Literature Review

Concordance of 30-day mortality and in-hospital mortality or hospice discharge after sepsisJAMA Network; by Hallie C. Prescott, Megan Heath, Namita Jayaprakash, Raymund B. Dantes, Chanu Rhee, Patricia J. Posa, Scott A. Flanders; 4/9/25In this all-payer, multihospital cohort of patients with community-onset sepsis, the proportion of hospitalizations ending in death or hospice discharge was similar to 30-day mortality and substantially higher than in-hospital mortality alone. Concordance between this composite outcome and 30-day mortality was high and greater than in-hospital mortality alone at the encounter level. These data suggest that the composite outcome of in-hospital mortality or hospice discharge may be a useful measure for national benchmarking of sepsis outcomes. While not identical to 30-day mortality, this composite outcome is available in real time for all patients and appears to have minimal systematic bias from variable hospital discharge practices.Publisher's note: An interesting study that includes "hospital discharge to hospice" as an important variable for consideration.

[Netherlands] A care ethical perspective on family caregiver burden and supportNursing Ethics; Maaike Haan, Jelle van Gurp, Marianne Boenink, Gert Olthuis; 3/25Family care-when partners, relatives, or other proxies care for each other in case of illness, disability, or frailty-is increasingly considered an important pillar for the sustainability of care systems. Especially in a palliative care context, however, family care can be challenging. Witnessing caregivers' challenges may prompt compassionate nurses to undertake actions to reduce burden by adjusting tasks or activities. The question is then whether self-sacrifice is a problem that nurses should immediately solve. Therefore, we suggest that caregiver experiences should always be interpreted in an explorative dialogue, focused on what caring means to a particular family caregiver. Nurses do not have to liberate family caregivers from the situation but should support them in whatever overwhelms or drives them in standing-by their loved ones until the end.

Without support, seniors aging in place may elect facility-based care, study finds McKnights Home Care; by Adam Healy; 4/16/25 Older adults aging in place may rethink whether they want to receive care at home if they do not receive certain aging-in-place supports from their care providers and loved ones, according to a new study published in the Journal of the American Geriatrics Society. The researchers interviewed nearly 300 older adults receiving care at home and in long-term care facilities. ... The first theme was participants’ personal health experiences. ... Similarly, loss of health of loved ones and friends may also influence where patients want to receive care. ... The final factor influencing older adults’ aging preferences was time, the study found. 

Cybersecurity contracts at risk as HHS cuts 150 IT workers: Report Becker's Health IT; by Naomi Diaz; 4/15/25 The Department of Health and Human Services could face a critical breakdown in its IT and cybersecurity systems after a sweeping reduction in force that eliminated key staff and leadership, Wired reported April 14, citing four current and former agency employees. More than 150 workers in HHS’ Office of the Chief Information Officer were among hundreds of administrative staff laid off April 1, according to the report. These employees were responsible for contract renewals and cybersecurity licenses and oversaw operations at the department’s Computer Security Incident Response Center — the hub for detecting and responding to cyberthreats across the department. Sources told Wired the cuts left no one in place to renew critical cybersecurity contracts, some of which are set to expire as soon as June.

Integrating social determinants into palliative care Hospice News; by Holly Vossel; 4/16/25 Strong staff education and reimbursement are among the keys to successfully integrating social determinants of health within a palliative care program. Screening tools developed by the U.S. Centers for Medicare & Medicaid Services’ (CMS) include five areas of social determinants of health: food and housing insecurity, transportation needs, utility difficulties and interpersonal safety. Supplemental domains include financial stability, employment and family and social support, among others.

Regulatory leaked HHS budget signals $40B in cuts, assumes ACA subsidies expire Fierce Healthcare; by Noah Tong; 4/17/25 Department of Health and Human Services (HHS) reorganization plans appear to have been revealed through a leaked Office of Management and Budget (OMB) document. The 64-page PDF with HHS’ plans were first reported by Inside Medicine and later reported by The Washington Post and other news publications. In an update, Inside Medicine said the entire document was authenticated by The Washington Post. ... While the restructuring was broadly announced, and individual offices have been reportedly axed in recent weeks, the leak provides greater insight into how the reorganization, firings, reductions in force and office eliminations and consolidations will fundamentally alter the agency.

This weekend: Passover and Easter with hospice patients and familiesHospice & Palliative Care Today; by Joy Berger, DMA, FT, BCC, MT-BC, editor in chief; 4/17/25 This weekend brings a confluence of the Jewish Passover and Christian Easter holy days. Whatever your faith system, understanding at least a bit about the diverse faith systems of those you serve matters. We provide these hospice-specific resources as references:

Palliative care and advanced cardiovascular disease in adults: Not just end-of-life care: A scientific statement from the American Heart Association AHAIASA Journals - American Heart Association; by Lucinda J. Graven, PhD, APRN, FAHA, Lisa Kitko, PhD, RN, FAHA, Martha Abshire Saylor, PhD, MSN, BA, RN, Larry Allen, MD, MHS, FAHA, Angela Durante, PhD, RN, Lorraine S. Evangelista, PhD, RN, CNS, WAN, FAHA, Amy Fiedler, MD, James Kirkpatrick, MD, Lakeisha Mixon, MSW, and Rachel Wells, PhD, MSN, BA on behalf of the American Heart Association Complex Cardiovascular Nursing Care Science Committee of the Council on Cardiovascular and Stroke Nursing; and Council on Cardiovascular Surgery and Anesthesia; 4/17/25  ... This scientific statement (1) discusses the application of effective communication, shared decision-making, age-friendly care, and advance care planning in advanced cardiovascular disease palliative care; (2) provides a summary of recent evidence related to palliative care and symptom management, quality of life, spiritual and psychological support, and bereavement support in individuals with advanced cardiovascular disease and their care partners; (3) discusses issues involving diversity, equity, and inclusion in cardiovascular disease palliative care; (4) highlights the ethical and legal concerns surrounding palliative care and implanted cardiac devices; and (5) provides strategies for palliative care engagement in adults with advanced cardiovascular disease for the care team.

One last game: student builds virtual reality experience for hospice patients Clemson News; by Sam Cannon; 4/15/25 At Clemson, a dedication to innovating health care and fostering wellness means more than just training the next generation of doctors and nurses. For Class of 2025 student Rob Martin, it has meant curating meaningful moments for members of his community. ... [Rob] joined the Tandem VR™ team, a concept invented by Olivia McAnirlin, Virtual Reality and Nature Lab co-director at Clemson, which helps people connect to past experiences and complete “bucket lists” with their loved ones. As part of this project, local hospice care patients were asked what they would want the chance to experience one more time before they pass. When the overwhelming response from patients was a Clemson football game, a research team of undergraduate and graduate students, practitioners and faculty got to work.

Ahead of National Volunteer Week and in celebration of National Volunteer Month, NPHI CEO urges Americans: “Step forward. Be present. Volunteer with your local hospice.” National Partnership for Healthcare and Hospice Innovation (NPHI), Washington, DC; by Matthew Wilkinson; 4/16/25 Ahead of National Volunteer Week next week, and in celebration of National Volunteer Month this April, the National Partnership for Healthcare and Hospice Innovation (NPHI) is shining a light on the often-unsung heroes of hospice: volunteers. These compassionate individuals are central to the mission of NPHI’s member providers nationwide, offering their time, energy, and hearts to patients and families during life’s most tender and vulnerable moments. NPHI member organizations rely on nearly 30,000 volunteers to keep their programs running—almost matching the number of full- and part-time staff employed across its national member network. Nationwide, hundreds of thousands of hospice volunteers contribute millions of hours of service annually. This deep tradition of volunteerism isn’t just symbolic—it’s built into the very structure of hospice care. All Medicare-certified hospices are required to have volunteers actively involved in patient and family support, reflecting the core values of compassion and community care that define the field.Editor's note: Throughout the year, find this and more national observances on our newsletters "Healthcare Observances" tab at the top of our website, https://www.hospicepalliativecaretoday.com/resources/healthcare-observances.

Aveanna CEO Jeff Shaner: Medicaid uncertainty detrimental to markets Home Health Care News; by Audrie Martin; 4/16/25 Earlier this month, Aveanna Healthcare Holdings (Nasdaq: AVAH) announced plans to acquire Thrive Skilled Pediatric Care for $75 million. ... This expands Aveanna’s private-duty services, home health and hospice care, and medical solutions in 27 states. ... Home Health Care News spoke with Aveanna CEO Jeff Shaner about this acquisition, future M&A plans, the impact of potential Medicaid cuts and the value of home-based care. ... Shaner: Regarding the broader M&A strategy, I would say M&A is not our core strategy; caring for pediatric, adult and geriatric patients remains our core mission. However, enhancing our growth profile through add-on acquisition strategies, primarily in our Medicaid business, private-duty service business like Thrive, and home health and hospice businesses, is our focus in 2025 and 2026. ... However, the uncertainty regarding Medicaid and federal funding prompts us to reconsider any long-term investments and ensure we have strategically contemplated the reasons for such investments. 

More than just meds: What a palliative care pharmacist learned from the bedside Pharmacy Times; by Trinh Bui, PharmD, Yale New Haven Health; April 2025 Issue A palliative care pharmacist highlights a spectrum of clinical opportunities for patients, caregivers, and clinicians when rounding at the bedside. ... I hold a unique clinical position. In 2018, the National Palliative Care Registry reported that less than 10% of national palliative care (PC) programs have a dedicated pharmacist. I am a member of the PC consultation service at a cancer hospital affiliated with a large tertiary academic medical center in New Haven, Connecticut. Routinely, we are consulted for at least 40 patients a day, with more than 2000 consults in 2024. ... A benefit of having a clinical pharmacist on the interdisciplinary team includes the ability to provide off-label medication to optimize complex medication regimens while honoring patients’ psychosocial, cultural, and spiritual needs. ...