Literature Review

Family caregiver perspectives on advance care planning discussions for residents with dementia led by trained nursing home staff: Insights from the APPROACHES project The Journal of the Post-Acute and Long-Term Care Medical Association; JAMDA; by Susan E. Hickman, PhD, Hillary D. Lum, MD, PhD, Kathleen T. Unroe, MD, MHA, MS; 3/6/26  Advance care planning (ACP) is essential in supporting family caregivers of nursing home residents with dementia, but nursing home (NH) staff often lack training to engage in proactive ACP discussions. An embedded pragmatic clinical trial was conducted to test a structured ACP training for NH staff called the ACP Specialist Program. This study explores family caregivers’ experiences related to discussions with the ACP Specialist, as well as needs and challenges in making ACP decisions for NH residents living with dementia.

Seniors who say they’re “not afraid of death” often still carry these quiet worries they don’t talk about Bolde; by Julie Brown; 4/1/26 My grandmother said it so matter-of-factly that it almost stopped the conversation. ... "I'm not afraid of it," she said. "I've had a very good life. When it's time, it's time." And she meant it. I believed her completely. But then, a few minutes later, she mentioned almost in passing that she hoped she wouldn't "get confused" at the end.

Nursing home profit status and pain among residents living with dementiaPain Management Nursing; by Sorah Levy, Barbara Resnick, Elizabeth Galik, Kelly Doran, Tara McMullen, Sarah Holmes; 2/26Nursing home (NH) residents living with dementia experience pain that is often sub-optimally managed. Nearly one in five nursing home residents with dementia experience pain symptoms.There is a known relationship between NH organizational factors, such as profit status, and quality of care. However, little attention has been paid to understanding the relationship between NH ownership profit status and pain among residents living with dementia. NH ownership profit status was not significantly associated with pain ... 

Medicare plan switching and hospice care among decedents with advanced cancer JAMA Network Open; by Xin Hu, Changchuan Jiang, Youngmin Kwon, Fangli Geng, Qinjin Fan, Kewei Sylvia Shi, Zhiyuan Zheng, Jingxuan Zhao, Joan L Warren, K Robin Yabroff, Xuesong Han; 3/2/16Importance: Hospice ... is an excluded benefit under Medicare Advantage (MA), with coverage instead provided by traditional Medicare (TM). With growing MA penetration, more beneficiaries also switch between MA and TM for financial protection and physician access considerations, although less is known about how different Medicare programs and plan switching behaviors affect EOL care for patients with advanced cancers.Conclusions and relevance: In this cohort study of Medicare decedents with advanced cancers, continuous MA enrollees were most likely to receive hospice at home, while those who switched from MA to TM more frequently received hospice care in nursing homes. Plan switching near the EOL may reflect access barriers, highlighting the importance of addressing care coordination to improve EOL care.

Hospice & Palliative Care of Chenango finalizes partnership with NYS Veterans Home in Oxford The Evening Sun, Oxford, NY; by Rebecca Laibowitz; 3/9/26 Hospice & Palliative Care of Chenango and the New York State Veterans Home at Oxford recently finalized a long-awaited partnership which now allows residents of the home and their families to receive hospice care from the nurses and volunteers of the organization. Prior to this partnership the home would have to send away people in seeking hospice care as strict regulations require a contract between a nursing home and hospice care provider in order for that type of care to be administered.

Outpatient curricular content for hospice and palliative medicine trainees: A national survey Journal of Pain and Symptom Management; by Harry J Han, Angelika Golebiowska, Emily N Hansen, Michelle Park, Victoria I Sweetnam, Christian T Sinclair, Jonathan C Yeh, Mary K Buss; 3/2/26, online ahead of print Context: More health systems are establishing outpatient palliative care (PC) programs, increasing demand for ambulatory PC clinicians. ... Little is known about the outpatient-specific knowledge and skills PC trainees should acquire for competent outpatient practice. Conclusion: This national survey identified foundational outpatient-focused educational topics for hospice and pallitive medical (HPM) learners and suggests that outpatient curricula prioritize deliberate education on the unique application of core PC skills in outpatient settings. This prioritized list provides education leaders a roadmap to enhance existing curricula and informs the development of outpatient educational resources that can be shared across institutions.

The measure isn’t wrong. The story is incomplete. McKnights Long-Term Care News; by Steven Littlehale; 2/27/26 Not long ago, I was sitting across from a nursing home leadership team as they stared at a quality measure report that didn’t make sense to them. ... So we did what more facilities should do when a QM score feels off: We stopped looking at the rating and started looking at the math. That’s where the real story surfaced. It wasn’t about poor care, but about exclusions not captured, covariates not fully coded, and pieces of the clinical picture that never made it into the structured data fields the Centers for Medicare & Medicaid Services reads. 

Azura Palliative Care & Hospice NBC WTMJ-TV, Milwaukee, WI; Press Release; 2/27/26 Azura has been the leader in Memory Care & Assisted Living for many years. They are now opening a new location in Mukwonago. They also have a new sister company Azura Palliative Care & Hospice. The two companies allow them to offer assisted living, memory care, respite, hospice, palliative care and an adult day program called TIME. 

“You’re not just there to do a job”: a qualitative examination of Canadian long-term care worker strengths BMH Health Services Research; by Duneesha Goonetilleke, Nick Boettcher, Sofia Celis & Bonnie Lashewicz; 2/25/26, online ahead of print Results: We present three themes identifying interlocking expressions of strength. First, during crisis, workers stretched roles, redistributed tasks, and supported one another to sustain care under extreme constraint. Second, staff upheld person-centred care in their daily actions, working from values of dignity, relationships, and residents’ goals. Third, workers translated experience into learning and advocacy, articulating ideas to improve staffing, role clarity, leadership practices, and visitation approaches. Across these expressions, workers’ tenacity, togetherness, and shared purpose enabled collective action, although these strengths often entailed costs such as fatigue and moral strain. 

Effect of antipsychotic medication use and type on mortality and cardiovascular risks in nursing home patients with dementiaAlzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring; by Hamid R. Okhravi, Fang Fang, Melissa P. Hunter, Brynn E. Sheehan; 1/26Antipsychotic medication (APM) use in nursing home (NH) patients with dementia is common but carries risks. APM use in NH dementia patients is linked to higher death risk. First‐generation APMs showed higher mortality risk than second‐generation APMs. Overall, APM use is associated with increased stroke risk. No association was found between APM use and MI risk overall.

‘It’s a collaborative effort’: Northern Light Medical Transport paramedics providing hospice supportWABI-5, Bangor, ME; by Alyssa Thurlow; 2/19/26 ... Paramedics can help patients across Maine with a variety of needs, but some are embracing a slower-paced role, focused on assisting those who are at the end of life. “Patients have access to care 24/7, and part of that coverage for after-hours is now coming through the community paramedicine program,” said hospice educator Allie Rohrer, RN. ... “It’s not with lights and sirens. It’s very low key. It’s driving there in a car, and then it’s talking through the issues,” said paramedic Ed Moreshead. ... Northern Light’s community paramedics are contracted with Northern Light Home Care & Hospice. Families in need of assistance call the triage number, and a hospice nurse and on-call physician can respond if needed.