Literature Review

The number of family caregivers helping older US adults increased from 18 million to 24 million, 2011–22 Health Affairs; by Jennifer L. Wolff, Jennifer C. Cornman, and Vick A. Freedman; 2/25 The evolving composition and experiences of the family caregiver workforce have profound ramifications for public policy but are not well understood. Drawing on the linked National Health and Aging Trends Study and National Study of Caregiving, we found that the numbers of family caregivers providing help to older adults increased by nearly six million between 2011 and 2022, rising from 18.2 million to 24.1 million. ... For family caregivers as a whole, challenges persist, and for those assisting people with dementia, tailored surveillance and effective support programs are needed.

UnitedHealth, Amedisys plan divesture of up to 128 locations Modern Healthcare; by Diane Eastabrook; 2/11/25 UnitedHealth Group said in a court filing Friday [2/7/25] its plans to sell at least 128 home health and hospice locations to ease the Justice Department's antitrust concerns around its acquisition of Amedisys. The divestiture plans were part of a filing in the United States District Court for the District of Maryland in a response to the Justice Department’s lawsuit to block the proposed acquisition. ... The company didn’t identify which locations would be sold, but said they would be in areas where UnitedHealth Group and Amedisys’ combined market share would exceed the thresholds federal regulators allege could harm competition. UnitedHealth Group said in the court filing it was in the process of identifying qualified buyers who would be able to operate and grow the divested locations.

In the wake of California fires, a hospice opens its arms to help a community heal Pasadena Now, Pasadena, CA; 2/8/25 A Los Angeles hospice organization announced Thursday it has extended its expertise in grief counseling to help residents process the collective trauma of the recent destructive wildfires. In the Arms of Grace Hospice, based in Los Feliz, will begin offering free weekly drop-in support groups for those affected by the Eaton and Palisades fires starting February 4. The open-format sessions at St. Gregory Church in Pasadena will be led by Dr. Ani Karayan, PhD, a clinical psychologist with more than two decades of experience in trauma-informed care. “The fires have caused significant disruption in the lives of many in the community,” said Kevin Tutunjian, president of In the Arms of Grace Hospice. “We wanted to create a safe and supportive space that validates the complex and nuanced emotions this community is going through.”

What is renal cell carcinoma?JAMA; Rebecca Voelker, MSJ; 1/25Renal cell carcinoma is a common cancer that forms in the kidneys. In 2023, an estimated 81,800 people were diagnosed with renal cell carcinoma in the US, making it the sixth most common cancer among males and the ninth among females. Renal cell carcinoma is most often diagnosed in people aged 60 to 70 years. Although the diagnosis has increased slightly in the US in recent years, deaths from renal cell carcinoma have declined. Although the survival rate of stage IV renal cell carcinoma varies among individuals, the average 5-year survival is 28%.

Learning from death: New memoir If We Never Meet Again imparts lessons from working with hospice patientsThe MarCom Journal, Charleston, SC; by Globe Newswire; 2/6/25While the topic of death is generally considered taboo, English teacher turned hospice administrator Matthew Cornett believes there is much to be learned from death. After becoming an empty nester, Cornett left the classroom behind and began a second career in hospice care. And the more time he spent with people as they approached the end of their life, the more he realized that their deaths had meaning. And what emerged from those final moments was something profound. Hoping to make others feel more comfortable when it comes to preparing for and talking about death, he presents a memoir of his journey into the world of hospice care. In If We Never Meet Again, Cornett chronicles his experiences providing compassion and support to hospice patients while adjusting to his new role. Finding inspiration in his patient’s “death stories,” he found himself on an unexpected path of self-discovery. Cornett’s personal reflections on these intimate and emotional interactions encourage readers to reconsider how they view death and dying.

Palliative care program for community-dwelling individuals with dementia and caregivers: The IN-PEACE randomized clinical trialJAMA Network; by Greg A. Sachs, Nina M. Johnson, Sujuan Gao, Alexia M. Torke, Susan E. Hickman, Amy Pemberton, Andrea Vrobel, Minmin Pan, Jennifer West, Kurt Kroenke; 1/25Among community-dwelling individuals with moderate to severe dementia, does a dementia care management program with integrated palliative care reduce patients’ neuropsychiatric symptoms? In this randomized clinical trial, a dementia care management program with integrated palliative care did not significantly improve patients’ neuropsychiatric symptoms.

Access tops list of Americans' healthcare concerns: 4 survey findings Becker's Clinical Leadership; by Erica Carbajal; 2/5/25A quarter of Americans rank healthcare access and affordability as the top public health priority they want government leaders to focus on, according to poll findings from Gallup and Emory University's Rollins School of Public Health. ... Four key findings:

HealthcareBusinessToday.com series on hospice careEditor's note: The following community education articles about hospice care were posted by HealthcareBusinessToday.com on 2/10/25.

New report details financial, emotional toll of Parkinson’s on family caregivers McKnights Home Care; by Foster Stubbs; 2/4/25 A new report sheds a light on the unique challenges faced by family caregivers who care for loved ones with Parkinson’s disease (PD). The report, Parkinson’s Disease Caregiving in the US, features insights from secondary analysis and supplementary interviews with 10 PD caregivers. These caregivers average 31 hours of unpaid care per week; half of interviewed caregivers exceed 100 hours each week, according to the report. The National Alliance for Caregiving (NAC), with support from The Michael J. Fox Foundation for Parkinson’s Research (MJFF) and Arcadia University, released the report.  

Long-term health care use among children surviving multiple organ dysfunctionJAMA Network Open; Robert Ohman, MD, MPH; Jerry J. Zimmerman, MD, PhD; 1/25Mortality outcomes of pediatric critical illness have improved over the last several decades, while concurrently the population of patients with technology dependency and complex chronic morbidities has continued to grow and the incidence of MOD [multiple organ dysfunction] has simultaneously increased. In the setting of declining critical illness mortality, pediatric outcomes research has broadened its scope to assess metrics beyond mortality, describing the trajectory of recovery from critical illness with measures of patient quality of life; physical, cognitive, and functional status; and family psychological and economic well-being. As the authors point out, assessment of the larger financial impact of this higher health care utilization on families themselves would be valuable future knowledge, as high health care utilization, appointments, and recurrent hospitalizations may detract from families’ ability to work, care for their other children, and attend to their own medical needs. Targeted support for families of survivors of MOD may be necessary to minimize these secondary impacts and to optimize outcomes for this vulnerable population of patients.

Brain biomarkers for pain sensitivityJAMA Neurology; Prasad Shirvalkar, MD, PhD; Christopher J. Rozell, PhD; 1/25Identifying objective biomarkers that track individual pain severity has been dubbed “the holy grail” of pain neuroscience. Chronic pain affects up to one-fifth of US adults, and its complexity is attributed to a confluence of physical, emotional, and cognitive factors that contribute to suffering and disability. The epidemic of chronic pain initially contributed to the rise of the opioid epidemic and continues to plague nearly all fields of clinical medicine. Identifying and validating biomarkers to predict individual risk for chronic pain facilitate a precision medicine approach to pain medicine. Despite the unknown provenance of the proposed biomarkers, the results of the present study have the potential to aid in the practical development of personalized pain management strategies.

Reimagining care and research for Amyotrophic Lateral SclerosisJAMA Neurology; Suma Babu, MBBS, MPH; Joshua M. Sharfstein, MD; Eva L. Feldman, MD, PhD; 1/25Amyotrophic lateral sclerosis (ALS) is a fatal neurological disease involving progressive motor neuron degeneration. In 2022, US Congress and the National Institutes of Health (NIH) commissioned the National Academies of Science, Engineering and Medicine (NASEM) to identify priorities to make ALS a livable disease within a decade. After extensive deliberations and input from the public, researchers, and persons with lived experience, the committee released its report, Living With ALS. To accelerate progress in patient care and therapeutics, one of the report’s major recommendations was for the National Institute of Neurological Disorders and Stroke (NINDS) to fund a clinical trials network dedicated to ALS that is distributed across diverse geographic regions and integrated within a novel hub-and-spoke system of care and research for ALS. The hubs are ALS Centers of Excellence that provide patient care and research, both basic and clinical, while the spokes represent a large number of community and regional ALS clinics that provide care and link to hubs for research. By integrating ALS clinical trials within this structure, we have the potential to transform ALS care, drive innovation in ALS therapeutic development, and pave the way for breakthroughs in other neurodegenerative diseases. 

Impact of inpatient palliative care on end-of-life care among patients with early-onset colorectal cancerJournal of Clinical Oncology; Suriya Baskar, Bohae R Lee, Rajiv Midha, Udhayvir Singh Grewal; 1/25Palliative care has proven benefits in elderly patients with advanced cancer; however, the objective benefits of palliative care in younger patients with cancer remain under-studied. We sought to examine the impact of inpatient palliative care consultation on end-of-life (EOL) care among hospitalized patients with early-onset colorectal cancer (EO-CRC). Inpatient palliative care consultation at EOL among patients with EOCRC was associated with lesser use of aggressive interventions and higher rates of DNR code status. We also noted significantly lower costs of hospitalization among patients receiving inpatient palliative care consultation at EOL. These results underscore the importance of integration of inpatient palliative care consultation among patients with EOCRC at EOL.