Literature Review

Study finds dementia influences decisions about life-sustaining treatment, even when advance directives request itCU Anschutz newsletter; by Kelsea Pieters; 10/7/26A new CU Anschutz study found that dementia status can influence end-of-life treatment decisions, even when a patient’s advance directive requests life-sustaining care. The findings highlight the importance of ongoing conversations about end-of-life wishes and choosing a surrogate who understands and will honor those preferences. People were about 19 percentage points less likely to recommend life-sustaining treatment for a seriously ill patient with dementia than for a patient without dementia, even when an advance directive requested life-sustaining care, according to new research from the University of Colorado Anschutz. The study, published in JAMA Network Open, surveyed nearly 6,000 U.S. adults to examine how a patient’s dementia status, advance directive, physician recommendations and a surrogate decision-maker’s own preferences influenced recommendations about end-of-life care.Publisher's note: Bold and italics mine - this is a striking finding!

Announcing JAMA AI - A new journal from the JAMA NetworkJAMA Network; by Roy H. Perlis, Annette Flanagin, Kirsten Bibbins-Domingo; 10/15/26We are pleased to announce that JAMA AI, the 14th journal in the JAMA Network, will launch in early 2027. JAMA AI will address the full spectrum of artificial intelligence (AI) in health care, from foundational advances to real-world clinical implications. We will strive to publish clinical research that involves not only AI, but the full range of computational tools as they are applied to improve human health. Beyond AI, the journal will publish impactful studies that incorporate mobile apps, wearable sensors, physiologic monitors, digital imaging and pathology, virtual reality, and all the analytic and implementation methods necessary to apply these technologies in medicine and health care. We will also publish studies that capture the effects of technology on health more broadly, including AI and social media.

‘A scalpel and not a shotgun’: Home care offers views on better fraud enforcementMcKnights Home Care; by Liza Berger; 10/15/26The crackdown on Medicare home care fraud escalated in May when the Centers for Medicare & Medicaid Services imposed its first-ever nationwide moratorium on new hospice and home health provider enrollments. While the home care advocacy community, which includes associations that represent for-profit and nonprofit providers, expressed various opinions of the six-month regulation, it agrees that the moratorium should end at its scheduled time in November. There also is consensus on a better long-term strategy for fighting fraud: targeted, risk-based enforcement... “I think that as we sort of look at this for the long haul, we’ve got to create an approach that allows for sustainability — sustainability at addressing the fraud and abuse issues,” said Tom Koutsoumpas, CEO of the National Partnership for Healthcare and Hospice Innovation (NPHI), which represents about 140 not-for-profit community-based programs throughout the country, in a recent McKnight’s Home Care podcast... In speaking during a quarterly “state of home care” webinar hosted by the Polsinelli law firm in September, Jennifer Sheets, CEO of the Alliance, may have said it best: “We need a scalpel and not a shotgun. And I feel like we’re under the shotgun right now.”

Collaboration between oncology and palliative care key to high-quality careCancer Therapy Advisor; by Jennifer Larson; 10/16/26High-performing oncology programs that foster mutual trust and real-time communication between oncology and palliative care teams achieve greater quality of care, better patient outcomes, and more timely hospice transitions.To ensure patients with cancer receive high-quality care, oncology programs may need to take a close look at strategies for improving the relationship between their team and the palliative care team, according to the results of a study recently published in JAMA Internal Medicine [Effective palliative care for hospice transitions, 9/26].

Aging life care managers can be a ‘Godsend’ for familiesKFF Health News; by Paula Span; 10/14/26If a combination of appointments, bureaucracy, vigilance, and worry about a vulnerable older person — often interspersed with medical emergencies — sounds familiar, it might help to know about a service its providers ruefully call the best-kept secret in eldercare... About a decade ago, these experts rebranded themselves as aging life care managers. It usually takes a couple of years to become one. Most enter the profession as nurses or social workers; some are physical or occupational therapists or gerontologists. They must attain a required combination of advanced education and supervised experience before they can take the certification exam. The Aging Life Care Association, the nonprofit that represents these professionals, was founded in the 1980s and has grown to more than 2,000 members... Aging life care managers work for the client and the family paying them, not for hospitals or insurance companies. Moreover, the association’s extensive code of ethics specifically prohibits “accepting or giving referral fees, fee splitting, kickbacks or other similar arrangements in exchange for client referrals.” ... Aging life care managers serve as coordinators, not hands-on caregivers, and the range of services they provide is quite broad.

‘Byzantine ownership arrangements’: Calls to scrutinize coding and profit incentives in nursing home Medicare paymentsSkilled Nursing News; by Zahida Siddiqi; 10/9/26Policy analysts at the nonpartisan agency that advises Congress on Medicare policy are planning to investigate potential coding distortions, payment inaccuracies and whether financial incentives influence patient selection by nursing home providers as part of an assessment of payment accuracy in fee-for-service Medicare’s skilled nursing facility and home health payment systems. At its October meeting Friday, the Medicare Payment Advisory Commission (MedPAC) discussed a research work plan, with commissioners calling attention to for-profit providers seeking to game the system, with a rising role of hidden private equity influence. [MedPAC presentation slides here.]Publisher's note: Bold and italics above are ours; if MedPAC is looking at this in SNF and HHA, hospice is likely not too far behind...

Social Media Watch 10/9/26

Reconnecting at the end: The healing power of nature in hospice and palliative careDr. Owen Wiseman blog; by Owen Wiseman; 8/18/26 [Originally published by Dr. Wiseman through the Canadian Hospice Palliative Care Association on 1/5/26]A caregiver gently holds the hand of an older adult resting in a hospital bed, conveying compassion, comfort, and human connection during serious illness or end-of-life care. When I think about comfort at the end of life, I picture difficult moments buffered by a sense of softness. Small moments that remind us that we’re part of something bigger. One of the most profound sources of comfort is nature. The feeling of sunlight warming our skin, the sound of birds outside a window, or that first breath of fresh air. In hospice and palliative care, every moment is important, and these connections to the world around us offer something no medicine or machine can. Why nature matters...

Out now: the Global Atlas of Palliative Care, 3rd editionWorldwide Hospice Pallaitive Care Alliance (WHPCA); by Stephen R. Connor; 10/9/26Today, at the 50th Montréal International Palliative Care Congress, we launched the third edition of the Global Atlas of Palliative Care. It offers the most complete picture yet of who needs palliative care worldwide, and who is receiving it. The picture shows real progress, but a gap that remains very wide.

LifeTouch Health data breach exposes Social Security numbers and health recordsData Breach Rights; 10/13/26Arkansas Hospice Inc., operating as LifeTouch Health, notified the Vermont Attorney General in October 2026 of a data breach exposing Social Security numbers, government ID numbers, financial account data, and health records. The number of people affected has not been publicly disclosed. Affected individuals should place a credit freeze and monitor both credit reports and insurance statements closely.

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!

When you realize that each day is not one more day, it's one less, you will start giving more value to the things that truly matter.

Traumatic bereavement among incarcerated women: Understanding and responding to complex grief after the death of a childMDPI; by Catherine Gallagher, Nena P. Messina; 9/26 Incarcerated women face elevated suicide risk at the intersection of chronic loss, cumulative trauma, and constrained environments. In prison, the death of a child constitutes a profound and overlooked traumatic bereavement. This conceptual manuscript examines how carceral environments restrict privacy, autonomy, family contact, mourning rituals, and social and clinical support, thereby adversely reshaping grief. Restricted information, exclusion from rituals and relational validation, and punishment for grief-related behavior may obstruct narrative reconstruction, continuing bonds, and maternal identity reorganization. The model further considers how acute grief interacts with chronic stress, sustained threat responsivity, sleep disruption, and cumulative allostatic burden to intensify psychological and somatic distress without assuming a uniform neurobiological pathway.