Literature Review

Nurse practitioners step in as geriatrician ranks shrink The Washington Post; by Jariel Arvin; 6/15/25 On Fridays, Stephanie Johnson has a busy schedule, driving her navy-blue Jeep from one patient’s home to the next, seeing eight people in all. Pregnant with her second child, she schleps a backpack instead of a traditional black bag to carry a laptop and essential medical supplies ... “Our patient isn’t just the older adult,” Johnson said. “It’s also often the family member or the person helping to manage them.” Johnson isn’t alone. Today, nurse practitioners are increasingly filling a gap that is expected to widen as the senior population explodes and the number of geriatricians declines. The Health Resources and Services Administration projects a 50 percent increas in demand for geriatricians from 2018 to 2030, when the entire baby boom generation will be older than 65. ...

The shrinking physician leadership pipeline Becker's Clinical Leadership; by Mariah Taylor; 6/6/25 Leaders across the nation are noticing a new trend — physicians seem less willing and interested in taking on roles beyond their clinical work. Traditionally, physicians have balanced full-time clinical loads with extra responsibility as a leader or educator. “But as people and the workforce have evolved, there’s a growing understanding: if you’re going to commit to something and do it well, you need dedicated time to focus on it,” Michael White, MD, executive vice president and chief clinical officer at Valleywise Health in Phoenix, told Becker’s. ... The increased interest in work-life balance for medical professionals has also contributed to younger physicians declining extra responsibilities. 

Serious illness has mental health implications — palliative care can help Becker's Behavioral Health; by Dr. Simeon Kwan and Dr. Rowland Pearsall; 6/12/25 ... As health plans and providers strive to deliver whole-person, value-based care, we must recognize that treating the body is only part of the equation. Mental and emotional well-being are critical dimensions of serious illness, and they demand more focused attention. Fortunately, we have a powerful but often underutilized ally: palliative care. ... According to multiple studies, up to 40% of patients with advanced cancer experience clinical depression. Anxiety and spiritual distress are also common, particularly when facing the unknown or confronting the loss of autonomy. For those managing progressive illnesses over time, mental health concerns can erode treatment adherence, accelerate physical decline, and strain family caregivers.

Nursing home is pressuring my mother-in-law to enter hospiceAging Care - Caregiver Forum - End of Life - Questions; question posed by "concerned8"; 6/12/25 I am her Health Care Surrogate but as they won't declare her incompetent it has not come into effect. I believe the home's intent is to prevent me from making the decision regarding hospice and instead to pressure her to enter it in various ways. ... I am not anti-hospice and expect her to enter it in the near future, but want that to be my decision, not the home's (even if it's portrayed as hers).  ... [An answer from another reader" Our family has only had bad experiences with three different hospice companies. Contrary to what most people believe, many patients are placed on hospice for free equipment and free services. I was told this by more than one hospice worker.Editor's Note: This post raises numerous troubling perceptions, with descriptions of poor hospice experiences. 

Nancy Streber Memorial Golf Classic continues record-breaking fundraising for McLaren Hospice myfenton.com, Fenton, MI; Press Release; 6/13/25 The 28th Annual Memorial Golf Classic, held on May 10 at Heather Hills Golf Course in Romeo, Michigan, raised more than $15,000 in support of McLaren Hospice’s end-of-life care services—surpassing its previous fundraising record set in 2024. Founded by Dave Streber and his family, the event honors the memory of his mother, Nancy, and the compassionate care her father received as a McLaren patient. This year’s outing welcomed 144 participants, making it one of the largest and most successful events in the tournament’s history.

Hospice a saving grace during our hardest time Pikes Peak Courier; by Mary Lovato; 6/11/25 ... I recently lost the two most important men in my life. My husband passed away from bladder cancer and within 6 months, my brother passed away from COPD. The individuals who worked for Hospice and helped us deal with the end of life of each of these loved ones were amazing. It wasn’t just the medical personnel, it was also the person who came to the house to set up the required equipment, it was the person who bathed the patient, it was the social worker, it was the person who offered spiritual guidance, it was even the person who in an emergency, delivered medicine in the middle of the night.

Medicare Home Health Care is the ideal platform for home-based palliative care at the end of lifeJournal of Palliative Medicine; by Tessa Jones and Sean Morrison, with Guest Editor note by Ira Byock, MD; 6/10/25Recognizing the central role of HH as a de facto means of providing home-based palliative care—and strategizing how to integrate palliative care principles and education into it—holds the potential to expand access to palliative care services and improve the quality of end of life for older Americans. The authors identify four main barriers to successfully integrating HH into the suite of palliative care delivery models. First, the HH workforce lacks training in fundamental palliative care. Second, the current lack of ongoing physician involvement in the HH setting. Third, reimbursement. Palliative care services are often excluded from traditional payment models, particularly in the HH setting. Lastly, financialization of the HH sector. They say that integration of palliative care within for-profit HH agencies may require a strategic emphasis on financial incentives.Guest Editor Note, Ira Byock, MD: This academic oped extends the drumbeat toward alternatives to hospice care. Overcoming barriers to home-based palliative care requires steps that are strikingly similar to those needed to make hospice programs successful. The authors repeatedly refer to HH interdisciplinary teams. In fact, home health is a multidisciplinary model of service delivery that lacks the clinical synergy of high-functioning interdisciplinary hospice teams.

Hospice & Palliative Care Today welcomes our new Guest Editor, Ira Byock, MD, a palliative care physician and emeritus professor of medicine and community & family medicine at Dartmouth's Geisel School of Medicine. Throughout his career he has written about the ethics and practice of caring for seriously ill and dying patients for medical journals. Since the early 1990s, he has contributed op-eds to national newspapers and gradually began writing story-driven books for the general public. His books include Dying Well (1997), The Four Things That Matter Most (2004), and The Best Care Possible (2012).  More information is available at IraByock.org. 

Providence announces 'difficult but necessary' restructure cutting 600 positions Fierce Healthcare; by Dave Muoio; 6/13/25 Providence said it launched a restructuring this week that will bring a reduction of 600 full-time-equivalent positions. The major nonprofit, which employs 125,000 people across seven Western states, said it will be shifting those affecting into other open positions “where possible.” There are more than 5,000 open roles across the system, it said. Affected roles are “primarily in non-clinical, administrative functions, though some patient-care roles are also impacted,” Providence said in its Thursday announcement. Transitional resources are being provided to impacted employees, it said. 

[Wales] 'Breaking point' as people in last 12 months of life occupy 'almost a fifth of Welsh hospital beds' Sky News; 6/3/25 People in the last 12 months of their life occupy "almost a fifth of Welsh hospital beds", according to a end of life care charity. Marie Curie Cymru says end of life care in Wales is "at breaking point" and is calling on the next Welsh government to ensure high-quality care. The charity says that, for many, support could be better provided at home or close to home, as it launched its manifesto for next year's Senedd election at Cardiff Bay's Norwegian Church on Tuesday. Gareth Miles died at home in Llanddarog, Carmarthenshire, in September 2023. Mr. Miles, who had Parkinson's disease, had spent 10 weeks in hospital before his last week.

Revolutionizing health in South Florida: The benefits of IV therapy and inclusive hospice care South Florida Reporter; by southfloridareporter.com; 6/8/25 ... South Florida is known for its multicultural population, making the expansion of hospice care to diverse groups particularly significant. Traditionally, certain cultural or community groups may have had hesitations or lacked access to hospice care due to language barriers, cultural misunderstandings, or lack of awareness. Increasingly, hospice organizations are focusing on outreach and education within these communities, breaking down barriers and encouraging patients and families to consider hospice as a valuable option for quality end-of-life care. 

Colorado exemplifies how to build upon paid leave progress to meet families’ evolving needs A Better Balance; 6/3/25 Colorado continues to pave the way for strong work-family protections by modeling how these policies can be expanded to meet families' needs. This spring, Colorado expanded the state’s paid family and medical leave program (the FAMLI Act, which our Colorado Office helped write and pass) to include an additional 12 weeks of paid leave for parents with a baby in the neonatal intensive care unit. Governor Polis signed the bill into law on Friday, May 30th, and Colorado workers with a child in the NICU will be able to take additional leave under the expansion beginning on or after January 1, 2026. ... For parents with children in the NICU, additional time off work to remain present can be a lifeline during a stressful time.Editor's note: As we know, the fragile and uncertain health of an infant in a neonatal intensive care unit can, heartbreakingly, lead to death. This—one of the most devastating forms of loss—often leaves parents to grieve in silence, their sorrow compounded by the experience of disenfranchised grief. While family and friends care deeply, they frequently falter in their efforts to provide meaningful support. Bravo to Colorado's FAMLI Act. May more states follow their lead.

Willamette Vital Health completes affiliation with Chapters Health System Hospice News; by Jim Parker; 6/6/25 Oregon-based Willamette Vital Health has completed its affiliation with Chapter Health System. Willamette now becomes part of Chapters Health West, an extension of Florida-based Chapters’ footprint into Nevada, California and Oregon. Chapters Health West came into being with the affiliation of four hospices with Chapters, including Nathan Adelson, California-based Hospice of Santa Cruz County and Hospice East Bay and Willamette. The organization is the second to complete an affiliation with Chapters. Las Vegas-headquartered Nathan Adelson was the first to complete in April.