Literature Review

6 health systems that faced worker strikes this month MedCity News; by Katie Adams; 7/22/25 Healthcare workers at six health systems across the country have launched strikes in July so far. These healthcare employees cite unsafe staffing levels, low wages and retaliation against union organizers as their main reasons for going on strike. From hospice centers to emergency rooms, frontline healthcare workers across the country have been striking this month to protest what they say are unsafe patient care conditions and poor bargaining behavior. Below are six examples of union activity resulting in a strike — all of which occurred in July.

Caring for a difficult elderly parent during a transitionPsychology Today - Caregiving; "Personal Perspective" by Franne Sippel, EdD, LP; 7/21/25 I am the only child of an only child who lives in an assisted living facility thousands of miles away. I unofficially diagnosed Mom with obsessive-compulsive personality disorder after struggling for years with a relationship fraught with guilt and frustration. ... It’s difficult enough to care for a frail parent when their health is failing. However, the added OCD personality, with its micromanaging, rules, and demands, tests patience beyond compare.  ... A good friend suggested I call hospice to evaluate her. Jim, a hospice RN in his 70s, arrived and instantly assessed the situation with laser-like precision. ... I spend many months going back and forth between South Dakota and Arizona to see my mom. Hospice continues to visit her three to four times a week at the assisted living facility, and a dear family friend also visits her several times a week. ... Editor's Note: Keep reading this article to its end. The insightful, practical, sensitive care from these hospice clinicians generated life-long transformations for this burdened caregiver-daughter. 

My mother refused treatment for her breast cancer. Her doctors should have respected her choice. Instead they dismissed her--and criticized me.STAT; by Joy Lisi Rankin; 7/21/25My mother died in January 2007. She told the family that she had breast cancer in 2002. We still don’t know when she knew, or when she had been diagnosed. One thing we did know: She chose not to treat the cancer. In her encounters with health care professionals — doctors, nurses, assistants — during the last years of her life, her choice was met with disbelief and disdain. “Why aren’t you treating your cancer?” “Do you understand what’s going to happen?” “You know you’re going to die, right?” A final thought went unsaid but was clear: “If you’re not going to do what I recommend, I can’t do anything for you.” [Limited access to STAT with three stories per month.]

Ok, please help calm my anxiety. My mother has drastically improved in the last couple of days since goin on hospice. Aging Care; by Oedgar23; 7/17/25 So in the hospital, my mother was in kidney failure. The last couple days after stopping vancomycin for about five days, her GFR had come up to 19. That’s the most recent Number and then they stopped drawing labs because we placed her on Hospice. We consulted with palliative care team. They wanted to do a feeding tube and we said no. They said she had advanced dementia. [Describes improvements since hospice.] ... What if she gets taken off hospice? ... What if she no longer qualifies for hospice, passes as normal cognitively, starts demanding to go home, does not qualify for long-term care, Medicaid, etc. ... But I am super unnerved because she looks a whole lot better than she has been looking. ...Editor's Note: Yes, we all know that the person can get better with hospice care, because of holistic person-centered care, caregiver education and support, and many more factors. This can be confusing. The dying trajectory may have been interrupted or simply calmed with better symptom management and quality of life. This daughter is asking normal, crucial questions which the hospice team needs to be addressing with her. Examine your live discharge data, Policies and Procedures, communication practices with the patient and family about recertifications, Incident Reports from upset caregivers/families, and CAHPS Hospice scores.

Collective leadership in home-based palliative care: Advancing APRN roles to enhance successHome Health Care Management & Practice; Nicole DePace, MS, APRN, GNP-BC, ACHPN; Rebecca Souza, DNP, ANP-BC, ACHPN; Therese Rochon, MA, MS, FNP-C; Paula Rego, DNP, AGPCNP-BC; Constance Dahlin, MSN, ANP-BC, ACHPN, FPCN, FAAN; 6/25Palliative advanced practice registered nurses are instrumental in responding to the opportunities and challenges in home-based palliative care through advocacy, practice, education, program development, and leading interprofessional teams. Collective leadership is proposed as a framework to address these tensions in home-based palliative care. Two cases are presented to compare and contrast collective and traditional leadership models, illustrate the role of the palliative advanced practice registered nurse leader, demonstrate how to avoid the pitfalls of a traditional leadership model, and build sustainable success through collective leadership principles. Finally, strategies to engage advanced practice registered nurses in leadership roles and address the tensions of the policy gaps in home-based palliative care are provided.

Leveraging speedy admissions to support hospice growth Hospice News; by Jim Parker; 7/16/25 Seamless and fast admissions processes are crucial to hospice growth. Speedy hospice patient admissions can lead to improved referral numbers, profitability and length of stay. Yet, hospices need to carefully navigate their patient admission processes to maximize both quality and their revenue. The hospices that do this effectively have a core set of key performance indicators that they look at consistently, according to Tony Kudner, chief strategy officer of the consulting firm Transcend Strategy Group. “The ones that look at data and are constantly asking themselves, ‘How can we paint the fullest picture of eligibility and get to that patient as quickly as possible?’ are the ones that we would say are the ones that are successful,” Kudner told Hospice News. “The people who have that information at their fingertips and use it to drive decision making are usually the ones who are sustaining their organizations and growing.”

Hospice nurse who amputated patient’s foot without permission for use in sickening taxidermy display escapes jail sentence New York Post; by Chris Nesi; 7/13/25 A Wisconsin nurse who amputated a patient’s frostbitten foot without authorization and planned to use it as a ghoulish display in her family’s taxidermy shop was given a sweetheart plea deal in which she’ll serve no time in prison and pay just $443 in court costs. ... The patient died days later, though no definitive link was made between his death and the amputation, according to a criminal complaint. ... The victim, Doug McFarland, was being treated for severe frostbite in both feet after suffering a fall in his home. His feet had become necrotic — remaining attached to his leg by only a tendon and two inches of skin — and he was moved to hospice care, according to KSTP. After cutting off his right foot — which she referred to as “mummy feet” — she told nursing home colleagues she planned to preserve the foot and display it in a taxidermy shop owned by her family as a graphic warning about the dangers of frostbite. ... Although Brown escaped a jail sentence, she may face disciplinary proceedings from the Wisconsin Board of Nursing and is no longer allowed to work as a caregiver in any capacity.

[Germany] A Berlin doctor goes on trial, accused of murdering 15 patients who were under palliative care U.S. News & World Report; by Associated Press; 7/14/25 A German doctor went on trial in Berlin Monday, accused of murdering 15 of his patients who were under palliative care. The prosecutor’s office brought charges against the 40-year-old doctor “for 15 counts of murder with premeditated malice and other base motives” before a Berlin state court. The prosecutor’s office is seeking not only a conviction and a finding of “particularly serious” guilt, but also a lifetime ban on practicing medicine and subsequent preventive detention. ... Parallel to the trial, the prosecutor’s office is investigating dozens of other suspected cases in separate proceedings. The man, who has only been identified as Johannes M. in line with Germany privacy rules, is also accused of trying to cover up evidence of the murders by starting fires in the victims' homes. He has been in custody since Aug. 6.

CDC reports rise in unintentional fall deaths among older adults JAMA; by Samantha Anderer; 7/11/25 The US Centers for Disease Control and Prevention (CDC) reported that deaths from unintentional falls among adults aged 65 years or older increased over the past 2 decades. Falls are currently the leading cause of injury for older adults, reaching 70 per 100 000 in 2023. As age increases, so does the likelihood of death due to a fall. And data from the National Vital Statistics System indicate that from 2003 to 2023, adults aged 85 years or older experienced the greatest increase in fall deaths. Rates for men, who are more likely to die from an unintentional fall, doubled from 178 to 373 per 100 000 people among those 85 years or older. For women in the same age group, deaths from falls increased 2.5 times, from 129 to 320 per 100 000. 

Home-based palliative care for cancer patients: Evaluating a decade of nursing-led interventionsAmerican Journal of Hospice and Palliative Medicine; Júnia de Oliveira Alves, RN; Eduardo Bruera, MD; Mônica Isaura Corrêa, MD; Sonia Souza, PhD; Marília Ávila de Freitas Aguiar, PhD; Ana Paula Drummond-Lage, PhD; 6/25Home-based palliative care is an effective approach for managing advanced-stage cancer patients, particularly in regions with limited healthcare infrastructure. In Brazil, the “Better at Home” Program enables interdisciplinary teams to deliver palliative care in patients’ homes, with nurses playing a central role in providing clinical and supportive interventions. Registered nurses (RNs) were responsible for complex procedures, supervision of nursing technicians (NTs), and caregiver training, while NTs performed routine clinical tasks and assisted with daily care. Notably, 99.4% of patients died at home, suggesting alignment with palliative goals of care. These findings underscore the central role of RNs in coordinating and delivering home-based palliative oncology care within a multidisciplinary framework.

‘Family’s Voice Diary’ improved support for caregivers of patients at the end of life Oncology Nurse; by Ryner Lai; 7/1/25 The authors of this study sought to understand the challenges that caregivers face when a patient is approaching end of life. For this study, they worked with bereaved relatives, members of the public, healthcare professionals, and policymakers to develop the Family’s Voice Diary (FVD), an initiative that allowed participants to freely express their thoughts regarding end-of-life care and the role of caregivers. ... These interviews illuminated some of the challenges that were faced when providing end-of-life care. For example, families expressed a lack of knowledge regarding what “normal” dying looks like and they wanted more support from healthcare staff, but were reluctant to ask or didn’t know how to approach the subject. Healthcare professionals themselves appeared to be reluctant to discuss matters associated with death. 

How AI is redefining the nurse’s day Becker's Health IT; by Naomi Diaz; 7/3/25 As generative AI continues to make its way into healthcare, chief nursing informatics officers say the technology’s influence is expanding beyond documentation and reshaping the way nurses work. [Examples described include the following:]

Palliative care knowledge, attitudes, and self-competence of nurses working in hospital settingsJournal of Palliative Care; Mona Ibrahim Hebeshy, PhD, RN; Darcy Copeland, PhD, RN; 6/25With the growing need to integrate palliative care into healthcare systems, nurses in hospital settings often provide care for patients with life-limiting conditions, many of whom lack formal education in palliative care. [Conclusions:] Nurses generally feel competent; however, they often lack confidence in addressing patients’ social and spiritual needs. They experienced unease when discussing death and exhibited paternalistic attitudes. Significant differences were found in educational background, nursing experience, personal caregiving experience, and practice setting. Positive correlations exist between attitudes, knowledge, and self-competence, indicating that greater knowledge and competence were associated with better attitudes toward end-of-life care.