Literature Review

Difference-making factors linked to higher reach of Specialist Palliative Care among people with heart failure across a national sample of VA Medical Centers American Journal of Hospice and Palliative Medicine; by Yan Zhan, PhD, RN, MBA, Edward J. Miech, EdD, Erica A. Abel, PhD, MD, and Shelli L. Feder, PhD, APRN, FPCN, FAHA; 11/10/25 Conclusion:  High Specialist Palliative Care (SPC) reach among people with advanced heart failure (aHF) was linked to combinations of several modifiable factors related to staffing, cardiology involvement, and outpatient palliative care. These findings provide actionable insights into improving SPC delivery across VAMCs.Editor's Note: What education or other partnerships do you have with VA Medical Centers in your service areas? Or, what gaps for veterans exist because of a lack of VA Medical Centers? Use these "combinations of modifiable factors related to staffing, cardiology involvement, and outpatient palliative care" for your strategic planning to improve care for veterans struggling with advanced heart failure.

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.

Clinician and parent perspectives on essential psychosocial care in pediatric cancerJAMA Pediatrics; by Kimberly S. Canter, Anne E. Kazak, Natalie Koskela-Staples, Michele A. Scialla, Kimberly Buff, Emily Pariseau, Victoria A. Sardi-Brown, Julia B. Tager, Lori Wiener; 10/25The Standards for Psychosocial Care for Children With Cancer and Their Families provide guidelines for evidence-based psychosocial care for children with cancer and their families. The Implementing the Standards Together: Engaging Parents and Providers in Psychosocial Care (iSTEPPP) study extends the standards through innovative collaborative research between clinicians and patient and family advocates, with the goal of widespread clinical implementation of standards that clinicians and parents or caregivers agree to be priorities. The 3 standards prioritized by parents and clinicians in this study offer insight into shared priorities for psychosocial care in pediatric cancer. However, misalignment on other priority standards (parental mental health, palliative care, and neurocognitive monitoring) highlights the differences in perception between parents and clinicians. Areas lacking agreement are a stark reminder of potential challenges when working to meet the holistic needs of children with chronic diseases and their families, as clinicians and parents may not agree on which needs are most important.

Enhancing end-of-life quality metrics: The role of palliative care in a community oncology practice.JCO Oncology Practice; by Katherine Baker, Aaron J. Lyss, Larry Edward Bilbrey, L. Johnetta Blakely, Casey Chollet-Lipscomb, Natalie R. Dickson, Leah Owens, Sandhya Mudumbi; 10/25As value-based payment (VBP) models expand in oncology, care teams adopt innovative strategies to improve outcomes, enhance patient experience, and meet evolving quality metrics (QMs). End-of-life care is one area where timely access to hospice remains inconsistent—especially in rural and underserved communities—and often outside oncology practices' direct control. Additionally, advances like immunotherapy, which may be well tolerated near end-of-life, challenge the hospice model as the sole supportive care option. NCCN and ASCO guidelines recommend early palliative care in advanced cancers, and many community oncology practices now integrate palliative care-to provide longitudinal, goal-concordant care that supports quality of life throughout treatment. Including palliative care receipt in end-of-life QMs offers a more nuanced, equitable way to evaluate care, ensuring patients receive needed support regardless of geography or treatment stage.

Mental health resources: Finding the help you need MSN News; by Lisa Rapaport; 10/23/25 Whether youre coping with anxiety, depression, a substance use disorder, grief, or something else, there are organizations that can help you often for free. Here are some to reach out to when you need mental health support. ...

Correctional health and oncologist perspectives on strategies to improve cancer care in US prisons-A qualitative studyJAMA Network Open; by Christopher R. Manz, Brett Nava-Coulter, Emma Voligny, Daniel A. Gundersen, Alexi A. Wright; 10/25Individuals diagnosed with cancer while incarcerated in US prisons have worse mortality than nonincarcerated individuals. In this qualitative study of clinicians delivering cancer care for incarcerated individuals, participants identified pragmatic strategies to improve cancer screening and treatment that address most identified barriers to care in US prisons. Application of these strategies may be associated with mitigation of disparities in cancer survival for incarcerated individuals. Participants identified strategies to improve care addressing nearly all previously identified barrier themes, including strategies for (1) conducting screening in prisons; (2) bringing cancer treatment into prisons and centralizing care; (3) using telehealth, navigators, and early oncologist involvement to improve care coordination; (4) improving communication and social support; (5) improving symptom management, access to palliative medicine, and end-of-life care; and (6) delivering patient-centered care. Strategies require implementation by prisons, prison clinicians, oncologists, oncology practices, and policymakers.

Incarceration and quality of cancer careJAMA Network Open; by Oluwadamilola T. Oladeru, Ilana B. Richman, Jenerius A. Aminawung, Jason Weinstein, Lisa B. Puglisi, Rajni Mehta, Hsiu-Ju Lin, Emily A. Wang, Cary P. Gross; 10/25The incarcerated population in the US is aging, and an estimated 15% of incarcerated adults, or approximately 175,000 individuals, are now 55 years or older. With this demographic shift, diseases of aging have become more prevalent, and cancer now ranks as the most common cause of death among people who are incarcerated in the US. Despite the growing prevalence, cancer outcomes among those incarcerated lag behind those with no history of incarceration. Individuals diagnosed with cancer while incarcerated or immediately following release have an approximate 2-fold increase in cancer-related mortality compared with the general population, even after adjusting for stage at diagnosis. Along with other published literature, this work suggests that gaps in quality of care may contribute to observed disparities in outcomes.Assistant Editor's note: Most of us cannot imagine what it would be like to be in prison. With cancer. And perhaps even dying there. Steven Garner knows. He spent many decades as an inmate at a state penitentiary. While there, he became a hospice volunteer supporting dying inmates, training other volunteers, and he served to pioneer Hospice in Corrections programs throughout the US. Steven is out of prison now, living his best life in Colorado and consulting around the nation about ways to improve end of life care for incarcerated persons. Oprah Winfrey was involved in sharing Steven's story in a Netflix documentary called Serving Life. NPR published an article about Steven in February 2024. Additionally, Hospice Analytics has posted a link to a 20-minute video about Steven's life and work in prison: Angola Prison Hospice: Opening the Door. And finally, if you'd like more information, Steven Garner has a website. 

Patients with advanced cancer often receive treatments that conflict with their goals Healio; by Josh Friedman; 10/20/25 Many patients with advanced cancer who prefer treatment that prioritizes quality of life receive therapies focused on preserving it. A retrospective analysis showed nearly 40% of individuals with advanced cancer who preferred treatment that improved their comfort felt clinicians gave them therapies meant to increase longevity.

The essential role of Speech-Language Pathologists in end-of-life swallowing intervention: A narrative reviewASHA Perspectives; by Sanora Yonan; 9/25Speech-language pathologists (SLPs) are essential in the intervention of dysphagia, particularly at the end of life (EoL), where their guidance can significantly improve patients' comfort and quality of life. However, despite a growing recognition of their importance in this palliative setting, SLPs continue to face obstacles for consistent involvement on the palliative care team. Three primary themes emerged [from this study]: diet texture adjustment, compensatory swallowing strategies, and patient and caregiver education. The review also identified significant barriers to SLP involvement, including inconsistent practices, limited resources, legal concerns, and a lack of interdisciplinary integration.Assistant Editor's note: In my experience, SLPs were rarely, if ever, utilized with hospice patients. However, this article clearly describes ways that SLPs could be helpful for patients with swallowing difficulties. SLPs can also be very useful for patients with speech difficulties. I think the IDT simply does not think of it-does not think of how a SLP could be helpful. Maybe it is also partly due to lack of knowledge of their value. Perhaps, both hospice and palliative care teams might consider arranging for an inservice from a SLP so that team members can learn more about how such therapy could be helpful in improving the quality of life of patients.

Impact of the Affordable Care Act on palliative and hospice care utilization among patients with gastrointestinal cancers: An interrupted time series analysisJournal of Palliative Medicine; by Eshetu Worku, Selamawit Woldesenbet, Mujtaba Khalil, Timothy M Pawlik; 9/25The Affordable Care Act (ACA) aimed to expand insurance coverage, improve health outcomes, and reduce costs. We assessed the impact of the ACA on hospice or palliative care utilization among [Medicare] patients with stage IV gastrointestinal (GI) cancer. Patients from minority racial groups ... and those in moderate ... and high ... Social Vulnerability Index (SVI) counties were less likely to use palliative care in both pre- and post-ACA eras. Palliative care use was associated with $2,633 lower total expenditure. Conclusion: ACA implementation did not improve palliative care utilization for racial minorities and high SVI groups.

The Center to Advance Palliative Care and the National Kidney Foundation make the case for the integration of palliative care into kidney disease management PR Newswire, New York; by The Center to Advance Palliative Care; 10/8/25 Despite facing high rates of distressing symptoms—including fatigue, pruritus, and pain—people living with advanced kidney disease are far less likely than those with cancer to receive appropriate pain and symptom management. And fewer than 10% of older adults receiving dialysis report having had conversations about their goals of care. These are two of the many important statistics highlighted in The Case for Palliative Care in Kidney Care, a new publication from the Center to Advance Palliative Care (CAPC) and the National Kidney Foundation (NKF), which emphasizes the critical need to integrate palliative care services into the treatment of patients with advanced kidney disease. 

Common hospice medications linked to higher risk of death in people with dementia EurkAlerts! American Association for the Advancement of Science (AAAS); by Michigan Medicine - University of Medicine; 10/14/25 ... [For] the growing number of Americans with dementia who enter hospice, their course is often long and unpredictable — making it especially important to ensure treatments align with each person’s goals and stage of illness. A new University of Michigan study published in JAMA Network Open finds that medications commonly prescribed to ease symptoms such as agitation, anxiety, and delirium — benzodiazepines and antipsychotics — may carry major unintended risks for people with dementia receiving hospice care. Among more than 139,000 nursing home residents with Alzheimer’s disease and related dementias enrolled in hospice between 2014 and 2018, those who began taking a benzodiazepine or an antipsychotic after enrollment were 41% and 16% more likely to die within six months, respectively, than very similar hospice patients with dementia who did not receive these medications.