Literature Review

Beyond the bottle: a whole person approach to pain management for veterans enrolled in inpatient hospice Medscape; by Tracy Shamas, APRN, MSN, ACHPN, Andrea Ruskin, MD, HEC-C, and Alexandra Laffer, PhD; 9/9/26 Background: ... Veterans Affairs inpatient hospice units are uniquely positioned to implement non-pharmacological pain interventions due to longer lengths of stay and broader resources compared to Medicare GIP-regulated settings. This quality improvement project aims to support the uptake and utilization of non-pharmacological pain management interventions for veterans receiving inpatient hospice care. ... Conclusions: Initial findings show that veterans with pain at end-of-life express interest in holistic non-pharmacological options, and integrating these approaches is feasible within inpatient hospice care. ... 

When lung cancer spreads to the liver: what to expect Everyday Health; by Ashley Welch, medically reviewed by Tingting Tan, MD, PhD; 9/8/26 Liver metastasis from lung cancer occurs when cancer cells from the tumor in the lung travel to the liver. Also known as stage 4, it’s the most advanced stage of lung cancer. ...

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? 

When end-of-life becomes the beginning of new life: Application of the Society of Critical Care Medicine Clinical Practice Guidelines on Adult End-of-Life Care in the ICU to the setting of donation after circulatory deathCritical Care Explorations; by Ian M. Oppenheim, Rita N. Bakhru, Carolina B. Maciel, Katharina M. Busl, on behalf of the Donor Care Unit Network for Optimizing Recovery (DONOR) GroupThe recently published Society of Critical Care Medicine Guidelines on Adult End-of-Life Care in the ICU provide a detailed and well-thought-out approach to a vital component of critical care, although they explicitly refrain from discussing how they may apply to organ donation. As representatives of the Donor Care Unit Network for Optimizing Recovery (DONOR), a group of intensivists experienced in managing donation after circulatory death (DCD), we wish to endorse equal delivery of high-quality end-of-life (EOL) care for organ donors. Although some logistical differences must be addressed, the EOL recommendations outlined in the Guidelines are still applicable to patients being evaluated for or undergoing DCD. Recent accounts of unacceptable patient care in the setting of DCD highlight a critical threat to patient welfare and public trust. Our mandate is clear: implement and audit protocols that guarantee dignity and symptom control while demonstrating that DCD remains wholly consistent with a compassionate, honorable, and fulfilling EOL.

Evasiveness in everyday hospital palliative care practice: a focused ethnography Journal of Clinical Nursing; by Carolien van Leussen, Evelien Kuip, Renske Kruizinga, Els van Wijngaarden; 9/2/26 Conclusion: This study shows how evasiveness in hospital-based palliative care is produced and sustained through biomedical routines, organizational pressures and professional and personal orientations. These factors make it difficult to realize the holistic ideals of palliative care in everyday practice. As a result, patients' fears, uncertainties and end-of-life wishes often remain insufficiently explored, whereas organizational routines shape what is considered appropriate and possible in clinical interactions.

Alzheimer’s blood test gets FDA clearance, but not CMS coverage Inside Health Policy, Washington, DC; by Jessica Karins; 9/2/26 A blood test aiming to help with early identification of Alzheimer’s disease, including in primary care settings, by detecting buildup in the brain of the key Alzheimer’s biomarker amyloid beta plague, has been cleared by FDA, but the test and others in its category are not yet covered by CMS or any Medicare Administrative Contractors, its developer confirmed, with MACs having to make an individual determination for each patient of whether payment for the test is appropriate.

Beloved celebrities who opened up about their battles with dementia MSN; by Travis Reeed; 8/31/26 Dementia and Alzheimer’s disease have affected people from many walks of life, including some of the most recognizable figures in entertainment, politics, and culture. Their experiences helped bring greater attention to memory loss, cognitive decline, and the challenges faced by families and caregivers. From Hollywood legends to celebrated musicians and political leaders, these individuals continued to leave lasting legacies despite their health struggles. Their stories also helped encourage public conversations about conditions that were once poorly understood or rarely discussed openly. [Click on the slides to see personalized stories of Tony Bennett, Sally Kirkland, Ronald Reagan, Sean Connery, Margaret Thatcher, Rita Hayworth, and Jimmy Stewart.] 

I lost my sister to cancer. Here’s what I learned about medically assisted death. The Washington Post; by Steven Petrow; 8/29/26 The same year that my parents died, my sister, Julie, then 55, was diagnosed with advanced ovarian cancer. Five years and three recurrences later, she’d exhausted all viable treatment options. At that point, she’d undergone one nine-hour surgery, six courses of chemotherapy and had joined two clinical trials. Like my parents’ physicians had done, Julie’s doctor eventually recommended palliative care, with at-home hospice, to keep her comfortable during her last months. ... [Julie, 61, chose legal MAID in 2023.] Approaching MAID as a journalist, I had questions: How is eligibility determined, what are the safeguards, does it always work, is a health care professional involved and many others. As a brother, however, I was conflicted and confused, and my questions felt more urgent and personal. ... [Access might be limited by a paywall.]  

Spirituality and religiosity in end-of-life decision-making in intensive care units: a systematic review of preferences, ethical framing, and meaning-making Cureus; by Dimitrios G. Apostolakis, Nikiforos V. Angelopoulos, Spiros Georgakis, Fotios Tatsis, Foteini Veroniki, Konstantinos Stamatis, Georgios Papathanakos, Mary Gouva, Vasilios Koulouras; 8/25/26 End-of-life decision-making in intensive care units (ICUs) is a complex and ethically challenging process shaped not only by clinical factors but also by patients' values, cultural contexts, and spiritual or religious beliefs. ...  [Spirituality] demonstrated a multidimensional role, facilitating acceptance of death, promoting support for palliative care in some contexts, and contributing to meaning-making during the end-of-life process. Cultural and contextual factors moderated these relationships, and the provision of spiritual care by healthcare professionals was associated with less aggressive end-of-life care. ... Integrating spiritual assessment and culturally sensitive spiritual care into routine clinical practice may enhance shared decision-making and improve alignment between treatment decisions and patients' values, preferences, and goals of care.

Frailty predicts more than age: strategies for hospitalists Medscape; by Julie Peck; 8/25/26 An 85-year-old who remains active and independent may recover from pneumonia more quickly than someone 20 years younger with multiple chronic illnesses, poor nutrition, and declining mobility. Growing evidence suggests that frailty — a state of diminished physiologic reserve and increased vulnerability to stressors — is one of the strongest predictors of prolonged hospitalization, complications, functional decline, discharge to post-acute care, readmissions, and mortality, often outperforming chronological age alone.

Wound care fraud: key insights for healthcare providers in 2026 JD Supra; by Lynette Byrd; 8/21/26 The U.S. Department of Justice (DOJ) and U.S. Department of Health and Human Services Office of Inspector General (HHS OIG) are prioritizing wound care fraud enforcement in 2026. Healthcare providers are facing scrutiny under the False Claims Act and Anti-Kickback Statute, with audits and investigations leading to substantial liability (among other consequences) in many cases. ... Allegations of wound care-related health care fraud can take many different forms. ... While it is critical that elderly patients (including hospice patients and other terminally ill patients) receive appropriate care, there are limits to what is considered appropriate when billing Medicare or Medicaid for wound care. ...