Other researchers and clinicians have raised concerns about medicalising grief. In 2022 “prolonged grief disorder” (PGD) was officially included in the DSM-5-TR in the trauma- and stressor-related disorders section. ... As human rights activists have argued, bereavement support is an inalienable human right, one that is centered on the right to health and well-being, for “bereavement health is as intrinsic to our humanity as any other aspect of health and citizenship” (Macaskill 2022). That is why there are increasing calls for investing in bereavement as a public good and for “cultivat[ing] a bereavement-conscious workforce.” (Lichtenthal et al. 2024, e273). As Lichtenthal notes, it is not only clinicians but also institutions and systems that must “shift bereavement care from an afterthought to a public health priority.”Editor's note: "Iatrogenic" refers to unintentional consequences/condition from a medical intervention. In the hospice context, this means bereavement/grief from the hospice death. How many patients do you serve? The CMS Hospice Conditions of Participation identify "bereavement" and/or "grief" 155 times. What priority do you give to bereavement care before, at and after your patients' deaths?

Michigan Center for Rural Health working to expand rural palliative care Hospice News; by Jim Parker; 1/29/25Recent studies have established a dire need for palliative care in rural areas, and the state of Michigan is no stranger to this situation. To respond to the need, the Michigan Center for Rural Health (MCRH) is partnering with Stratis Health, a nonprofit consulting firm that specializes in assisting rural communities with providing palliative care services. The two organizations, which have partnered on projects related to critical care hospitals and Medicare beneficiaries, will choose five rural communities in the state with the goal of increasing their capacity to provide palliative care. In the current phase of the project, Stratis will be training MCRH staff to apply their framework for implementing palliative care programs in the target areas.

Palliative care may improve quality of life in esophageal cancer Cure; by Tim Cortese; 1/27/25 Palliative care consultations helped patients with esophageal cancer at end-of-life experience better quality of life and less financial strain by reducing the need for intensive interventions, according to a poster presented at the 2025 ASCO Gastrointestinal Cancers Symposium. The mean length of hospital stay was 7.5 days (plus or minus 11.3 days) for patients who received palliative care and 8.9 days (plus or minus 14.9) for those who didn’t; and total charges were $97,879 (plus or minus $195,868) and $146,128 (plus or minus $321,830), respectively. Patients who received palliative care consultation had a Charlson Comorbidity Index of 9.4 (plus or minus 3.3) versus 9.1 (plus or minus 3.5) for patients who did not.

Main Line Health cuts 200 administrative roles Becker's Health IT; by Naomi Diaz; 1/22/25 Bryn Mawr, Pa.-based Main Line Health has eliminated approximately 200 administrative and management positions, including roles in IT, The Philadelphia Inquirer reported Jan. 22. The majority of the cuts targeted administrative support areas such as information technology, finance, human resources, revenue cycle, and accounting, according to Main Line Health CEO Jack Lynch. "The landscape in healthcare is awful, and it's only getting worse," Mr. Lynch told the publication. He cited several factors driving the decision, including inadequate payment increases from Medicare and Medicaid — which account for 65% of the system's patient coverage — rising insurance denials, and the delayed arrival of $25 million in federal COVID-19 aid. 

It's easy to make a buck. It's a lot tougher to make a difference. ~ Tom Brokaw

Health equity guide aims to improve care for Black patients with serious illnesses Healio; by Jennifer Byrne; 1/28/25 Black individuals in the U.S. with serious illnesses receive disproportionately poor pain management and health care communication, compared with white individuals, a focus group led by the Center to Advance Palliative Care showed. Black individuals with these illnesses — such as cancer, heart failure or dementia — also experience higher family caregiver burden, findings showed. To address these inequities, the Center to Advance Palliative Care (CAPC) issued a comprehensive guide titled, “Advancing Equity for Black Patients with Serious Illness.”

We need to talk about hospiceMedCity News; by Skelly Wingard, Asher Perzigian and Elizabeth Annis; 1/28/25 In the quiet corners of healthcare, there’s a conversation that needs to be had. It’s a conversation about hospice — a critical yet often misunderstood part of end-of-life care. ... Nearly three-quarters of hospice care agencies are for-profit ownership. ... The impact of these acquisitions on the industry is complex. ... On the one hand, these investments can bring valuable resources to hospice care, funding geographic expansion, scaling technological infrastructure, improving facilities and enhancing services. On the other hand, a strong focus on efficiency and optimization has led to challenges such as staff burnout, higher turnover, and decreased patient satisfaction when compared with non-profits. Coupled together, this complexity can contribute to reduced quality of care due to cost-cutting measures, aggressive marketing leading to overuse of services, increased billing and fraud and a lack of community investment. Not all for-profit hospices operate this way. ... [Click on the title's link to continue reading.]

DEA proposed telemedicine prescribing rule could burden hospice physicians and hospice operations Morgan Lewis, Washington, DC; by Howard J. Young, Jacob J. Harper, and Roshni Edalur; 1/27/25 Signaling a possible future approach to regulating Schedule II-V prescribing via telemedicine in lieu of in-person examinations, on January 17 the DEA issued a notice of proposed rulemaking regarding its next iteration of controlled substance prescribing controls. With comments due March 18, 2025, the Proposed Rule is not subject to the Trump administration’s executive order freeze on new proposed regulations. [Click on the title's link to continue reading.]

Bettis Academy instills leadership skills with Eagles L.E.A.D. Program The Post and Courier, North Augusta, SC; by Bianca Moorman; 1/27/25 Bettis Preparatory Leadership Academy is helping to build the next generation of leaders with its new Eagle's L.E.A.D. Initiative. Eagle's L.E.A.D. – which stands for Learn through Experience, Excel in Academics, Aspire to Inspire and Drive for Change – aims to teach students the skills needed to become leaders through hands-on service projects. The school officially launched the program on Oct. 28, 2024. ... Each grade level has selected a unique service project for the program. ... First-graders are partnering with Gentiva Hospice to learn about the work of first responders. Second-graders are collaborating with heart doctors to raise awareness about childhood heart disease. Third-graders are creating "little libraries" to place in various locations throughout the community. [Click on the title's link for grades 4-8.]

[Hospice of the Western Reserve Volunteer] WWII veteran celebrates 100th birthday, years of service Fox 8 WJW-TV Cleveland, OH; 1/24/25 What were you doing on this day 100 years ago? Well, if you were World War II Veteran Bob Zonneville, you were saying “hello” to the world! On Thursday, many of his friends and family got together at David Simpson Hospice House to celebrate this incredible accomplishment. Hospice of the Western Reserve hosted the event, which had a very special meaning to both the organization and Zonneville.  Over the years, not only has this World War II veteran offered tireless support to the Hospice program, but he’s also responsible for raising nearly $100,000. Zonneville has been a passionate Hospice volunteer for decades. According to Hospice of the Western Reserve, Zonneville received the prestigious Chair’s Award for his extraordinary contributions to the hospice community in 2008. ...

Former hospice physician alleges retaliation against nonprofit healthcare provider Northern California Record; by Northern California Record State Court; 1/23/25 In a gripping legal battle that raises questions about medical ethics and employee rights, a former hospice physician has filed a lawsuit against his previous employer, alleging wrongful termination and retaliation. The complaint was lodged by Kamaldip Ghei in the Superior Court of California, County of San Francisco, on January 10, 2025, targeting Sutter Visiting Nurse Association and Hospice dba Sutter Care at Home. ... Ghei claims he was wrongfully terminated after raising concerns about the organization's practices regarding patient care. Specifically, he alleges that he was pressured to keep patients in hospice care even when it was not medically justified. ...

Hospice rationale should be reassessed, says ethicist Medscape; by Arthur L. Caplan, PhD, Medical Ethics at NYU’s Grossman School of Medicine; 1/23/25 ... Decades ago, I first found out about the idea that came from England and a nurse, Cicely Saunders, to change the setting in which people die. ... I think that was a wonderful idea, and it has revolutionized end-of-life care. We have many excellent, superb hospice programs. ... The hospice institution is decades old, and it’s time to take another look at what’s going on there.  ... Private equity is all over this area, buying up hospice chains and home care hospice — looking to make big profits but not looking to maintain the quality requirements that ought to be there or to do more than is minimally required to set up and staff hospice. ... ... For reasons of serving the best interests of hospice patients, we should be rechecking the fairness of reimbursement, not overburdening families with care that ought to be provided by hospice programs, and making sure that those who are dying are monitored adequately and receiving checkups regularly. ...