Literature Review

If opportunity doesn't knock, build a door. ~ Milton Berle

Building a strong foundation for pediatric palliative care in Connecticut Solomon Center for Health Law and Policy at Yale Law School, Targeted News Service; by Wendy Jiang, Elle  Rothermich, Eugene Rusyn; 8/12/25 The Solomon Center for Health Law and Policy at Yale Law School has released a white paper outlining concrete pathways for Connecticut to guarantee pediatric palliative care (PPC) from diagnosis--not only at end of life--while building a workforce equipped to deliver it statewide. The report highlights two foundational barriers: coverage that generally triggers only when a child receives a six-month terminal prognosis, and a shortage of clinicians trained in primary palliative skills, leading to delayed referrals and fragmented support for families facing serious childhood illness. The authors recommend two primary coverage strategies for the state.Editor's Note: Though written for Connecticut, this 42-page white paper from Yale provides excellent information and recommendations to examine for one's own state. Its sub-title is "Establishing a statewide coverage pathway & expanding primary palliative care education for pediatric clinicians."

Implementation of the Pressure Injury Prevention Care Bundle at a home based hospice program: A quality improvement project The Texas Medical Center (TMC) Library Health Sciences Resource Center; by Adaeze U. Amechi-fannin; 8/11/25 Pressure injuries remain a common and serious problem in hospice care, especially among patients who are immobile or confined to bed. Although effective prevention methods are known, inconsistent use of these methods, limited caregiver training, and poor documentation have continued to prevent success in many hospice settings. These wounds cause pain, increase infection risk, and reduce quality of life, making prevention especially important in end-of-life care. ... This project demonstrates that combining structured training, evidence-based care steps, and attention to individual patient needs can successfully reduce pressure injuries in home hospice environments.

This test tells you more about your heart attack risk KFF Health News; by Paula Span; 8/1/25 A long list of Lynda Hollander’s paternal relatives had heart disease, and several had undergone major surgeries. ... A cardiologist told Hollander that based on factors like age, sex, cholesterol, and blood pressure, she faced a moderate risk of a major cardiac event, like a heart attack, within the next 10 years. ... Her doctor explained that a coronary artery calcium test, ... could provide a more precise estimate of her risk of atherosclerotic heart disease. “The test is used by more people every year,” said Michael Blaha, co-director of the preventive cardiology program at Johns Hopkins University. Calcium scans quadrupled from 2006 to 2017, his research team reported, and Google searches for related terms have risen even more sharply. Yet “it’s still being underused compared to its value,” he said. One reason is that although the test is comparatively inexpensive ...Editor's Note: Good news. This test predicts and protects heart health, potentially providing extra years of good (or at least better) quality of life. Bad news. It is "being underused compared to its value," partly because "the test is comparatively inexpensive"? Bad news. What does the low-cost factor say ethics, choices, and quality of life? Good news. Because of my family's cardiac history, my physician recently recommended I take this test. I did, and received great results! I move into the future with greater confidence, less fear, and more gratitude for the some 100,00 heartbeats we each experience, each day.

Gov. Moore launches Longevity Ready Maryland, a landmark state plan to support thriving aging population The Bay Net, Annapolis, MD; by Governor Wes Moore; 7/30/25 Governor Wes Moore today launched Longevity Ready Maryland, the state’s first comprehensive, 10-year multisector plan to coordinate services and policies that support Maryland’s growing population of older adults. ... Longevity Ready Maryland is a collaborative, long-term plan that aims to support the work of service providers by consolidating resources; coordinating efforts across government, businesses, and communities; and transforming systems of care to more sustainably accommodate a greater number of older Marylanders. To advance the objectives of the plan, the Maryland Department of Aging will work to encourage collaboration between state agencies, support local initiatives, and improve access to home- and community-based services.

State Medicaid coverage policies for community-based palliative care: Lessons from NASHP’s State Institute National Academy for State Health Policy; by Ella Taggart, Wendy Fox-Grage; 8/11/25 Six states recently participated in NASHP’s two-year State Policy Institute to Improve Care for People with Serious Illness (the Institute): Colorado, Maine, Maryland, Ohio, Texas, and Washington. ... Specifically, the six participating states received guidance on policy mechanisms to cover palliative care services in the community and completed cost analysis on palliative care services for Medicaid beneficiaries. While all the states balanced the same forces and demands, ... each state modeled a benefit that was responsive to its particular needs and circumstances. ... CBIZ Optumas and TFA Analytics then designed a cost calculator for each state to help with different scenarios. 

Would you go to a local Death Cafe? It's a chance to eat cake and talk end-of-life issues Times Telegram, Utica, NY; by Amy Neff Roth; 8/12/25 Key Points:

2 factors fueling disparities in home-based deaths Hospice News; by Holly Vossel; 8/11/25 Having a limited understanding about end-of-life care options can hinder patients’ ability to die in the home, recent research has found. This trend is fueling disparities in home-based hospice care. Access to respite care more than doubles the odds of patients having a home death, a recent study found, which was published in the BMC Palliative Care journal. ... Additional significant factors included timely access to community-based nursing services, home health and hospice, as well as the integration of a palliative care approach, the study found.

My wife of 52 years just died. My grief is so overwhelming, I can barely cope. HuffPost; by Ronald Paxton; 8/11/25 ... March 1, 2022, was the day our lives changed forever. ...  My spouse, my wife of 52 years, my high school sweetheart was going to die, and there was nothing I or anyone else could do about it. ... The house is quiet now. I’m trying to move forward, but it’s hard. I thought we would grow old together. We did, but not nearly old enough. Diane’s death has taught me that no matter how much we love someone, we all have our own lives to live. The best way for me to honor the life Diane and I had together is to live the rest of my life the best way I know how. It’s late. I should try to sleep, but I think I’ll turn on the television. I need something to cover the sound of crying.

Amazon documentary exposes 'neglect and pain' in many nursing homes. It's only going to get worse. Morningstar; by Jessica Hall; 8/9/25  Susie Singer Carter's mom, Norma Pecora, suffered from Alzheimer's disease for 16 years and spent the last five years of her life in a nursing home. She died at age 89 after enduring sepsis, urinary-tract infections, bed sores and dehydration at a five-star facility in Los Angeles. ... In a new three-part documentary streaming on Amazon Prime (AMZN) called "No Country for Old People: A Nursing Home Expose," Carter walks viewers through her mom's early life, including her time as a singer for Capitol Records, as well as her final months - when she suffered from infections and other complications that required emergency hospitalizations while being cared for at a nursing home. 

Demographic variations and temporal trends in hospice and palliative care fellowship matches in the United States Scientific Reports; by Aman Goyal, Samuel L. Flesner, Urooj Shamim, Sonia Hurjkaliani, Priya Goyal, Mohamed Daoud & Amir Humza Sohail; 8/8/25 ... In summary, the number of Hospice and Palliative Care fellowship training programs, positions, and applicants increased. Female applicants, compared to males, and White applicants, relative to their representation in all fellowships, accounted for a larger proportion of applications and had higher match rates. ... Future research should focus on initiatives to address challenges such as the underrepresentation of certain demographics in palliative care and the growing demand for trained professionals as the population ages. 

Merging clinical and legal: How home health providers achieve medical appeals success Home Health Care News; by Joyce Famakinwa; 7/31/25 For home-based care providers, medical appeals can be extremely costly. When navigating the medical appeals process, home health clinical and legal teams must operate in lockstep in order to achieve successful results and avoid financial blowback, ... ROI should be the biggest determining factor when deciding to appeal, according to Bill Dombi, senior counsel for Arnall Golden Gregory law firm. He formerly served as the president of the National Alliance for Care at Home. ... Despite the hefty costs that medical appeals can potentially rack up, sometimes figuring out the ROI can go beyond dollars and cents. For example, if a provider is going through the Medicare Targeted Probe and Educate (TPE) audit process.