Literature Review

Medical interpreters’ experiences with patients who are near end-of-life and their family membersJournal of Pain and Symptom Management; by Joycelyn Howard, Alexia M. Torke, Susan E. Hickman, Greg Sachs, Sylk Sotto-Santiago, James E. Slaven, Denise Robinson; 3/25In 2019 the United States Census Bureau reported 8% of the United States Population “speak English less than very well”. Ensuring individuals with a non-English language preference (NELP), previously referred to as limited English proficiency, have equitable access to healthcare includes providing high quality interpreter services. Although self-efficacy for interpreting EOL [end of life]conversations is generally high, interpreters desire education about EOL care. Interventions are also needed to address the high emotional toll of interpreting EOL conversations. Education and training about EOL care may help them to not only convey information accurately but also cope with emotional nuances characteristic of these significant conversations, ultimately elevating the quality of care for patients and family members in vulnerable and important moments.

Medicare and 24-hour in-home hospice care​: Is it covered?Healthline; Medically reviewed by Shilpa Amin, MD, CAQ, FAAFP and written by Mandy French; 3/25/25... Medicare offers hospice coverage for beneficiaries. However, there are certain eligibilities and guidelines that they must meet. ...

[Austria] Influence of prior knowledge and experience on willingness to pay for home hospice services: a contingent valuation study International Journal of Health Economics and Management; Caroline Steigenberger, Andrea M Leiter, Uwe Siebert, Claudia Schusterschitz, Magdalena Flatscher-Thoeni; 3/25/25 Home hospice services contribute to dying in dignity by addressing medical and social needs at the end of life. ... We aim to quantify the benefits of home hospice services to society using society's monetary valuation and examine the influence of prior knowledge and experience on willingness to pay for home hospice services. A nationwide cross-sectional contingent valuation study was conducted in Austria. ... The two-part regression analysis showed a statistically significant positive impact on the probability of having a positive willingness to pay by prior knowledge of home hospice services, prior donations, and the wish of not dying alone. [Continue reading ...]Editor's note: Pair this research from Austria with today's USA post, "Medicare and 24-hour in-home hospice care: Is it covered?" Too often, we take for granted our Hospice Medicare payment system. Some choose to misuse it in ways that lead to fraud. This research reinforces openess to hospice services per "prior knowledge of home hospice services, prior donations, and the wish of not dying alone."

Hospice Care and Community Center, Cleveland: First look Healthcare Design; by Tracey Walker; 3/24/25 Hospice of the Western Reserve (Cleveland), a provider of end-of-life palliative care, caregiver support, and bereavement services, chose a lakefront setting for its new Hospice Care and Community Center. Scheduled to open in 2025, the center will provide critical services, create a more efficient care environment, and support the evolving healthcare needs of Northern Ohio. Designed by architecture and interior design firm E4H Environments for Health Architecture (Williston Vt.), the facility will replace the existing Hospice House on the adjacent property, which has served the community for nearly 30 years. [Continue reading for "Interior design strategies" ...]

‘Disturbing’ outlook: Hospices’ top regulatory concerns in 2025 Hospice News; by Holly Vossel; 3/20/25 Telehealth policies and program integrity concerns represent two of the leading regulatory issues on hospices’ radar this year. Regulatory changes and increasing oversight were the second-most cited concerns among nearly a quarter (21%) of 112 hospice professionals who participated in this year’s Outlook Survey by Hospice News and Homecare Homebase. Challenges around staffing and improved public awareness also topped the list of providers’ concerns. This is the third piece of this three-part Hospice News series that explores the significant regulatory challenges facing hospice providers in 2025. 

I share with you the agony of your grief, by Howard Thurman in "Meditations of the Heart"  I share with you the agony of your grief,  The anguish of your heart finds echo in my own...  This I do in quiet ways, that on your lonely path you may not walk alone.Click the link above to read the full poem.

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

Multidisciplinary clinician perceptions on utility of a machine learning tool (ALERT) to predict 6-month mortality and improve end-of-life outcomes for advanced cancer patientsCancer Medicine; Nithya Krishnamurthy, Melanie Besculides, Ksenia Gorbenko, Melissa Mazor, Marsha Augustin, Jose Morillo, Marcos Vargas, Cardinale B. Smith; 3/25There are significant disparities in outcomes at the end-of-life (EOL) for minoritized patients with advanced cancer, with most dying without a documented serious illness conversation (SIC). This study aims to assess clinician perceptions of the utility and challenges of implementing a machine learning [ML] model (ALERT) to predict 6-month mortality among patients with advanced solid cancers to prompt timely SIC. Our study found that clinicians expressed widespread acceptability of ALERT and identified clear benefits, particularly in triggering earlier SIC and standardizing prognosis discussions across care teams. [Additionally,] a recent study found that ML prognostic models decreased use of aggressive chemotherapy at EOL and increased SIC frequency fourfold.

Ethics in patient preferences for artificial intelligence–drafted responses to electronic messagesJAMA Network Open; Joanna S. Cavalier, MD; Benjamin A. Goldstein, PhD; Vardit Ravitsky, PhD; Jean-Christophe Bélisle-Pipon, PhD; Armando Bedoya, MD, MMCi; Jennifer Maddocks, PT, MMCi; Sam Klotman, MPH; Matthew Roman, PT, MHA, MMCi; Jessica Sperling, PhD; Chun Xu, MB; Eric G. Poon, MD, MPH; Anand Chowdhury, MD, MMCi; 3/25The rise of electronic communication sent to clinicians via the patient portal has directly led to clinician burnout and dissatisfaction. With patients increasingly messaging their clinicians, replying to in-basket messages (akin to email) has become a burdensome task consisting of medical questions, refill requests, and administrative and scheduling requests. This survey study of 1,455 respondents showed that while overall satisfaction was high (>75%) regardless of author, respondents preferred responses written by AI [artificial intelligence] over those written by a human ... However, when an AI author was disclosed, satisfaction was lower for AI compared with a human author ... Meaning: Reduced satisfaction due to AI disclosure should be balanced with the importance of patient autonomy and empowerment.

Racial disparities in ALS progression: Time to clinical events observed in a single center Wiley Online Library; by Shanshan Chen, Demetrius Carter, Jillian Prier, JoBeth Bingham, Shital Patel, Manisha Kotay, Paula Burke Brockenbrough, Kelly Gwathmey; 3/10/25 Studies examining racial differences in ALS have previously focused on diagnostic delay and disease severity. Time to critical clinical events has rarely been investigated, despite its importance in revealing differences in ALS patients' disease courses. This study explores racial disparities in time to specific clinical events in Black and non-Hispanic White ALS patients at a single center. ... Our single-center findings demonstrate a large racial difference in time to clinical events for Black versus White ALS patients referred for NIV, AAC, hospice, and wheelchair, suggesting more advanced disease at the time of presentation or more rapid progression.

Population-based payments to deliver health care to unhoused individualsJAMA Health Forum; Sudhakar V. Nuti, MD, MSc; Amanda K. Johnson, MD, MBA; Theodore Long, MD, MHS; 3/25The 770,000 people experiencing homelessness in the US have a high prevalence of disease and high health care utilization. Compared to the general population, unhoused individuals in the US have a 3.5 times higher mortality rate and 27-year reduced life expectancy. To this end, we propose population-based payment models (PBPs) as a novel mechanism to provide increased, stable, and predictable funding for health care for unhoused individuals. PBPs are the most advanced category of value-based alternative payment models, where health care organizations are given a prospective payment to care for a population of patients, with the flexibility to tailor care without incentivizes to optimize billable encounters, while being held accountable for improved outcomes and costs. The flexibility in how to invest and earn funding is essential for focused investment in these models, as increased reimbursement alone is insufficient.

Today is the National Vietnam War Veterans Day, honoring 50 years since the war's end U.S. Department of Veterans Affairs - The United States of America Vietnam War Commemoration Join us on 29 March, National Vietnam War Veterans Day, as Americans unite to thank and honor Vietnam veterans and their families for their service and sacrifice. ... The United States of America Vietnam War Commemoration honors all veterans who served on active duty in the U.S. Armed Forces at any time from November 1, 1955 to May 15, 1975, regardless of location, and their families. Editor's note: Several hospice "We Honor Veterans" programs have been using this commemoration to thank their community's Vietnam veterans, especially in light of differences between their returns home from those of WWII veterans. Within your networks of colleagues, friends and families, whom can you informally honor, today?

[Switzerland] The use of artificial nutrition at the end-of-life: a cross-sectional survey exploring the beliefs and decision-making among physicians and nursesSupport Care Cancer; by Christophe Pala, Claudia Gamond, Steffen Eychmuller, Francois Herrmann, Sophie Pautex; 3/17/25 Background: The use of artificial nutrition in the last month of life raises many concerns for patients, relatives, and healthcare professionals. Conclusion: Whereas decisions on artificial nutrition at the end of life are common they may be mostly guided by physicians and nurses' beliefs, and patients' requests more than by robust evidence. Fostering palliative care education is pivotal. Our results emphasize the need to improve physicians and nurses' awareness of the complex interplay between values and evidence when decisions concerning artificial nutrition are taken.