Literature Review

After her son’s painful death, a Cheshire mother highlights Connecticut’s pediatric hospice gap New Haven Register, Norwalk, CT; by Cris Villalonga-Vivoni; 10/26/25 Carolyn Torello believes that no parent should outlive their children, yet that became her reality. ...  As his condition worsened, the family faced his impending death without the support of pediatric palliative or hospice care. No provider, she said, seemed to know how to help or where to begin. He died at 15 years old in 2021. ... In 2020, an estimated 7,800 children in Connecticut were living with complex medical conditions that limited their life expectancy and could have benefited from palliative or hospice care, according to data from the National Survey of Children's Health. ... Torello thinks that if Michael had access to hospice care, he could have died with greater dignity, and their family could have focused on simply being together. ... Efforts to create a more formalized pediatric palliative care system have been underway since 2024, led by a state-commissioned working group that will make recommendations to the legislature on potential reforms.

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.

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.

Where comfort and nutrition meet: A case series of children with severe neurologic impairment receiving home parenteral nutrition at the end of lifeNutrition in Clinical Practice; by Dana Steien, Erin Alexander, Molissa Hager, Andrea Armellino, Megan Thorvilson; 9/25Increasingly, home parenteral nutrition (HPN) ... is used for intractable feeding intolerance (IFI), which can occur near the end of life (EOL) in children with severe neurological impairment (SNI). [Four cases were retrospectively examined and we] found that the pediatric palliative care team (PPCT) was involved in all cases during HPN decision-making and planning. The pediatric nutrition support team (PNST) and PPCT collaborated to provide individualized, goal-directed care. All [patients] were enrolled in hospice while receiving HPN. HPN at EOL requires careful ethical consideration, particularly of autonomy because families often find comfort in providing nutrition.

Pediatric home-based palliative care and hospice: Characterizing and comparing the populationsJournal of Pain and Symptom Management; by Ben Reader, Sibelle Aurelie Yemele Kitio, Steven M Smith; 9/25Home-based palliative care (HBPC) and hospice programs offer support for children with complex life-shortening conditions. However, there is little comparison of the characteristics and care trajectories of children and young adults enrolled in HBPC versus hospice, particularly across different age groups. Of 113 participants, hospice recipients were younger (median 2 vs. 7 years; ...), more likely to have an oncologic diagnosis, and had a higher mortality during the study period (69.6% vs. 22.1%; ...). HBPC participants had more hospital admissions, longer inpatient stays, and more outpatient visits. Subgroup analyses of children ≥1 year revealed diagnosis and code status differences, with hospice participants more likely to have 'allow natural death' orders and experience a code status change. 

Economic benefits of investment in palliative care: An appraisal of current evidence and call to actionJournal of Pain and Symptom Management; by Liz Gwyther, Maya Jane Bates, Bach Tran, Liz Grant, Richard Harding, Eric L. Krakauer, Peter May, Eve Namisango, MR Rajagopa, Eleanor Reid, Charles Normand; 9/25This article summarises the literature suggesting that palliative care can provide cost savings to society as a whole (health systems, patients, families) as well as providing good care in line with patient preferences. The evidence indicates that palliative care is effective in providing patient-centred care, in managing symptoms and patient distress, and in saving money for both the family and the health system. Funding mechanisms for palliative care may exist in high-income countries, but many low-and middle-income countries do not yet have sustainable mechanisms of funding palliative care services.

Chesapeake Supportive Care and Southern Maryland House Calls partner to expand access to in-home palliative care in Calvert County Southern Maryland News Net, Chesapeake, MD; 10/16/25 Chesapeake Supportive Care (CSC), the palliative care arm of Hospice of the Chesapeake, is excited to announce a new partnership with Southern Maryland House Calls (SMHC), a trusted leader in home-based geriatric care, to enhance access to palliative care services for residents of Calvert County. ... “Southern Maryland House Calls has been an exceptional partner in caring for our shared patients,” Becky Miller, President and CEO of Hospice of the Chesapeake, said. “Together, we’re building on that relationship to help more people access the kind of care that truly improves quality of life.”

With palliative care, earlier referrals mean fewer end-of-life emergency department visits ONS Voice; by Anne Snively, MBA, CAE; 10/15/25 Patients with cancer who are referred to palliative care within one month of death have a mean of 1.17 emergency department (ED) visits, compared to a mean of 0.13 visits for patients referred to palliative care 12 months or more before death—a 160% difference. The data are part of a new study published in JAMA Network Open in July 2025. ... Most of ED visits (47.0%) and EOL ED visits (81.4%) occurred within one month of the palliative care consultation, but the researchers found that both kinds of ED visits “gradually decreased as the time from consultation to death extended.” 

Stiff person syndrome in the hospice patient: A case report and discussion  Journal of Palliative Medicine; by Molly Svendsen, B Parker Layton, Shiri Etzioni, Mark Edwin; 10/13/25 Stiff Person Syndrome (SPS) is a rare, progressive autoimmune neurological disorder characterized by painful spasms, muscle rigidity, and heightened sensitivity to external stimuli. Management often relies on therapies that fall outside standard hospice formularies, creating challenges in end-of-life care for affected individuals. ... This case highlights the need for flexible, patient-centered approaches in hospice care for rare neurological conditions like SPS. Continuation of disease-specific therapies for symptom palliation can be ethically and clinically appropriate when integrated with clear goals of care. 

[Global] Top designs revealed in buildner’s Fourth Annual Hospice – Home for the Terminally Ill competition ArchDaily; 10/13/25 Buildner has announced the results of its fourth annual Hospice - Home for the Terminally Ill international architecture ideas competition. This global call for ideas continues to explore how architecture can support end-of-life care with empathy, dignity, and contextual sensitivity. The competition invited architects and designers to move beyond clinical requirements and envision spaces that offer emotional warmth, social connection, and a profound sense of place. ... An international jury reviewed the submissions for their design clarity, emotional resonance, and architectural depth. 

‘Lack of urgency’ a top cause of hospice admissions delays, industry consultants say McKnight Home Care; by Adam Healy; 10/9/25 Hospices’ delays in admitting patients can bog down operations and stifle growth. To avoid holdups, providers should act with urgency and prioritize outside-the-box thinking, industry consultants at Transcend Strategy Group recommended. ... Transcend Strategy Group recently released a new insights guide titled “Driving Sales and Admissions Success in Hospice Care.” The guide reveals hospice providers’ top reasons for admissions delays, the problems caused by these delays, and the strategies providers can use to clear bottlenecks. The insights guide noted that admissions delays are problematic for both providers and their clients. ... Hospices should get creative to solve admissions problems, Transcend’s experts agreed. Rather than look for a tool or technology to help speed up operations, look internally to identify practices that prevent care from being delivered, they said.

Care that never gives up - in honour of World Hospice & Palliative Care Day 2025 The Morung Express; by Dr. Victoria Seb, MBBS, PDGDM, FIPM; 10/10/25 Quoting the Father of Medicine, Hippocrates, himself : ‘To cure sometimes, to relieve often, to comfort always’, these timeless words echo deeply the realm of palliative care, reminding us that the heart of healthcare lies not only in curing disease but in easing suffering and preserving dignity. The World Hospice & Palliative Care Day 2025 theme “Achieving the Promise: Universal Access to Palliative Care” calls to action for communities, healthcare systems and policy makers to ensure that palliative care is not a privilege but a universal right – accessible to every person, everywhere. ... In an era marked by medical advancement and increased life expectancy, the demand for holistic, compassionate care at the end of life has never been greater. Yet, despite its proven benefits, access to palliative care remains limited worldwide. The need for palliative care is urgent and growing, especially as populations age and chronic diseases become more prevalent. 

Beyond bars: Evaluating end-of-life care and surrogate decision-making for hospitalized incarcerated personsJournal of Palliative Medicine; by Zack Watson, Julie Brown, Abhinav Vyas, Stacey Tillman, Sumi Misra, Rajiv Agarwal, Cheryl Gatto, Allison McCarthy, Mohana Karlekar; 9/25Incarcerated persons (IPs) retain the constitutional right to health care, yet they face unique challenges in accessing palliative care (PC) and designating surrogates, especially when incapacitated. We present two cases of hospitalized IPs with life-limiting illnesses who experienced significant barriers in identifying and engaging surrogates. Both cases underscore the effect of delays in communication with surrogates and restricted end-of-life (EOL) visitation due to correctional policies. These delays limited the delivery of optimal interdisciplinary PC and bereavement support. Despite clear legal guidance under the Tennessee Health Care Decisions Act, misinformation and procedural ambiguity among medical and correctional staff impeded timely and appropriate care.