Literature Review

Empowering elderly Chinese Americans: Advance care planning educational workshopGeriatric Nursing; by Mengyao Zhao, Tammy Tyree; 7/26Advance care planning (ACP) is important to ensure an individual's values and preferences are followed at the end-of-life (EOL). However, elderly Chinese Americans have a much lower advance directive (AD) completion rate than the national average. This quality improvement project aimed to improve ACP engagement and AD completion rates among elderly Chinese Americans at a local senior center in Arizona. Three monthly culturally tailored educational workshops were conducted, and ... data analysis showed a significant increase in ACP engagement scores over time ...  Additionally, AD completion rates rose by 220% after the intervention. These findings indicate that culturally tailored educational workshops can effectively improve ACP engagement and AD completion rates in elderly Chinese Americans.

Goal-concordant care for older adults with advanced heart failure: A retrospective cohort studyPalliative Medicine; by Sarah Godfrey, Maryjane Farr; 7/26Older adults with advanced heart failure experience significant morbidity and mortality and face higher complication rates from advanced therapies. Of 212 patients, 91 (42.9%) underwent evaluation for advanced therapies, though few received a heart transplant (16, 7.5%) or left ventricular assist device (32, 15.1%). Most (148, 69.8%) had only one palliative physician visit. One hundred thirty-nine (65.6%) died, often in the hospital (55, 40%) and with life-sustaining therapy in the last 24 h (73, 52.5%). Most (167, 78.8%) received goal-concordant care, with the main reasons for discordance being the desire for advanced therapy (33, 15.6%) and complications post-implantation affecting quality of life (9, 4.2%). Conclusions: Few older adults received advanced therapies, and palliative care was underutilized, with many patients seeing palliative care only once. Most received goal-concordant care, but decisions were often made late, highlighting the need for earlier, longitudinal palliative care for these vulnerable patients.

[Israel] Existential suffering at the end of life in long-term care: A critical essay on recognition, dignity, and witnessPalliative Care & Social Practice; by Anat Romem, Rachel Bardach; 7/26Existential suffering is widely acknowledged in palliative care, but it remains inconsistently recognized and unevenly addressed in long-term care. This critical essay argues that the gap is not caused by clinician indifference, but by a persistent mismatch between whole-person ideals and care systems organized around measurable symptoms, risk management, task completion, and professional uncertainty. [This] ... essay identifies three interrelated shortcomings: the reduction of suffering to medically actionable symptoms; the depersonalizing effects of institutional routines on frail older adults; and the absence of shared existential literacy across interdisciplinary teams. The essay also cautions against romanticizing suffering or treating meaning-making as a clinical expectation. It proposes a practical framework of recognition, dignity, and witness: recognizing biography and identity as clinically relevant; protecting dignity in the ordinary details of care; and enacting witness ... Long-term care cannot resolve every existential wound, but it can reduce existential neglect by treating personhood as a core quality indicator of palliative care.

Saturday newsletters focus on headlines and research - enjoy!

SOS: What does Google and ChatGPT say about SSVI and quality?Substack; by Joan Teno; 8/26Medicare recently finalized a new hospice scorecard called the Service and Spending Variation Index (SSVI). It gives each Medicare-certified hospice a number from 0 to 16, built from nine billing-based measures, where a higher score flags a hospice whose spending and service patterns look unusual compared with its peers. A high score is not proof of bad care or fraud — it mainly signals to Medicare which hospices may be worth a closer look. In this post I asked Google Gemini and ChatGPT to interpret a sample hospice’s score, and I compare how well each explained what the number does, and does not, mean for a family choosing a hospice.Publisher's note: Even though Substack is a blog site rather than a journal, Joan's content is outstanding and also fits here on a Saturday research issue!

Nurses, consider these documentaries Healthcare NOW Radio; by Zelda Meeker; 8/5/26 Tired of scrolling to find something to watch? We’ve got a list of excellent healthcare-related documentaries that will grab and keep your attention. Healthcare documentaries offer a window into the complexities of this world and show the daily struggles and triumphs of nurses, patients, and other healthcare providers. Over the past few years, several films have stood out for addressing critical and often controversial healthcare topics and offering insight into the realities of the healthcare system. Below are 12 such documentaries impossible for any nurse to ignore — films that are sure to stir emotions and provide perspectives on your career. ...

NPHI enters new phase of high growth as national community continues to expand National Partnership for Healthcare and Hospice Innovation (NPHI), Washington, DC; Press Release; 8/18/26 The National Partnership for Healthcare and Hospice Innovation (NPHI) is experiencing a period of significant growth, welcoming a growing number of mission-driven, community-based organizations from across the country since its 2026 Summit. ... This continued expansion brings new expertise, perspectives and community connections into NPHI’s national network, strengthening a community united by a commitment to high-quality, compassionate, people-first care. ... In recent weeks, NPHI has welcomed:

Palliative care for Alzheimer’s: what families should understand WNY News Now; by News Staff; 8/19/26 Alzheimer’s disease gradually affects memory, judgment, communication, mobility, and personal care. As abilities change, families face decisions about symptom relief, treatment limits, safety, and emotional well-being. Palliative care addresses those needs while respecting the person’s values and previously expressed wishes. Assistance can begin at any stage of disease, especially when discomfort, behavioral changes, or caregiver strain become difficult to manage without clinical guidance. What details should families check for? ...

Getting accurate AI insights securely with a certified HIPAA data access layer CDATA; by Mohammed Mohsin Turki; 8/18/26 If your organization creates, receives, maintains, or transmits protected health information (PHI), it inherits HIPAA’s compliance obligations. That’s true the moment PHI flows to an AI system or agent instead of the staff who used to handle it, whether that AI is a pilot, a proof of concept, or a model that’s “just reading” records. Most healthcare AI projects stall at the same point. The data still lives in systems that were never built with AI access in mind. A HIPAA-compliant AI data access layer fixes that before the model ever sees ePHI. This blog covers how to choose a HIPAA-compliant AI data access layer that keeps insights accurate, plus the new risks AI adds that older security programs miss. 

How Andrew Bird wrote Louie’s farewell ballad for ‘The Pitt’: ‘What’s more fundamental than the fear of dying alone?’ Gold Derby; by Lyndsey Parker; 8/19/26... Andrew Bird wasn't even familiar with The Pitt when he was cold-called by the show's composer, Gavin Brivik, with an invitation to collaborate on a song for one of the series' most heartbreaking and gut-punching moments. [It was for] that scene, ... in which fan-favorite character Louie Cloverfield, the lovable alcoholic with a heart of gold, dies with only the Pittsburgh Trauma Medical Center staff by his side — the lyrics for "Need Someone" came quickly. There's a small but especially tearjerking detail when Emma grabs Louie's hand, right as Dr. Robby is telling them about how Louie had lost his eight-months-pregnant wife and their unborn child in a car accident years ago. Apparently hospitals leave a deceased patient's hand out from under the blanket so that a loved one at the bedside can hold it, but Louie only has the hospital staff, who've sort of become his honorary family, with him when dies. This goes perfectly with your lyric about how "you need someone who is gonna cry for you." ... Bird was partially inspired by the 2020 pandemic — not just society's shared post-COVID trauma, but the lack of appreciation of healthcare workers ...

READOUT: FinCEN holds engagement to eliminate hospice fraud in CaliforniaU.S. Treasure Financial Crimes Enforcement Network, Los Angeles, CA; 8/19/26 On August 17, the U.S. Department of the Treasury’s Financial Crimes Enforcement Network (FinCEN) convened law enforcement and financial institutions for an engagement on health care benefits fraud, including the exploitation of hospice care services. Participants discussed new and emerging health care fraud schemes targeting federal and state health insurance programs, associated financial typologies and red flag indicators, and opportunities to boost awareness around hospice care fraud. Additionally, FinCEN held a training session for law enforcement on August 18 on how to use Bank Secrecy Act data to combat fraud. These engagements build on FinCEN’s work to counter fraud in partnership with the White House Task Force to Eliminate Fraud. 

Nearly one in five Medicare hospice patients now leaves the program alive rather than through death Medical Daily; by Dorothy Brooks; 8/17/26 Almost one in five people who leave Medicare hospice care each year leaves alive rather than through death, and the share has climbed every year since 2021. Federal data released this spring put the live discharge rate at 19.1 percent in fiscal year 2025, up from 16.9 percent four years earlier. For families, this is the rule almost nobody explains at enrollment. Hospice is not a permanent placement. It is a benefit tied to a prognosis, and when that prognosis changes, the benefit can end while the patient is still living, still ill, and still needing care. Understanding it before it happens is the difference between a planned transition and a phone call that lands like an eviction.