Literature Review

Changes in RI hospice utilization and quality of care with increase in number of hospice programsJournal of Pain and Symptom Management; by Joan Teno; 3/26The number of licensed hospice programs in Rhode Island increased from four prior to 2017 to eleven by 2025, with many new providers being for-profit entities, some backed by private equity. Using public data, I analyzed trends in hospice use and quality, hypothesizing that the growth in providers may increase health care costs and raise concerns about the quality of care. Using public data, I analyzed trends in hospice use and quality, hypothesizing that the growth in providers may increase health care costs and raise concerns about the quality of care... Compared to not-for-profit hospices, for-profit providers showed significant differences in several measures, including a higher focus on enrolling patients with dementia—a population that may be more profitable because of their long length of stay and higher live discharge rates. A four-point difference in bereaved caregiver willingness to recommend for profit hospices indicates a moderate effect size5 and raises concerns about quality.

Identifying key components of neuropalliative care fellowship using nominal group techniqueJournal of Pain & Symptom Management; by Sachi Y Gianchandani, Jocelyn M Jiao, Kwame O Adjepong, Yaowaree L Leavell, Jessica M Besbris, Neha M Kramer, Joel N Phillips, Paul M Vermilion; 2/26There is no standardized curriculum for neurology-focused palliative care training. An adapted nominal group technique (NGT) was used to collect and rank responses to 2 key questions: "In designing the ideal dedicated neuropalliative care clinician training experience, what core components should be included?" and "When a general palliative care fellowship has a neurologist in their program, how could the program/program director potentially tailor the year to their unique needs?" For both key questions, the top-ranked responses included: dedicated outpatient neuropalliative care experience, mentorship from faculty with expertise in neuropalliative care, and a core didactic curriculum that includes neurology-specific content. Additionally, appropriateness for certification in hospice and palliative medicine was identified as crucial.

Effects of psychoeducation on burden, depression, and anxiety in informal caregivers of patients with dementia: A systematic review of randomized controlled trialsWestern Journal of Nursing Research; by Hyeyeon Shin, Chanchanok Wandee, Kathy D. Wright, Dónal P. O’Mathúna; 2/26As dementia rises globally, caregivers face prolonged and demanding responsibilities, increasing their risk of burden, depression, and anxiety. We aimed to identify the effectiveness of psychoeducation on burden, depression, and anxiety among informal dementia caregivers. This review clarifies the benefits of psychoeducation to inform the development of effective, targeted interventions. Psychoeducation offers dementia-related information, behavior management strategies, and caregiver support to improve mental health and caregiving effectiveness.

The business case for family caregiver skills training: Results from a multisite trial in the Veterans health care systemJournal of the American Medical Directors Association; Brystana G Kaufman, Michael A Lourie, Kasey Decosimo, Cynthia J Coffman, Joshua Dadolf, Matthew Tucker, Leah Christensen, Virginia Wang, Kelli D Allen, Susan N Hastings, Courtney H Van Houtven; 2/26Increasing caregiver training programs is valuable; however, even minimal health insurance cost-sharing can reduce access for those who need it most. We evaluated costs from the VA perspective, in which veterans and caregivers do not face high out of-pocket costs. Outside the VA, Medicare beneficiaries with care needs and caregivers do face these costs, potentially exacerbating health disparities. Integration and documentation of all caregivers in need of training is needed to support the systematic implementation of programs. Policies like the RAISE Family Caregivers Act encourage health systems to identify and provide necessary skills to family caregivers of hospitalized patients; yet, few health systems include a caregiver field in their EHR. As the need for caregiver training increases, health systems may leverage new reimbursement mechanisms to support the financial feasibility of delivering evidence-based caregiver training programs.

Hospice and palliative care during COVID-19 in New York City: Clinician-reported patient and family experiences and lessons for future crisesAmerican Journal of Hospice and Palliative Care; by Junyi Lin, Shih-Yin Lin, Daniel David, Laura T Moreines, Emily Franzosa, Abraham A Brody, Melissa D Aldridge, Dena Schulman-Green; 2/26The COVID-19 pandemic complicated hospice and palliative care (HPC) experiences of patients and family caregivers. We sought to understand HPC professionals' perceptions of patients' and family caregivers' HPC experiences during the COVID-19 pandemic in New York City and to make recommendations for improving HPC delivery during future public health crises.

The ASCENT Consortium: A new resource to support palliative care science across the lifespanJournal of Pain and Symptom Management; by Jean S Kutner, Melissa D Aldridge, Abraham A Brody, Chris Feudtner, Kimberly Johnson, Stacy M Fischer, Susan Lysaght Hurley, Alexis Bakos, Elena M Fazio, Karen A Kehl, Sandra A Mitchell, Elizabeth A Necka, Brennan Parmelee Streck, Chandra Keller; 2/26The ASCENT Consortium was funded by the National Institutes of Health (NIH) in August 2025 with the goal of advancing palliative care (PC) research, evidence, implementation and practice to improve care of persons with serious illness and those who care for them across the lifespan. ASCENT aims to: (1) Develop and coordinate the national scientific infrastructure and community needed to advance PC research... (2) Generate new PC research knowledge and methodologies... (3) Foster career development and impact of the PC scientist workforce by funding career development and pilot and exploratory awards... (4) Disseminate PC research findings and facilitate subsequent implementation via a multi-pronged approach...

Religion and spirituality in pediatric end-of-life: A systematic reviewJournal of Pediatric Psychology; by Kara Jackson, Alyssa Marchetta, Barry Nierenberg, Jessica M Valenzuela; 2/26Spirituality is a recognized element of palliative care, with documented benefits for adult patients. However, limited research exists on how religion and spirituality affect children at end-of-life (EOL) and their parents. Findings revealed diverse religious and spiritual practices among families, including faith stability, spiritual care use, and prayer. Key outcomes associated with spirituality included enhanced coping, acceptance, meaning-making, hope, caregiver spiritual well-being, decision-making, and improved parent-child communication. Across studies, spiritual support emerged as a vital component of the pediatric EOL experience.

Burden and well-being among dementia caregivers in Puerto Rico: The role of behavioral and psychological symptoms of dementiaThe Journals of Gerontology; by Junyub Lim, Ross Andel, Frank Puga, María P Aranda, Maricruz Rivera-Hernandez, Ana Luisa Dávila-Roman, Michael Crowe; 2/26Dementia is more prevalent in Puerto Rico than in the U.S. mainland, increasing demands for caregiving. We examined caregiver burden and depressive symptoms among Puerto Rican dementia caregivers while also considering behavioral and psychological symptoms of dementia (BPSD). Caregivers were 63 ± 10 years of age on average, and 77% were women. In this Puerto Rico-based sample, perceptual disturbances/apathy, and appetite/eating symptoms specifically, were most likely to magnify the caregiver burden-depressive symptoms link.

Physicians are not providers: The ethical significance of names in health care: A policy paper from the American College of PhysiciansAnnals of Internal Medicine; by Lois Snyder Sulmasy, Jan K. Carney, for the ACP Ethics, Professionalism and Human Rights CommitteeMore than 25 years ago, Pellegrino and Relman noted the increasing commercialization of the learned professions, anticipating what many physicians are increasingly experiencing today: an impairment of their ability to practice in accordance with standards of medical ethics and professionalism. These hurdles to the physician’s ability to do right by the patient contribute to what leaders in medicine and the American College of Physicians have called deprofessionalization. An example is the use of the term provider to describe physicians and other health professionals. The use of this terminology has been reviewed in medical journal articles but has not been adequately explored as a matter of ethics and professionalism. Through that lens, this paper examines the trends, significance, and implications for patients, physicians, and health care of the use of the term provider.

What does moral agency mean for nurses in the era of artificial intelligence?Hastings Center Report; by Connie M Ulrich, Oonjee Oh, Sang Bin You, Maxim Topaz, Zahra Rahemi, Liz Stokes, Lisiane Pruinelli, George Demiris, Patricia Flatley Brennan; 2/26Being a moral agent was once thought to be an irreplaceable, uniquely human role for nurses and other health care professionals who care for patients and their families during illness and hospitalization. Today, however, artificial intelligence systems are often referred to as “artificial moral agents,” “agentic,” and “autonomous agents.” As these systems begin to function in various capacities within health care organizations and to perform specialized duties, the question arises as to whether the next step will be to replace nurses and other health care professionals as moral agents. Focusing primarily on nurses, this essay explores the concept of moral agency, asking whether it remains exclusive to humans or can be conferred on AI systems. We argue that AI systems should not supplant nurses’ moral agency, as patients come to hospitals or any other health care setting to be heard, seen, and valued by skilled professionals, not to seek care from machines.

Call for applications: Investigator in Residence ProgramASCENT press release; 3/2/26The Advancing the Science of Palliative Care Research Across the Lifespan (ASCENT) Consortium invites applications for its 2026 Investigator in Residence Program. The goal of this program is to increase the number of palliative care investigators, expand the range of institutions where palliative care research is performed, and develop scientific and leadership capabilities leading to future successful grant proposals, both through ASCENT and extramurally. Applications due Thursday, March 26 at 5:00 pm PT.