Literature Review

What is water cremation and why did Pa. lawmakers just back a bill to legalize it? LeighValleyLive.com, Leigh Valley, PA; by Lehigh Valley Community News; 10/5/25 The Pennsylvania House of Representatives passed bipartisan legislation on Wednesday authorizing alkaline hydrolysis, commonly known as water cremation, as an approved cremation method in the state. The bill would give Pennsylvania families a more environmentally sustainable option for end-of-life services. Alkaline hydrolysis uses a mixture of water and alkali in a sealed pressurized steel chamber to reduce the body to bone, which is then processed into ash. The process consumes significantly less energy than traditional flame cremation, which requires temperatures exceeding 1,600 degrees Fahrenheit. According to the Mayo Clinic, alkaline hydrolysis uses only about one-quarter of the energy required for flame cremation. 

Visiting Nurse Association rejects Cape Cod Healthcare's latest contract proposal Cape Cod Times, Hyannis, MA; by Desiree Nikfardjam; 10/2/25 Visiting Nurse Association of Cape Cod registered nurses have voted "overwhelmingly" to reject Cape Cod Healthcare's contract offer that was proposed on Sept. 11, according to a press release. The offer was the "last, best, and final" from Cape Cod Healthcare, according to the statement. The nurse association members are represented by the Massachusetts Nurses Association. ... The Visiting Nurse Association's nurses provide essential home health and hospice care to patients across Cape Cod and the Islands and had previously voted 96% in favor of authorizing a three-day strike if progress at the bargaining table was not made.

Bridging gaps in palliative care for undocumented immigrants using the social determinants of health frameworkAmerican Journal of Hospice and Palliative Medicine; by Lisa Cross, Rachael Salguero; 9/25Systemic policies and inequities, rather than immigration status itself, create barriers to health. In the United States, an estimated 11 million individuals live without legal authorization, a population that faces profound challenges in accessing equitable care. These barriers pose particular difficulties for palliative care nurses in recognizing and addressing the needs of undocumented immigrants. Identifying nursing interventions in this manner aligns with the overarching goals of the American Nurses Association and reflects the principles of ethical compassionate palliative nursing.

Evaluation of a flexible artist-facilitated storytelling intervention on a palliative care unitJournal of Pain and Symptom Management; by Kyle J. Drouillard, Regine Krechowicz, Kim Kilpatrick, Shirley H. Bush, Cory J. Ingram, Kaitlyn Boese, Jaya Rastogi, Jessica Roy, Carol Wiebe, Jenny McMaster, Claudia Hampel, Sarina Isenberg; 9/25A professional storyteller facilitated sessions with patients, caregivers, and healthcare professionals on a palliative care unit, starting with an open-ended question (e.g., “What story do you want to tell?”). From 18 sessions, patients (n=6), caregivers (n=8), and healthcare professionals (n=6), found the storytelling session acceptable, appropriate, feasible, meaningful and worthwhile. The storyteller perceived participants as enthusiastic and appreciative. Patient and caregiver stories described the palliative care unit as a calm site of reflection, and framed illness as a journey. Healthcare professionals’ stories reflected pride in and gratitude for their work.

Decoding code status: Assessing end of life care knowledge in high-risk ED populationsThe Journal of Emergency Medicine; by Shreyans Sanghvi, Jacqueline Furbacher, Thaddeus Puzio, Caroline Ha, Deena Abdelhalim, Mariah Arneson, Alaina Sturkie, Erika Richey, Benjamin Cooper, Samuel Luber; 9/25The National Institute on Aging projects that the U.S. population over age 65 will nearly double by 2050, placing further strain on an already burdened healthcare system. The emergency department (ED) plays a critical role in caring for this vulnerable population, initiating intensive care for approximately 2,000 older adults daily. However, such care often conflicts with the treatment preferences of most Americans; 80% of older adults report a desire to avoid intensive care and repeated hospitalizations at the end of life (EOL). Among 187 patients [surveyed], 84% reported never having heard of code status options (of those who had, 73% were primarily English-speaking) and 83% were unaware of their current code status. Additionally, 74% lacked any ACDs [advance care directives]. Regarding CPR, 80% believed it successfully restarts the heart of sick patients more than 50% of the time, while 83% and 84% had never been informed about what CPR entails or its associated risks, respectively. 

Children’s experiences of parental deaths due to suicide, homicide, overdose, alcohol, or drug useJAMA Network Open; by Sean Esteban McCabe, Eric Hulsey, Luisa Kcomt, Rebecca J. Evans-Polce, Glenn Radford, Samuel D. Tennant, Vita V. McCabe; 9/25Childhood bereavement resulting from parental mortality in the US has increased substantially over the past decade, including a surge in parental deaths from stigmatized causes, which are defined as drug overdose, homicide, suicide, and alcohol-induced or other drug-induced deaths. This cohort study found that the number of children bereaved from stigmatized parental deaths has increased and now account for 2 in every 5 parental deaths in Michigan. The increase in children who experienced stigmatized parental deaths is concerning given the increased risks of mental health disorders, child welfare involvement, and criminal justice involvement for children immediately following a parental death. Children and families who are bereaved from a stigmatized death may experience a more complex bereavement process and require a higher level of 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.

Today is the 2025 World Hospice & Palliative Care Day: Achieving the Promise: Universal Access to Palliative Care Organized by the Worldwide Hospice Palliative Care Alliance; primary article by Stephen Connor; in preparation for 10/11/25This year we celebrate the 20th anniversary of World Hospice & Palliative Care Day (World Day). What started as ‘Voices for Hospice’ concerts around the world turned into a day to recognise hospice and palliative care starting in 2005. Having a day each year to recognise the importance of hospice and palliative care is a valuable part of every health care movement and is essential for advocacy and awareness raising. World Day is organized by the Worldwide Hospice Palliative Care Alliance each second Saturday in October, this year on 11 October 2025, on behalf of the global palliative care community, including international, national, and regional palliative care organisations such as the IAHPC, ICPCN, PallCHASE, APCA, EAPC, ALCP, APHN, and including national organisations such as the IAPC.Editor's Note: Additional links of interest include ...

Hospice Research Information 10/11/25

[England] One in five hospices ‘face a deficit of over £1m’ while many axe services – data MSN - The Irish News US; by  Jane Kirby and Ella Pickover; 10/9/25 One in five hospices in England have a deficit of more than £1 million, while many are cutting services, according to new data. Hospice UK said short-term Government funding has helped plug some gaps but the sector is still majorly struggling due to a lack of cash. Some 57% of hospices in England ended the last financial year (2024-25) in deficit, with a fifth having a deficit of more than £1 million.

Rehab patients practice skills by building hospice care packages as Oak Park police and Lincoln Rx donate supplies. Feiga Bowick connects it all.  The Detroit Jewish News; by Rochel Burstyn; 10/9/25 ... Small steps can quickly snowball and make a big difference. Feiga Bowick, LMSW, CDP, the manager of Social Services and Community Engagement at PARC Home Care and Hospice of Southeast Michigan, ... [described] her recent hospice collaboration with Life Skills Village ... a rehabilitation center mainly for patients who have developmental delays and traumatic brain injuries. “I met with their occupational therapist ...: "How could these patients help others in a way that would be helpful to their own recovery?” Bowick said. “Many patients at Life Skills Village are working on fine motor skills and organizational skills, and we decided to try and get items together so they could create care packages for PARC hospice patients — while practicing their skills.” [Continue reading this inspirational story.]

Conspiracy of verticals:  Rethinking healthcare models with Peter Benjamin Teleios collaborative Network (TCN); video/podcast hosted by Chris Comeaux with Peter Benjamin; 10/8/25 In this conversation, Peter Benjamin and Chris Comeaux discuss the impact of COVID-19 on mortality rates, particularly the concept of 'death pull forward' and its implications for Hospice Care. Peter highlights the significant role of assisted living facilities in Hospice days and explores macro trends in healthcare, emphasizing the shift from vertical to horizontal care models. The discussion also covers the evolution of Palliative Care, frail elderly practices, and institutional special needs plans (iSNPs), while stressing the importance of measuring quality of care, particularly in pain management. 

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.