Literature Review
How thanatology is driving hospice care innovation
06/22/25 at 03:20 AMHow thanatology is driving hospice care innovation Hospice News; by Holly Vossel; 6/13/25 Thanatologists examining dying and grief practices have uncovered significant trends shaping hospice and bereavement care models in recent years. Thanatology is derived from the Greek word for death, “thanatos.” It is commonly described as the study or description of death, dying and loss and the psychological, social, cultural, biological and spiritual aspects of these processes. Editor's Note: A significant addition to this thanatology article for you to know is ADEC, the Association for Death Education and Counseling: The Thanatology Association, at www.adec.org, celebrating its 50th anniversary in 2026. This article describes thanatology as "recent years" and that "several studies have examined examined aspects of the dying process ..." Thanatology--and ADEC's contributions to our end-of-life care field--are much more than "recent," "several studies," and "aspects." ADEC emerged within the same era as Kübler-Ross's first book and the first hospices in the US, years before the Hospice Medicare Benefit. ADEC's thanatology ground-breaking leaders and members include thousands of national and international researchers, editors/authors, academicians, and clinicians throughout the evolution of our end-of-life care field, e.g., William Worden (founding member), Ken Doka (past president), Robert Neimeyer (past president), and so many more. When you see the "FT" or "CT" credential, know that this person has earned the advanced professional credential "Fellow in Thanatology" or "Certified in Thanatology." Recognize the professionals in your organization with these important thanatology credentials. Support your professionals who seek it.
College Station store hosts Hospice Brazos Valley’s benefit this Father’s Day
06/22/25 at 03:15 AMCollege Station store hosts Hospice Brazos Valley’s benefit this Father’s Day KBTX, Bryan, TX; by Abigail Truman; 6/9/25This Father’s Day, Hospice Brazos Valley is partnering with Murdoch’s Ranch and Home to encourage families to spend their holiday with classic cars, barbecue, and supporting a good cause. Guys, Gears, and Grills is an event that gives you a chance to do all of dad’s favorites while raising money to support Brazos Valley Hospice. “We’re the only nonprofit hospice in the Brazos Valley, meaning we’ll never send you a bill... And we gave over $250,000 in complementary care last year,” Collen Broussaurd with Brazos Valley Hospice explained its mission.
2025 World Hospice and Palliative Care Day: Using the Toolkit Effectively webinar
06/22/25 at 03:10 AM2025 World Hospice and Palliative Care Day: Using the Toolkit Effectively webinar Worldwide Hospice Palliative Care Alliance (WHPCA); press release / email; 6/17/25The Worldwide Hospice Palliative Care Alliance (WHPCA) invites you to attend a 2025 World Hospice and Palliative Care Day: Using the Toolkit Effectively Webinar and you must register in advance, HERE. The theme for WHPCD is Achieving the Promise: Universal Access to Palliative Care, and this year’s World Day will be on 11 October. World Hospice and Palliative Care Day (WHPCD) is a unified day of action in support of hospice and palliative care. Palliative care is an interdisciplinary caregiving approach that optimises quality of life and mitigates health-related suffering among people with very serious illnesses and their carers. WHPCD has been marked every year for the last 19 years.
Chapter 6: Medicare’s measurement of rural provider quality
06/22/25 at 03:05 AMChapter 6: Medicare’s measurement of rural provider quality MedPAC; 6/12/25 ... Because of low patient volumes in many rural health care settings, there are practical challenges in measuring some individual rural providers’ quality of care and in holding these providers accountable in quality reporting programs. ... The Commission acknowledged these difficulties when it established specific principles to guide expectations about quality in rural areas. These principles were developed with hospitals in mind but could be applied to other providers. ... [On page 4 of 40] Rural skilled nursing facilities and dialysis facilities had lower shares of providers with publicly reported quality results compared with their urban counterparts; in contrast, rural home health agencies and hospices had higher shares of providers with publicly reported quality results compared with their urban counterparts.Editor's Note: For ranking of hospices by quality scores, examine the National Hospice Locator, provided to the public by Hospice Analytics (a sponsor of this newsletter).
Sunday newsletters
06/22/25 at 03:00 AMSunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!
Today's Encouragement 6/22/25
06/22/25 at 03:00 AMA truly educated person is one who knows how much they do not know. ~Morimer J. Adler
Families demand end to Medicare waiting period for early-onset Alzheimer’s patients
06/22/25 at 03:00 AMFamilies demand end to Medicare waiting period for early-onset Alzheimer’s patients Washington Examiner; by Elaine Mallon; 6/15/25 Jason Raubach was diagnosed at 50 years old with early-onset Alzheimer’s disease — a diagnosis that affects nearly 200,000 Americans. He received the diagnosis in 2018, completely upending life for his family. His youngest child was just a freshman in high school. ... Shortly before receiving an official diagnosis, Jason Raubach lost his job, having to move his family onto a consolidated omnibus budget reconciliation act health plan, or COBRA plan, which allows a person to keep their health insurance even after losing their job. “It wasn’t cheap,” Elizabeth Raubach said.However, once diagnosed, Jason Raubach had to wait two and a half years before he could receive coverage under Medicare, health insurance for those 65 years and older or those with qualifying disabilities. But Elizabeth Raubach, along with dozens of other caretakers for people diagnosed with Alzheimer’s, called on Congress in a letter to eliminate the 29-month waiting period required for those under the age of 65 to receive coverage under Medicare. ...
Today's Encouragement 6/21/25
06/21/25 at 03:55 AMThe only thing wrong with trying to please everyone is that there's always at least one person who will remain unhappy. You. ~Elizabeth Parker
Palliative care in liver transplantation
06/21/25 at 03:45 AMPalliative care in liver transplantationCurrent Transplantation Reports; Michelle Ng, Elliot Tapper; 5/25 Palliative care is an underutilized resource due to the misconception that being a liver transplant candidate precludes patients from accessing these services. However, early integration of palliative care has become increasingly important for both pre- and post-liver transplant patients as it not only improves patient outcomes, but also promotes quality of life that extends beyond graft or patient survival. We discuss strategies to manage pain, ascites, hepatic encephalopathy, pruritis, muscle cramps, sexual dysfunction, depression, anxiety, insomnia, and malnutrition. These symptoms are best addressed with a multi-modal approach with non-pharmacologic therapies as an adjunct.
Mindfulness and relaxation interventions reduce depression, negative affect and stress in widow(er)s
06/21/25 at 03:40 AMMindfulness and relaxation interventions reduce depression, negative affect and stress in widow(er)sJournal of Loss and Trauma; Lindsey M. Knowles, Deanna M. Kaplan, Melissa Flores, Sydney E. Friedman, Mary-Frances O’Connor; 6/25Mindfulness training (MT) and progressive muscle relaxation (PMR) interventions show promise for improving bereavement-related grief (Knowles et al. 2021). Mindfulness training (MT) develops the systematic and secular practice of focusing one’s attention on present moment experiences, emotions, and thoughts, from an open, nonreactive, and nonjudgmental perspective (Bishop et al., 2004). Progressive muscle relaxation (PMR) facilitates physiological and psychological relaxation via a systematic release of generated bodily tension (Bernstein et al., 2000). MT and PMRhave been shown to reduce depression relapse, and improve depression, perceived stress, mindfulness and/or quality of life in clinical and non-clinical populations ...
Caring beyond cure-Perspectives of pediatric oncology nurses on end-of-life care
06/21/25 at 03:35 AMCaring beyond cure-Perspectives of pediatric oncology nurses on end-of-life careJournal of Hospice & Palliative Nursing ; Scarperi, Peter BSN, RN; MacKenzie Greenle, Meredith PhD, RN, ANP-BC, CNE; June, 2025In a sample of nursing students and nurses working in pediatric oncology, this mixed-methods study aimed to describe attitudes toward and experiences of providing end-of-life care and examine the relationship between education, work experience, and attitudes. Overall, participants held positive attitudes toward end-of-life care, with staff nurses more positive than student nurses. All participants had provided end-of-life care, yet only 2 (5.41%) thought their education thus far prepared them. Age, education, experience, and burnout were associated with attitudes toward providing end-of-life care. Qualitative themes included challenges of preparedness and training, the nurse’s role, and parent team barriers. Training in pediatric end-of-life care is crucial to improve nurses’ comfort with providing this care.
Strategies to prepare hospice providers to interact with adolescents with a parent in hospice
06/21/25 at 03:30 AMStrategies to prepare hospice providers to interact with adolescents with a parent in hospicePalliative & Supportive Care; William Grayson, Denice Kopchak Sheehan, Pamela S Stephenson, Kristen DeBois, Caitlin Sheehan; 5/25The sample included 18 young adults (18-28 years old) whose parents died in hospice or palliative care while they were adolescents (12-18 years old). Semi-structured interviews were conducted virtually via Microsoft Teams. The participants described a variety of skills that are important for hospice providers to know. They provided specific suggestions for hospice providers who seek to help adolescents navigate this critical time when their parents are dying or have recently died. These results can also be used to inform the development of interventions that assist hospice providers with strategies tailored to an adolescent's specific needs.
Examining education models for clinical staff working with people with intellectual and developmental disabilities in hospice and palliative care: A narrative literature review
06/21/25 at 03:25 AMExamining education models for clinical staff working with people with intellectual and developmental disabilities in hospice and palliative care: A narrative literature reviewAmerican Journal of Hospice and Palliative Care; Caitlyn M Moore; 5/25Despite individuals with intellectual and developmental disabilities (IDD) living longer with serious illness, healthcare professionals report inadequate training in this area. Additionally, IDD specialists consistently express discomfort and limited knowledge regarding HAPC [hospice and palliative care]. Findings indicate that while several studies demonstrate positive outcomes regarding knowledge, self-efficacy, and satisfaction among participants, there is a lack of standardized training and patient-centered metrics. Existing interventions largely focused on improving the knowledge of IDD staff regarding HAPC, with limited attention given to educating HAPC professionals on the nuances and complexities needs of people with IDD. This review underscores the importance of developing and implementing evidence-based and standardized training programs that encompass the needs of both HAPC and IDD specialists.
Can a chatbot be a medical surrogate? The use of large language models in medical ethics decision-making
06/21/25 at 03:20 AMCan a chatbot be a medical surrogate? The use of large language models in medical ethics decision-makingNEJM-AI; Isha Harshe, B.S., B.A.; Kenneth W. Goodman, Ph.D.; Gauri Agarwal, M.D.; 6/25 The use of AI in health care has raised numerous ethical challenges. Issues concerning data privacy, accountability, bias perpetuation, and the identification of appropriate uses and users have prompted scholars and scientists to tackle these challenges. Our findings indicate that while AI systems may assist in identifying considerations and guidelines for ethical decision-making, they do not consistently demonstrate the flexibility of thought that humans exhibit when addressing novel ethical cases. AI can support ethical decision-making, but it is not currently capable of showing autonomous ethical reasoning for consultation regarding patient care.
Cocota's story: Life lessons in aging, resilience, and end-of-life agency from a Brazilian matriarch
06/21/25 at 03:15 AMCocota's story: Life lessons in aging, resilience, and end-of-life agency from a Brazilian matriarchJournal of the American Geriatrics Society; Thiago J Avelino-Silva, Niousha Moini; 6/25In Cocota's case, a hip fracture in her 80s did not lead to permanent disability; rather, she reclaimed her daily routines, demonstrating the interplay between physical robustness and unwavering determination. Equally telling was her decision to "stop eating and drinking" near life's end, exemplifying resilience as a final expression of agency. We further explore how her experiences align with deeper forms of well-being, marked by purpose and prosocial behavior, and practical wisdom, including emotional regulation and sound moral judgment. By examining her life journey, clinicians and community partners can better appreciate how resilience spans physical, cognitive, psychosocial, and spiritual domains, ultimately guiding more integrated strategies to support older adults. The lessons learned have direct relevance for clinical interventions, community programs, and public health initiatives aimed at fostering autonomy and meaningful engagement in later life.
Sacred moment experiences among internal medicine physicians
06/21/25 at 03:10 AMSacred moment experiences among internal medicine physiciansJAMA Network Open; Jessica Ameling, MPH; Nathan Houchens, MD; M. Todd Greene, PhD, MPH; David Ratz, MS; Martha Quinn, MPH; Latoya Kuhn, MPH; Sanjay Saint, MD, MPH; 5/25Some have described sacred moments as sudden intimacies or moments of deep memorable connection with another person. The health care setting is replete with opportunities for the types of human connections that lead to sacred moments, such as times of crises or grief, or conversely, times of great happiness. These moments leave participants with a sense of joy, peace, and empathy for the others involved. In this survey study of 629 physicians, 68% reported experiencing a sacred moment with a patient, and physicians who considered themselves very spiritual or possessing a strong sense of purpose in life or work had increased odds of experiencing a sacred moment. Both experiencing sacred moments often and discussing them with colleagues were associated with less burnout [and] improve[d] physician well-being.
[China] Efficacy of music therapy on quality of life in cancer patients: A systematic review and meta-analysis
06/21/25 at 03:05 AM[China] Efficacy of music therapy on quality of life in cancer patients: A systematic review and meta-analysisPsycho-Oncology; Ting Luo, Suting Zhang, Mi Zhao, Hong Song, Shuo Wang, Jing Han; 5/25Music therapy was effective in improving the QoL [quality of life] of patients with cancer, with passive music therapy being superior to active-passive music therapy. Meanwhile, anxiety and depression were relieved as well.
Evaluation of reporting of race and ethnicity in hospice and palliative care research
06/21/25 at 03:05 AMEvaluation of reporting of race and ethnicity in hospice and palliative care researchJournal of Palliative Medicine; Kimberly S Johnson, Karen Bullock, Cardinale B Smith, Deborah B Ejem, Nadine J Barrett, A'mie Preston, Kenisha Bethea, Marisette Hasan, Ramona L Rhodes; 5/25The disproportionate impact of the COVID-19 pandemic on marginalized communities due to structural racism has led to an increased focus on diversity, equity, and inclusion in medical literature. Among the eligible articles reviewed, there were 48 unique racial and ethnic categories [and] the most common groups specified were White (N = 77), Black (N = 52), and Hispanic/Latino (N = 36). Over half of articles (n = 53, 60.2%) combined minoritized groups into a nonspecific category (e.g., "other"), and 30 (34.1%) articles specified White populations alone or White populations with a nonspecific category for other groups. Seventeen (19.3%) articles included over 90% White participants, and only 3 (3.4%) articles had a minority health or health disparity focus. In this review of high impact, practice changing articles, the lack of appropriate representation of minoritized racial and ethnic groups, frequent use of non-standard categories to describe race and ethnicity, and the small number of articles focused on health disparities raise concerns about the generalizability of research findings, equity in research processes, and attention to populations that experience disparities in palliative care outcomes.
The e-PainSupport digital application for assessing pain and pain management in home hospice: A randomized controlled trial
06/21/25 at 03:00 AMThe e-PainSupport digital application for assessing pain and pain management in home hospice: A randomized controlled trialWestern Journal of Nursing Research; by Masako Mayahara, JoEllen Wilbur, Louis Fogg, Mary Clare Houlihan, Debra Parker Oliver, Jacquelyn J Benson, Arlene M Miller; 6/25Poor patient pain management in home hospice is associated with low family caregiver adherence to analgesic regimens. Health care technology can improve caregiver access to education and communication to hospice nurses... The e-PainSupport intervention produced a small positive effect on reducing pain intensity (d = 0.27) and statistically significant increase in adherence (P = .003), compared with usual care... Caregiver use of the e-PainSupport app is feasible and may contribute to decreasing hospice patient pain.
Saturday newsletters
06/21/25 at 03:00 AMSaturday newsletters focus on headlines and research - enjoy!
[Ireland] Palliative care nurse specialists’ perspectives on spiritual care at end of life—A scoping review
06/21/25 at 03:00 AM[Ireland] Palliative care nurse specialists’ perspectives on spiritual care at end of life—A scoping reviewJournal of Hospice & Pallaitive Nursing; Dunning, Bronagh MSc, PGCert, BSc, RGN, RNT, FHEA; Connolly, Michael PhD, MSc, BA, RGN, RNT; Timmins, Fiona PhD, FAAN, MSc, BA (Open), BSc (Open), BNS, FFNRSCI, RNT, RGN; June 2025The purpose of this scoping review was to explore and to summarize the published literature on palliative care nurse specialist’s perspectives of spiritual care at end of life. The research demonstrates that specialist palliative care nurses perceive spiritual care as an important element of holistic care at end of life; however, these nurses also agree that spiritual care is lacking. This deficiency results from a lack of education in spirituality; experience of the nurse; the nurses’ own spiritual and religious beliefs and values, fears, and difficulties in communication; and the nurse-patient relationship. The findings demonstrate the necessity to increase the level of spiritual care education in nurse programs, educating nurses on the provision of spiritual care, and how to deal with conflicts in spiritual and religious beliefs.
Snowline rethinks donation policy
06/20/25 at 03:15 AMSnowline rethinks donation policy Mountain Democrat, Placerville, CA; News Release; 6/18/25 ... Operated in support of Snowline’s nonprofit mission, its thrift stores raise crucial funds to provide palliative care, hospice services, bereavement and veteran support to individuals and families throughout our region. Recently, in response to feedback from the community about donation limitations, Snowline opened its doors to accept a broader range of donated items. The goal was simple: to be more accommodating and say “yes” more often to those wanting to give. ... While the outpouring of donations was generous and deeply appreciated, this well-intentioned shift led to a significant rise in items that simply could be resold, things that were broken, torn, incomplete or nonfunctional. As a result, waste removal costs have skyrocketed in the thousands due to an increased number of trash runs and landfill fees. These unexpected expenses threaten Snowline’s ability to direct maximum funds toward the care programs that are at the heart of its mission. “We want to be a resource for our community and also remain good stewards of the donations we receive,” said Director of Thrift Operations Daron Hairabedian. “But we also have a responsibility to ensure the dollars raised through our thrift operations go where they matter most, supporting patients and families in the most vulnerable times of their lives.” To preserve the long-term sustainability of Snowline’s vital programs, including palliative care and grief support services, Snowline Thrift Stores will return to a more selective donation process.
Today's Encouragement: Not all who wander are ...
06/20/25 at 03:00 AMNot all who wander are lost. ~ J.R.R. Tolkien
From burnout to belonging: Creating space for grief in clinical education
06/20/25 at 03:00 AMFrom burnout to belonging: Creating space for grief in clinical education American Academy of Pediatrics (AAP) Journals Blog; by Rachita Gupta; 6/16/25 ... While significant progress has been made in addressing burnout and emotional distress in medicine, and in incorporating these topics into medical education, many clinicians remain hesitant and uncertain about how to address grief and distress from patient care in day-to-day clinical practice. This uncertainty exists both in terms of their own experiences and, even more so, in supporting trainees. A lack of emotional processing in these difficult situations can accelerate burnout and further disconnect clinicians from the humanism and vulnerability that are intrinsic to the privilege of practicing medicine. ... The recently published Hospital Pediatrics article by Bloomhardt et al, “Good Grief? Introducing the TEARS Framework for Educator to Support Learners Experiencing Grief,” (10.1542/hpeds.2024-008096) addresses the hesitancy many clinicians experience when assessing learners’ emotional processing during or after distressing patient cases by introducing the TEARS framework. ...Editor's Note: See a related post in today's newsletter, "“Her toes fell off into my hand”: 50 moments that changed healthcare workers forever."
How AI tools help home health providers dramatically lessen OASIS time burden
06/20/25 at 03:00 AMHow AI tools help home health providers dramatically lessen OASIS time burdenHome Health Care News; by Joyce Famakinwa; 6/18/25 As home health leaders continue to identify areas where artificial intelligence (AI) can be most beneficial to their businesses, some are beginning to utilize these tools to reduce the time burden of the Outcome and Assessment Information Set (OASIS). Payment and outcomes are directly impacted by OASIS data collection, making accurate OASIS data collection crucial for home health providers. Yet for many clinicians, OASIS data collection can be a major pain point due to its complexity and time demands. Providers who have turned to AI-powered tools report “dramatic” efficiency gains. Still, experts note that some “fine tuning” remains to be done before the technology reaches its full potential.