Literature Review

[Korea] Earlier palliative cancer care cuts end-of-life ED visits Medscape; ed. by Gargi Mukherjee; 7/23/25 A recent retrospective study found that earlier outpatient palliative care referrals for patients with advanced cancer were associated with a small increase in overall emergency department (ED) visits but significantly fewer end-of-life ED visits and improved advance care planning. ... A substantial proportion of patients with advanced cancer visited the ED, including during the final month of life. Earlier palliative care referrals were associated with fewer end-of-life ED visits, “emphasizing the importance of timely integration of [palliative care] to reduce unnecessary interventions and ensure goal-concordant care,” the authors wrote. The researchers also noted that the findings underscore the need for structured advance care planning discussions across care settings to enhance the quality of end-of-life care.

'A long, beautiful time together': Photo exhibit 'Til Death Do Us Part'KUT 90.5, Austin, TX; by Michael Lee; 7/21/25“Well, we have to go back five years to the beginning of the pandemic,” says photographer Becky Wilkes, recalling how she came to create the exhibit Til Death Do Us Part. ... Wilkes and her siblings found themselves making frequent trips to Waco to care for their almost-90-year-old parents, and then the looming threat of a global pandemic made an already-difficult situation worse. ... She’d already started snapping some cell phone photos to share with her siblings, but seeing her parents together again, with what seemed like a renewed sense of love and togetherness, Wilkes decided to capture more and better photos. “And then I did have a conversation with them very quickly and I requested permission to photograph them,” she says. The resulting photography exhibit, Til Death Do Us Part, chronicles that last year of her parents’ lives.  ... The story ultimately ends in their death and our understanding of their death. But the story is really about their living. And, that's really… that's really beautiful.” Editor's Note: Click here for Becky Wilkes' website page with her descriptions and photos. 

How to perform a Regret Audit: A simple question that can help you live with purpose and have fewer regrets. Psychology Today; by Jordan Grumet, MD; 7/20/25 As a hospice doctor, I’ve spent countless hours sitting at the bedsides of dying patients, listening to the echoes of lives well-lived and those haunted by regret. As Bronnie Ware described in The Five Regrets of the Dying, many end-of-life reflections center around missed chances to live more authentically, joyfully, and meaningfully. But we don’t have to wait until our final moments to face these truths. I’ve long advocated for the hospice life review as a proactive tool. It’s a structured set of questions used by hospice professionals to help patients process their lives and find peace. The questions are simple but profound:

Ok, please help calm my anxiety. My mother has drastically improved in the last couple of days since goin on hospice. Aging Care; by Oedgar23; 7/17/25 So in the hospital, my mother was in kidney failure. The last couple days after stopping vancomycin for about five days, her GFR had come up to 19. That’s the most recent Number and then they stopped drawing labs because we placed her on Hospice. We consulted with palliative care team. They wanted to do a feeding tube and we said no. They said she had advanced dementia. [Describes improvements since hospice.] ... What if she gets taken off hospice? ... What if she no longer qualifies for hospice, passes as normal cognitively, starts demanding to go home, does not qualify for long-term care, Medicaid, etc. ... But I am super unnerved because she looks a whole lot better than she has been looking. ...Editor's Note: Yes, we all know that the person can get better with hospice care, because of holistic person-centered care, caregiver education and support, and many more factors. This can be confusing. The dying trajectory may have been interrupted or simply calmed with better symptom management and quality of life. This daughter is asking normal, crucial questions which the hospice team needs to be addressing with her. Examine your live discharge data, Policies and Procedures, communication practices with the patient and family about recertifications, Incident Reports from upset caregivers/families, and CAHPS Hospice scores.

[Norway] iLIVE volunteer study: Volunteer and healthcare professional perceptions of newly developed hospital end-of-life-care volunteer services, in five countriesPalliative Medicine; Tamsin McGlinchey, Stephen Mason, Grethe Skorpen Iversen, Dagny Faksvåg Haugen, Inmaculada Ruiz Torreras, Pilar Barnestein Fonseca, Miša Bakan, Berivan Yildiz, Ruthmarijke Smeding, Anne Goossensen, Agnes van der Heide, John Ellershaw; 5/25Volunteer services that provide direct support to patients receiving palliative and end-of-life care in hospitals are new and developing, but little is known about the use and experience of such services from key stakeholders. 20 Volunteers and 20 healthcare professionals were recruited. Three overall themes were generated: (1) Volunteers provided 'unique, distinct, 'community' support' bringing familiarity to an unfamiliar, medically focussed environment. (2) Volunteers were able to 'establish a connection centred on 'being there' within the acute hospital environment' despite the fast paced and highly changeable environment. (3) Through 'relational interactions adapted to the individual person' volunteers attended to patients' existential and emotional needs. These services confer benefits that are transferrable across cultures and countries, 'fusing' formal care with the informal visiting of family or friends, attending to patients' existential needs.

Leveraging speedy admissions to support hospice growth Hospice News; by Jim Parker; 7/16/25 Seamless and fast admissions processes are crucial to hospice growth. Speedy hospice patient admissions can lead to improved referral numbers, profitability and length of stay. Yet, hospices need to carefully navigate their patient admission processes to maximize both quality and their revenue. The hospices that do this effectively have a core set of key performance indicators that they look at consistently, according to Tony Kudner, chief strategy officer of the consulting firm Transcend Strategy Group. “The ones that look at data and are constantly asking themselves, ‘How can we paint the fullest picture of eligibility and get to that patient as quickly as possible?’ are the ones that we would say are the ones that are successful,” Kudner told Hospice News. “The people who have that information at their fingertips and use it to drive decision making are usually the ones who are sustaining their organizations and growing.”

Time and location of specialty palliative care for women dying with metastatic breast cancer Breast Cancer Research and Treatment; by Andrea King, Cynthia Ortiz, Rachna Goswami, Tara L Kaufmann, MinJae Lee, Lynn Ibekwe-Agunanna, Navid Sadeghi, Donghan M Yang, Lindsay G Cowell, Timothy P Hogan, Lauren P Wallner, Megan A Mullins; 7/15/25 online ahead of print Background: Despite guideline recommendations, evidence suggests many women with metastatic breast cancer (mBC) do not receive specialty palliative care services despite high morbidity burden. ... Results: ... Most palliative care encounters were inpatient and occurred within ~ 1 month of death. ...Conclusion: Palliative care for women with mBC is infrequent and often late, with referrals seemingly driven by the imminence of death rather than metastatic diagnosis. Strategies to better identify and triage specialty palliative care needs and make timely referrals are needed.

Grieving the living: How Hospice of St. Lawrence Valley helps caregivers cope North Country Now, St. Lawrence County, NY; by Kate Favaro, Hospice of St. Lawrence Valley; 7/10/25 With caregiving comes grief, there’s no way around it. You will grieve two important things that you’ve lost: who the person you’re caring for used to be, and the things that will never be. Take the time to explore the grief you’re experiencing so you can provide the best care possible. If you’re not taking care of yourself, you won’t be able to take care of anyone else. Hospice of St. Lawrence Valley offers the following on the grief of caregiving:

Health economic analysis of an all-virtual, at-home acute care modelJAMA Network Open; Brad Spellberg, MD; Christopher Lynch, MD; Hal F. Yee, MD, PhD; Josh Banerjee, MD; 6/25Hospital-at-home care models send staff, durable medical equipment (DME), and therapeutics (eg, intravenous infusions) to patients’ homes to provide care. In the US, Medicare requires in-person evaluations at least twice daily to receive payment for hospital-at-home services. In the UK National Health Service, virtual wards at home are increasingly being used in lieu of inpatient care. This economic evaluation of ... patients receiving all-virtual, at-home acute care ... found that the virtual program was cost-saving (due to avoided variable hospital costs) only for unfunded patients or patients with Medicaid, but was cost-losing for Medicare and commercially insured patients due to substantial lost inpatient revenue. These findings suggest that current payer rates for inpatient care financially disincentivize development and implementation of novel acute, at-home care models, but a simple reimbursement schema could enable net savings to both hospitals and payers.

Home-based palliative care for cancer patients: Evaluating a decade of nursing-led interventionsAmerican Journal of Hospice and Palliative Medicine; Júnia de Oliveira Alves, RN; Eduardo Bruera, MD; Mônica Isaura Corrêa, MD; Sonia Souza, PhD; Marília Ávila de Freitas Aguiar, PhD; Ana Paula Drummond-Lage, PhD; 6/25Home-based palliative care is an effective approach for managing advanced-stage cancer patients, particularly in regions with limited healthcare infrastructure. In Brazil, the “Better at Home” Program enables interdisciplinary teams to deliver palliative care in patients’ homes, with nurses playing a central role in providing clinical and supportive interventions. Registered nurses (RNs) were responsible for complex procedures, supervision of nursing technicians (NTs), and caregiver training, while NTs performed routine clinical tasks and assisted with daily care. Notably, 99.4% of patients died at home, suggesting alignment with palliative goals of care. These findings underscore the central role of RNs in coordinating and delivering home-based palliative oncology care within a multidisciplinary framework.

Virginia Cancer Specialists expands and rebrands its Palliative Care Program to support patients through every step of cancer treatment PR Newswire, Fairfax, VA; Press Release; 7/8/25 Virginia Cancer Specialists, the largest private cancer practice in Northern Virginia, named #1 practice in cancer care and all medical specialties by Castle Connolly in 2024 and 2025, is proud to announce the rebranding and expansion of its former Palliative Care Program – now called Supportive Cancer Care – to deliver more comprehensive, integrated support services to help patients better maintain quality of life throughout the treatment process. Virginia Cancer Specialists designed this newly enhanced program with 3 key objectives:

5 ways to have a ‘good death’ — including one of the biggest mistakes people make New York Post; by Reda Wigle; 7/3/25 No one gets out of life alive — but one expert says we can take steps to make sure we leave the earthly plane riding the high of a “good death.” “While 80% of people want to die at home surrounded by loved ones, only 30% actually do,” End Well founder Dr. Shoshana Ungerleider told The Post. “This massive gap reflects our system’s inability to honor what patients actually value.” As our cultural relationship to mortality has changed, Ungerleider notes that we have become disconnected from the process of death and, in turn, fail to plan appropriately for it. But if you’re not sure where to start, she has a helpful checklist of everything you should be doing to avoid a “bad death.”

Palliative care in the ICU: From oxymoron to standard of careIntensive Care Medicine; Nancy Kentish-Barnes, Judith E. Nelson; 6/25 Palliative care can be integrated into intensive care through ICU clinicians and palliative care specialists, and these approaches are complementary and synergistic. One study found that proactive specialist involvement in ICU rounds for high-risk patients led to more and earlier family meetings and shorter hospital stays. However, collaboration challenges, such as continuity of communication, highlight the need for close team cooperation. The integrative model trains intensivists and ICU nurses to embed palliative care into routine practice, ideally starting in medical and nursing education. Research has shown that improved communication and support from intensivists and ICU nurses are associated with better bereavement outcomes for families, including reduced post-traumatic stress, anxiety, depression, and prolonged grief.