Literature Review

Benzodiazepine or antipsychotic use and mortality risk among patients with dementia in hospice careJAMA Network Open; by Lauren B. Gerlach, Lan Zhang, Hyungjin Myra Kim, Joan Teno, Donovan T. Maust; 10/25Benzodiazepines and antipsychotics are commonly used in hospice to manage symptoms such as agitation, anxiety, and terminal delirium in people with ADRD [Alzheimer disease and related dementias], often in response to behaviors that are distressing not only to the patient but also to family caregivers and staff. While these medications can offer symptom relief, they carry risks, including falls, sedation, and confusion. In this national case-control study of nursing home residents with ADRD receiving hospice care, initiation of benzodiazepine or antipsychotic use was associated with increased 180-day mortality. While these medications may provide symptom relief in appropriate clinical scenarios, their use is associated with substantial risks. These findings highlight the need for careful prescribing decisions and the development of dementia-specific hospice prescribing guidelines.

Grateful patient finds strength and support through UConn Health’s ALS Program UConn Today; by Jennifer Walker; 11/17/25 ... ALS, also known as Lou Gehrig’s disease, is a progressive neurodegenerative disorder that affects the nerve cells in the brain and spinal cord responsible for muscle movement. ... Originally conceptualized by Dr. Amanda Hernandez, division chief of Neuromuscular Medicine, the UConn Health ALS and MD Program provides a “one-stop shop” for patients with progressive neuromuscular diseases that often require coordination across multiple specialties. ... “Our social worker meets every patient,” said Viguera Altolaguirre. “We address caregiver stress, financial barriers, and emotional coping. Palliative care helps patients navigate difficult decisions about feeding tubes, ventilation, and future planning—always at their own pace and comfort level.” 

Telehealth survives again: What the most recent flexibility extension means for providers JD Supra; by Conor Duffy and Danielle Tangorre; 11/17/25 On November 12, 2025, President Trump signed H.R. 5371 the “Continuing Appropriations, Agriculture, Legislative Branch, Military Construction, and Veterans Affairs and Extensions Act, 2026” (the Act). The Act ended the federal government shutdown by providing necessary funding; it also extends key Medicare telehealth flexibilities to January 30, 2026. ... This represents another short-term extension of Medicare telehealth flexibilities that will again need to be revisited in January 2026. ... Medicare Telehealth Flexibilities Extended by the Act [include]:

Sage advice on aging and dying from a Colorado geriatrician CPR News; by Andrea Dukakis; 11/17/25 Geriatricians – doctors trained to treat older adults – are a scarce commodity across the country and in Colorado. The state has about a million residents aged 65 and older and, according to the most recent data available, only 110 geriatricians. ... Here are five things we learned about aging from Dr. Erika Altneu, a geriatrician in Salida:

United Way helps Hospice in the Pines bring care to all The Lufkin Daily News, Lufkin, TX; by Ruben Ibarra, Jr.; 11/15/25 For nearly four decades, Hospice in the Pines has offered end-of-life care with compassion to hundreds of families each year. Now approaching its 40th anniversary, the nonprofit continues to provide care to patients across 12 counties, with crucial support from the United Way of Angelina County helping fill the gaps for those who cannot afford care. ... Through the United Way, Hospice in the Pines receives funding that directly supports charity care for uninsured patients. Each year, the nonprofit provides more than $250,000 worth of medical services and equipment to individuals who have no Medicare, Medicaid or private insurance coverage, making sure patients receive the same level of care as any other.

Prevalence and factors associated with receiving a prescription for antithrombotic therapy on hospice admissionJournal of the American Geriatrics Society; by Emily K Short, Phuong Y Duong, Jennifer Tjia, Matthew Alcusky, Mary Lynn McPherson, Jon P Furuno; 10/25This was a cross-sectional study using electronic health record data from adult (age ≥ 18 years) decedents of a large, for-profit hospice chain who died between January 1, 2017, and December 31, 2019. Overall, 11,360 patients (20.8%) had at least one antithrombotic prescription on hospice admission. The most frequently prescribed antithrombotic classes were antiplatelets (15.7%) and direct oral anticoagulants (3.7%). Patients with PPS scores of 20%-30% ... were significantly more likely to receive an antithrombotic prescription compared to patients with a PPS score < 20%. Additionally, patients receiving care in an assisted living facility ... , nursing home ... , or at home ... were more likely to receive an antithrombotic prescription compared to patients receiving care in an inpatient hospice setting.

Hospice to deliver meals for homebound patients' Thanksgiving: Program volunteers will deliver over 700 Thanksgiving Day dinners on Nov. 27. Pike County Courier, Scranton, PA; 11/12/25 Hospice of the Sacred Heart will again spread the spirit of gratitude and compassion this holiday season through its annual Thanksgiving Program, taking place on Thanksgiving morning, Thursday, Nov. 27. This is the program’s 20th year. Each year, staff and volunteers come together to prepare, package, and deliver traditional Thanksgiving meals to Hospice of the Sacred Heart patients receiving care at home, along with their families. Over 700 meals are expected to be delivered. ... Diane Baldi, CEO, Hospice of the Sacred Heart said, “This program allows us to bring comfort, care, and a sense of togetherness to our patients and their families on one of the most meaningful days of the year.”

Opportunities to improve end-of-life care in assisted living: Results from a national survey of administrators The Journal of the Post-Acute and Long-Term Care Medical Association; by Emmanuelle Belanger, PhD, Nicole Rosendaal, MSc, Michelle L. Rogers, PhD, Tamara A. Sequeira, RN, MSN, Kali S. Thomas, PhDe ∙ Joan M. Teno, MD, MS, Susan L. Hayes, MPAf, Xiao (Joyce) Wang, PhD, Pedro L. Gozalo, PhDa, David M. Dosa, MD, MPHh, Melissa A. Clark, PhD; 11/9/25 Among 4796 eligible assisted living communities invited, 2084 administrators completed the survey from all 48 targeted states, a response rate of 43.4%. ... This national study of administrators highlights important opportunities to improve end-of-life care both as part of assisted living care processes for dying residents and through collaboration with hospice. These novel survey measures will help determine how end-of-life care processes vary along state regulations and shape residents' outcomes.

NCPA and USC launch first publicly available tool to identify pharmacy shortage areas across America National Community Pharmacists Association (NCPA), Alexandria, VA; Press Release; 11/4/25 The National Community Pharmacists Association (NCPA), in collaboration with the University of Southern California (USC), unveiled an interactive, user-friendly pharmacy shortage area mapping tool available to the general public for the first time. Previously accessible only to select individuals and organizations, the public [can now] identify pharmacy shortage areas and understand access challenges in their local communities. ... The mapping tool reveals that approximately one in eight U.S. neighborhoods — representing millions of Americans — persistently lack convenient access to pharmacy services. In rural areas and underserved urban communities, the problem is far more severe, with some states and counties experiencing shortage rates approaching 50 percent.

Telehealth flexibilities expired. Here's how providers are coping. TechTarget - xtelligent Virtual Healthcare; by Anuja Vaidya; 11/10/25 Telehealth flexibilities ended on Sept. 30, forcing providers to halt new virtual visits, risk financial losses or drive hundreds of miles for rural patient care. ... This has not only had a significant impact on the operations and finances of these providers but also led to concerns about the future of telehealth access. ...

Providence home health venture launches in California, includes North Bay The Press Democrat, North Bay, CA; by Cheryl Sarfaty; 11/4/25Providence and home-health care provider Compassus have finalized plans to provide home health, hospice, palliative care and personal home care services to multiple California regions, including Sonoma and Napa counties. California becomes the second of the three-phase joint venture. The first, announced March 3, includes Alaska, Texas and Washington. The third phase, in Oregon, is still pending regulatory review and approval in that state, according to Providence and Compassus. Under the agreement, Compassus will manage operations for all locations of the combined entity, called Providence at Home with Compassus. 

State-level variability in location of death of patients with end-stage liver diseaseDigestive Diseases & Sciences; by Julia Meguro, Michael Huber, David Goldberg; 10/25 Although deaths from end-stage liver disease (ESLD) and hepatocellular carcinoma (HCC) in the United States increasingly occur at home or in hospice, inpatient medical facility deaths remain high. Despite the decrease in in-hospital deaths for all causes, non-White decedents are more likely than White decedents to die in a hospital setting. This study aimed to determine state-level variability in the location of death among patients with ESLD and HCC and to assess racial/ethnic differences in these patterns, focusing on Black, White, and Hispanic/Latino patients. Findings from this study identify states where policies and programs that reduce inpatient deaths for ESLD patients may be most needed. Targeted interventions to improve access to high-quality EOL care for all patients address the national variability of hospice use, especially for those who are Black or African American and in states with high numbers of inpatient deaths and low rates of hospice use, should also be identified and implemented.

National Alliance CEO Steve Landers on hospices’ top policy priorities Hospice News; by Jim Parker; 11/6/25Medicare advantage and telehealth are key hospice policy priorities for the National Alliance for Care at Home. On the home health front, the organization is also embroiled in efforts to stave off proposed payment and Medicaid cuts. The Alliance came into being last year with the merger between the National Hospice and Palliative Care Organization and the National Association for Home Care & Hospice. Hospice News spoke with Alliance CEO Dr. Steven Landers about how the two legacy organizations are integrating, the hospice public policy landscape and how providers can get involved at a grass roots level.