Literature Review

State POLST program maturity status and dying in the nursing home or hospice in the United States: An event time studyJournal of the American Medical Directors Association; by Komal Patel Murali, May Hua, Patricia W Stone, Andrew Dick, Tadeja Gracner; 2/26State Physician Orders for Life-Sustaining Treatment (POLST) programs ensure documentation of orders for treatment are documented for the provision of goal-concordant care at the end of life. The national POLST organization tracks the maturity stages of state programs and categorizes them as developed (beginning of use) and endorsed (benchmarks and standardized use). Examining the association between POLST program maturation and the likelihood of dying in place can help clarify how implementation stage may affect end-of-life care and place of death. POLST program maturity is associated with a higher likelihood of NH residents dying in place or in hospice, potentially supporting goal-concordant care and reducing burdensome hospital transfers near the end of life.

Changes in RI hospice utilization and quality of care with increase in number of hospice programsJournal of Pain and Symptom Management; by Joan Teno; 3/26The number of licensed hospice programs in Rhode Island increased from four prior to 2017 to eleven by 2025, with many new providers being for-profit entities, some backed by private equity. Using public data, I analyzed trends in hospice use and quality, hypothesizing that the growth in providers may increase health care costs and raise concerns about the quality of care. Using public data, I analyzed trends in hospice use and quality, hypothesizing that the growth in providers may increase health care costs and raise concerns about the quality of care... Compared to not-for-profit hospices, for-profit providers showed significant differences in several measures, including a higher focus on enrolling patients with dementia—a population that may be more profitable because of their long length of stay and higher live discharge rates. A four-point difference in bereaved caregiver willingness to recommend for profit hospices indicates a moderate effect size5 and raises concerns about quality.

HMN 2026: How Nursing’s moral agency cannot be outsourced to AI Health Medicine Network; by George Demiris, PhD, Patricia Brennan, PhD. Oonjee Oh, MSN, and Sang Bin You, MSN; 3/24/26 ... Recommendations for health  systems: The article emphasizes that nurses must not be passive users of technology but active leaders in its design and implementation. To preserve the public’s trust, the authors offer several critical recommendations.

Regional pediatric Education and Assistance Collaborative for Hospice nurses (REACH): A tele-educational intervention Journal of Hospice and Palliative Nursing; by Taylor Aglio, Alexa Bobelis, Ashley Autrey, Tracy Hills, Alexandra Superdock, Arshia Madni, Kelly Bien, Nidhi Mali, Erica C Kaye; 3/20/26... To address [the gaps between hospice care for seriously ill children and their families and adult-focused hospice paradigms], a multidisciplinary team comprising physicians, nurses, psychosocial clinicians, community members, and bereaved parents was convened to develop the Regional Pediatric Education and Assistance Collaborative for Hospice Nurses (REACH) initiative. Using a community-based participatory research approach, a stakeholder-driven tele-educational intervention was designed, refined, and implemented as a pilot for hospice nurses across Tennessee. Pilot data showed this hub-and-spoke model to be feasible, acceptable, and impactful, increasing hospice nurses' knowledge and comfort with provision of pediatric care in the community.

Identifying key components of neuropalliative care fellowship using nominal group techniqueJournal of Pain & Symptom Management; by Sachi Y Gianchandani, Jocelyn M Jiao, Kwame O Adjepong, Yaowaree L Leavell, Jessica M Besbris, Neha M Kramer, Joel N Phillips, Paul M Vermilion; 2/26There is no standardized curriculum for neurology-focused palliative care training. An adapted nominal group technique (NGT) was used to collect and rank responses to 2 key questions: "In designing the ideal dedicated neuropalliative care clinician training experience, what core components should be included?" and "When a general palliative care fellowship has a neurologist in their program, how could the program/program director potentially tailor the year to their unique needs?" For both key questions, the top-ranked responses included: dedicated outpatient neuropalliative care experience, mentorship from faculty with expertise in neuropalliative care, and a core didactic curriculum that includes neurology-specific content. Additionally, appropriateness for certification in hospice and palliative medicine was identified as crucial.

Effects of psychoeducation on burden, depression, and anxiety in informal caregivers of patients with dementia: A systematic review of randomized controlled trialsWestern Journal of Nursing Research; by Hyeyeon Shin, Chanchanok Wandee, Kathy D. Wright, Dónal P. O’Mathúna; 2/26As dementia rises globally, caregivers face prolonged and demanding responsibilities, increasing their risk of burden, depression, and anxiety. We aimed to identify the effectiveness of psychoeducation on burden, depression, and anxiety among informal dementia caregivers. This review clarifies the benefits of psychoeducation to inform the development of effective, targeted interventions. Psychoeducation offers dementia-related information, behavior management strategies, and caregiver support to improve mental health and caregiving effectiveness.

The business case for family caregiver skills training: Results from a multisite trial in the Veterans health care systemJournal of the American Medical Directors Association; Brystana G Kaufman, Michael A Lourie, Kasey Decosimo, Cynthia J Coffman, Joshua Dadolf, Matthew Tucker, Leah Christensen, Virginia Wang, Kelli D Allen, Susan N Hastings, Courtney H Van Houtven; 2/26Increasing caregiver training programs is valuable; however, even minimal health insurance cost-sharing can reduce access for those who need it most. We evaluated costs from the VA perspective, in which veterans and caregivers do not face high out of-pocket costs. Outside the VA, Medicare beneficiaries with care needs and caregivers do face these costs, potentially exacerbating health disparities. Integration and documentation of all caregivers in need of training is needed to support the systematic implementation of programs. Policies like the RAISE Family Caregivers Act encourage health systems to identify and provide necessary skills to family caregivers of hospitalized patients; yet, few health systems include a caregiver field in their EHR. As the need for caregiver training increases, health systems may leverage new reimbursement mechanisms to support the financial feasibility of delivering evidence-based caregiver training programs.

Hospice and palliative care during COVID-19 in New York City: Clinician-reported patient and family experiences and lessons for future crisesAmerican Journal of Hospice and Palliative Care; by Junyi Lin, Shih-Yin Lin, Daniel David, Laura T Moreines, Emily Franzosa, Abraham A Brody, Melissa D Aldridge, Dena Schulman-Green; 2/26The COVID-19 pandemic complicated hospice and palliative care (HPC) experiences of patients and family caregivers. We sought to understand HPC professionals' perceptions of patients' and family caregivers' HPC experiences during the COVID-19 pandemic in New York City and to make recommendations for improving HPC delivery during future public health crises.

[Italy] Vicarious post-traumatic growth in health professionals facing their patients’ end of lifeEuropean Journal of Trauma & Dissociation; by David Faggi, Gabriella Aprea, Chiara Fioretti; 3/26This study explored forms of vicarious post-traumatic growth perceived by professionals working in EoL [end of life] care settings. The findings indicate the presence of positive transformations, consistent with the construct of vicarious post-traumatic growth, among professionals who work daily in contact with patients’ suffering and finitude. The four themes identified (care as witnessing and mission; learning to live with death anxiety; personal vulnerability and resources; and authentic communication  [with terminally ill patients].The authors discuss the results, considering clinical implications and the potential role of post-traumatic growth in protecting healthcare professionals from distress and psychological suffering due to daily contact with death and dying.

The ASCENT Consortium: A new resource to support palliative care science across the lifespanJournal of Pain and Symptom Management; by Jean S Kutner, Melissa D Aldridge, Abraham A Brody, Chris Feudtner, Kimberly Johnson, Stacy M Fischer, Susan Lysaght Hurley, Alexis Bakos, Elena M Fazio, Karen A Kehl, Sandra A Mitchell, Elizabeth A Necka, Brennan Parmelee Streck, Chandra Keller; 2/26The ASCENT Consortium was funded by the National Institutes of Health (NIH) in August 2025 with the goal of advancing palliative care (PC) research, evidence, implementation and practice to improve care of persons with serious illness and those who care for them across the lifespan. ASCENT aims to: (1) Develop and coordinate the national scientific infrastructure and community needed to advance PC research... (2) Generate new PC research knowledge and methodologies... (3) Foster career development and impact of the PC scientist workforce by funding career development and pilot and exploratory awards... (4) Disseminate PC research findings and facilitate subsequent implementation via a multi-pronged approach...

How closed-ended survey questions and narrative comments interact in characterizing caregivers’ overall assessment of hospice care Rand.org, published in American Journal of Hospice and Palliative Medicine; by Denise D. Quigley, Anagha Alka Tolpadi, Danielle Schlang, Joshua Wolf, Rebecca Anhang Price, Melissa A. Bradley; April 2026 online ahead of  print Introduction: Responses to open-ended questions on experience surveys provide rich information and are useful for quality improvement (QI). We examine the usefulness of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey comments for informing hospice QI.Conclusion: Closed-ended questions on the CAHPS Hospice Survey elicit comprehensive insights on hospice care experiences. While many caregivers elected to provide open-ended feedback, a minority of these comments were actionable for QI, and comments did not provide substantial, unique information. CAHPS Hospice Survey measures are sufficient, without open-ended comments, to guide QI, prioritize actions, benchmark performance and assist caregivers in hospice selection.

Corticosteroid use and risk of adverse events in metastatic hormone-sensitive prostate cancerThe Prostate; by Umang Swami, Qiujun Shao, Tamuno Alfred, Maelys Touya, Frank Cao, Pinal Kamdar, Jasmina Ivanova, Johanna Celli, David Nimke; 2/26Among the approved therapies for metastatic hormone-sensitive prostate cancer (mHSPC), abiraterone and docetaxel are administered concomitantly with corticosteroids. This study evaluated the association between corticosteroid use and risk of adverse events among patients with mHSPC. Our findings suggest that patients exposed to corticosteroids are at increased risk of adverse events, hospitalization, and death. As not all mHSPC treatments require concomitant use of corticosteroids, these findings may help to inform treatment decision-making.