Literature Review

C-TAC announces reintroduction of the Improving Access to Advanced Care Planning Act The Coalition to Transform Advanced Care (C-TAC), Washington, DC; by Debra McCarron; 9/18/25 The Coalition to Transform Advanced Care (C-TAC) today announced the reintroduction of the Improving Access to Advanced Care Planning Act, a key bill designed to expand access to advanced care planning (ACP) services under Medicare. The announcement was made by Senator Warner (D-VA), a long-time champion of patient rights, during the National Partnership for Healthcare and Hospice Innovation Washington Leadership Meeting. The bill continues to enjoy bipartisan support and has been cosponsored by Senator Collins (R-ME).

What makes a good death? GeriPal - A Geriatrics and Palliative Care Podcast for Every Healthcare Professional; by Alex Smith with Karen Steinhauser, Rasa Mikelyte and Edison Vidal; 9/18/25What is a “good death”? How should we define it, and who gets to decide? Is the concept of a “good death” even useful? ... In today’s podcast, we are honored to have Karen join us to discuss this pivotal study and the nature of a “good death”. We are also joined by Rasa Mikelyte and Edison Vidal, co-authors of a recent study comparing the perspectives of people with dementia in the UK and Brazil on what constitutes a good death. In addition to exploring the nature of a good death and their individual studies, we will discuss:

Heart disease tops US mortality in 2024, CDC reports McKnights Long-Term Care News; by Foster Stubbs; 9/12/25 The leading causes of death in the United States in 2024 were heart disease, cancer and unintentional injury, the Centers for Disease Control and Prevention said in a September report. ... In total, there were 3,072,039 total deaths that occurred in the US in 2024 with a death rate of 722.0 per 100,000 people. This was 3.8% lower than the totals in 2023. Death rates also decreased for all race and ethnicity groups but rates for Black people remain higher than those for all other groups. Overall, death rates were highest for males, older adults and Black people, demonstrating a need for further examination of the health of these demographic groups. Heart disease caused 683,037 deaths, cancer caused 619,812 deaths and unintentional injury resulted in 196,488 deaths. Mortality statistics were collected by The National Center for Health Statistics’ (NCHS) National Vital Statistics System (NVSS) using US death certificate data. [The CDC Report is at Vital Statistics Rapid Release, Number 039, September 2025.]

What I learned about dying while caring for my husbandBK Books; by Barbara Karnes; 9/3/25It is hard to comprehend that our special person will die no matter what we do. No matter how many treatments, how much medicine, or how much food we give, death will come. We often don’t see what we don’t want to see. When it comes to acknowledging the end of life’s approach, this sentence is very true. My husband recently died of cancer. I am an end of life educator. I know what dying looks like, how it progresses, and what to do to support the person on their journey. Here are some insights that have been added to my knowledge as the result of walking in caregiver shoes...Publisher's note: Having a family member die earlier this year and building on Barbara's theme, I ask hospice providers, "Does the hospice care your loved one received match the quality of hospice care you deliver?"

Social Media Watch 9/12/25

New Salem-based hospice opens with focus on nursing staff wellness Salem Reporter, Salem, OR; by Hailey Cook; 9/11/25 After 12 years working as a hospice nurse, Christie Rivelli reached her breaking point. The pressure had built since the pandemic, when her workload went from 15 patients at a time to 28. ... By opening a new, locally-owned hospice company, they’re bucking a trend. ... Solterra currently has a staff of 19, with a range of one to three decades of experience in hospice care. As a nurse herself, Rivelli said she’s prioritized her staff’s workload and benefits. Everyone starts by getting training about post-traumatic stress disorder, and she said new hires have had trouble adjusting to a slower pace of work. ... Rivelli said. “Downtime in your workday should be built in … but boy, that’s not how it’s been in hospice.” She said some companies will assign 40 patients to one nurse, which forces the nurses to do pop-in check-ups rather than getting to know their patients. It can also mean the patient will see a rotation of unfamiliar faces rather than one nurse.

Fulfilling end-of-life dreams: A scoping review of bucket lists in palliative and hospice care Palliative Supportive Care - Cambridge University Press; by Swasati Handique, Michael Bennett and Scott D Ryan; 9/12/25 Results: Four major themes were established using thematic content analysis: (1) impact on holistic well-being, (2) role of family in wish fulfillment, (3) cultivation of gratitude, and (4) collaborative leadership in wish fulfillment. In wish fulfillment, the results significantly pointed to the need for more intricate evaluation among patients and interventions that cover beyond the physical aspect. Significance of results: Palliative and hospice care settings should work toward securing sustainable funding for structured wish-fulfillment programs to address existing accessibility gaps and further enhance the holistic nature of care in these settings. Editor's Note: For hospice organizations that can receive donations, setting up a Wish/Bucket List Fund makes for a meaningful, easy-to-demonstrate ROI on donated gifts. With this, you need to have some type of discretionary review/approval process in place, with assurances of confidentiality when important to the person and/or family.

Hospice AI - Summarize national and state hospice utilization trends over the past 10 yearsHospice & Palliative Care Today staff; 9/15/25Today we asked ChatGPT to summarize hospice utilization trends over the past decade using a spreadsheet uploaded from Hospice Analytics. One "key takeaway" was that growth is slowing nationally, suggesting hospice has matured in penetration, though opportunities remain in underutilizing states. Click here for the 4-page detailed summary, including AI-generated charts. Of note, while the AI-generated charts were correct, the accompanying text was incorrect - reinforcing the need for humans to double-check output!

COUNTDOWN: 9 Days Until HOPE Tool Starts, October 1, 2025 

A rapid review of states' Portable Medical Order forms and the National POLST Paradigm for Advanced Care PlanningJournal of Hospice and Palliative Nursing; by Tracy Fasolino, Megan Pate, Nancy Dias, Rikki Hooper, Lena Burgess, Megan Golden, Savannah Horvick, Jamie Rouse, Elizabeth Snyder; 8/25Hospice and palliative care nurses initiate goals of care conversations with patients and family members while advocating for the completion of advance directives. As leaders in these conversations, nurses must have a working knowledge of the various forms, such as portable medical orders. The National Physician Orders for Life-Sustaining Treatment (POLST) Paradigm calls for the standardization of portable medical orders to ensure goal-concordant care that can cross all healthcare settings. This rapid review provides an overview of state-level portable medical order forms, compares and contrasts them with the National POLST form, and proposes policy recommendations for hospice and palliative care nurses to advocate within their state, territory, or tribal nation. 

Serious illness communication in homecare nursing: A concept analysisJournal of Hospice and Palliative Nursing; by Christine S Davidson, Olga Ehrlich, Toni L Glover; 8/25Many seriously ill patients receive nursing care at home to manage their illness [and] there is a growing overlap between homecare and palliative or hospice care. In the homecare setting, nurses may be uncertain about their role and responsibility for engaging in "serious illness communication." The term "serious illness communication" is sometimes used ambiguously, overlapping with other terms such as goals of care discussions or end-of-life conversations. Proponents of serious illness communication emphasize the need for a shift from traditional advance care planning toward a real-time, patient-centered dialogue adaptive to the evolving nature of serious illness.

Associations of patient experience with doctor-patient communication and patient-reported physical and mental health in seriously ill adultsJournal of Patient Experience; by Sarah F. D’Ambruoso, Anne M. Walling, Neil S. Wenger, Rebecca L. Sudore, Lisa Gibbs, Maryam Rahimi, Ron D. Hays; 8/25We administered the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) communication scale, Patient-Reported Outcomes Measurement and Information System (PROMIS®) global health items, and the PROMIS-29 depression and anxiety scales. Better global health (PROMIS) at baseline was associated with better doctor-patient communication (CAHPS) at 12 months ... and better doctor-patient communication at baseline was related to better mental health at follow-up ...The results suggest that patients’ overall health may influence doctor-patient communication, and this communication may impact patients’ mental health over time.

The best end-of-life care begins with TRUTHProfessional Case Management; by Julie-Kathryn E Graham, Christina Kelley, Gabriella Malagon-Maldonado; 9/25For decades, research has recommended truth and transparency in end-of-life care discussions with patients, families, and family-centered care. This study demonstrated that, in practice, this is often not done, resulting in further traumatization to families at the end of life ... [which] makes information processing and decision-making very difficult. At end-of-life, person-centered care is family-centered care. A person's individuality is inextricable from who they are to their family. If we do not care for the family, we do not care for our patients.