Literature Review

Hospitalists should champion hospice as ‘life with dignity’ Medscape; by Julie Peck; 5/29/25 If anyone can put a positive spin on the end of life, it’s Charles Vialotti, MD, director of Hospice Care at Holy Name Medical Center’s Villa Marie Claire in Bergen County, New Jersey. Violotti, who at the age of 80 lives at the 20-bed Villa Marie Claire to serve its residents full-time, says the hospice industry needs hospitalists’ help with sort of a rebrand, one that will almost certainly have a positive effect on patient and family satisfaction. “Providers used to stress offering people death with dignity. And if you think about that, who is ever going to choose anything that offers death? Death in any form is still death,” Vialotti said. “So, we really like to focus on offering people life with dignity, giving people back choice, giving them the option to structure their final days, weeks, or months the way they would most like to see it happen."

IU Health gets $20M gift for clinical innovation institute  Becker's Hospital Review; by Madeline Ashley; 5/20/25 Indianapolis-based Indiana University Health has received a $20 million donation from Sarah and John Lechleiter and Deborah and Randall Tobias to create the Tobias-Lechleiter Institute for Clinical Innovation. IU Health will match the donation, bringing the investment in the institute to $40 million, according to a May 20 news release shared with Becker’s. ... The institute plans to recruit 75,000 residents yearly in advanced medical studies; enroll 300,000 patients in the Indiana Biobank initiative over five years to aid research into genomic risk factors pertaining to Indiana’s population; attract and retain top fellows, students and faculty; enhance research resources; and increase the impact and pace of statewide medical research.

From an old ambulance, they help the growing homeless population CT Mirror; by Ginny Monk; 5/25/25 The needs of the unhoused are becoming more complex, and the fight for state support is fierce. ... Launched in 2021, the [Neighborhood Health workers] team drives a refurbished ambulance to shelters or encampments, then provides health care on-site for people experiencing homelessness. They’re out nearly every day. In recent months, as more people, particularly seniors, have lost their housing, health workers are finding that the cases they handle are more complicated. People often have multiple diagnoses, and with older age groups, there are often health complications that make the illnesses or injuries harder to treat. Sometimes, conversations are veering to end-of-life care. These conversations between health care professionals and patients are poignant as state lawmakers debate funding for the systems that offer shelter and other services for the unhoused population. ...

Johnson champions Eddie's Law to bring dignity to end-of-life-care in Illinois Public, Springfield, IL; News Release; 5/22/25 After an incarcerated man named Eddie Thomas died alone in a prison infirmary without receiving any end-of-life care, State Senator Adriane Johnson is championing legislation to bring dignity, compassion, and transparency to hospice and palliative care services in Illinois correctional facilities. "This bill is about basic human dignity," said Johnson (D-Buffalo Grove). "No one should die in pain, in isolation or without the comfort of care - no matter who they are or where they live. House Bill 2397 brings transparency to a system that too often leaves people to suffer silently." ... House Bill 2397 would require the Illinois Department of Corrections to prepare and publish an annual report detailing its hospice and palliative care programs. The bill aims to provide lawmakers with data that can guide future policy decisions on compassionate and medically appropriate end-of-life care for people incarcerated in Illinois. 

[UK] An exploration of perceived impact of receiving complementary therapies on service users during the palliative and end-of-life care phaseInternational Journal of Palliative Nursing; Jason Vickers, Brian Nyatanga, Hayley Holden; 4/25Background: To explore and understand the narratives of service users in the hospice setting regarding the value they place on complementary therapies and their perceived impact on overall wellbeing. The benefits derived from complementary therapy sessions include managing anxiety and stress, developing better sleep strategies and devising coping techniques for personal situations and contexts through guided discussions and personal reflection. 

‘Wake-up call’: Aggressive cancer care common at end of life, supportive care lackingHealio; by Josh Friedman; 5/22/25Nearly half of people with advanced cancer receive aggressive care at the end of life, a rate little changed from a decade ago. At the same time, use of palliative or supportive care remains rare, despite increasing evidence that they are a key component of high-quality, patient-centered care. ... Meanwhile, two other studies showed oncologists’ individual practice patterns and institutional resources can play a significant role in determining which patients receive systemic therapy or early palliative care at the end of life.

New law will fast-track completion of hospice death certificatesFlorida Politics; by Drew Wilson; 5/21/25 Grieving families will spend less time waiting on paperwork come July 1.Gov. Ron DeSantis has signed legislation that would take some stress off palliative care physicians who guide patients through their final hours, as well as the grieving families they leave behind. Sponsored by Republican Rep. Dana Trabulsy, HB 647 would allow Advanced Practice Registered Nurses (APRNs) to complete and file death certificates for hospice care patients. Valid death certificates must record both time of death and cause of death before the deceased’s remains can be turned over to a funeral director. Under current law, a doctor must determine the cause of death and sign the certificate. That will remain the case after Trabulsy’s bill goes into effect July 1 for non-hospice deaths.

What caregivers should know about end-of-life rallies  AARP; by Jamie Ducharme; 5/19/25People with advanced illnesses sometimes experience unpredictable bursts of energy or clarity. Here’s how caregivers should handle these episodes. Roughly a decade after her mother was diagnosed with Alzheimer’s disease, Liz Donnarumma got her back — but only for an instant. It happened one evening in 2021, more than a year after Donnarumma first realized her mother, Theresa, didn’t recognize her. Theresa took Donnarumma’s face in her hands, called her by her nickname and thanked her. “When she put her hands on my face and I looked into her eyes, she was totally there. It was my mother,” Donnarumma says. “It was like a second, just one second, and it was gone.” Donnarumma’s mother had an episode of “paradoxical lucidity” — that is, an unexpected burst of mental clarity, despite her advanced condition. While these moments are as unexplained as they are unexpected, experts say they are more common than many people realize. ...

[Australia] Overtreatment of older people near end of life: A qualitative scoping review of modalities, drivers, and solutionsOmega-Journal of Death and Dying; Samantha Fien, Emily Plunkett, Daniel Wadsworth, Magnolia Cardona; 4/24This study aimed to understand the drivers better to help minimise further risks of overtreatment for older people near the end of life (dysthanasia). Determinants included healthcare system factors, patient-centered care, family and caregiver, and clinician perspectives. This review confirms that despite almost two decades of recognition of the potential harms of overtreatment near the end of life, society, patients, and health systems have a role to play in reducing and addressing the determinants. We offer a range of solutions for clinicians, health service managers, and members of the public to consider.

The future of dying with Dr. Ira Byock | Pop 1205 Practice of the Practice; podcast by Joe Sanok with Dr. Ira Byock; 5/14/25 How can we embrace conversations about death and dying? What is the healing power of forgiveness and connection in end-of-life care? When we face morality, how can we transform fear into meaningful connections? In this podcast episode, Joe Sanok speaks about the future of dying with Dr. Ira Byock. .. In this podcast: 

Palliative and end-of-life care during critical cardiovascular illness: A scientific statement from the American Heart Association American Heart Association; by Erin A. Bohula, MD, DPhil, Michael J. Landzberg, MD, Venu Menon, MD, FAHA, Carlos L. Alviar, MD, Gregory W. Barsness, MD, FAHA, Daniela R. Crousillat, MD, Nelia Jain, MD, MA, Robert Page II, PharmD, MSPH, FAHA, Rachel Wells, PhD, MSN, and Abdulla A. Damluji, MD, PhD, MBA, FAHA on behalf of the American Heart Association Acute Cardiac Care and General Cardiology Committee of the Council on Clinical Cardiology; and Council on Cardiovascular and Stroke Nursing; 5/15/25 Abstract: Cardiac intensive care units are witnessing a demographic shift, characterized by patients with increasingly complex or end-stage cardiovascular disease with a greater burden of concomitant comorbid noncardiovascular disease. Despite technical advances in care that may be offered, many critically ill cardiovascular patients will nevertheless experience significant morbidity and mortality during the acute decompensation, including physical and psychological suffering. Palliative care, with its specialized focus on alleviating suffering, aligns treatments with patient and caregiver values and improves overall care planning. Integrating palliative care into cardiovascular disease management extends the therapeutic approach beyond life-sustaining measures to encompass life-enhancing goals, addressing the physical, emotional, psychosocial, and spiritual needs of critically ill patients. This American Heart Association scientific statement aims to explore the definitions and conceptual framework of palliative care and to suggest strategies to integrate palliative care principles into the management of patients with critical cardiovascular illness.

Dementia patient discharged from hospice over Medicare requirement. Here’s why it happened WKMG-6, Deltona, FL; by Erika Briguglio and Louis Bolden; 5/14/25A Volusia County family is left scrambling after their loved one is abruptly dropped from hospice care. To qualify for hospice, patients must have a life expectancy of six months or less. However, for dementia patients, the prognosis can be unpredictable. Hospice care can be extended as long as the patient continues to meet Medicare requirements. Unfortunately, these requirements are why Amy Yates lost coverage for her 91-year-old grandmother. ... “I think it’s she hasn’t died fast enough, and it’s costing them money that they don’t want to spend,” Yates told News 6. ... What Yates’ family is dealing with is what Medicare calls live discharge, and they are not alone. The Hospice Foundation of America reports that 17% of people in 2022 who were admitted to hospice care were discharged; about 6% of the total caseload was discharged because they no longer met Medicare requirements for care under the hospice benefit.Editor's note: What are your hospice stats for live discharges? For Length of Stay (LOS)? This factor--with the face-to-face recertification requirement--is crucial. Unfortunately, many hospices misused President Jimmy Carter's extraordinarily long LOS with misleading information about hospice care. They watered down "end-of-life" care and never mentioned anything about a basic recertification process. Warm, user-friendly language can be used with integrity, authenticity, and patient/caregiver support.