Literature Review

Follow-up: Helene and hospice care in the western North Carolina mountains Hospice & Palliative Care Today; summary from a meeting between Vern Grindstaff (CEO, Compassionate Care Western North Carolina), Chris Comeaux and Tina Gentry (Teleios Collaborative Network), Cordt Kassner and Joy Berger (this newsletter); 1/28/25 Hospice recovery efforts from Hurricane Helene in North Carolina's mountains have been massive, with extensive long-term needs ahead. Vern Grindstaff, CEO of Compassionate Care Western North Carolina described the "new normal" they are experiencing.  Photos of this hospice and its service area vividly portrayed this hospice before, soon after Helene, and in its current recovery. Key topics included unthinkable patient care challenges with creative problem-solving, financial implications amounting to a $350,000 deficit for repairs, and the trauma experienced by staff—both professionally and personally. Discussions highlighted the importance of long-term recovery strategies, including the involvement of larger trusts for sustained funding, while also recognizing community support efforts by organizations like the Cajun Navy and Samaritan's Purse. Additionally, Chris Comeaux is presenting to hospice organizations about Emergency Disaster Management, equipping leaders to learn from this tragedy. Editor's note: Click here for a map of Compassionate Care Western North Carolina's service area (CCWNC). Click here to donate to their ongoing recovery. We thank our readers for your previous support to this and other hospices affected by emergency disasters. Additional resources:

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.Editor's Note: Editor's Note: This article puts forth significant information (with links) for all states, for all hospices. Having served on the firmly rooted Pediatrics Team of Hospice & Palliative Care of Louisville (begun in 1980) for four years (1997-2001), I take for granted how some type of pediatric hospice care needs to be available in every region. For related articles we have recently posted:

Risk of dementia diagnosis after injurious falls in older adultsJAMA Network Open; Alexander J. Ordoobadi, MD; Hiba Dhanani, MD, ScM; Samir R. Tulebaev, MD; Ali Salim, MD; Zara Cooper, MD, MSc; Molly P. Jarman, PhD, MPH; 9/24In this cohort study, new ADRD [Alzheimer disease and related dementias] diagnoses were more common after falls compared with other mechanisms of injury, with 10.6% of older adults being diagnosed with ADRD in the first year after a fall. To improve the early identification of ADRD, this study’s findings suggest support for the implementation of cognitive screening in older adults who experience an injurious fall that results in an ED visit or hospital admission. 

The hospice conversations that defined 2025 - Best of TCNtalks Teleios Collaborative Network (TCN); by Chris Comeaux; 12/24/25 With nearly 45,000 total downloads across TCNtalks and Anatomy of Leadership, this milestone reflects a shared commitment to thoughtful leadership, courageous conversations, and care as it should be. We’ve curated standout moments from episodes that challenged assumptions, clarified complexity, and pointed toward a better future for serious-illness care. ... This highlight episode isn’t just a recap—it’s a reflection of where hospice and serious-illness care has been, where it is, and where it must go next. These conversations underscore the urgency of leadership rooted in clarity, compassion, and courage. Whether you’re revisiting a favorite or discovering an episode you missed, we hope this collection sparks insight, conversation, and renewed purpose as we head into 2026.

When the nurse becomes the daughter: Lessons from my father's final daysAmerican Journal of Hospice & Palliative Care; by Keshia R Brown; 11/25Military service demands sacrifice, but no professional challenge prepared me for the deeply personal experience of caring for my father at the end of his life. This experience transformed my understanding of nursing by revealing the profound impact of presence, love, and dignity-centered care. Caring for my father illuminated the intersection of professional skill and personal devotion, demonstrating that the heart of nursing extends beyond clinical interventions. It resides in honoring the whole person and offering unwavering compassion in their most vulnerable moments. This narrative reflects on the emotional, ethical, and spiritual lessons learned as I walked my father through his final chapter-an unexpected gift and the greatest honor of my nursing career.

Is moral adequacy possible in the face of structural disadvantage? The experiences of health and social care staff in supporting homeless people using substances at the end of life Palliative Care and Social Practice; by Gary Witham https, Gemma Anne Yarwood, Sarah Galvani, Lucy Webb, and Sam Wright; 11/26/25 Background: Homeless people using substances at the end-of-life face many challenges in accessing and receiving good care. These can relate to poor interdisciplinary working by health and social care practitioners, stigma and structural disadvantage.Results: The data analysis resulted in three key discourse positions relating to how practitioners position themselves in relation to the practice challenges of supporting homeless people using AODs and approaching end of life. These were as follows: (i) what constitutes a good death and where, (ii) the limitations of professional boundaries and (iii) maintaining moral adequacy in the face of traumatic death.

Top healthcare sectors attracting private equity in 2025 Covenant Health Advisors; 12/18/25 ... If you’ve ever wondered how private equity shapes the healthcare world, stick around. We’ll break it down in simple terms, so it’s easy to follow. ...

Executive Personnel Changes - 12/19/25

Validation of a claims-based algorithm for specialist palliative care delivery in metastatic cancerJournal of Pain and Symptom Management; by May Hua, Zhixin Yang, Ling Guo, J Brian Cassel, R Sean Morrison, Guohua Li; 11/25The lack of valid methods to identify specialist palliative care (PC) delivery in population-level data impedes comprehensive understanding of its use... We developed a claims-based algorithm to identify specialist PC, using a physician billing claim from a known PC clinician as the gold standard, retaining candidate variables with a positive predictive value (PPV) >60%... A simple algorithm can identify receipt of specialist PC care in Medicare claims for patients with metastatic cancer with reasonable accuracy.Publisher's Note: While this is a statistically sophisticated article, findings support use of the palliative care provider specialty code (Provider Specialty Code 17) and encounter for palliative care code (ICD-10 Z51.5) to identify specialist palliative care delivery in a specific population (Medicare beneficiaries with metastatic cancer claims).

Clarification: Dr. Byock reached out to clarify that the fee-for-service performance margins he cited (Hospice, heal thyself) are from 2020. He regrets not making that clear in the paper. He’s been made aware of recently updated figures from 2023 that reflect significantly diminished margins of 13.7% for for-profits and -1.3% for non-profits (MedPAC 12/5/25). This reflects a serious downward trend that obviously threatens non-profits hospice providers. This dangerous trend highlights the need for strenuous efforts to shift to quality-based competition, making success in the marketplace dependent on demonstrated quality of care and outcomes, particularly patient-family experience.

[Canada] Rethinking palliative care through three institutional ethnographic stories of people living with homelessness and life-limiting illnessINQUIRY: The Journal of Health Care Organization, Provision, & Financing; by Courtney R. Petruik, Katrina Milaney; 11/25Fifteen to thirty percent of Canadians have access to palliative care, with even fewer access opportunities for people with experiences of homelessness. Part of a larger study, this paper examines how health and social systems shape the need for community-based palliative and end-of-life care, using 3 stories from clients of the Community Allied Mobile Palliative Partnership (CAMPP). Findings reveal systemic demands like renewing insurance for medical equipment, restrictive housing rules, and standardized hospital protocols that overwhelm capacities of many people with experiences of homelessness. Community-based palliative teams like CAMPP fill critical gaps in mainstream services by tailoring care to complex social realities.