Literature Review

Rehab and death: Improving end-of-life care for Medicare skilled nursing facility beneficiariesJournal of the American Geriatrics Society; by Sarguni Singh, Christian Davis Furman, Lynn A. Flint, Joan Teno; 8/25Hospitalized older adults with serious illness may be discharged to a skilled nursing facility (SNF) [and] ... for those that do not improve, discharge to a SNF can begin a cycle of costly care transitions between hospital, home with home health care, SNFs, and long-term care facilities, leading to fragmented care and missed opportunities for discussions about preferences for care, illness understanding, and to address distressing symptoms. In this article, we describe key policies that contribute to high-cost, low-value care near the end of life for older adults using the Medicare SNF benefit.

Living with dementia: To improve lives, we need to change how we think and talk about this experience in aging societies EurekAlert! - AAAS (American Association for the Advancement of Science); peer reviewed publication by The Hastings Center; 9/24/25 To experience or even contemplate dementia raises some of the most profound questions: What does it mean to be a person? How does someone find meaning in life while facing progressive neurological deterioration? ... To improve the lives of our fellow citizens who are living with dementia or providing dementia care, all of us need to pay attention to how we imagine and talk about these interwoven and increasingly common experiences, concludes Living with Dementia: Learning from Cultural Narratives in Aging Societies, a special report published by The Hastings Center for Bioethics. This report responds to calls from health care and social service practitioners for new ways to depict and talk about dementia, a collective term for Alzheimer disease and related dementias. Editor's Note: Click here for free access to multiple articles in this crucial report, such as

[Canada] Availability of respite care almost triples a palliative care patient’s chance of dying at home EurekAlert! - AAAS; News Release by McGill University; 9/22/25 Access to respite services for family caregivers increases a palliative care patient’s probability of dying at home almost threefold, according to a McGill University-led study. Previous surveys suggest most Canadians with a serious illness would prefer to spend the end of their lives at home. ... Funded by Quebec’s health ministry as part of its action plan for equitable access to quality palliative and end-of-life care, the study set out to find which factors matter most in helping patients avoid a transfer to a hospital or palliative care centre in their final days. Respite care – professional help that allows family caregivers to take short breaks –emerged as the strongest predictor, with patients 2.7 times more likely to die at home when it was available.

AI can aid in end-of-life care decisions, but can't replace human teams MarylandToday; by Fid Thompson; 9/19/25 “Would I be surprised if this person were not alive 12 months from now?”  This so-called “surprise question,” combined with clinical risk calculators, helps doctors make decisions about care for patients near the end of life. Increasingly, clinicians also use artificial intelligence (AI) models to predict remaining life expectancy and better inform palliative care decisions. In a recent study out in the Journal of Palliative Medicine, a University of Maryland researcher sought to understand what palliative care teams think about these AI tools that give an estimated life expectancy or prognosis in end-of-life care, and found mixed reactions. 

Beyond grief: Quantifying bereavement needs of rural family caregiversPalliative and Supportive Care; by Catherine Vanderboom, Diane Holland, Cory Ingram, Brystana G Kaufman, Allison Gustavson, Jay Mandrekar, Ann Marie Dose, Ellen Wild, Carole Stiles, Joan M Griffin; 9/25Family caregivers (FCGs) may experience numerous psychosocial and practical challenges with interpersonal relationships, mental health, and finances both before and after their care recipient (CR) dies. The specific challenges affecting rural FCGs who often have limited access to palliative care services, transitional care, and other community resources are not well understood... Bereavement support should extend beyond a focus on grief to include practical challenges experienced by FCGs. Because challenges experienced in the bereavement period often begin before a CR's death, there is benefit in continuity of FCG support provided by a known clinician from pre- to post-death. When given an option, many rural FCGs are open to bereavement support as early as a week after the death of a CR.

Suicide bereavement among Black-Americans: Evidence from the General Social SurveyOmega-Journal of Death and Dying; by William Feigelman, Julie Cerel, John McIntosh, Nina Gutin, Alice C. Edwards; 8/25Limited research attention has focused on examining the diverging adaptations of American Blacks and Whites to suicide losses. We utilized the 2016 General Social Survey, which included questions related to experiencing suicide bereavement, investigating hypotheses past studies suggested predicting Blacks face more grieving difficulties than their White counterparts. This data did not confirm any evidence of heightened grief or mental health problems among the Black respondents. Owing to the limited number of measurements of mental health assessments more research will be needed to confirm these findings.

“I know you didn’t want to stay”: Emergency Department conversations about disposition for people living with dementia The Gerontologist; Justine Seidenfeld, Matthew Tucker, Melissa Harris-Gersten, Gemmae M Fix, Nina R Sperber, Susan N Hastings; 8/25When people living with dementia present to the emergency department (ED), the disposition decision- to admit them to the hospital or discharge them home- can be difficult for providers. Major themes included 1) disposition conversations had significant variation in depth and content, 2) patient and care partner participation varied with disposition, and 3) satisfaction was driven by alignment of disposition preferences. Our study suggests that there are no consistent formats of disposition conversations for people living with dementia. Improving quality may be most needed when preferences are misaligned, and this should be identified early in the encounter.

[UK] Key themes and approaches in palliative and end-of-life care education for the general public: A systematic reviewBMC Palliative Care; by Muzeyyen Seckin, Rumandeep Tiwana, David Fry, Cara Bailey; 8/25 These [twenty] studies involved a total of 10,307 participants and identified 16 different educational programmes for the public, volunteers, and lay caregivers. The analysis revealed six main themes: foundational concepts and philosophies, communication and decision-making, planning and preparation, symptom management, end-of-life care practices, and caregiving support. This review highlights the importance of training programmes to improve community involvement in caregiving and enhance the quality of care for individuals with life-limiting conditions. Expanding access to such educational resources can empower more people to contribute confidently to end-of-life care in their communities.

Top ten tips palliative care clinicians should know about intentionally interprofessional collaboration Journal of Palliative Medicine; by Michelle M Milic, DorAnne Donesky, Naomi Tzril Saks, Rebecca Cammy, Constance Dahlin, Susan DeSanto-Madeya, Tracy Fasolino, Seiko Izumi, Amanda Kirkpatrick, Joshua R Lakin, Vickie Leff, Kashelle Lockman, Jennifer Walter, William E Rosa, Cara L Wallace; 9/9/25 This article supports individuals to practice at the top of their education, clinical training, and scope of practice while maximizing the functionality of the palliative care team as a whole. We intentionally use the term interprofessional rather than interdisciplinary to clarify that we are focused on collaboration of team members who represent multiple professions or occupations that require specialized training and meet ethical standards (e.g., nursing, chaplaincy, social work, medicine, and pharmacy) rather than interactions among specific fields of study (e.g., cardiology, nephrology, and oncology).

Developing competencies to advance health care access and quality for Latino, Hispanic, and Spanish origin populations-A consensus statementJAMA Network Open; by Débora H. Silva, John A. Davis Rodríguez, Hector Rasgado-Flores, Pilar Ortega, Deion Ellis, Fernando Sánchez Mendoza, Victor Cueto, Fabiola Quintero-Rivera, Norma Iris Poll-Hunter, Minerva Romero Arenas, Kenneth Lee Dominguez, Juan Emilio Carrillo, José E. Rodríguez, John Paul Sánchez; 8/25Question: What competencies and milestones are essential for advancing health equity for Latina, Latino, Latinx, Latine, Hispanic, and Spanish Origin (LHS+) populations? Since the 1970s, the LHS+ population has increased 6-fold and grown to be the largest ethnic or racial group in the US and accounts for approximately 20% of the US population. The LHS+ health equity competencies and milestones resulting from this study add to prior work by creating a blueprint for standardization and broader application of such educational experiences on a national level. As a tool to enhance CBME [competency-based medical education ] efforts aligned with care for LHS+ populations, the competencies may aid educators and institutions through an LHS+–informed lens in conducting gap analyses for the development of local curricula, developing teaching and assessment materials, supporting the professional development of learners and faculty, and facilitating educational scholarship. 

Medicare Advantage plan spending and payments under the hospice carve-outJAMA Network Open; by Meghan Bellerose, Andrew M Ryan, Claire K Ankuda, David J Meyers; 8/25In 2021, the Centers for Medicare & Medicaid Services implemented a Value-Based Insurance Design (VBID) model to test the impact of including hospice services in the Medicare Advantage (MA) benefits package. In December 2024, the VBID was ended following widespread dissatisfaction ... Under the carve-out model, after an MA enrollee elects hospice, health care related to their terminal illness is paid for by fee-for-service (FFS) Medicare. MA plans stop receiving the inpatient and outpatient portions of that enrollee's capitated payment but continue to receive premium and rebate payments. In this cross-sectional study, MA plans received high premium and rebate payments for beneficiaries enrolled in hospice despite low health care spending after enrollees elected hospice. To reduce excess payments, the Centers for Medicare & Medicaid Services could require MA plans to submit information on enrollees' use of supplemental benefits and adjust payments made after election of hospice to align with spending.

Improving community-based palliative care explanations: Insights from persons declining servicesAmerican Journal of Hospice & Palliative Care; by Kira G Sheldon, Kathryn H Bowles, Elizabeth A Luth; 8/25Beneficiaries and caregivers had mixed understandings of palliative care, including: no knowledge, belief that it was the same as or pre-hospice, and accurate, but often one-dimensional understandings of it. Participants recommended providing individualized, tailored explanations focused on the person's health concerns in simple language with follow-up materials to improve engagement with palliative care. Small adjustments to how palliative care is explained may increase understanding among older adults and caregivers, particularly among those with limited or inaccurate knowledge. Among those familiar with palliative care, providing accessible and clear explanations customized to the person's specific care needs can further broaden understanding and increase perceived relevance.

Implementing education for community adult hospice nurses to expand pediatric hospice and palliative careJournal of Hospice and Palliative Nursing; by Shelly C Wenzel; 8/25Pediatric hospice and palliative patients require specially-trained clinicians to provide holistic support in areas such as disease progression, illness trajectory, and goals of care. An asynchronous online educational module, including a pre- and postmodule survey, was developed to provide education on timely pediatric quality-of-life conversations and skills for nurses who work with the adult population. Following the education module, participants reported an increase in comfort from 25% to 93.3% and willingness from 59% to 93.3%. Additionally, postmodule confidence level increased to 94%. These findings suggest an asynchronous educational module approach benefits the needs of community-based adult hospice and palliative nurses and gains learned from this module may enhance nurse skill and improve access to care.