Literature Review

When to reconsider artificial nutrition and hydration near the end of life South Hospital News and Healthcare Report; by Kamal Wahab, MD, HMDC; 9/24/26 Few end-of-life decisions generate more emotion and uncertainty than whether to continue or initiate artificial nutrition and hydration. Clinicians must balance the potential benefits of these interventions against the burdens while keeping the patient’s goals and quality of life at the center of the discussion. Hospice does not mean stopping treatment. Patients may continue treatments that relieve symptoms or improve quality of life. The guiding principle is whether the intervention is helping the patient achieve what matters most to them.

Palliative and psycho-oncology care: Dr. Ramy Sedhom on patient distress signs Oncology Nursing News; by Alex Biese; 9/21/26Ramy Sedhom, MD, of Penn Medicine Princeton Health discusses blending palliative care with psycho-oncology to treat patient distress in oncology care. ... In this Q&A with Oncology Nursing News, Sedhom discusses strategies for bridging historical silos between palliative care and psycho-oncology, debunks persistent misconceptions surrounding supportive interventions in curative settings, and identifies clinical red flags for unseen distress. 

The critical competencies hospice leaders must build for value-based care cuccess | part one Teleios Collaborative Network (TCN); podcast hosted by Chris Comeaux with Dr. Jessica Hubbs; 9/16/26 Value-based care isn’t just changing how hospice gets paid—it’s redefining what hospice leaders must be capable of delivering. In Part One of The Critical Competencies Hospice Leaders Must Build for Value-Based Care Success, host Chris Comeaux sits down with Dr. Jessica Hubbs, Chief Clinical Officer at Advanced Care Innovations, to explore the accelerating shift from fee-for-service healthcare toward models built around outcomes, total cost of care, and coordinated care delivery.  Dr. Hubbs explains why emerging models such as LEAD (Long-term Enhanced ACO Design) matter to hospice and palliative care leaders—and why the movement upstream into serious illness and home-based care could represent both a competitive headwind and an extraordinary opportunity.

Top ten tips palliative care clinicians should know when caring for seriously ill patients with stimulant use disordersJournal of Palliative Medicine; by Rebekka DePew, Nicole Dussault, Kyle Quirk, Erin Vipler, Josh Borris, Sandra DiScala, Teddy Scheel, Katrina Nickels, Gregg Robbins-Welty, Janet Ho; 8/26Stimulant use disorder (StUD) is common in the hospice and palliative care (PC) setting, though guidance for clinicians remains limited. Stigma around stimulant use is widespread and can lead to impaired clinician/patient communication, poor symptom control, and lower quality of care. PC clinicians should be able to diagnose StUD, understand the potential pharmacologic and nonpharmacologic management options, engage with patients in a trauma-informed way, and refer to addiction medicine colleagues when appropriate. When utilizing opioids for pain management, PC clinicians should be aware of the impact of stimulant use on opioid risk and toxicity. In this article, a multidisciplinary group of PC, hospice, addiction medicine, psychiatry, ethics, and pharmacy clinicians presents ten practical tips for caring for seriously ill patients with current or prior StUD.

Death Matters: The bedside vigil (Part 2) — after death arrivesSequim Gazette, Sequim, WA; by Jeanette Stehr-Green and Astrid Raffinpeyloz; 9/16/26The bedside vigil is the act of sitting by a dying person during their final hours or days, holding space for them with a loving presence, and tending to their needs. The vigil can provide comfort and companionship to the dying person. It can offer meaning and peace to all involved. The undertaking, however, does not end with the loved one’s last breath. Immediately following the death, the vigil enters a new stage, one that allows time to honor the moment but also attend to the practical steps that must follow. ...

The critical competencies hospice leaders must build for value-based care cuccess | part one Teleios Collaborative Network (TCN); podcast hosted by Chris Comeaux with Dr. Jessica Hubbs; 9/16/26 Value-based care isn’t just changing how hospice gets paid—it’s redefining what hospice leaders must be capable of delivering. In Part One of The Critical Competencies Hospice Leaders Must Build for Value-Based Care Success, host Chris Comeaux sits down with Dr. Jessica Hubbs, Chief Clinical Officer at Advanced Care Innovations, to explore the accelerating shift from fee-for-service healthcare toward models built around outcomes, total cost of care, and coordinated care delivery.  Dr. Hubbs explains why emerging models such as LEAD (Long-term Enhanced ACO Design) matter to hospice and palliative care leaders—and why the movement upstream into serious illness and home-based care could represent both a competitive headwind and an extraordinary opportunity.

Perceived importance of good death components among patients with advanced cancer and family caregivers JAMA Network; by Hammoda Abu-Odah, PhD, Gulbeyaz Can, PhD, Sotirios Plakas, PhD, Juanjuan Zhao, PhD, Xixi Wang, MSN, Alexandros Stergiou, MSc(c), Ourania Govina, PhD, Kimya Kilicaslan, PhD, Bahar Ozdemir, MD, Matthew J. Allsop, PhD, Mitsunori Miyashita, PhD, Alex Molassiotis, PhD, Janelle Yorke, PhD, and Frances Kam Yuet Wong, PhD; 9/14/26Importance: Although the concept of a good death is central to palliative care policy and practice, empirical evidence is largely derived from high-income Western or single-country contexts, limiting cross-setting relevance.Objective: To determine the importance of good death components, compare priorities across settings, and examine patient–caregiver differences and setting-by-role interactions. ... Conclusions and Relevance: In this cross-sectional study, patients with advanced cancer and family caregivers across 5 settings shared a broad aspiration for a good death, but priorities varied across settings. Emotional peace, dignity, and family connection were consistently highly valued. These findings suggest that culturally sensitive palliative care models should recognize both shared end-of-life priorities and setting-specific meanings of a good death.

Enhancing quality of life for terminally ill veterans during the COVID-19 pandemic and beyond Medscape | Federal Practitioner; by Denise Kresevic, PhD, RN, APN-BC, Marilyn Swanson, DNP, RN, FNP-C, Muralidhar Pallaki, MD, Bridgette Wasil, MSN, RN CHPN, Rosalie Diaz, PsyD, and Christopher J. Burant, PhD; 9/14/26 Background: Honoring individualized preferences for end-of-life interventions for veterans is a priority for families and caregivers. Medications used to treat symptoms such as pain, anxiety, and delirium may also result in sedation, making it difficult to balance comfort while minimizing sedation. ... Conclusions: The See Me, Hear Me, Comfort Me model may help hospice teams better align end-of-life care with individual preferences. ...

[Hospice bereavement director] A non-anxious presence: Red Cross volunteer supports Flight 93 families and responders American Red Cross; video interview with Patti Anewalt, PhD; 9/1/26 [Dr. Patti Anewalt is the retired director of Hospice and Community Care's Pathways Center for Grief and Loss, Mount Joy / Lancaster, Pensylvania. Of note, her hospice organization supported her volunteer time in this crucial Red Cross disaster mental health role.] When Patti Anewalt first learned about the terrorist attacks on Sept. 11, 2001, she immediately sensed her phone might ring. At the time, Patti was an American Red Cross volunteer in Central Pennsylvania and an experienced grief counselor [whose PhD was in trauma]. As coworkers gathered around televisions to watch events unfold, she told her boss she thought she would be called to respond. She was right. The next day, Patti was deployed to Somerset County, Pennsylvania, where United Flight 93 crashed near Shanksville ... For two weeks, she worked alongside fellow Red Cross volunteers, supporting victims' families, disaster workers and responders as they navigated one of the most tragic moments in American history. ... As family members arrived in Pennsylvania, many visited the crash site for the first time. Some were unsure whether they even wanted to go. ... "Whenever we're teaching in hospice, we say we're a non-anxious presence at a very difficult time in people's lives," she said. "The role I had there was no different than my day role at hospice because it's just being a non-anxious presence to people who are in the worst time in their lives and being present for them." ...Editor's Note: Many readers know Patti--both as faithful friend and for her prolific leadership teaching about trauma, grief, and hospice organization's appropriate (and not appropriate) responses to community tragedies, especially in the years following 9/11. Patti led NHPCO's professional Bereavement Group to be the most active, growing group during her 6-year volunteer tenure. Patti was a regular reader of our newsletter until her well-deserved, recent retirement.

Time is of the essence: evaluating short-term prognosis tools in cancer and non-cancer patients Journal of Pain and Symptom Management; by Kayla Sheehan, Navasuja Kumar, Julia Pudar, Susan Duong, Megan Bricely, Mohamman Alhameed, Mohammed Kabeto, Donglin Zeng, Adam Marks; 8/27/26 Accurate end-of-life prognostication supports patient, family, clinician, and health system decision-making. The Palliative Prognostic Index (PPI), Palliative Performance Scale (PPS), and Short-Term Prognosis Signs (SPS) have been used in palliative care populations, particularly advanced cancer (1-3), but their utility for short-term prognostication in non-cancer patients is less established.

When the end of life feels like a beginning: a hospice encounter raises questions medicine can't answerBroadview; by Ralph Klose; 9/8/26 As a retired neuropsychologist and longtime hospice companion, I often wonder what can still be measured at the end of life — and what cannot. ... Magda had lived in the hospice for three months. A former violinist, she rarely spoke about her past. But her hands still moved in gentle arcs, as if drawing invisible phrases from the air. ... One afternoon, I entered her room and paused. The air felt different — not cold, not scented, but bright. The blinds were closed. No sunlight entered. And still, the space around her shimmered faintly, like a curtain of breath. Her skin looked translucent. Her lips moved, but no sound came. Later, as I sat quietly at her bedside, a nurse whispered, “She’s speaking with someone.” There was no theology in her gestures. No visions of angels. But something had changed — as if a second world had unfolded beside the first, not replacing it, but resting gently alongside. ...

Central Illinois nursing home fined $25K by state after resident's death Pekin Daily Times, Perioa, IL; by Zach Roth; 9/6/26 A Canton nursing home was fined $25,000 after a resident died last year after being taken off medication that was prescribed to prevent blood clots. ... On March 31, 2025, a verbal order was given to stop providing Xarelto because the woman began hospice care one month prior. ... The care plan noted that she had a history of strokes and that medication needed to be provided as ordered by her doctor. ... The hospice's owner said that the power of attorney had contacted them after the woman had died asking about the medication situation, noting that they hadn't seen anything to show that her Xarelto had been discontinued. The hospice owner also said that they hadn't received an order from a hospice physician or nurse to discontinue it. Editor's Note: Details are more complex than space allows in the short summary above. A verbal order to stop a medication, without a documented physician directive or clear communications with the family, is a quiet risk hiding in plain sight at hospice transitions — one that can hasten death rather than ease it. Deprescribing has its place in end-of-life care, but only through structured, physician-ordered, shared decision-making. Does your hospice's process protect against this, or could it happen to one of your patients tomorrow?