Literature Review

A man's true wealth is the good he does in the world. ~Khalil Gibran

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!

What matters about what matters mostJAMA Network Open; by Mary E. Tinetti, Brenda S. Nettles; 10/25The authors note that “Identifying what matters is essential for providing person-centered care, guiding clinical visits, tailoring care plans, and providing a starting point to foster further patient engagement.” These are lofty expectations of a single, simple question ["what matters most?"]. While the what matters question alone cannot guide care planning or tailor interventions, it can serve as a starting point for ongoing conversations about patient health goals and care preferences. These priorities, in turn, can guide patient-centered decision-making and care. The question also provides an opportunity to get to know the patients we care for as individuals. That, in itself, is an invaluable gift reminiscent of a period when clinicians had more time with patients and cared for them over years.

Effectiveness of a telephonic Aging Brain Care Model for Medicaid Home and Community Services for dementia patients and their caregiversJournal of the American Geriatrics Society; by Malaz A Boustani, Steven R Counsell, Anthony Perkins, Abdelfattah Alhader, Kathryn I Frank, Diana P Summanwar, Karen L Fortuna; 10/25The primary purpose of the present study was the implementation and evaluation of the ABC Community program, a community-based and telephonically administered version of the Aging Brain Care model delivered by Area Agencies on Aging (AAAs) staff. This study employed a ... design with ... the main outcome measure being the total score of the Health Aging Brain Care (HABC) Monitor at 3- and 6-month follow-up. The HABC Monitor has demonstrated excellent reliability and validity in monitoring and measuring the burden of dementia symptoms and the quality of life and stress of the informal caregivers. Approximately 46% of informal caregivers who had at least mild burden at baseline had no such burden at 6 months, and 92% of those who had no stress at baseline remained burden-free at 6 months. Conclusion: The ABC community program might be a scalable collaborative dementia care model targeting socially vulnerable people living with dementia.

State-level variability in location of death of patients with end-stage liver diseaseDigestive Diseases & Sciences; by Julia Meguro, Michael Huber, David Goldberg; 10/25 Although deaths from end-stage liver disease (ESLD) and hepatocellular carcinoma (HCC) in the United States increasingly occur at home or in hospice, inpatient medical facility deaths remain high. Despite the decrease in in-hospital deaths for all causes, non-White decedents are more likely than White decedents to die in a hospital setting. This study aimed to determine state-level variability in the location of death among patients with ESLD and HCC and to assess racial/ethnic differences in these patterns, focusing on Black, White, and Hispanic/Latino patients. Findings from this study identify states where policies and programs that reduce inpatient deaths for ESLD patients may be most needed. Targeted interventions to improve access to high-quality EOL care for all patients address the national variability of hospice use, especially for those who are Black or African American and in states with high numbers of inpatient deaths and low rates of hospice use, should also be identified and implemented.

Developing medical cannabis competencies-A consensus statementJAMA Network Open; by Yuval Zolotov, Leslie Mendoza Temple, Richard Isralowitz, David A. Gorelick, Rebecca Abraham, Donald I. Abrams, Kyle Barich, Kevin F. Boehnke, Stephen Dahmer, Joseph Friedman, Patricia Frye, Aviad Haramati, Jade Isaac, Mary Lynn Mathre, Marion E. McNabb, Melinda Ring, Ethan B. Russo, Deepika E. Slawek, Brigham R. Temple, Genester S. Wilson-King, Julia H. Arnsten, Mikhail Kogan; 10/25An initial list of 9 competencies was refined and consolidated into 6 core competencies [for the use of medical cannabis]: (1) understand the basics of the endocannabinoid system; (2) describe the main components of the cannabis plant and their biological effects; (3) review the legal and regulatory landscape of cannabis in the US; (4) describe the evidence base for health conditions that are commonly managed with cannabis; (5) understand the potential risks of medical cannabis use; and (6) understand basic clinical management with medical cannabis. Each competency is supported by 2 to 7 subcompetencies, resulting in 26 subcompetencies reflecting granular topics, such as patient safety, vulnerable populations, structural inequities, and interdisciplinary care. These consensus-derived competencies provide a structured, evidence-informed foundation to guide the integration of medical cannabis into undergraduate medical education.

When hospice referrals are placed to improve acute care hospital mortality metricsJournal of Pain & Symptom Management; by Gina M Piscitello, Emily Martin, Gregg A Robbins-Welty, Ryan Baldeo, Joseph Shega, Michael T Huber; 10/25Risk-adjusted inpatient mortality is one way in which the quality of US acute care hospitals is assessed. While the specification of inpatient mortality measurements can vary, patients transitioned to general inpatient hospice (GIP) status are often excluded. GIP is one of four levels of hospice care intended for short-term inpatient management of uncontrolled symptoms that cannot be effectively managed in another setting. This care may be provided in acute care hospitals through partnerships with hospice agencies. As such, a patient may potentially be discharged from the hospital and enrolled in GIP in the same hospital location, even the same bed, and excluded from the hospital’s inpatient mortality measures.

Improving access to inpatient hospice: Implementation and impact of a dedicated comfort care service in a tertiary care hospitalJournal of Palliative Medicine; by Neha Kayastha, Eric Pollak, Yvonne Acker, David Fisher, Noppon Setji, David Casarett; 10/25Many hospitalized patients on comfort care (CC) have a high symptom burden and qualify for General Inpatient Hospice (GIP) care. At our institution, many hospitalized patients who qualified for GIP were unable to discharge to stand-alone hospice facilities due to clinical instability or lack of beds. In July 2022, we created the General Medicine 24 (GM24) Comfort Care and Hospice Team to improve access to high-quality hospice services for hospitalized CC patients. In the three years since the creation of GM24, GIP admissions have increased annually, now 107% higher compared to the year before GM24 was created. Discharges to stand-alone inpatient hospice facilities have increased by 65% in the three years since GM24 was created compared to the year before GM24 was created.

[Italy] Can cannabinoids alleviate behavioral symptoms in older adults with dementia? A systematic reviewJournal of Psychopharmacology; by Adele Ravelli, Chiara Ceolin, Mario Virgilio, Margherita Vergadoro, Maria Devita, Marina De Rui, Paolo Simioni, Giuseppe Sergi, Alessandra Coin; 10/25Behavioral and psychological symptoms of dementia (BPSD) affect patients’ and caregivers’ well-being. Cannabinoids may offer a promising therapeutic option for managing BPSD. Ten studies ... showed cannabinoids helped reduce agitation and nocturnal disturbances. In conclusion, cannabinoids show promise in managing BPSD in dementia, with good tolerability and safety. 

Nurse swapped hospice patient’s medicine with household cleaner in MA, feds say The Herald; by Julia Marnin; 11/4/25 A registered nurse caring for a non-verbal hospice patient in Massachusetts was caught replacing the patient’s liquid pain medication with household cleaner, according to federal prosecutors. Now, a federal indictment charges the nurse, Lori Robertson, of Salem, New Hampshire, with one count of tampering with a consumer product. Federal authorities arrested Robertson, who worked at a long-term care and rehabilitation center in Amesbury, Massachusetts, on Oct. 31, according to court records. She pleaded not guilty at an arraignment that day.

Bereavement support for oncology nurses caring for patients and families Journal of Hospice & Palliative Nursing; Tami Borneman, RN, MSN, CNS, FPCN, Paige Hayward, and Haley Buller, MSHSC; 10/28/25 Six themes emerged from the open-ended question that asked participants to share case studies describing a patient or family member that they had cared for who was experiencing grief and nurse interventions: (1) treatment failure/out of options, (2) unexpected death or recent loss, (3) impending death, (4) multiple or overlapping losses, (5) coping, and (6) anticipatory grief. 

Attorney General Bonta secures felony sentencing of Inland Empire Hospice operators for Medicare and Medi-Cal fraud  Rob Bonta - Office of the Attorney General, California Government; Press Release; 11/5/25 California Attorney General Rob Bonta today announced the sentencing of Inland Empire Hospice operators, Ralph and Rochell Canales, for submitting false claims to the Medicare and Medi-Cal programs. Ralph was sentenced by the San Bernardino County Court to seven years and four months in state prison and was jointly ordered to pay $1,455,233, alongside his wife Rochell Canales. Rochelle was sentenced to one year in jail, and ordered to abstain from working with Medicare and Medi-Cal beneficiaries ...

Palliative care & hospice poll reveals major gaps Michigan Medicine - University of Michigan; by Michigan Medicine; 11/6/25 Many older adults don’t know much about care options for people with serious illness, but express interest once they’re explained to them. ... In all, 33% of older Michiganders were aware of palliative care, ... leaving 67% saying they knew little or nothing about it. But after being given the definition of palliative care, 79% of Michiganders were interested in receiving palliative care if they had a serious illness ... Michiganders were as likely as those in the rest of the U.S. to know about (68%) and be interested in (82%) hospice care. However, there was a sizable gap in hospice interest between Black Michiganders (70%) and white Michiganders (84%).