Literature Review

Rethinking slow codes: Gina Piscitello, Parker Crutchfield, Jason WassermanGeriPal podcast; by Eric Widera, Alex Smith, Gina Piscitello, Parker Crutchfield, Jason Wasserman; 10/23/25I’m going to begin with a wonderful quote from a recent editorial in Bioethics by our guests Parker Crutchfield & Jason Wasserman. This quote illustrates the tension between the widely held view in bioethics that slow codes are unethical, and the complexity of real world hospital practice: “Decisive moral positions are easy to come by when sitting in the cheap seats of academic journals, but a troubling ambivalence is naturally characteristic of live dilemmas.” ... Today we talk about what constitutes a slow code, short code, show code, and “Hollywood code.” We talk about walk don’t run, shallow compressions, and…injecting the epi into the mattress! We explore the arguments for and against slow codes: harm to families, harm to patients, moral distress for doctors and nurses; deceit, trust, and communication; do outcomes (e.g. family feels code was attempted) matter more than values (e.g. never lie or withhold information from family)? ... One thing we can all agree about: the ethics of slow codes need a rethink.

Pastime activities, social connectedness, and grief resolution: A brief report highlighting the salience of socializing for grief resolution among bereaved older adultsThe Journal of Nervous & Mental Disease; by Xin Yao Lin, Holly G Prigerson, Yifan Chou, Paul K Maciejewski; 10/25We sought to examine the relationship between pastime activities (i.e., activity engagement), social connectedness with family and friends, and severity of Prolonged Grief Disorder (PGD) symptoms across younger, middle-aged, and older adults. Cross-sectional findings showed that engagement in pastime activities (e.g., travel, sports) was associated with greater social connectedness for older adults, and social connectedness was associated with lower PGD symptom severity. Engagement in pastime activities was associated with lower PGD symptom severity for middle-aged adults. Results are consistent with the socioemotional selectivity theory and the microsociological theory of adjustment to loss and suggest that grief interventions should have age-specific strategies, encourage specific pastime activities, and promote feelings of social connectedness.

Hospice of the Chesapeake and Partners In Care join to support aging communityHospice of the Chesapeake press release; by Elyzabeth Marcussen; 10/24/25Hospice of the Chesapeake is proud to announce that Partners In Care of Maryland, Inc., has officially joined its family of services under a newly formed umbrella organization, Chesapeake Health Partners... As Maryland’s largest independent nonprofit hospice organization, Hospice of the Chesapeake has been a trusted resource for individuals and families facing serious illness, helping them live each day with intention and peace. Partners In Care, a Maryland-based nonprofit, has built its legacy on helping older adults remain independent and engaged through its signature Service Exchange model where members help one another with transportation, handyman services, social connection and more.Note: This is in addition to Chesapeake Supportive Care and Southern Maryland House Calls partner to expand access to in-home palliative care in Calvert County, which we posted on 10/17/25.

Executive Personnel Changes - 10/24/25

Incarceration and quality of cancer careJAMA Network Open; by Oluwadamilola T. Oladeru, Ilana B. Richman, Jenerius A. Aminawung, Jason Weinstein, Lisa B. Puglisi, Rajni Mehta, Hsiu-Ju Lin, Emily A. Wang, Cary P. Gross; 10/25The incarcerated population in the US is aging, and an estimated 15% of incarcerated adults, or approximately 175,000 individuals, are now 55 years or older. With this demographic shift, diseases of aging have become more prevalent, and cancer now ranks as the most common cause of death among people who are incarcerated in the US. Despite the growing prevalence, cancer outcomes among those incarcerated lag behind those with no history of incarceration. Individuals diagnosed with cancer while incarcerated or immediately following release have an approximate 2-fold increase in cancer-related mortality compared with the general population, even after adjusting for stage at diagnosis. Along with other published literature, this work suggests that gaps in quality of care may contribute to observed disparities in outcomes.Assistant Editor's note: Most of us cannot imagine what it would be like to be in prison. With cancer. And perhaps even dying there. Steven Garner knows. He spent many decades as an inmate at a state penitentiary. While there, he became a hospice volunteer supporting dying inmates, training other volunteers, and he served to pioneer Hospice in Corrections programs throughout the US. Steven is out of prison now, living his best life in Colorado and consulting around the nation about ways to improve end of life care for incarcerated persons. Oprah Winfrey was involved in sharing Steven's story in a documentary called Serving Life. NPR published an article about Steven in February 2024. Additionally, Hospice Analytics has posted a link to a 20-minute video about Steven's life and work in prison: Angola Prison Hospice: Opening the Door. Steven is featured in The Historic New Orleans Collection's recently released book Captive State: Louisiana and the making of mass incarceration and he shared God Behind Bars' YouTube video Life changing day inside Angola Prison. If you'd like more information, Steven Garner has a website.

After her son’s painful death, a Cheshire mother highlights Connecticut’s pediatric hospice gap New Haven Register, Norwalk, CT; by Cris Villalonga-Vivoni; 10/26/25 Carolyn Torello believes that no parent should outlive their children, yet that became her reality. ...  As his condition worsened, the family faced his impending death without the support of pediatric palliative or hospice care. No provider, she said, seemed to know how to help or where to begin. He died at 15 years old in 2021. ... In 2020, an estimated 7,800 children in Connecticut were living with complex medical conditions that limited their life expectancy and could have benefited from palliative or hospice care, according to data from the National Survey of Children's Health. ... Torello thinks that if Michael had access to hospice care, he could have died with greater dignity, and their family could have focused on simply being together. ... Efforts to create a more formalized pediatric palliative care system have been underway since 2024, led by a state-commissioned working group that will make recommendations to the legislature on potential reforms.Editor's Note: Editor's Note: This article puts forth significant information (with links) for all states, for all hospices. Having served on the firmly rooted Pediatrics Team of Hospice & Palliative Care of Louisville (begun in 1980) for four years (1997-2001), I take for granted how some type of pediatric hospice care needs to be available in every region. For related articles we have recently posted:

AHA responds to OSTP request on AI policies for health care American Hospital Association; by Ashley Thompson, AHA Senior Vice President, Public Policy Analysis and Development; 10/27/25 ... On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners — including more than 270,000 affiliated physicians, 2 million nurses and other caregivers — and the 43,000 health care leaders who belong to our professional membership groups, the American Hospital Association (AHA) appreciates the opportunity to provide comment on the Office of Science and Technology Policy (OSTP) request for information (RFI) regarding regulatory reform on artificial intelligence (AI). ... [Our] members have urged that policy frameworks strike the appropriate balance of flexibility to enable innovation while ensuring patient safety. The AHA offers four categories of recommendations to maximize the potential for AI to improve care, accelerate innovation and support the health care workforce.

10 health systems most cited by AIBecker's Health IT; by Giles Bruce; 10/9/25 AI chatbots are increasingly citing health system websites in their answers to healthcare-related questions. But which organizations show up the most in these AI-generated responses? Marketing agency Outcomes Rocket analyzed 5,472 unique citations in August generated by ChatGPT, Google Gemini, Claude and Perplexity. Here is where U.S. health systems ranked among the most popular sources, according to the September report and data shared with Becker’s:

Survey update during government shutdown - REVISED Guidance, 10/21/2025CHAP blog; 10/21/25CMS posted and update to the memo, Contingency Plans – State Survey & Certification Activities in the Event of Federal Government Shutdown (QSO- 26-01-ALL-Revised) on 10/21/2025 that provides updates to state survey activity during the ongoing federal government shutdown. The revised guidance appears in red text. CMS has instructed CHAP that our survey activity is unaffected, and we will conduct our survey accreditation business as usual.

Driving sales and admissions success in hospice careTranscend Strategy Group; 10/13/25Behind every referral, every admission and every family supported by hospice care is a story. It is the story of providers working against the clock, of families making overwhelming choices, and of staff navigating the delicate balance between operational realities and the urgent need for compassionate care. Hospice admissions and sales are not merely about numbers or processes – they represent moments when trust, urgency and compassion converge.

GeriPal Live! at CAPC: Karen Bullock, Kim Curseen, Matt GonzalesGeriPal podcast; by Eric Widera, Alex Smith, Karen Bullock, Kim Curseen, Matt Gonzales; 10/9/25Eric and I had the pleasure of doing a GeriPal Live! Podcast as the closing keynote for the recent Center to Advance Palliative Care (CAPC) National Assembly in Philadelphia PA. For this podcast, we invited 3 guests to each select an article of interest to them, and engage in a discussion about the article, including questions from the CAPC attendees in the audience. Matt Gonzales used AI to select an article by Ravi Parikh on algorithm based nudges to default patients with advanced cancer into a palliative care consult... Kim Curseen selected an article by Harry Han in JPSM that surveyed palliative care fellowships... Karen Bullock selected a letter she first authored in response to Ira Byock’s white paper on a path forward in hospice and palliative care.

National Hospice Locator – Sixth quality score updateHospice Analytics blog; by Cordt T. Kassner; 10/14/25Based on feedback from hospice leaders nationwide, the sixth update of the hospice quality score calculation was uploaded on October 14, 2025. Launched in 2012, the National Hospice Locator helps individuals find hospice providers in their area and now averages 15,000+ monthly visits and searches. Beginning in 2023, the default sort order changed to prioritize quality scores, offering a more meaningful measure of excellence. This marks the first (and only) publicly available national ranking of all hospices by quality. Notably, nine hospices achieved a perfect score of 100 in this update. Congratulations: