Literature Review

The roots of palliative care: Michael Kearney, Sue Britton, and Justin SandersGeriPal - A Geriatrics and Palliative Care Podcast for Every Healthcare Professional; by Alex Smith; 3/13/25 ... As far as we’ve come in the 50 years since Balfour Mount and Sue Britton opened the first palliative care at the Royal Victoria Hospital in Quebec, have we lost something along the way? In today’s podcast we welcome some of the early pioneers in palliative care to talk about the roots of palliative care.  Sue Britton was the first nurse hired on that palliative care unit. Michael Kearney on a transformational meeting in Cicely Saunders’s office, with Balfour Mount at her side and a glass of sherry.  Justin Sanders wants to be sure the newer generations of palliative care clinicians understand the early principles and problems that animated the founders of hospice and palliative care, including:

[UK] Exploring the challenges experienced by patients and families using palliative and end-of-life care services: A qualitative focus group studyPalliative and Supportive Care; Gina Kallis, Gary Hodge, Hannah Wheat, Tomasina M Oh, Susie Pearce; 3/25In the UK, access to dignified and compassionate palliative care is increasingly being reported as inadequate. A range of challenges were identified at different stages of the patient and family carer journey near the end-of-life. These included issues related to the delivery of care, such as communication challenges, a lack of out of hours care, and also a lack of personalized care. Patients and families also experienced everyday challenges due to the impact of living with a life-shortening condition and altered family dynamics as family members became carers. There were also some traumatic experiences of death and a sense of abandonment when care could not be accessed. 

Northern Light Palliative Care helps patients live their best lives The Piscataquis Observer - The Voice of Rural Maine; by Stuart Maine; 3/13/25 People who have received a chronic, life-altering or life-limiting diagnosis can live their best life with the help of Northern Light Palliative Care, and there have been recent changes in the delivery of palliative care.  ... Northern Light Health Palliative Care Service Line Medical Director Dr. Vanessa Little, DO, FAAHPM [described,] ... “We’ve had nurse practitioners who visited people in the home exclusively and now we’re moving to expand the program to a clinic setting and the in-home model is going to be changing a bit." ... Patients can still receive home care “but we’re trying to have palliative care be available to more people,” she said. “We are going to be relying on technology to get the providers, nurse practitioners, and physicians in homes via technology and then have people in person through Northern Light Homecare & Hospice with nursing, critical therapy, and occupational therapy just as we always have.”

[Multi-cultural] Honouring traditions: Integrating cultural wisdom into palliative care - Saif Mohammed ehospice; by Saif Mohammed; 3/10/25[Personal Story] ... "Reflecting on this experience, I realize that caregiving is deeply embedded in tradition and culture, a natural extension of communal life." Caregiving is as old as humanity itself. One of the earliest known cases of palliative care dates back 45,000 years to Shanidar 1, a Neanderthal male found in present-day Iraq. His skeletal remains indicated severe injuries, yet he had survived for decades, suggesting that his community had cared for him. This example highlights that palliative care is a deeply human and historical practice, far predating modern medicine. Cultures around the world continue to recognize the importance of caregiving, often embedding it in traditions and religious beliefs. ... In some societies, the emphasis on independence can make caregiving more complex, as patients may refuse assistance to maintain self-sufficiency. ... Palliative care workers must be equipped to understand and respect the cultural traditions of the communities they serve. This requires training in cultural competence, which involves:

CMS deletes Medicare Advantage vision statement, signaling another shift from health equity Fierce Healthcare - Regulatory; by Noah Tong; 3/10/25 The Centers for Medicare & Medicaid Services (CMS) wiped away the agency’s stated intentions for the future of Medicare Advantage (MA), underlining new uncertainty for the future of health-related social needs, CMS Innovation Center models and the federal health program. ... A frequently asked questions page gave further explanation, as did an executive summary of a report to be released in early 2025. The page included a section with the question, “What is CMS’ vision for the future of the MA program?” as of Feb. 22, archived versions of the web page shows. But that question and answer was quietly deleted, and the page was last modified Feb. 26. It previously described how the VBID model helped health plans address health-related social needs and stressed health equity as an important cornerstone of its mission. ... The CMS did not immediately respond to a request for comment.

Intervention increases palliative cancer care consultations/lowers EOL care CancerNetwork.com; by Roman Fabbricatore; 3/11/25A palliative care (PC) intervention combining algorithm-based automated identification of patients eligible for PC led to an increase in PC visits and a decrease in end-of-life systemic therapy among patients with cancer, according to a randomized clinical study (NCT05590962) published in JAMA Network Open. ... "...  Prior efficacy trials in oncology have tested early PC in controlled, primarily academic settings.2To our knowledge, this is the first effectiveness randomized clinical trial of algorithm-driven default specialty PC in community oncology.”

Local pharmacist advising Ohio health director on palliative care Herald-Star, Steubenville, OH; by Christopher Dacanay; 3/10/25 A local pharmacist hopes to “expand utilization” of palliative care in Jefferson County and increase patients’ quality of life from her new position as an adviser to the Ohio Department of Health director. Steubenville resident Mary Mihalyo, doctor of pharmacy, was appointed Dec. 10 to the Palliative Care and Quality of Life Interdisciplinary Council. Bringing her own expertise, Mihalyo joins a diverse, 20-person group of professionals with experience in the provision of palliative care. ... Mihalyo, who founded Steubenville’s A&B Pharmacy with her husband, is the former CEO of Delta Care Rx LLC. She now serves as chief clinical officer for the company, which has been rebranded as Dragonfly Health. ... Her professional work, since [1999], has focused on serving hospice and palliative care patients locally and nationally as part of interdisciplinary teams. ... [Council members] ... actively consult with and advise the director on palliative care initiatives in the state, identify standards of practice, pinpoint initiatives at the state or national level integrating palliative care into the healthcare system and developing its practice and lay out patient identification guidelines for health care providers.

J-Sei Home closes after 30 years, leaving Bay Area Japanese seniors in need KQED, San Francisco, CA; by Cecilia Lei; 3/10/25 ... For decades, Bay Area Japanese American families have sought culturally sensitive senior care facilities like J-Sei Home for aging loved ones. Community members said that about a decade ago, there were approximately 10 Japanese senior care homes in the region. Today, that number has declined by about half. The most recent closure came in January, when the last residents of J-Sei Home moved out, and the facility permanently closed its doors after 30 years of operation. A majority of the displaced residents were Japanese Americans in their 90s and had cognitive impairment. ... They had tender caregivers who spoke Japanese. They ate familiar comfort foods like miso soup and pickled vegetables, and they participated in daily activities such as drum circles and singing Japanese songs. ...

At the end of life, doctors’ actions and patients’ wishes may be misaligned, according to a Rutgers Health study Rutgers; by Greg Bruno; 2/28/25 For terminally ill cancer patients, the final days of life are immensely personal, having the choice to continue cancer treatments, or to stop treatments and prioritize a more comfortable passing. What a patient wants, however, isn’t always what they receive, according to a Rutgers Health study published in the journal Cancer. “A patient's end of life is often not a reflection of what they want, but rather, who their oncologist happens to be,” said Login S. George, a health services researcher at the Rutgers Institute for Health, Health Care Policy and Aging Research, and lead author of the national study. “The data doesn’t indicate patient-centered treatment decisions, but rather, more habitual or default ways of treating patients,” says George, who is also a member of the Cancer Prevention and Control Program at Rutgers Cancer Institute, the state’s only National Cancer Institute-designated Comprehensive Cancer Center. ... [Click on the title's link for more statistics, insights, and recommendations.]

Algorithm-based palliative care in patients with cancer-A cluster randomized clinical trialJAMA Network Open; Ravi B. Parikh, MD, MPP; William J. Ferrell, MPH; Yang Li, MS; Jinbo Chen, PhD; Larry Bilbrey; Nicole Johnson, BSN; Jenna White, MSW; Ramy Sedhom, MD; Natalie R. Dickson, MD; Stephen Schleicher, MD; Justin E. Bekelman, MD; Sandhya Mudumbi, MD; 2/25In this randomized clinical trial conducted in a community oncology network between November 2022 and December 2023 among 562 patients with advanced cancer identified by an automated electronic health record algorithm, default orders increased palliative care consultation (44% vs 8%) and decreased end-of-life systemic therapy (6% vs 16%) compared with usual care but did not improve patient-reported or hospice outcomes. The findings suggest that default algorithm-based palliative care orders are a scalable implementation strategy to increase palliative care referrals and reduce intensive end-of-life care. 

Unity Hospice and Palliative Care, with over 30 years experience, broadens services to southern Wisconsin EIN Presswire; by Unity Hospice and Palliative Care; 3/6/25 Unity Hospice and Palliative Care is expanding its services to Southern Wisconsin, bringing decades of expertise in delivering personalized, heartfelt care and support to individuals and families facing life-limiting illnesses. The new location will serve patients in Kenosha, Milwaukee, and Racine counties, ensuring greater access to high-quality hospice and palliative care. "For over 30 years, Unity Hospice and Palliative Care has provided expert, compassionate support to patients and families," said Michael Klein, CEO of Unity Hospice and Palliative Care. "Expanding to Southern Wisconsin allows us to bring that same commitment to even more communities, ensuring that individuals facing serious illness receive the personalized care they deserve."

Central Coast VNA & Hospice expands registered nursing services in Monterey Buzz; 3/5/25 Central Coast VNA & Hospice is significantly expanding its registered nursing care services in Monterey, providing residents with increased access to high-quality, personalized healthcare delivered directly in their homes. … Key expanded services include advanced care planning, which helps patients and families make informed medical decisions, and a palliative care program focused on relieving symptoms and reducing stress for patients with serious illnesses. The organization also offers specialty programs targeting specific health conditions such as cardiac care, diabetic care, and orthopedic support. 

Patient put in hospice at 52 celebrates life years after admission, thanks to heart surgery KCTV-5, Kansas City, MO; by Morgan Riddell; 2/27/25 A local man with heart failure who was told numerous times he only had months to live now has a new outlook on life two years later. ... It started in 2023. Sam Edwards, who was diagnosed with ALS after serving in the military, started experiencing new pains. He went to doctors who all determined Sam was just experiencing issues related to ALS. Then, a doctor at the VA Hospital noticed some tests were off and found Sam was experiencing heart failure. What he needed was open heart surgery, but doctors determined the risk of putting Sam on the operation table was too high. Not only was he at risk of having a stroke and dying on the operating table, but his recovery would also be months long and painful. They declined to do the surgery at the VA and suggested Sam go get a second opinion. This is when he was connected with Dr. Michael Gibson.Editor's note: While we in the palliative and hospice field promote earlier admissions to care and elimination of overtreatment, another side of the coin exists. Click on the title's link to read more about this hospice patient who sought out a second opinion. Imagine: the hospice patient is you (at age 52); or a family member; or a best friend. Especially as AI becomes more prevalent in assessing palliative and hospice referrals, we must see the bigger picture and retain human element.