Literature Review

Advance care planning with people living with dementia: Ethical considerations of physicians in the United States and the Netherlands The Journals of Gerontology; by Jingyuan Xu, David R Mehr, Marieke Perry, K Taylor Bosworth, Kate McGough, Wilco P Achterberg, Hanneke Smaling, Jenny T van der Steen; 8/25Interviews with 50 Dutch physicians and 47 American physicians and 3 nurse practitioners generated three themes of ethical considerations: 1) Respecting the autonomy of the person with dementia, 2) Rationality as the basis for decisions and subsequent actions, and 3) Minimizing burden and suffering. The complexity of ACP [advance care planning] for people living with dementia is reflected in the challenges within each ethical consideration and the tensions between them, especially between autonomy and rationality. We recommend an approach to ACP that balances the ethical considerations, focusing on the values of the people living with dementia and allowing flexibility in future decision-making to take the current best interest of the person into account.

A decade of interactive educational exchange: Impacting interprofessional palliative care educationJournal of Pain and Symptom Management; by Laura J Morrison, Shirley Otis-Green, Julie Bruno, Pamela N Fordham, Elise C Carey; 9/25The interprofessional clinical practice model is arguably the most impactful and generative aspect of hospice and palliative care (HPC) clinical practice. This article describes the innovative shared interprofessional leadership model, andragogical infrastructure, program development, educational impact, and critical lessons from the Interactive Educational Exchange (IEE). In response to a deficit in interprofessional HPC educational opportunities for rapid scholarship dissemination and mentorship, interprofessional leaders from medicine, social work and nursing proposed and implemented the IEE at the Annual Assembly of Hospice and Palliative Care presented by the American Academy of Hospice and Palliative Medicine and Hospice and Palliative Nurses Association from 2010-2020. The reported outcome measures for interprofessional scholarship and engagement, session evaluations, and attendance demonstrate why this successful innovation was repeated annually for over a decade pre-COVID. 

Let's face (to face) it: Important changes to hospice face-to-face attestation requirements and other tidbits from the 2026 Hospice Final Rule Husch Blackwell; podcast by Meg Pekarske; 9/24/25 ... All in all, the news is positive: while there is a new requirement for the F2F attestation to be signed and dated, the signed and dated F2F clinical note on its own can now serve as the F2F attestation. In this episode, Husch Blackwell attorneys Meg Pekarske and Andrew Brenton share their thoughts on what the updated F2F attestation rules mean for hospice operators and weigh in on other components of the final rule, including CMS’s attempt at housekeeping by clarifying the types of hospice physicians who can certify patients. 

Cancer patients are living longer than ever. Pain drugmakers haven’t kept up. Biopharma Dive; by Jacob Bell; 9/25/25 Decades of slow-moving research, along with broader failures of the healthcare system, have left millions of people in daily pain. Doctors fear that’s bound to continue. ... More than 2 million people in the U.S. alone are diagnosed with cancer each year. Conservative estimates hold that between 20% and 50% experience related pain, though that figure can climb as high as 80% for patients with advanced disease. Despite the large number of patients and the need for more therapies, drugmakers have mostly shied away from pain altogether, fearing that its complicated biology makes for too risky a research investment.  ... Opioids remain the core of many treatment regimens. This lack of drug choices is aggravated by much broader failures of the healthcare system. 

Exploring the opportunities and mitigating the challenges of Artificial Intelligence in nursing education Delaware Nurses Association; by Kristine Gawrych, Ed.D., RN; 9/22/25 The recent and rapid advances in artificial intelligence (AI) have generated both excitement and concern in higher education. Opportunities for AI in nursing education can be transformative, including simulation, accessibility, and personalized learning. Just as the opportunities can be transformative, concerns such as bias, privacy, security, and ethics must be given due consideration. Nurse educators must understand enough about AI to effectively maximize its benefits and mitigate the challenges when preparing future nurses. ... Nurse educators must educate themselves on this ever-evolving technology to be able to develop strategies to mitigate the challenges of AI. 

New ‘action plan’ gives providers tools to prevent falls, minimize injuries  McKnights Home Care; by Adam Healy; 9/18/25 The National Council on Aging this week published its 2025 National Falls Prevention Action Plan, a report that offers strategies home care providers can use to protect their clients from injury. NCOA’s action plan has six goals: boosting awareness, expanding funding, promoting clinical interventions, enhancing care coordination, upgrading technological capabilities and improving data collection for fall prevention activities. While the action plan aims to inform policymakers about ways to protect older adults from falls, it also includes actionable strategies home care providers can employ to keep their clients safe.

The role of the palliative medicine and supportive oncology APP Oncology Nursing News; by Antonia Corrigan, MSN, ANP-C; 9/22/25 ... A cancer diagnosis can bring an avalanche of psychosocial and physical obstacles for patients to navigate. ... Advanced practice providers (APPs) are key in providing quality supportive care. ... The American Society of Clinical Oncology (ASCO) guidelines recommend that patients with cancer be referred to interdisciplinary palliative care teams within 8 weeks of diagnosis. Early palliative referral benefits patients with high symptom burden, both physical and psychosocial, and enhances caregiver support. 

AI can aid in end-of-life care decisions, but can't replace human teams MarylandToday; by Fid Thompson; 9/19/25 “Would I be surprised if this person were not alive 12 months from now?”  This so-called “surprise question,” combined with clinical risk calculators, helps doctors make decisions about care for patients near the end of life. Increasingly, clinicians also use artificial intelligence (AI) models to predict remaining life expectancy and better inform palliative care decisions. In a recent study out in the Journal of Palliative Medicine, a University of Maryland researcher sought to understand what palliative care teams think about these AI tools that give an estimated life expectancy or prognosis in end-of-life care, and found mixed reactions. 

What makes a good death? GeriPal - A Geriatrics and Palliative Care Podcast for Every Healthcare Professional; by Alex Smith with Karen Steinhauser, Rasa Mikelyte and Edison Vidal; 9/18/25What is a “good death”? How should we define it, and who gets to decide? Is the concept of a “good death” even useful? ... In today’s podcast, we are honored to have Karen join us to discuss this pivotal study and the nature of a “good death”. We are also joined by Rasa Mikelyte and Edison Vidal, co-authors of a recent study comparing the perspectives of people with dementia in the UK and Brazil on what constitutes a good death. In addition to exploring the nature of a good death and their individual studies, we will discuss:

Associations of patient experience with doctor-patient communication and patient-reported physical and mental health in seriously ill adultsJournal of Patient Experience; by Sarah F. D’Ambruoso, Anne M. Walling, Neil S. Wenger, Rebecca L. Sudore, Lisa Gibbs, Maryam Rahimi, Ron D. Hays; 8/25We administered the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) communication scale, Patient-Reported Outcomes Measurement and Information System (PROMIS®) global health items, and the PROMIS-29 depression and anxiety scales. Better global health (PROMIS) at baseline was associated with better doctor-patient communication (CAHPS) at 12 months ... and better doctor-patient communication at baseline was related to better mental health at follow-up ...The results suggest that patients’ overall health may influence doctor-patient communication, and this communication may impact patients’ mental health over time.

Wound care marketing can create confusion around hospice relatedness Hospice News; by Jim Parker; 9/16/25 Hospices provide wound care to many patients, but confusion can arise over questions of relatedness to the terminal illness. The goals of palliative wound care include primarily symptom management, comfort and dignity, but it does not always focus on healing the injury, a 2023 study indicated. This differs from general wound care, which does target healing. Palliative wound care is essential for hospice patients and most of the time should be considered related to the patient’s terminal condition, according to Felicia Walz, director of hospice quality for Colorado-based provider HopeWest. “Providing wound care to hospice patients is always appropriate,” Walz told Hospice News.

Health systems should empower their primary care physicians to deliver better palliative and end-of-life care Medscape - Family Medicine; by Edward L. Burns, MD, MA; 9/17/25 Primary care physicians (PCPs) play a pivotal role in managing the overall well-being of their patients. However, when it comes to palliative and end-of-life care, many health systems do not train or empower their PCPs to manage this important part of their patients’ lives. ... By systematically training PCPs in palliative care principles and communication skills, health systems can simultaneously deliver significantly higher quality, patient-centered care that aligns with families’ values and wishes, while reducing unnecessary hospitalizations, ICU admissions, and aggressive interventions that may not align with patients’ wishes. 

Wound care at Sheridan VA gives 95-year-old Veteran a second chance: Veteran removed from hospice care at Sheridan VA after wounds heal VA News; by Jesus Flores; 9/12/25 When 95-year-old Air Force Veteran Roy Clifton arrived at Sheridan VA Medical Center (SVAMC) in March 2025, he thought he didn’t have much time left. “I had a bone infection in both feet and could barely walk,” he said. “Then I had a fall that caused a bleed in my brain. That’s when I decided to call it quits and go to hospice.” ... [Scroll ahead to this hospice's expert wound care.] Although both feet had exposed bones, and the injuries looked and smelled bad, Clifton’s body was healing. ... Clifton’s condition improved so much, he was taken off hospice care. “It made me feel great to survive hospice,” he said, smiling. “They’re all great. The staff took good care of me.”