Literature Review

A hospice volunteer has a fascinating new take on people's most common deathbed regret Upworthy; by Cecily Knobler; 8/1/25 ... Over the years, many hospital and hospice workers have paid close attention to what people who are on their deathbeds say. What they're most proud of, and yes, what are their main regrets. ... [This author refers to] Jancee Dunn's New York Times article, "3 Lessons for Living Well, from the Dying." In it, she discusses her friend who is a hospice volunteer. "She hears one regret over and over from patients: letting relationships wither. They wish that they had made more plans with good friends, or they thought about getting back in touch with an old buddy, and talked themselves out of it." ...  One wrote,"My mother always told me, 'Your friends will get you through life.'"Editor's Note: What friend do you want to reach out to, today? 

Study reveals how medication side effects can lead to dangerous medication cycles in adults 65+ McKnights Long-Term Care News; by Donna Shryer; 7/31/25 When doctors treat drug side effects as new illnesses, older adults may be prescribed even more medications — a cycle known as a “prescribing cascade.” A new study says this prescribing cycle can increase the risk of harm. A prescribing cascade example cited in the research involves older patients taking calcium channel blockers for blood pressure control, which can cause ankle swelling side effects. Instead of first adjusting the blood pressure drug, some doctors immediately prescribe a diuretic to reduce the swelling — which for some, can create an unnecessary drug pair.

Hospice of Humboldt expands services Redwood News, Eureka, CA; 7/31/25 ... Through a fundraising effort called the Compassionate Growth Campaign, Hospice of Humboldt was able to raise $750,000, enough to recruit another team of caregivers and double the capacity of the hospice house. “It was a heavy lift for our organization. We recruited and trained an additional 19 staff members,” Keating said. Doctor Charles Knoll, the medical director on campus, walks families through the process. 

Combining clinical insight and data-driven expertise: The case for morning huddles in primary care HEAL Security; by Becky Trotter and Aliya Ali; 7/1/25 The daily huddle, also called a morning huddle, is a brief standup meeting commonly associated with inpatient and surgical care. In these settings, safety is the predominant focus of the meeting. However, the same idea can be used in primary care settings to get care teams ready for the patients scheduled for that day. Morning huddles are an opportunity to merge clinical knowledge with data and analytics to help ensure primary care teams are aligned and specific care needs are recognized before patients walk into the practice. Editor's Note: Is this practice so new? Back in the 1990's at Hospice & Palliative Care of Louisville, each morning began with going through my hospice voicemail box for our well-oiled system of receiving and replying to voicemails for the whole team or individual members, from on-call staff, from leaders from throughout our organization, or other voicemails. These first-thing-in-the-morning communication/tech "huddles" were so crucial then--and are important today (with better tech and data)--because our patients often die during the night. Or, a new patient must be assessed. Or, the patient was transferred from home to an inpatient unit. Or, you know the common, literally life-changing needs. Is your hospice behind the times or leading the way with today's clinical communications and data?

Andwell Health Partners CEO: Medicare Advantage becoming  ‘failed policy,’ jeopardizes home health accessHome Health Care News; by Morgan Gonzales; 7/21/25 The rise of Medicare Advantage (MA) has reshaped the home-based care landscape, but it’s putting home health providers in precarious positions while increasingly failing to deliver for beneficiaries. That’s according to the leader of Lewiston, Maine-based nonprofit provider Andwell Health Partners, which has significantly changed the way it cares for patients, including adjusting care plans, to adjust to increased penetration of MA. Andwell Health Partners’ CEO Ken Albert said MA is rapidly becoming a “failed policy,” on a recent episode of Home Health Care News’ Disrupt podcast. Formerly known as Androscoggin Home Healthcare + Hospice, Andwell Health Partners offers home health care, palliative care, hospice services and a slew of other services across Maine. Albert sat down with HHCN to discuss how the nonprofit will survive industry headwinds, the new service lines and innovations he has plotted for the organization, the future of Medicare Advantage and how nonprofit providers have to innovate to survive. 

How health care systems shape end-of-life care—A step toward transparencyJAMA Network Open; by Jacqueline M. Kruser, Gordon D. Rubenfeld; 7/25Our health care systems, in all their multifaceted complexities, are more influential in shaping the delivery of care than individual human effort or error. Influential system-level factors span many different domains: how we are paid, the buildings we work in, the technology around us, who and how many we have on the team caring for patients, our workload, and our local social networks of influence. One pragmatic first step in addressing the problem of invisible, inaccessible, and/or inflexible patterns of end-of-life care is to build awareness of and foster transparency about the current patterns and their default orientation. Building from this deeper understanding of how our everyday routines and practice patterns influence care, we can then take the bigger step of intentionally designing our routine clinical practice patterns to be systematic yet flexible in their support of patients with serious illnesses.

Simulating the overall hospital quality Star ratings with random measure weightsJAMA Network Open; by Benjamin D. Pollock, Daniel S. Ubl, Subashnie Devkaran, Sean C. Dowdy; 7/25We found that only 244 US hospitals achieved reliable excellence in hospital quality in 2024 when defined as 90th percentile performance or better in at least 50.0% of 100,000 simulations using random weights for each measure in the CMS Overall Star Ratings. Our analysis highlights that there is meaningful variation in hospital quality performance across the spectrum of quality measures, even among 5-star hospitals. Future efforts to assess this variation may allow for better identification of reliably excellent hospitals, which could in turn lead to solicitation of evidence regarding the processes or cultures that separate reliable excellence from inconsistent greatness in hospital quality.  

System wide goals of care implementation: A podcast with Ira Byock, Chris Dale, and Matt GonzalesGeriPal podcast; by Eric Widera, Alex Smith, Ira Byock, Chris Dale, Matt Gonzales; 7/24/25Most health care providers understand the importance of goals-of-care conversations in aligning treatment plans with patients’ goals, especially for those with serious medical problems. And yet, these discussions often either don’t happen or at least don’t get documented. How can we do better? In today’s podcast, we sit down with Ira Byock, Chris Dale, and Matthew Gonzales to discuss a multi-year healthcare system-wide goals of care implementation project within the Providence Health Care System. Spanning 51 hospitals, this initiative [found] an increase from 7% to 85% in goals of care conversation documentation for patients who were in an ICU for 5 or more days. How did they achieve this? Our guests will share insights into the project’s inception and the strategies that drove its success, including:

When grief involves trauma − a social worker explains how to support survivors of the recent floods and other devastating losses The Conversation; podcast by Gemma Ware with Dr. Liza Lane; 7/17/25 The July 4, 2025, floods in Kerr County, Texas, swept away children and entire families, leaving horror in their wake. Days later, flash floods struck Ruidoso, New Mexico, killing three people, including two young children. ... When death is sudden, violent, or when a body is never recovered, grief gets tangled up with trauma. In these situations, people don’t only grieve the death. They struggle with the terror of how it happened, the unanswered questions and the shock etched into their bodies. I’m a social work professor, grief researcher and the founder of The Young Widowhood Project, a research initiative aimed at expanding scholarship and public understanding of premature spousal loss. Both my personal loss and professional work have shown me how trauma changes the grieving process and what kind of support actually helps. To understand how trauma can complicate grief, it’s important to first understand how people typically respond to loss.

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

My doctor asked if anyone in my family suffers from mental illness. I said, "No, we all seem to enjoy it!"

[Sweden] Ethical reflection: The palliative care ethos and patients who refuse informationPalliative Care & Social Practice; Joar Björk; 7/25Situations wherein a patient refuses potentially important information present tricky ethical challenges for palliative care staff. Taken as a whole, the palliative care ethos seems to recommend a strategy of using communication skills and time to try to get information across to the patient without forcing things. The recommendation is nuanced and highly contextualised, which increases its validity for clinical practice. Some meta-ethical questions are discussed regarding the use of the palliative care ethos as a source of guidance in ethically challenging clinical situations.