Literature Review

$7,500 to Hospice of the Valley; $7,500 to Northland Hospice and Palliative CareAZCentral.com, Arizona Republic, "Here are the Season for Sharing grantees for 2024-25 who received $1.3M in grant funds"; by Silvia Solis; 3/23/25The 2024-25 Season for Sharing campaign brought in more than $1.3 million, which went to 156 Arizona nonprofit agencies across Arizona. [Among the grantees were two hospice agencies.]

How a Lewiston health care nonprofit diversified to sustain services Mainebiz; by Laurie Schreiber; 3/20/25 Ken Albert leads Lewiston-based Andwell Health Partners, an independent, nonprofit home- and community-based health care organization. The former Androscoggin Home Healthcare and Hospice, founded in 1966, focused on home health care and hospice in Androscoggin, Oxford and Franklin counties. Rebranded in 2024 to reflect its expansion in recent years, Andwell now has locations throughout Maine, with additional service lines including in-home hospice care, Maine’s first inpatient hospice facility, the Maine Center for Palliative Medicine, community and behavioral health, mobile wound care, in-home care giving, private-duty nursing, therapy care, ad maternal and child health. This week, it opened Andwell Audiology in Lewiston. 

Trump’s first 60 days: The impact on the home health industry Home Health News; by Audrie Martin; 3/20/25 Tax, immigration and diversity, equity and inclusion policies are some of the top-of-mind regulatory concerns for home health agencies in 2025. The first 60 days of the Trump Administration and their impact on the home health care industry were highlighted during a webinar hosted by the Polsinelli Law Firm on Thursday. National Alliance for Care at Home CEO Steve Landers and Home Care Association of America (HCAOA) CEO Jason Lee joined representatives from Polsinelli to discuss potential Medicaid cuts, the importance of extending telehealth services, and the need for workforce expansion. The webinar also explored how executive orders and administrative actions are affecting home care and hospice services. [Click on the title's link to continue reading.]

Disparities in end-of-life symptom burden linked to complex interplay among wealth, health, and social supportJAMA Network Open; Peter A. Boling, MD; 3/25On average, US health care spending in the last year of life alone was $80,000, with 12% ($9,500) being out of pocket and mostly incurred before the final 6 months. This problem worsened in the past decade when the nonspecific diagnosis of failure to thrive was removed as a condition eligible for hospice care and more stringent definitions were applied for dementia, which became the next bubble as the hospice balloon was squeezed. Hospice care is a means of reducing symptom burden, but the Medicare payment model discourages prolonged enrollment during slowly progressing advanced chronic illness and effectively limits funding of social support during hospice care, which is particularly problematic for patients with cognitive and functional impairment and for their friends and families. Considering suffering as a medical condition warranting treatment rather than a social problem requiring support services might help with the evolution of a Medicare policy that might provide a more graduated approach to end-of-life care.

‘Early discussions on what to expect can lessen the strain’ Nursing Times; by Kylie Chaffin; 3/19/25 The article explains the pros and cons of nutrition and hydration at end of life and the several types of artificial nutrition and hydration that can be used, written in a way patients and families can understand. Resources and educational articles, like this one, can also be a great way to introduce new or even more effective ways nurses and care team members can support patients and families when pursuing a palliative approach to their health and wellbeing. My question for readers is, “Should the conversation of end-of-life, hospice and palliative care, and nutritional changes, be initiated sooner rather than later in patients with a terminal diagnosis?”

Improvement plans for hospital car park BBC News; by Ruth Lucas; 3/18/25 ... NHS Frimley has announced plans to make "positive improvements" to the car park at Frimley Park Hospital in Surrey Heath. ... NHS Frimley says this will increase capacity by 10%, while LED lighting and improved parking bay markings will also be installed. ... Free parking is currently available for disabled people, frequent outpatient attenders, parents of sick children staying overnight and visitors with relatives who are gravely sick, terminally ill or under palliative care.Editor's note: For hospital-based hospice/palliative care, do you provide any type of free parking, vouchers, middle-of-the-night security, or some other type of support for families of persons in your hospice/palliative care units? Consider the common experience of the patient dying in the middle of the night, and family leaving the hospital--especially if your parking conditions are unsafe or expensive. 

Salutes hospice staff, volunteers The Messenger, Fort Dodge, IA; Letter to the Editor by Mary E. Larson; 3/19/25 My heart was saddened when I heard that the Paula J. Baber Hospice Home is closing. I was the volunteer coordinator for UnityPoint Hospice volunteers from 2003-2022. A lot of our volunteers spend many hours in our wonderful Hospice Home helping our patients, their families and guests and staff. This home is such a blessing to our community. When our patients would come to the hospice home, our staff would care for them so their loved ones could spend more time being with them in their final days. ... It will be a huge loss for our community when it closes. Mary E. Larson

Medicaid’s role in health and in the health care landscape: LDI expert insights and key takeaways from select publications Penn LDI - Leonard Davis Institute of Health Economics, Philadelphia, PA; by Julia Hinckley, JD; 3/17/25... Medicaid accounts for one-fifth of U.S. health care spending and covers more than a quarter of Americans. LDI researchers have examined the services it provides in supporting aging adults, people with disabilities, and children, as well as its role in health crises such as chronic disease and suicide. ... Below are select key findings from recent peer-reviewed research, along with expert insights for policymakers considering changes to Medicaid funding in the federal budget.

End-of-life conversations: ‘When they open the door, you have to go in’ Oncology Nursing News; by Pattie Jakel, MN, RN, AOCN; 3/13/25Oncology nurses have a unique relationship with patients that allows for difficult but essential end-of-life conversations, says expert Patricia Jakel, MN, RN, AOCN. Jakel, one of the editors in chief of Oncology Nursing News, emphasized that following up with patients and ascertaining what answers and support they need comes with the close bonds that oncology nurses form with patients with cancer. ... [Jakel describes:] We play a really important role. And sometimes patients ask us difficult questions, and we have to be prepared for it. I remember a lovely young patient I had, she had 2 little girls, and she was very sick. And things weren’t going well for her in the hospital, and she just—she looked up at me and she said, "Am I dying today?" And I thought, "She’s opening the door. She needs to have this conversation.” And I said, “It’s not going to be today, but I think it’s going to be soon.” And she kind of chuckled, because her sister was at the bedside, and she said to her sister, “I need my makeup done. I want my makeup on today, if today’s not the day.” And that took us to a whole conversation about what dying would look like for her.Editor's note: Read and share this significant, sensitive video/article from its source, Oncology Nursing News. What communication education and support do you provide for your nurses? Explore this similar article from Oncology Nursing News, "APPs, Oncologists Work Together for End-of-Life Discussions," 11/2/24.

Less wealth at death linked to more end-of-life symptoms McKnights Long-Term Care News; by Kristen Fischer; 3/10/25 Older people with less wealth showed a higher burden of symptoms when they approached the end of their lives compared with those who had more wealth, a study found. The report was published in JAMA Network Open on March 6. Investigators looked at data from 8,976 older adults. The team evaluated 12 end-of-life symptoms including difficulty breathing, frequent vomiting, low appetite, difficulty controlling arms and legs, depression, and severe fatigue or exhaustion.Then they correlated symptoms to individuals’ wealth. Wealth was broken into three categories: low wealth was having less than $6,000; medium wealth was having between $6,000 and $120,000; and high wealth was considered having more than $120,000 at the time of death. Of respondents, 22.5% had low wealth, 50.5% had medium wealth and 27.1% had higher wealth. People who had less wealth were more likely to have a higher burden of symptoms compared to those who had more money. Functional impairment, multimorbidity and dementia were factors that affected the association, data revealed.Editor's note: Click here for this important JAMA article, posted in our Saturday Research issue 3/15/25, "Wealth disparities in end-of-life symptom burden among older adults."

2 tailwinds shaping hospice growth, care delivery Hospice News; by Holly Vossel; 3/14/25 Rising demand for end-of-life care is pushing hospice growth opportunities to the forefront in value-based reimbursement. More payers in this arena are increasingly recognizing the depth of potential beneficial outcomes when it comes to collaborative hospice partnerships. Swelling aging populations have fueled rising health care costs across the country, with payers and providers alike seeking ways to ensure affordable access and sustainable services. ... “As far as tailwinds for the industry specific to hospice, [it’s] predictions for demographic growth,” [David Jackson, CEO and founding partner of Choice Health at Home] said. “The biggest opportunities for growth [are] talking about vertical integration and how we reach up into the health care system. [It’s] talking about the value that we bring from the perspective of patient care, and then talk about the plans, the payers, the opportunity to enhance their financial outcomes.”

MedPAC’s flawed recommendations would harm patients and increase costs National Alliance for Care at Home, Alexandria, DC and Washington, DC; Press Release; 3/14/25 The National Alliance for Care at Home (the Alliance) released the following statement on the Medicare Payment Advisory Commission’s (MedPAC) March 2025 Report to Congress: Medicare Payment Policy. ... “MedPAC’s recommendations are based on flawed and incomplete analyses with conclusions unsupported by all the available facts. These recommendations severely undervalue the critical role that home health and hospice providers play in ensuring the health and well-being of Medicare beneficiaries,” said Alliance CEO Dr. Steve Landers. “Recommending unthinkable cuts for home health and stagnant payment rates for hospice in the face of workforce shortages and inflation threaten access to these vital services for our aging population and undermine the dedicated providers who support them. ..."