Literature Review

VITAS medical director: improve hospice referrals for cancer patients Hospice News; by Jim Parker; 7/16/26 Hospice utilization among some cancer patients is leveling off and slowing growth, but healthcare providers and medical educators can adopt certain strategies to move the needle. This is according to Dr. Ileana Leyva, regional medical director for VITAS Healthcare. ... Neuro-degenerative, lung and cardiac diseases are gaining more prominence among hospice diagnoses. In 2024, senile degeneration of the brain was the most common terminal diagnosis among Medicare decedents at 9%, followed by Alzheimer’s at 6%, according to the National Alliance for Care at Home. Chronic obstructive pulmonary disease rounded out the top three at 4.2%. Lung cancer was the 11th most common diagnosis that year, at 2.1%, the highest rate for any form of cancer. Hospice News spoke with Leyva about the barriers that prevent cancer patients from accessing hospice sooner and what stakeholders can do to drive improvement.

Restaurant owner shelves Easter plans to fulfill dying man's last wish to feed his hospice nurses Daily Good; by Good News Network; 4/7/26 Frank Ozimek spent his final days in hospice care, but what occupied his mind wasn't his own suffering -- it was how to thank the nurses who had tended to him with such devotion. When his brother Ken struggled to find a restaurant open on Easter to fulfill Frank's wish to feed the hospice staff, Tommy Milani, owner of a local pizza shop, didn't hesitate: "Absolutely, whatever you need, Ken." Milani set aside his holiday plans and delivered pizzas to the entire nursing staff, completing a circle of care that began with strangers and ended with gratitude. In his last act, Frank found a way to say what perhaps mattered most -- that he had seen the kindness given to him, and wanted to give it back.  

“It wasn’t just a lyric — it was him” Their Life Song; personal story by Amber Gould, original music about her father by Johnny Warren; 7/15/26Grief doesn’t follow a timeline. Amber Gould knows this well. “There are little everyday moments that remind me of him,” she says. “Whether it’s a familiar place, a scent, or a memory that suddenly comes back, he’s still a part of my daily life. I couldn’t think of a better way to honor those memories and feel connected to him than through music.” That's where Johnny Warren and Their Life Song come in. After Amber responded to Johnny's "remembering" questions about her dad, Johnny--owner of Their Life Song--wrote a deeply personal song about him. Upon turning her memories into song, what Amber found wasn’t closure — it was connection. Editor's Note: Click here for Johnny's tender song about Amber's dad, "The River You Showed Me."

HHS pausing $1 billion in Medicaid payments to California, Minnesota over fraud LI; by Mary Chastain; 7/21/26 The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have paused more than $1 billion in Medicaid payments to California and Minnesota due to fraud concerns. “That includes more than $887 million for California and over $200 million for Minnesota,” HHS Secretary Robert F. Kennedy Jr. said at a press conference. “If those states want that money, they need to provide documentation that these payments are legitimate.”

“I wish to be in the same room as my wife so I can hold her hand”: CalvertHealth grants husband’s final wishThe Baynet, Calvert County, MD; by CalvertHealth; 7/19/26 It was one final wish Phillip “Phil” Pfanschmidt shared after learning he had terminal cancer. Just days earlier, his wife of more than 66 years, Joyce “Joy” Pfanschmidt, had entered hospice care at CalvertHealth Medical Center. Now, Phil had entered hospice as well. When members of the palliative care team asked about his wishes, he didn’t hesitate. He wanted to be with Joy.Caregivers across CalvertHealth worked together to make that wish a reality. Phil was reunited with Joy, and the couple spent precious moments together, hand in hand. Less than two hours later, Joy peacefully passed away with her hand resting on Phil’s arm. ...In his autobiography, Born to Live, Phil reflected on what mattered most. “For the last 64 years [as of 2024], every morning when I wake up and every evening before I go to sleep, I give thanks for the woman sleeping beside me.” ... Phil passed away on Friday, July 10, just nine days after Joy.

Toward home cancer care—Reducing time toxicity for the right patients with prostate cancerJAMA Network Open; by David-Dan Nguyen, Bruce L. Jacobs; 6/26Cancer care imposes a substantial burden, not only through the diagnosis itself and treatment-related adverse effects but also through the time spent traveling to appointments, waiting, and receiving care. Even in advanced stages of prostate cancer, many patients live for years with a chronic disease trajectory that requires ongoing monitoring, repeated visits, and long-term systemic therapy. Bange and colleagues ask whether some of this burden can be alleviated by moving elements of care from the cancer center into patients’ homes through an enhanced telehealth model for patients receiving androgen deprivation therapy. Their intervention is distinctive in combining several strategies that have individually shown promise, including paired telehealth visits with home-based phlebotomy, remote blood pressure monitoring, and at-home injections. Their central finding is encouraging: this model appeared both feasible and highly acceptable to patients and clinicians.

When technology meets its limits: Integrating Medical Aid in Dying with withdrawal of a left ventricular assist deviceCureus; by Yvette Vieira, Paola Reveco; 6/26As outcomes improve and patients [with advanced heart failure] live longer with [surgically implanted left ventricular assist devices], ... clinicians across disciplines are increasingly confronted with the complex clinical, ethical, and practical challenges that arise when life-sustaining therapy is dependent on implanted technology, particularly in the context of end-of-life decision-making. We present a case report of a 76-year-old man with advanced heart failure supported by an implanted cardiac pump [who wanted to pursue] ... medical aid in dying ... [in his own home] ... Deactivating a cardiac assist pump typically occurs in a hospital with intravenous sedation for the abrupt heart failure symptoms that can occur when the pump is turned off. An end-of-life care navigator and a carefully assembled interdisciplinary team providing medical aid in dying in conjunction with pump deactivation achieved the patient’s home death at his selected date. Coordinating implanted cardiac device withdrawal with medical aid in dying is clinically achievable, ethically defensible, and legally sound. Healthcare systems must develop written protocols, train hospice providers, provide anticipatory counseling, fund necessary infrastructure, and support this end-of-life care.

Caring with confidence: A guided approach to end-of-life careJournal of Pain & Symptom Management; Laura Maldoon, Stacy L. Nilsen; 6/26Nurses may face uncertainty when caring for dying patients due to inadequate education and experience. This uncertainty coupled with varying practices for end-of-life care may affect both care quality and nurses’ attitudes. In nurses caring for hospitalized End-of-Life patients, does having a guided End-of-Life template and care resources, compared to current practices, improve registered nurse attitudes in providing individualized end-of-life care? Two inpatient nursing units received a 30-minute End-of-Life educational intervention utilizing the City of Hope’s Comfort, Airway, Restlessness and Delirium, Emotional and Spiritual Support (CARES) toolset as a standard resource to assess and prioritize end-of-life symptom management and family communication. This project suggests improved comfort and confidence among RNs in providing end-of-life care with the use of the CARES toolset. Nurses also demonstrated increased interest in seeking additional education.

Exploring the relationship between usage of a digital mindfulness app and perceived stress among caregivers of persons living with dementiaAging & Mental Health; by Michael P. Williams, Morgan Seward, Elizabeth M. Allen, Raquel G. Tatar, Darby M. Simon, Jennifer Huberty, Ana-Maria Vranceanu, Evan Plys; 6/26Mindfulness digital health interventions (DHIs) can support stress management among caregivers of persons living with dementia (PLWD), yet few studies investigate dose-response relationships. This study is a secondary analysis of a feasibility randomized controlled trial of Healthy Minds Program for Caregivers (HMP-C), a mindfulness DHI to reduce stress among caregivers of PLWD, against an educational podcast control (Wellness App [WA]). Participants were instructed to use HMP-C or WA 10 min per day. Every 10 min of HMP-C usage per week was significantly associated with a decrease in perceived stress by 0.7 ... Higher baseline stress and anxiety were related to lowered usage in active control ... , but not in HMP-C.

[Italy] Fever in a palliative care setting: Clinical insights and implications from a prospective observational cohort studyPalliative Medicine; by Stefania Cheli, Elena Angeli, Oscar Corli, Sofia Dinegro, Agostino Zambelli, Tania Carta, Romina Shazivari, Michaela Smolikova, Paolo Franceschi, Francesco Molà, Yara Silva Cruzeiro, Emilio Clementi, Andrea Gori; 5/26Fever is a frequent but complex symptom in adults with a limited prognosis, arising from multifactorial causes beyond infection. The study was conducted in an inpatient hospice palliative care unit within the Luigi Sacco Hospital in Milan, Italy (January and December 2024). Fever occurred in 40% of patients, with a median onset of 5.5 days after admission. In 39.7% of cases, fever was attributed to infections, mainly catheter-associated urinary tract infection. Its strong association with medical devices highlights the need for proportional, personalised interventions that primarily consider prognosis, symptom relief, and quality of life.