Literature Review

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.

Navigating choice: Eating, drinking and decision-making at end of life for individuals with cognitive impairmentJournal of Clinical Practice in Speech-Language Pathology; by Laura Chahdaa, Druvni Pererab, Darcy Longc, Laura Knauerb, Sanora Yonand; 10/25Current clinical guidelines offer limited direction for speech-language pathologists (SLPs) supporting eating and drinking decisions in palliative care (PC), particularly for individuals with dysphagia and co-occurring cognitive impairment. This population presents unique clinical, ethical and interpersonal challenges that often fall outside existing frameworks such as ‘Eating and Drinking with Acknowledged Risk’. This scoping review explores the key considerations for SLPs involved in end-of-life decisionmaking in these complex cases. A qualitative scoping review was conducted and analysed thematically [and] ... six overarching themes were identified: person-centred care; emotional and relational dynamics; ethical decision-making complexity; medical risk; barriers to effective clinical practice; and legal considerations. Findings reveal inconsistencies in practice and limited guidance for SLPs navigating care for individuals with cognitive impairment at the end of life.

Addressing palliative care gaps for rare congenital disease in adults: CM-AVM2 as an exampleJournal of Pain & Symptom Management; by Matthew W Kenaston, Ryan Baldeo, Tyler K Murphy; 10/25Capillary malformation-arteriovenous malformation type 2 (CM-AVM2) is a rare vascular disorder marked by complex, progressive symptoms and limited treatment options. As more individuals with rare diseases reach adulthood, palliative care plays an essential role in supporting quality of life when disease-directed therapies begin to fail. We present a young adult male with EPHB4-positive CM-AVM2, transferred to our tertiary care center for progressive malnutrition, refractory diarrhea, and worsening abdominal pain despite extensive subspecialty care. Through medication optimization, dynamic communication, and consistent interdisciplinary collaboration, the [palliative care] team helped stabilize aspects of his comfort and gradually facilitated GOC [goals of care] discussions. We further discuss how palliative care in this setting differs from standard frameworks, requiring proactive use of disease-specific resources and protracted, anticipatory care planning to optimize quality of life.

[France] End-of-life sedation and spousal grief: Exploring bereavement narratives with and without continuous deep sedationPalliative Care & Social Practice; by Livia Sani, Yasmine Chemrouk, Marthe Ducos, Pascal Gauthier, Marie-Frédérique Bacqué; 10/25This study explored how bereavement experiences differ based on the use of CDSUD [Continuous Deep Sedation Until Death]. Spouses whose partners received CDSUD often reported emotional disruption and unresolved grief, while those without CDSUD described greater relational continuity and a more gradual farewell. Across both groups, the quality of communication, emotional preparedness, and involvement in end-of-life decisions shaped the grieving process. These findings emphasize the emotional complexity of CDSUD, particularly when implemented suddenly or without sufficient explanation. Palliative care teams should prioritize transparent, timely discussions about sedation options and provide tailored emotional support throughout the dying process.

Estimating the number of services & patients receiving specialized palliative care globally in 2025 Journal of Pain and Symptom Management; by Stephen R. Connor PhD, Eduardo Garralda MA, Vilma A. Tripodoro MD, PhD, Carlos Centeno MD, PhD; November 2025 Issue In 2025, the estimated number of specialized palliative care service delivery teams worldwide reached approximately 33,700 - representing a 35.6% increase from the 25,000 identified in 2017. Service delivery expanded across all WHO regions. The estimated number of patients served rose from almost 7 million in 2017 to approximately 10.4 million in 2025. This figure represents roughly 14% of the total global need for palliative care. ...Despite notable growth in service availability, significant disparities persist, particularly in low- and middle-income countries. 

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. ...

Palliative care & hospice poll reveals major gaps Michigan Medicine - University of Michigan; by Michigan Medicine; 11/6/25 Many older adults don’t know much about care options for people with serious illness, but express interest once they’re explained to them. ... In all, 33% of older Michiganders were aware of palliative care, ... leaving 67% saying they knew little or nothing about it. But after being given the definition of palliative care, 79% of Michiganders were interested in receiving palliative care if they had a serious illness ... Michiganders were as likely as those in the rest of the U.S. to know about (68%) and be interested in (82%) hospice care. However, there was a sizable gap in hospice interest between Black Michiganders (70%) and white Michiganders (84%). 

The Valerie Fund pledges $3.5 million to establish new pediatric pain and palliative care program at Hackensack Meridian Joseph M. Sanzari Children’s Hospital News Wise, Hackensack, NJ; by Hackensack Meridian Health; 11/3/25 Hackensack Meridian Joseph M. Sanzari Children’s Hospital today announced a transformative, 5-year, $3.5 million commitment from The Valerie Fund to significantly expand its Pediatric Pain and Palliative Care Program. The landmark donation will establish The Valerie Fund Pediatric Pain and Palliative Care Program at the Joseph M. Sanzari Children’s Hospital, located at Hackensack University Medical Center in Hackensack, NJ, ... This new partnership will allow the hospital to care for more people annually, growing from approximately 1,750 to 3,500 patient visits. 

Compassionate care, measurable impact: Evaluation of embedded physician-led palliative care in a community oncology practiceJCO Oncology Practice; by Haibei Liu, Jillian Hellmann, Jessica Heintz, Geoffrey Daniel Moorer, Karen Miller; 10/25This analysis indicates that embedding palliative care physicians within a community oncology practice significantly increases hospice enrollment and LOS [length of stay] greater than 3 days. These findings support a cooperative care model as a practical strategy for integrating palliative care physicians into community-based oncology practices to improve patients’ EOL outcomes. 

Trends in state palliative care legislation across the USJAMA Network; by Na Ouyang, Ling Han, Wendy Jiang, Stacie Sinclair, Eugene Rusyn, Shelli L. Feder; 10/24/25More than 13.7 million people in the US could benefit from palliative care. Yet, access is uneven due to workforce shortages, low public awareness, variability in service availability, and federal delays. Although states play a pivotal role in shaping health policy, the extent of their legislative efforts regarding palliative care is unknown. Using data from the Palliative Care Law and Policy GPS, a database developed by the Yale Solomon Center for Health Law and Policy in partnership with the Center to Advance Palliative Care, we examined trends in the introduction and enactment of state-level palliative legislation, categorized legislative content, and mapped distribution across states and regions from 2009 to 2023... States introduced 819 pieces of legislation during the study period, peaking in 2018. States most frequently introduced quality/standards, public awareness, and payment policies. States that introduced the most legislation included Massachusetts with 111 pieces, New York with 72, and New Jersey with 61.

Improving end-of-life care: Making hospice and home support accessible Cure; by Maureen Canavan and Dr. Kerin Adelson; 10/22/25 Maureen Canavan and Dr. Kerin Adelson, healthcare executive, chief quality and value officer, and professor of Breast Medical Oncology at MD Anderson Cancer Center, sat down with us to discuss critical issues in end-of-life care. In this interview, they explore the urgent need for policy and system-level changes to improve access to hospice and supportive home care, highlighting how current reimbursement structures often fail to meet the needs of patients and families at the end of life. Canavan is an epidemiologist at Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center (COPPER) and affiliated faculty at Yale Institute for Global Health.