Literature Review

Hospice House seeking to regain tax exemption after losing it this year Owatonna People's Press; by Josh Lafollette; 2/21/25 Despite a few hurdles ahead, there’s a light at the end of the tunnel for the community members seeking to reopen the Homestead Hospice House. After a difficult hiatus, the Hospice House is set to resume serving patients thanks to a partnership with Seasons Hospice, of Rochester. The house, which provided a comforting setting for patients in end-of-life care, closed over a year ago when the previous care provider, Allina Health, discontinued its services there, citing labor reductions within its system and a decline in patients requesting that specific service. Seasons signed a lease with the HHH Board earlier this week. While the future of the house is starting to become clear, the organization is still dealing with the ramifications of Allina’s departure.

What is death positivity? Phaneuf Funeral Homes & Crematorium, New Hampshire & Vermont; by Phaneuf; 2/19/25 Death positivity is a growing movement that challenges the long-held taboos surrounding death. Rather than shying away from the subject, death positivity encourages individuals and communities to discuss mortality openly. It’s about accepting death as a natural part of life, reducing the fear and stigma often associated with it, and using that acceptance as a foundation for better end-of-life planning and living more fully. Historically, many cultures—including those in the New England region—often treated death as a private, somber affair. Today, however, a new narrative is emerging: one that celebrates the life lived, honors the memories left behind, and helps families make informed, compassionate decisions about the future.

Patients without family or health care proxies face overtreatment or limbo in hospitals WHYY - PBS; by Maiken Scott; 2/24/25 A program matches unrepresented patients with volunteers who can make care decisions for them during health care crises. ... [Intensive care physician David] Oxman says unrepresented patients are a small, but growing group. Some have outlived their family members, or are estranged from them. Maybe they’ve moved a lot, sometimes substance use or homelessness plays a role. The situation is especially complicated with patients who have dementia, or who can’t communicate their wishes for other reasons. ... Most states have provisions where medical guardians and medical decision makers can be appointed by a court, but that takes a long time. In the meantime, a search for relatives begins. David Sontag, director of ethics for Beth Israel Lahey Health in Massachusetts, ... created a matching program where health care professionals volunteer to represent patients, not within their own hospital systems because that could cross ethical boundaries, but at other hospitals. “This is an opportunity for us to help some of the most vulnerable members of our communities, those who have nobody to speak for them when they can no longer speak for themselves. And that allows us to respect their autonomy throughout their lives,” he said.

New ACS research finds low uptake of supportive care at the end-of-life for patients with advanced cancer EurekAlert! - American Association for the Advancement of Science (AAAS); Peer-Reviewed Publication by American Cancer Society; 2/21/25  Despite considerable efforts to improve the quality of end-of-life care in the United States, a new retrospective study led by American Cancer Society (ACS) researchers revealed that close to half of patients with advanced cancer received potentially aggressive care at the end-of-life at the expense of supportive care. The findings are out today in the Journal of the American Medical Association (JAMA) Health Forum. ... Study results showed only one-quarter of patients diagnosed with advanced cancer received any palliative care in the last 6 months of life, and those who received it did so mainly in the month of death. Overall, 45% of decedents experienced any indicator of potentially aggressive care. There was an increase in the mean number of acute care visits (from 14.0 to 46.2 per 100 person-months), hospice use (from 6.6 to 73.9 per 100 person-months), palliative care (from 2.6 to 26.1 per 100 person-months), and advanced care planning (from 1.7 to 12.8 per 100 person-months) over the last 6 months of life. ...

Over a quarter of adolescents, young adults with cancer who want to die at home do not Healio; by Jennifer Byrne; 2/20/25 More than one-fourth of adolescents and young adults with cancer who wished to die at home did not attain this goal, according to research published in JAMA Network Open. Researchers conducted a retrospective cohort study that included adolescents and young adults (AYA; age range, 12 to 19 years) with cancer who died between 2003 and 2019. The cohort included patients treated at Dana-Farber Cancer Institute, Kaiser Permanente Northern California or Kaiser Permanente Southern California. ... Healio spoke with Odejide about the rationale for the study, the importance of the findings, and strategies oncologists can employ to ensure more goal-concordant end-of-life care for AYA patients with advanced cancers. [Click here for Helio's discussion with the lead researcher, Oreofe O. Odejide, MD, MPH, associate professor of medicine at Dana-Farber Cancer Institute.]  Editor's note: Examine this JAMA article, which we posted in our Saturday Research issue, 1/18/25: "Preferred and actual location of death in adolescents and young adults with cancer."

Part payer, part provider: VNS Health embraces the futureHome Health Care News; by Joyce Famakinwa; 2/18/25As one of the biggest home-based care organizations in New York, VNS Health is leaning into its size and capabilities. ... “Our real challenge is, how do we leverage the large number of programs and services we already offer to ensure a seamless journey through the most difficult times in a person’s life,” VNS Health CEO and President Dan Savitt told Home Health Care News. ... "Being both a payer and provider allows us an opportunity to work with people in our community throughout their health care journey." ... "We use analytics to identify home care patients with late stage conditions who can benefit from enrollment in our advanced illness management program. Then we use analytics to determine when it may be appropriate to consider moving this patient population into hospice care." 

New insights into older hearts  The New York Times; by Paula Span; 2/15/25 It turns out that the Isley Brothers, who sang that 1966 Motown hit “This Old Heart of Mine (Is Weak for You),” were onto something when they linked age to an aching and flagging heart. Heart disease, the nation’s leading cause of death and disability, has been diagnosed in about 6 percent of Americans ages 45 to 64, but in more than 18 percent of those over 65, according to the Centers for Disease Control and Prevention. ... [In] recent years, dramatic improvements in treatments for many kinds of cardiovascular conditions have helped reduce both heart attacks and cardiac deaths. ... That can complicate decision-making for heart patients in their 70s and beyond, however. Certain procedures or regimens may not markedly extend the lives of older patients or improve the quality of their remaining years, especially if they have already suffered heart attacks and are contending with other illnesses as well. “We don’t need to open an artery just because there’s an artery to be opened,” said Dr. Alexander, referring to inserting a stent. “We need to think of the whole person.” ...

Valley Hospice House to open Feb. 25, expanding hospice care in the region Bladen Online, Fayetteville, NC; contributed by Cape Fear Valley Health; 2/14/25 Cape Fear Valley Health is proud to announce the official opening of Valley Hospice House, a new, dedicated facility for hospice care, located at 2431 Legion Road. The facility will begin accepting patients on Tuesday, Feb. 25, providing specialized General Inpatient (GIP) Hospice Care and Respite Care in a compassionate, home-like setting. “The opening of Valley Hospice House marks a significant step forward in enhancing hospice services for our community,” said Susan Dees, Chief Nursing Executive. 

[England] Hundreds protest amid fears of hospice closure BBC News, Liverpool, England; by Suzanne Hailey & Rumeana Jahangir; 2/15/25 Hundreds of people have attended an emotional protest against the potential closure of a Marie Curie hospice. The 26-bed inpatient unit at the site in Woolton, Liverpool, has been temporarily shut since July amid shortages in specialised nursing staff. ... [Independent] councillor Lucy Williams, who worked at the hospice as a palliative care nurse for two years, told BBC North West Tonight the charity's management said on Friday "they were considering closure" as one of their options. At a protest outside the hospice on Saturday many people held up pictures of loved ones who had died, with some saying they were "angry" about the current state of uncertainty. Ms Williams said: "Marie Curie are going to be met with the wrath of Liverpool. The whole community is going to get behind this."

How to help caregivers of patients with dementia Physician's Weekly; by Linda Girgis, MD, FAAP; 2/13/25 Dr. Linda Girgis discusses how physicians can assist caregivers of patients with dementia, helping these critical caretakers avoid experiencing burnout. ... As doctors, we all have witnessed caregiver burnout. Often, it was a family member who bore the brunt of the responsibility, one for whom there were no vacation days or sick time available. Whatever specialty we practice, we know patients with dementia can present a significant problem. ... How can we assist caregivers of patients with dementia?

Hospice advocates push bill for a third time despite two Hochul vetoes Spectrum News 1, New York State; by susan Arbetter; 2/12/25 Last spring, Capital Tonight sounded an alarm about for-profit hospice care. The Federal Bureau of Investigation (FBI) had just issued public warnings about for-profit hospice fraud in four states; it was alerting consumers to a scam in which patients were being enrolled without their knowledge by recruiters who were “selling” hospice to people who weren’t eligible. Hospice fraud like this has also been extensively reported by The New Yorker and Pro Publica. After Gov. Kathy Hochul twice vetoed a bill preventing the expansion of for-profit hospice in New York, a new bill (S.3437/ A. 565) is being introduced by the chair of the state Senate Finance Committee, Liz Krueger, and chair of the state Assembly Health Committee, Amy Paulin. “If a family is faced with a loved one that is dying, they should not also be faced with the possible incentive of money,” Assembly member Paulin told Capital Tonight. There are a variety of drawbacks to for-profit care, and there is clear data that shows profit motives drive for-profit hospice to neglect patient care and prioritize volume over quality.

A CEO’s strategic guide to leading people facing cancer CEO World Magazine; by Joelle Kaufman; 2/10/25 Cancer doesn’t just affect individuals – it impacts entire organizations. As leaders, we must anticipate and prepare for the moment when cancer touches our teams. With over 18 million cancer survivors currently in the U.S. workforce and over 2 million new diagnoses annually, the question isn’t if cancer will affect your organization but when and how you’ll respond. ... The first step will be how you respond when an employee shares that cancer is impacting their life. The second step is how you will manage while cancer is having its impact. ... When we get this right, we build more than just protocols – we build resilient organizations that demonstrate our values through action. In doing so, we create the kind of workplace where people can bring their whole selves, face life’s challenges with dignity, and continue contributing meaningfully to our shared mission. Editor's note: Getting this "right" matters especially for hospice and palliative care organizations. Read this article for both strategic professional guidelines and a personal story from a CMO/business owner.

As I held my dying daughter’s hand, what did I feel? Immense pride in a young woman who – despite a lifetime of complex special needs – taught us that perfection comes in many different guises Express Digest - DailyMail.co.uk; 2/7/25 As I held my dying daughter's hand, what did I feel? Immense pride in a young woman who – despite a lifetime of complex special needs – taught us that perfection comes in many different guises. ... There is no doubt that without her, our own lives might have been easier and much less of an emotional roller-coaster – yet they would also have been so much poorer. For she introduced us to the richness of worlds and wonderful people that we might never have encountered without her.  ... Iona showed that life was for living, despite her disabilities and health struggles. She fuelled my compassion, smoothed my sharper edges and gave me courage ...