Literature Review

Most Americans prefer to die at home, but the US healthcare system often prevents it ArcaMax; by Karen Lutfey Spencer; 7/14/26 Ask people what they want at the end of their lives, and overwhelmingly the answers will revolve around comfort, dignity and time at home with loved ones. Yet the U.S. healthcare system often thwarts these wishes. Most Americans say they want to die at home, but only one-third do. What could be an intentional last chapter may instead become a roller coaster of hospitalizations and decisions made with incomplete information. News headlines reflect the challenges of facing the end of life in crisis mode. ... Unfortunately, these crisis scenarios are happening to millions of families each year.

Utilization of hospice and palliative care among patients with mental illness: a retrospective cohort study Journal of the American Geriatrics Society; by Sean O'Mahony, Utpol Das, Yuanyi Zhang, Anirudh S. Babu, Mukaila A. Raji, James Gerhart, Yong-Fang Kuo; 7/11/26 Background: Individuals with mental illness (MI) experience premature mortality and health disparities, yet little is known about their access to hospice and palliative care. Conclusions: Mental illnesses were associated with complex hospice utilization patterns characterized by longer length-of-stay, higher likelihood of enrollment far from death, lower likelihood of enrollment within 180 days before death, and lower palliative care consultation use in some groups.

Relationships between advance care planning engagement, patients’ religious practices, and spirituality American Journal of Hospice and Palliative Medicine; by Robyn M. Axel-Adams, MS, MDiv, BCC, HEC-C, Emily Fox Ludden, MDiv, MGS, and Alexia M. Torke, MD; 7/2/26Background: Research has shown that people who consider themselves religious have a lower advance directive (AD) completion rate. However, advance care planning (ACP) includes a broader range of activities that are important in determining medical treatments. ... Conclusions: In contrast to prior findings of lower AD completion in more religious individuals, this study found that higher religiosity and spirituality are associated with higher ACP engagement. These results suggest ACP opportunities offered for religious congregations or spirituality focused communities may be especially successful.

Impact of specialized pediatric palliative care on bereaved parents' mental and physical healthJournal of Pain & Symptom Management; by Claudia Delgado-Corcoran, Huong D. Meeks, Sarah E. Wawrzynski, Barry P. Markovitz, Brandy Harman, Jasmine R. Masih, Kuan Li, Mark Harousseau, Dominic Moore, Jacob Wilkes, Stefanie G. Ames; 6/26Pediatric death can lead to long-term adverse effects on parents’ health. [In this study] of 776 deceased children linked to 773 mothers and 711 fathers, 36.1% received a SPPC [specialized pediatric palliative care] consultation prior to death. Higher rates of mental and physical health burden were observed in mothers than fathers across all time points. Lack of SPPC was associated with increased risks for new mental and physical health burden for mothers within 12 months after the child’s death ... Conclusions: Bereaved parents, especially mothers, experienced new mental and physical health burden up to 24 months after a child’s death.

Palliative care for older adults with hip fracture: An explanatory sequential mixed-methods studyJournal of Pain & Symptom Management; by Daniel I Hoffman, Sydney Moore, Amanda J Reich, Christina Sheu, Mengyuan Ruan, Masami Tabata-Kelly, Kate Sciacca, Tamryn F Gray, Daniel Dohan, Charlotta Lindvall, Zara Cooper; 6/26After hip fracture, older adults experience burdensome treatments and high mortality; they may therefore benefit from palliative care (PC). Among 1,433 hip fracture admissions, GOCC [goals of care conversations], hospice discussions, and specialty PC were documented in view on their role in GOCC. Conclusion: Limited standardization, role uncertainty, and cultural factors limited PC documentation and delivery, highlighting opportunities to strengthen PC integration in surgical care.

Outcomes for hospitalized patients with comfort measures only ordersJournal of Palliative Medicine; by Gina Piscitello, Donna Durant, Tami Minnier, Marika Haranis, Robert M Arnold, Jane Schell; 6/26Clinicians place comfort measures only (CMO) orders for hospitalized patients at the end-of-life when a decision has been made to focus on patient comfort and allow the natural dying process to occur. Our primary aim was to assess the associations of specialty palliative consults (SPC) or documented goals of care conversations (GOCC) with in-hospital mortality among patients with CMO orders. Of 6,789 hospitalized patients with CMO orders ... seventy-three percent died in-hospital, and 22% were discharged with hospice. SPC placed anytime during hospital admission were associated with lower in-hospital mortality ... and higher discharge with hospice ... In contrast, documented GOCC anytime during admission were associated with higher in-hospital mortality ...  and lower discharge with hospice ...

Big Bend Health announced as parent company of Big Bend Hospice, reflecting expanded continuum of care across North Florida Big Bend Health; Press Release; 7/9/26 Big Bend Hospice, North Florida’s trusted nonprofit leader in end-of-life care for more than 40 years, today announced the formal introduction of Big Bend Health as its parent company; a strategic brand evolution that reflects the organization’s growing continuum of care while reinforcing Big Bend Hospice as its primary and most recognized service. Big Bend Health, formerly known as Seven Oaks Health, unifies Big Bend Hospice and its related healthcare services under one cohesive continuum of care. While the parent name will be used primarily for formal and legal purposes, the community will continue to see Big Bend Hospice as the forward-facing brand and the cornerstone of compassionate end-of-life care.

2025 Pediatric Facts and Figures Report now available National Alliance for Care at Home, Alexandria, VA; Press Release; 7/8/26 The National Alliance for Care at Home (the Alliance) published the 2025 Pediatric Facts and Figures, a report that provides an overview of pediatric palliative care and hospice in the United States and presents the results of a national survey of providers. The survey that informed the report had a response rate of 56% and yielded 295 entries representing distinct pediatric programs. Responses represent all 50 states and Washington, DC, and the survey was active from May through August of 2024. The report takes a close look at topics like pediatric patient characteristics, location and access to care, reimbursement for care, provider characteristics, barriers and facilitators to care, and concurrent care.  [Download]

N.J.’s hospice problem is also an equity problem | opinion NJ.com; by Christopher Rinn; 7/5/26 Again and again, families tell me the same thing after a loved one enters hospice care: “We wish we had called sooner.” By the time many New Jersey families reach hospice, they are physically exhausted, emotionally overwhelmed and navigating a medical crisis that has already taken a heavy toll. In our state, the median length of stay in hospice is just 13 days. That means many patients are receiving only days, not months, of the support, comfort and guidance hospice was designed to provide. The biggest reason is not denial or a lack of compassion from families. It is misunderstanding. ...

Guardianship and hospice care fail dying patients MedPage Today's KevinMD.com; by Kirsten Engel, MD & Madha Tripathi; 6/3/26 “Mr. L” is alone, lying flat on his back in a slightly inclined bed, eyes squeezed shut, hands raised in the air as immobile fists. He has not spoken in weeks. ... The medical team calls it catatonia, a severe psychiatric syndrome that has rendered him mute, immobile, and medically fragile. The psychiatric care team has recommended comfort measures, and our hospice team is ready to accept him. ... Mr. L cannot access hospice because an overworked stranger appointed by the court has not yet returned the hospital’s calls. This is a guardian, a professional fiduciary who has never met Mr. L, who must sign the papers first. So we wait for the court to hold a hearing to approve the order. And Mr. L, still, silent, and suffering, waits with us.

7 ways palliative care can help people with ATTR-CMEveryday Health; by Abby McCoy, RN; 7/3/26 Transthyretin cardiac amyloidosis (ATTR-CM), a rare type of heart failure, can cause symptoms that affect more than just your heart, and many of them can lower your quality of life. But palliative care, or care meant to provide symptom relief, comfort, and support, can help you live better with this condition. ... Here’s how your palliative care team can help you manage life with ATTR-CM and feel your best.

CMS proposes community-based palliative care benefit Hospice News; by Jim Parker; 7/1/26 The U.S Centers for Medicare & Medicaid Services (CMS) has proposed coverage of community-based palliative care through the Medicare home health benefit. CMS included the palliative benefit in its 2027 proposed home health rule. ... The agency emphasized that palliative care under the home health benefit would be separate from hospice care and could support patients earlier in the course of serious illness.

My parents moved in with us before my dad got sick. It made all the difference when he passed. Business Insider; by Justin Murphy; 6/27/26