Literature Review

Timing matters: Impact of early advance care planning conversations on hospice utilization in outpatient oncologyJCO Oncology Practice, An American Society of Clinical Oncology Journal; by Lydia Mills, Malia Albin, Ami Gorsky-Zabukovic, Liz Hutchison, Molly Mendenhall, and Robyn Tibert; 10/7/25  Results: 53% of physicians interviewed defined [Advance Care Planning] ACP as hospice, end-of-life, or code status conversations. This group of providers preferred waiting to conduct ACP discussions until later in a patient’s disease trajectory. However, 33% of physicians interviewed viewed ACP as broader discussions, to include patients’ values, goals and preferences for EOL care. These physicians stated they engage in ACP conversations as early as the first or second visit, especially with patients who have Stage IV disease or have a poor prognosis, introducing hospice as a potential option and revisiting these discussions throughout the course of treatment. PI data showed that providers who engage in early and consistent ACP discussions have a 17% higher hospice enrollment rate compared to their peers. 

The expanding role of family medicine in Alzheimer's Disease and other dementias Patient Care; by Grace Halsey; 10/7/25 [From the 2025 Family Medicine Experience conference] Family medicine's unique position in dementia management spans initial diagnosis through end-of-life care. ... Dementia Staging: Clinical Assessment and Hospice EligibilityFor practical bedside assessment and hospice determination, the Functional Assessment Staging Tool (FAST) proves particularly valuable.1 The FAST scale includes 7 main stages, progressing from no impairment (stage 1) through severe dementia requiring total care (stage 7). Stage 7 breaks down further into substages (7a-7f) that capture specific functional losses including ambulation, independent sitting, smiling, and head control. Eligibility for hospice care generally requires FAST stage 7c or beyond, indicating ... [continue reading this important criteria] Editor's Note: Leaders must understand hospice eligibility criteria when setting census goals, guiding teams, and communicating with families. Getting it wrong risks fraudulent billing, angry caregivers when live discharges occur, or too little care that comes too late. Getting it right ensures dignity, humanity, and meaningful final moments amid dementia's long goodbyes—true measures of compassionate hospice dementia care.

Milton Village Open House builds community to support caregivers of individuals with Alzheimer's, dementia, or other cognitive conditions GreatNews.Life; by Lauren Grasham; 10/6/25 To help healthcare providers better understand the numerous resources available, Milton Village hosted an open house on Tuesday, September 30. Milton Village is a collaborative effort between Milton Adult Day Services (a program of the Center for Hospice Care) and Alzheimer’s & Dementia Services of Northern Indiana (a REAL Services program) to provide comprehensive care and support to individuals living with Alzheimer’s or other cognitive conditions and their caregivers. “Inviting healthcare providers to see our facility and learn more about our programs is a great way to help them understand our unique model,” said Sarah Youngs, director of Milton Adult Day Services. “As providers tour the facility and hear how our guests engage in the programming, it’s so satisfying to see them recognize what this can mean for their patients and the patients’ caregivers.”

Life lessons from a palliative care psychologist - and how to support a dying loved one HELLO! onMSN; by Pilar Hernán; 10/5/25 ... Psychological support becomes a fundamental pillar for providing comprehensive and humane care, from managing emotional pain to adapting to the new reality. MD Anderson Cancer Centre psycho-oncologist Fátima Castaño helps us understand the process, explaining how we can support a loved one in palliative or end of life care, and shares the powerful life lessons she has learned through her work.

How palliative care supports families emotionally and physically Elevated Magazines; 10/3/25 People often feel lost when someone they love is diagnosed with a serious illness. The shift in daily routines, the constant medical appointments, and the uncertainty about the future can feel overwhelming. Palliative care steps in to ease this transition, offering medical expertise and guidance that helps families adjust to new roles and responsibilities. Having a care team that understands both medical needs and the emotional burden can make a significant difference.

Healthcare AI in the United States — navigating regulatory evolution, market dynamics, and emerging challenges in an era of rapid innovation The National Law Review; by Nadia de la Houssaye, Andrew R. Lee, Jason M. Loring, Graham H. Ryan of Jones  Walker LLP; 10/2/25 The use of artificial intelligence (AI) tools in healthcare continues to evolve at an unprecedented pace, fundamentally reshaping how medical care is delivered, managed, and regulated across the United States. As 2025 progresses, the convergence of technological innovation, regulatory adaptation (or lack thereof), and market shifts has created remarkable opportunities and complex challenges for healthcare providers, technology developers, and federal and state legislators and regulatory bodies alike. ...

Not everything is delirium at the end of life: A case reportAnnals of Palliative Medicine; by Daniel Gilbey, Eduardo Bruera, Patricia S Bramati; 9/25In this report, we highlight the challenges faced by clinical teams diagnosing and managing delirium, in particular when a language barrier is present. Case description: A patient in his late sixties with low English proficiency with a metastatic neuroendocrine tumor was transferred to a palliative care unit on non-invasive bilevel ventilation. He appeared to become delirious and agitated, trying to remove the face mask, wriggling in bed, and tapping the bedrails. Haloperidol and lorazepam were required when non pharmacological interventions failed to calm him down. The following morning, the patient was able to explain that the positive-pressure facemask was suffocating him and that he could not breathe. So, he was transitioned to high-flow oxygen via nasal cannula, and within a few hours, his respiratory distress significantly improved, and he regained his previous self.

[Spain] Mapping palliative care for people living with advanced cancer in phase 1 clinical trials: A scoping reviewPalliative Medicine; by Diego Candelmi, Alazne Belar, Carla Zapata Del Mar, Ana Landa-Magdalena, Anna Vilalta-Lacarra, Mariano Ponz-Sarvisé, Carlos Centeno; 9/25This review highlights the unique needs of patients and caregivers in Phase 1 Cancer Clinical Trials and the complexities of integrating palliative care. Key results revealed patients' limited life expectancy, high symptom burden, distress and unmet spiritual needs [and]... patients were reluctant to seek prognostic information or engage in end-of-life discussions, complicating advance care planning. End-of-life care involved frequent unscheduled hospital admissions, hospital deaths and late hospice-care referrals. Caregivers experienced significant distress, while healthcare professionals faced barriers to integrating palliative care. Palliative care interventions varied widely in approaches, settings and outcomes.Assistant Editor's note: This article discusses how palliative care could benefit patients that are enrolled in phase 1 clinical trials for cancer. Traditionally, it has not been common practice for palliative care programs to serve these kinds of patients and their loved ones. This represents an opportunity for the expansion of much needed palliative care services.  

Instilling hope: A comprehensive model of cancer care for younger adults Targeted Oncology; by Andrea Eleazar, MHS and Shane Dormady, MD, PhD; 9/29/25 In the past decade, the incidence of numerous cancer types has increased, particularly among younger adults under age 50. For younger adults, many of whom are primary breadwinners of their households or in the height of their educational or professional careers, a cancer diagnosis at this life stage can be unexpected and jarring. ... In an interview with Targeted Oncology, Shane Dormady, MD, PhD, medical director of El Camino Health Cancer Center, describes the unique needs and challenges of younger adults, outlines El Camino Health’s comprehensive care strategy, and offers insights and considerations for treating and interacting with this patient population.

Adobe Population Health expands footprint through acquisition of clinical programs from MedZed Physician Services Adobe Population Health; by PRNewswire/PRWeb; 9/26/25 Adobe Population Health, an innovative care management company, proudly announces the acquisition from MedZed Physician Services of certain assets related to MedZed Physician Services' California based In-Home Primary Care and Palliative Care services. The acquisition of such assets, contracts, and employees supports Adobe's expansion into California, reinforcing Adobe's commitment to closing care gaps and addressing the needs of the most vulnerable populations. Adobe Population Health offers proactive care management services through a tech-enabled, hybrid care model delivering whole-person care.

Outpatient pediatric palliative care: A national survey of clinic structures and operationsJournal of Pain and Symptom Management; by Ashley Kiefer Autrey, Caroline Stafford, Casie James, Suraj Sarvode Mothi, Elissa G. Miller, Alexis Morvant, Erica C. Kaye; 8/25Despite the rapid growth of pediatric palliative care (PPC) over the past two decades, outpatient pediatric palliative care (OPPC) remains an underdeveloped resource for children living with serious illness and their families. Characterizing the utilization of clinic models and workflow processes among OPPC programs is essential for establishing benchmarks to help improve OPPC operationalization and hospital-specific program development. This paper presents national data to address this gap, with the goal of supporting PPC programs in their efforts to expand service lines to meet the growing needs of patients with serious illness and medical complexity and their families.

Emergency Departments report more consults for hospice, palliative care Michigan State University, East Lansing, MI; by Michigan State University; 9/25/25 One-third of Americans will visit an emergency department, or ED, within a month of their death. While EDs are primarily purposed to provide emergent care, they’re increasingly becoming an initial touchpoint for hospice and palliative care, or HPC, referrals and consultations, according to a new study from several researchers at Henry Ford Health + Michigan State University Health Sciences.  Why this matters:

Building blocks of hospice family caregiver support Hospice News; by Holly Vossel; 9/24/25 Untapped reimbursement opportunities exist when it comes to developing a sustainable family caregiving infrastructure in the face of rising demand for home-based hospice care. ... Among the payment avenues with potential to improve support for caregivers is the Medicaid-funded Structured Family Caregiving (SFC) program. SFC coverage includes a modest financial stipend to health care providers that offer home- and community-based services for caregivers. ... Roughly 63 million Americans are family caregivers, an increase of nearly 50% since 2015, according to a report from the National Alliance for Caregiving and AARP. About one-in-every-four adults is a caregiver to a family member, with 40% of these individuals providing high-intensity care, the report found. About half of the nation’s caregivers reported negative financial impacts, with one-in-five unable to afford basic needs such as food and 25% taking on debt. Additionally, one-in-five caregivers have poor health outcomes, the report found.Editor's Note: Are you aware that the 2008 CMS Hospice Conditions of Participation identify the "family" 423 times? (Yes, I've searched, counted, and categorized.) Click here for AARP's 2025 edition of Caregiving in the US.