Literature Review

The Exec: Hamilton Medical Center CMO on incremental successes in change management HealthLeaders; by Christopher Cheney; 10/13/25 In healthcare, attempts to make changes quickly at a grand scale are often unsuccessful, this CMO says. The primary element of success in change management is to pursue a strategy that emphasizes small and incremental changes, according to [Ricard Perez] the new CMO of Hamilton Medical Center in Dalton, Georgia. ... If you are going to be affecting people's daily work lives, your best bet for success is to make sure that those people have some representation at the table," Perez says. "Once you have stakeholders at the table, they can become advocates and catalysts for change because they will have an intricate understanding of why change needs to happen."

Care that never gives up - in honour of World Hospice & Palliative Care Day 2025 The Morung Express; by Dr. Victoria Seb, MBBS, PDGDM, FIPM; 10/10/25 Quoting the Father of Medicine, Hippocrates, himself : ‘To cure sometimes, to relieve often, to comfort always’, these timeless words echo deeply the realm of palliative care, reminding us that the heart of healthcare lies not only in curing disease but in easing suffering and preserving dignity. The World Hospice & Palliative Care Day 2025 theme “Achieving the Promise: Universal Access to Palliative Care” calls to action for communities, healthcare systems and policy makers to ensure that palliative care is not a privilege but a universal right – accessible to every person, everywhere. ... In an era marked by medical advancement and increased life expectancy, the demand for holistic, compassionate care at the end of life has never been greater. Yet, despite its proven benefits, access to palliative care remains limited worldwide. The need for palliative care is urgent and growing, especially as populations age and chronic diseases become more prevalent. 

Beyond bars: Evaluating end-of-life care and surrogate decision-making for hospitalized incarcerated personsJournal of Palliative Medicine; by Zack Watson, Julie Brown, Abhinav Vyas, Stacey Tillman, Sumi Misra, Rajiv Agarwal, Cheryl Gatto, Allison McCarthy, Mohana Karlekar; 9/25Incarcerated persons (IPs) retain the constitutional right to health care, yet they face unique challenges in accessing palliative care (PC) and designating surrogates, especially when incapacitated. We present two cases of hospitalized IPs with life-limiting illnesses who experienced significant barriers in identifying and engaging surrogates. Both cases underscore the effect of delays in communication with surrogates and restricted end-of-life (EOL) visitation due to correctional policies. These delays limited the delivery of optimal interdisciplinary PC and bereavement support. Despite clear legal guidance under the Tennessee Health Care Decisions Act, misinformation and procedural ambiguity among medical and correctional staff impeded timely and appropriate care.

[Brazil] Integrating holistic communication into psychedelic-assisted therapies in hospice and palliative care: An approach based on Peplau's theoryJournal of Holistic Nursing; by Ana Cláudia Mesquita Garcia, Felipe Teixeira, Lucas Oliveira Maia; 9/25 Psychedelic-assisted therapy (PAT) has shown promising results in alleviating psychological and existential suffering among individuals with serious illnesses. This article explores the application of Peplau's Theory of Interpersonal Relations (PTIR) as a foundation for holistic communication in PAT, particularly in hospice and palliative care. We examine how PTIR's core concepts (person, health, environment, and nursing) along with its articulation of therapeutic roles, phases of the nurse–patient relationship, and the concept of anxiety as a signal of unmet needs, can be integrated into PAT's preparation, dosing, and integration phases. Drawing on a fictional case study involving a patient with advanced cancer, we illustrate how nurses can use PTIR to support emotional processing, foster insight, and promote personal growth during psilocybin-assisted therapy.

Bipartisan group of N.Y. legislators urge Hochul to sign bill preventing for-profit hospice expansion Spectrum News 1, Northern New York; by Susan Arbetter; 10/9/25 Because hospice care doesn’t provide curative treatment, for-profit companies, including private equity firms, are swiftly entering the field because they can make a lot of money. It hasn’t worked out well. In New York state, there are 39 not-for-profit hospice programs and two for-profit. There are those who point to the state’s low hospice utilization rate and say the answer is to open the state up to more for-profit hospice. State Sen. Liz Krueger, a Democrat from Manhattan, and state Assemblyman Brian Maher, a Republican from the Hudson Valley, both strongly disagree.

The expanding role of family medicine in Alzheimer's Disease and other dementias Patient Care; by Grace Halsey; 10/7/25 [From the 2025 Family Medicine Experience conference] Family medicine's unique position in dementia management spans initial diagnosis through end-of-life care. ... Dementia Staging: Clinical Assessment and Hospice EligibilityFor practical bedside assessment and hospice determination, the Functional Assessment Staging Tool (FAST) proves particularly valuable.1 The FAST scale includes 7 main stages, progressing from no impairment (stage 1) through severe dementia requiring total care (stage 7). Stage 7 breaks down further into substages (7a-7f) that capture specific functional losses including ambulation, independent sitting, smiling, and head control. Eligibility for hospice care generally requires FAST stage 7c or beyond, indicating ... [continue reading this important criteria] Editor's Note: Leaders must understand hospice eligibility criteria when setting census goals, guiding teams, and communicating with families. Getting it wrong risks fraudulent billing, angry caregivers when live discharges occur, or too little care that comes too late. Getting it right ensures dignity, humanity, and meaningful final moments amid dementia's long goodbyes—true measures of compassionate hospice dementia care.

Timing matters: Impact of early advance care planning conversations on hospice utilization in outpatient oncologyJCO Oncology Practice, An American Society of Clinical Oncology Journal; by Lydia Mills, Malia Albin, Ami Gorsky-Zabukovic, Liz Hutchison, Molly Mendenhall, and Robyn Tibert; 10/7/25  Results: 53% of physicians interviewed defined [Advance Care Planning] ACP as hospice, end-of-life, or code status conversations. This group of providers preferred waiting to conduct ACP discussions until later in a patient’s disease trajectory. However, 33% of physicians interviewed viewed ACP as broader discussions, to include patients’ values, goals and preferences for EOL care. These physicians stated they engage in ACP conversations as early as the first or second visit, especially with patients who have Stage IV disease or have a poor prognosis, introducing hospice as a potential option and revisiting these discussions throughout the course of treatment. PI data showed that providers who engage in early and consistent ACP discussions have a 17% higher hospice enrollment rate compared to their peers. 

Living with injustice: Gary Tyler had his life taken away, yet managed to claw it back. The Progressive Magazine; by Bill Lueders; 10/6/25 Just as I sat down to write this review of former death row inmate Gary Tyler’s memoir, I noticed that its publication date is the fifty-first anniversary of the day that upended his life: October 7, 1974. This undoubtedly deliberate timing, like the book itself, serves to help close the circle around Tyler’s remarkable—at times, almost unbelievable—life journey. That was the day Tyler, then a sixteen-year-old Black youth, was arrested for the shooting death of a thirteen-year-old white boy at their high school in Destrehan, Louisiana, about twenty-five miles from New Orleans. He was taken into custody and beaten so severely that he was left with permanent physical scars, as well as psychological ones. Police and prosecutors ignored and withheld evidence of his innocence, and suborned perjury by threatening witnesses. One witness, Natalie Blanks, was told she would be charged as an accessory to murder and miss out on her baby’s life if she didn’t falsely testify that she saw Tyler fire a gun from inside a bus. Stitching Freedom: A True Story of Injustice, Defiance, and Hope in Angola Prison is, for much of its first half especially, an intensely bleak book.Editor's Note: See previous significant posts in our newsletter about Gary Tyler and this transformative hospice program at Angola Prison.

Milton Village Open House builds community to support caregivers of individuals with Alzheimer's, dementia, or other cognitive conditions GreatNews.Life; by Lauren Grasham; 10/6/25 To help healthcare providers better understand the numerous resources available, Milton Village hosted an open house on Tuesday, September 30. Milton Village is a collaborative effort between Milton Adult Day Services (a program of the Center for Hospice Care) and Alzheimer’s & Dementia Services of Northern Indiana (a REAL Services program) to provide comprehensive care and support to individuals living with Alzheimer’s or other cognitive conditions and their caregivers. “Inviting healthcare providers to see our facility and learn more about our programs is a great way to help them understand our unique model,” said Sarah Youngs, director of Milton Adult Day Services. “As providers tour the facility and hear how our guests engage in the programming, it’s so satisfying to see them recognize what this can mean for their patients and the patients’ caregivers.”

Healthcare AI in the United States — navigating regulatory evolution, market dynamics, and emerging challenges in an era of rapid innovation The National Law Review; by Nadia de la Houssaye, Andrew R. Lee, Jason M. Loring, Graham H. Ryan of Jones  Walker LLP; 10/2/25 The use of artificial intelligence (AI) tools in healthcare continues to evolve at an unprecedented pace, fundamentally reshaping how medical care is delivered, managed, and regulated across the United States. As 2025 progresses, the convergence of technological innovation, regulatory adaptation (or lack thereof), and market shifts has created remarkable opportunities and complex challenges for healthcare providers, technology developers, and federal and state legislators and regulatory bodies alike. ...

How palliative care supports families emotionally and physically Elevated Magazines; 10/3/25 People often feel lost when someone they love is diagnosed with a serious illness. The shift in daily routines, the constant medical appointments, and the uncertainty about the future can feel overwhelming. Palliative care steps in to ease this transition, offering medical expertise and guidance that helps families adjust to new roles and responsibilities. Having a care team that understands both medical needs and the emotional burden can make a significant difference.

Not everything is delirium at the end of life: A case reportAnnals of Palliative Medicine; by Daniel Gilbey, Eduardo Bruera, Patricia S Bramati; 9/25In this report, we highlight the challenges faced by clinical teams diagnosing and managing delirium, in particular when a language barrier is present. Case description: A patient in his late sixties with low English proficiency with a metastatic neuroendocrine tumor was transferred to a palliative care unit on non-invasive bilevel ventilation. He appeared to become delirious and agitated, trying to remove the face mask, wriggling in bed, and tapping the bedrails. Haloperidol and lorazepam were required when non pharmacological interventions failed to calm him down. The following morning, the patient was able to explain that the positive-pressure facemask was suffocating him and that he could not breathe. So, he was transitioned to high-flow oxygen via nasal cannula, and within a few hours, his respiratory distress significantly improved, and he regained his previous self.