Private equity ownership in hospice care:  a systematic review (2012-2026) 
American Journal of Hospice and Palliative Medicine; by Denise D. Quigley, Shannon Walsh, Cordt T. Kassner, Lara Dhingra, Andrew W. Dick; 7/28/26 
Hospice care is associated with improved end-of-life outcomes. Recent shifts in hospice utilization highlight several key trends. Alzheimer’s disease and related dementias (ADRD) (25%) have surpassed cancer (23%) as the leading primary diagnosis. Concurrently, industry ownership has transitioned from predominantly nonprofit to for-profit (70%) and private equity (PE) ownership has grown dramatically from 3% to 15%. To date, no study has synthesized evidence on PE ownership in hospice care.  We conducted a systematic review of English-language, peer-reviewed studies published 2012-2026, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

"It felt like throwing in the towel": Family caregiver perspectives on end-of-life decision making in chronic obstructive pulmonary disease
Journal of Palliative Medicine; by Natalia Smirnova, Tivona Batieste, Sarah H Cross, Samir Jamdar, Catherine S Peterson, Camille P Vaughan, Dio Kavalieratos; 7/26
Chronic obstructive pulmonary disease (COPD) has an unpredictable trajectory and high symptom burden, complicating end-of-life (EOL) decisions around place of death and hospice use. We conducted semi-structured interviews with bereaved caregivers of people with COPD who received pulmonary care at a U.S. academic center and died within 12 months. Fifty-six percent of decedents received hospice; 33% died at home. Caregivers described five themes: missed prognostic cues and poor communication; hospice as both loss and relief; home as ideal but hospital as default; financial influences on decisions; and mismatch between hospice and COPD needs. Caregivers identified a readiness gap driven by prognostic uncertainty, communication challenges, and financial constraints.

Mandatory mortality surprise question screening in the ED: Identification and associations with end-of-life care outcomes
Journal of Palliative Medicine; by Nancy Kim, Karen Jubanyik, Peiyuan Liu, Giselle O'Connor, Ling Han, Rohit B Sangal, R Lynn Fiellin, Jennifer Kapo, Elizabeth Prsic, Shelli Feder; 7/26
Early identification of patients with serious illness remains challenging in the emergency department (ED), where clinical decisions are made under time constraints. The mortality surprise question (MSQ) is a brief prognostic screen that may help identify patients needing end-of-life services. Results: Among 113,397 admissions (74,816 patients), MSQ completion was 100%; 7.8% received a "No" response. A "No" response was strongly associated with increased palliative care consultation ... , ACP documentation ... , hospice referral ... , comfort-measures-only orders ... , hospice disposition ... , higher inpatient mortality ... , and increased 30-day readmission ... Palliative care consultation occurred earlier among MSQ "No" than MSQ "Yes" encounters.

Aging and end-of-life care planning among transgender and nonbinary individuals: A systematic review
LGBT Health; by Ginger H Kwak, G Nic Rider, Emily A Paine, Walter O Bockting, Steven A John; 7/26
The objective of this review was to identify perceptions of end-of-life (EOL) care needs among transgender and nonbinary (TNB) individuals. We identified five major themes during thematic analysis: fear of discrimination in long-term care facilities, fear of loss of independence, maintaining social circles with aging, obstacles to EOL logistics, and what defines successful aging. Additional subthemes included fear about loss of identity, preference for euthanasia versus loss of identity, participation in EOL planning, and advance care plan/will completion. Psychosocial aspects were the most substantial barriers to successful EOL planning.

Ethical implementation of organ donation following medical assistance in dying: Recommendations of the ethics committee of the Transplantation Society
Transplantation; by Kristof Van Assche, Johannes Mulder, Curie Ahn, Richard D M Allen, Jan Bollen, Katrina A Bramstedt, Patrizia Burra, Patrick Cras, Kumud Dhital, Ian Dittmer, Beatriz Domínguez-Gil, James Downar, Riadh A S Fadhil, Patrick Ferdinande, John L R Forsythe, Marie-Chantal Fortin, Michael A Freeman, Rik T Gerritsen, Kim E Grayson, Andrew Healey, Alex Kazemi, Vivek B Kute, Dominique E Martin, Diethard Monbaliu, Elmi Muller, Alejandro Nino-Murcia, Gert Olthuis, Helen I Opdam, Brendan Parent, Alicia Pérez Blanco, Sam D Shemie, Marion Siebelink, Amina Silva, Vanessa Silva E Silva, Hans P Sonneveld, Peter G Stock, Rankie Ten Hoopen, Carrie Thiessen, Walther van Mook, Dirk Van Raemdonck, Anji E Wall, Matthew J Weiss, Larna Woodyatt, Dirk Ysebaert, David Thomson; 7/26
Medical assistance in dying (MAiD) is legally permitted in a growing number of jurisdictions ... Organ donation following MAiD offers patients an opportunity to address transplant needs as a final act of altruism, but it also raises complex ethical questions that require strong safeguards to protect patients, professionals, and public trust. We identified key ethical issues and safeguards by analyzing guidelines and protocols from the 6 countries where organ donation following MAiD is performed: Australia, Belgium, Canada, the Netherlands, New Zealand, and Spain. Three domains of ethical concern emerged: (1) safeguarding the integrity of patients' decision-making (voluntariness, informed consent, and how and when information is presented); (2) ethical governance of donation following MAiD (adherence to the Dead Donor Rule, death determination, and consent for premortem interventions); and (3) implications for care relationships and professional practice (end-of-life impacts, recipient information and donor anonymity, and professional support, including conscientious objection). Key recommendations include clear and consistent policies; a patient-centered, nondirective approach; rigorous eligibility and voluntariness assessments; and strict separation between MAiD and donation/transplantation teams.

"Ask us anything": A framework for understanding bereaved children's questions about illness, dying, and grief
Palliative Care & Social Practice; by Ceilidh Eaton Russell, Liana Bailey, Ashwini Pugazhendhi, Karleigh Sutton, Sandra Twiner Ross, Joanna Humphreys; 7/26
Grieving children may wonder about questions of illness, dying, and death as they navigate the death of, or grief for, someone who matters to them. Parents and caregivers, as well as health and psychosocial clinicians frequently report feeling uncertain and unprepared to engage in these conversations even if they are aware of their helpfulness. Interested in examining the questions bereaved children wonder about, this study analyzed 710 anonymous questions submitted by children aged 5-17 during Ask Us Anything sessions at a bereavement camp in Ontario, Canada between 2009 and 2024. Question focuses (i.e., what it says about the core topic) spanned across: Body, Condition, Dying and Death, Grief, while question functions (i.e., what it says about what the person seeks to understand about the topic) spanned: How it Works, Catch, Cause, Cure, Care, Connect. Children's questions can be helpful windows into what their grief experiences are like and what their emotional, existential, and/or informational needs are within this experience.

[Greece] Patient-reported outcome measures in palliative care: A systematic review to inform health policy and health system performance
Health Policy; by Maria Katharaki, Christos Triantafyllou, Julie Ling, Joao Breda; 7/26
Health systems increasingly recognise palliative care as an essential component of universal health coverage. Assessing palliative care quality and value remains challenging, as key outcomes are often missed by routine indicators. Patient-reported outcome measures (PROMs) can address this gap, but their use remains fragmented. Seventy studies were included. The most commonly used PROMs were the Integrated Palliative Care Outcome Scale (IPOS), Edmonton Symptom Assessment Scale (ESAS), and the EORTC QLQ-C15-PAL instrument. Implementation challenges included patient frailty, workload and time constraints, limited standardisation, and poor integration into clinical workflows and health information systems.

When I was a boy and I would see scary things in the news, my mother would say to me, "Look for the helpers. You will always find people who are helping.”  ~ Fred Rogers