Literature Review

Understanding hospice care: Eligibility, cost and purpose Emmanuel Hospice; 6/5/25 How do you want to live? It may be surprising to learn that’s the first question Emmanuel Hospice asks every new patient. Isn’t hospice about dying? While hospice is often associated with death, Melissa Wedberg will tell you it’s more about living, especially at Emmanuel Hospice, where she serves as vice president of community relations. With more than a decade in the hospice industry, Wedberg has spent years dispelling this and many other myths. Despite having roots in the U.S. dating back to the 70s, there remains a lot of mystery about hospice. Common questions Wedberg hears include: What is hospice and who’s eligible? How does hospice work? How is hospice paid for? Editor's note: This simple question jumps to the core of person-centered care, "How do you want to live?"

Sister Grace spent her life helping the homeless. Now in hospice, she reflects on legacy and lessons WXXI News NPR, Rochester, NY; by Gino Fanelli; 6/6/25Sister Grace Miller smiles as she props herself up in her hospice bed and gently teases her strands of chestnut brown hair. “How does my hair look?” she asks. It’s the type of remark one would expect from Miller. Sister Grace is many things: a radical compassionate, a devout follower of the Catholic faith, a civil disruptor, and a wielder of a sharp, slightly sardonic wit. ... The 89-year-old champion for the homeless and destitute is dying, in hospice care at a congregation home on Carter Street. But her spirit is alive and well. “I would fight with them over whatever, whatever the people needed,” Miller said, referring to the county and city administrations she often tangled with over the years. “I would fight for the people. ... She said it was, ultimately, an undying, uncompromising commitment to the work she does as a fierce and fearless advocate for the poor.

A World War II hero is facing his final battle - with Medicare | PennLive letters PennLive Patriot News; by PenLive Letters to the Editor; 6/5/25 “Is this how one treats a 100-year-old World War II Army veteran?” I am such, having defended my country in the Philippines and then as one of the first GIs to step on Japan’s shores when it surrendered. Today, I am a widower, living alone under hospice care in the same small, comfortable home my wife and I cherished for so many years. My health condition has deteriorated dramatically, due to the ravages of ESRD, bladder cancer, anemia, high blood pressure, depression, and loss of balance. I am mostly bedridden, waiting for the inevitable. And yet, just now, I have received a Notice of Discharge from hospice because of an “extended prognosis,” literally meaning in lay terms that, “I’m living too long for hospice and Medicare purposes.” They argue that I’m now able enough medically to make it on my own without hospice care! ... I know I have only weeks, perhaps a month to live, but their rejoinder is simply, “Thank you for your service, but get out of our sight.”Editor's note: Click here for a similar related article and my editor's note, Dementia patient discharged from hospice over Medicare requirement. Here’s why it happened. (One of our "most read" Sunday posts.) These cases are too common. Basic communication, information, and coordinated care planning can mitigate much of the distress and pain. How does this dynamic play out with the patients and families you serve?

Implementing palliative care in nursing homes: A podcast with Connie Cole, Kathleen Unroe, and Cari LevyGeriPal podcast; by Eric Widera, Alex Smith; 6/5/25The need for better palliative care in nursing homes is significant. Consider this: the majority of the 1.4 million adults residing in U.S. nursing homes grapple with serious illnesses, and roughly half experience dementia. Many also suffer from distressing symptoms like pain. In addition, about 25% of all deaths in the United States occur within these facilities. Despite these substantial needs, specialized palliative care beyond hospice is rare in nursing homes. Furthermore, only about half of nursing home residents nearing the end of life receive hospice care. So, how can we improve palliative care for individuals in nursing homes? Today’s podcast explores this crucial question with three leading experts: Connie Cole, Kathleen Unroe, and Cari Levy.

Provider MiraSol Health launches new Behavioral Health Program Hospice News; by Jim Parker; 6/3/25 MiraSol Health has launched a new behavioral health program designed to amplify emotional and psychological support for its hospice and palliative care patients. Branded as Rays of Hope Behavioral Health, the program offers individual and group therapy sessions, both in person and via a secure telehealth platform. Through Rays of Hope, MiraSol’s licensed therapists will help address anticipatory grief, caregiver stress, loss and other struggles that patients and families face during a time of chronic, serious or terminal illness.

Confronting global inequities in palliative care BMJ Global Health; by Anna Peeler, Oladayo Ayobami Afolabi, Katherine E Sleeman, Maha El Akoum, Nahla Gafer, Asmus Hammerich, Richard Harding; 5/15/25

US trends from 1999 to 2020: Mortality and location of deaths in ischemic stroke Neurology Advisor; by Meghna Rao; 6/2/25 Patterns of ischemic stroke mortality have varied over the last 2 decades in the United States, according to study findings published in PLOS One. Stroke is one of the leading causes of mortality in the US. Researchers studied the trends in location of ischemic stroke deaths to improve end-of-life care and address health care inequities.The Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database was used to examine trends in ischemic stroke mortality between 1999 and 2020. 

CMS’ TEAM Payment Model: What hospices need to know Hospice News; by Jim Parker; 5/30/25 A forthcoming alternative payment model for hospitals focuses on discharge planning and ensuring effective post-acute care, including hospice and palliative care when appropriate. The U.S. Centers for Medicare & Medicaid Services (CMS) late last year unveiled its new Transforming Episode Accountability Model (TEAM). Participation in the model will be mandatory for select hospitals. The program is set to launch on Jan. 1, 2026 and run through Dec. 31, 2030. CMS designed the program based on lessons learned from previous episode-based payment models, as well as input from stakeholders in response to a Request for Information published in 2023.  

Timing and outcomes of palliative care integration into care of adolescents and young adults with advanced cancerOncology Practice; Jeremiah Bonnet, BA; Colin Cernik, MS; Hajime Uno, PhD; Lanfang Xu, MS; Cecile A. Laurent, MS; Lauren Fisher, MS; Nancy Cannizzaro, BA; Julie Munneke, BA; Robert M. Cooper, MD; Joshua R. Lakin, MD; Corey M. Schwartz, MD; Mallory Casperson, BA; Andrea Altschuler, PhD; Lawrence H. Kushi, ScD; Chun R. Chao, PhD; Lori Wiener, PhD; Jennifer W. Mack, MD, MPH; 5/25Adolescent and young adult (AYA) patients with cancer frequently receive intensive measures at the end of life; many also express care goals that align with a palliative approach. [In this study] nearly three quarters (73%) [of  AYA patients] were referred to palliative care before death. Thirty-six percent of palliative care referrals took place before the last 90 days of life; 30% were in the last month of life. Palliative care referrals and their timing were associated with care received at the end of life, with earlier referrals associated with fewer intensive measures near death, including chemotherapy in the last 14 days of life ... as well as intensive care unit admissions, emergency room visits, and hospitalizations in the last month of life ... Patients who were referred to palliative care were more likely to have symptoms assessed in the last 90 days of life, including pain, dyspnea, nausea, diarrhea, constipation, depression, and anxiety ... 

A ‘cloak of comfort’: an integrated approach to palliative care for cancer patients Sinai Health; 5/26/25 At Mount Sinai Hospital, palliative care is fully integrated into cancer care, providing comprehensive, person-centered support for those with advanced illness. Palliative care, derived from the Latin pallium meaning “cloak,” offers comfort and support to individuals with serious illnesses. Often misunderstood as solely end-of-life care, it actually provides relief at any stage of a life-threatening illness and can be provided in tandem with cancer treatment. This holistic approach addresses physical, emotional, and spiritual needs, aiming to improve quality of life for both patients and their families. In fact, early integration of palliative care can enhance symptom management, extend life and offer greater support to caregivers. Patients can receive care at Mount Sinai Hospital’s Cancer Care Clinic, at home through the Temmy Latner Centre’s home palliative care program, and in the palliative care unit at Hennick Bridgepoint Hospital.  

WHO unveils new guideline to improve global access to controlled medicines World Health Organization; by Departmental update; 5/26/25 The World Health Organization (WHO) has released a rapid communication outlining its comprehensive new guideline on balanced national policies for controlled medicines. The guideline’s recommendations were officially presented during a high-level side event at the Seventy-eighth World Health Assembly on Friday 23 May 2025. It is designed to support countries in ensuring safe, equitable and affordable access to essential controlled medicines which are critical for treating acute and chronic pain, mental health conditions, substance use disorders and other serious health issues.

National Alliance for Care at Home publishes CONNECT to Care Report National Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 5/27/25 The National Alliance for Care at Home (the Alliance) published the results of new research conducted by Transcend Strategy Group exploring perceptions of hospice care among underserved communities. This research compiles findings from a series of surveys of 2,000 people and explores perceptions of hospice care among Black, Hispanic, Asian American, LGBTQ+, and rural communities. Using the CONNECT acronym – Communication, Outcomes, Network, Nurture, Engagement, Collaboration, and Transparency – the report aims to help providers support equitable, inclusive, and comprehensive access to care and is part of the Alliance’s ongoing commitment to increasing access to hospice and home care through knowledge sharing, data collection, and collaborative discussion.  Along with key research findings, CONNECT to Care offers recommendations for hospice providers to help increase understanding of hospice care and help overcome barriers to access.  

Johnson champions Eddie's Law to bring dignity to end-of-life-care in Illinois Public, Springfield, IL; News Release; 5/22/25 After an incarcerated man named Eddie Thomas died alone in a prison infirmary without receiving any end-of-life care, State Senator Adriane Johnson is championing legislation to bring dignity, compassion, and transparency to hospice and palliative care services in Illinois correctional facilities. "This bill is about basic human dignity," said Johnson (D-Buffalo Grove). "No one should die in pain, in isolation or without the comfort of care - no matter who they are or where they live. House Bill 2397 brings transparency to a system that too often leaves people to suffer silently." ... House Bill 2397 would require the Illinois Department of Corrections to prepare and publish an annual report detailing its hospice and palliative care programs. The bill aims to provide lawmakers with data that can guide future policy decisions on compassionate and medically appropriate end-of-life care for people incarcerated in Illinois.