Literature Review

From stigma to support: Changing the cancer conversation Oncology Nursing Society (ONS); by Anne Snively, MBA, CAE; 4/29/25 Certain treatments (palliative care, opioids) and diagnoses (lung cancer) are more prone to association with cancer-related stigma. Nurses can play a vital role in reframing these thoughts and promoting empathy. ... Caner-related stigma has wide-reaching effects across the care continuum, including poorer patient outcomes. ...

Hospice use by cause of death: A cohort study using Utah population database American Journal of Hospice and Palliative Medicine - Sage Journals; by Rebecca L. Utz, PhD, Michael Hollingshaus, PhD, Attrayee Bandyopadhyay, MS, Kathie Supiano, PhD, Margaret Clayton, PhD, Katherine A. Ornstein, PhD, Djin Tay, PhD, Eli Iacob, Ken Smith, PhD, and Caroline Stephens, PhD; first published online 4/29/25 Illnesses such as cancer often follow a predictable trajectory of decline, while others, such as Alzheimer’s Disease and Related Dementias (ADRD) and Chronic Obstructive Pulmonary Disease (COPD), follow a more dwindling and protracted decline. ... This study assesses whether hospice use differs by the underlying cause of death and whether current hospice eligibility and practices provide optimal EOL to all causes of death. Major Findings: Non-cancer decedents were more likely to have sub-optimal patterns of hospice care, including minimal use, lasting less than a week, and extended use, lasting more than 6 months. Stroke decedents were the most likely to have minimal-use patterns of hospice, whereas dementia and COPD decedents were most likely to have extended use. Conclusion: New models of hospice-like EOL care that can accommodate both short-term and long-term palliative care needs may help meet the diverse needs of patients and families facing different EOL trajectories associated with common causes of death.Editor's note: Compare this data with your own data of disease-related Length of Stay (LOS), live discharges, disease-related accuity needs, and more. How can we improve disease-related patient care, across the different trajectories of palliative/hospice care?

Video: California firefighter ‘Living the best of these last months’ on hospice care VITAS Healthcare, Irvine, CA; Press Release; 4/28/25 “Hospice is not something that means death right away. It means health and happiness,” said Debbie Forrester, spouse and patient caregiver for former firefighter Jim Forrester of Orange County, California. In a new video, launched during Patient Experience Week, VITAS® Healthcare shares the story of a patient with terminal cancer whose life was dramatically impacted by the help of his hospice care team. Within a week of being cared for by the interdisciplinary team at VITAS, Mr. Forrester, who had been depressed and was unable to walk, began enjoying time with his grandchildren and even riding his bike again.

Hospice Choices: VITAS Healthcare expands in Austin, Texas Globe Newswire - Small Business World Journal; Press Release; 4/23/25... VITAS Healthcare has expanded its reach in the Austin area by opening a new administrative office in Pflugerville. With the addition of this North Austin location, VITAS now serves the entire metro area and surrounding counties, bringing greater access to compassionate, expert end-of-life care for patients and their families. ... Grand opening celebrations for the Kyle and Pflugerville offices are scheduled for late June.

While claiming transparency, CMS quietly drops health equity elements of EOM American Journal of Managed Care (AJMC); by Mary Caffrey; 4/22/25 Key Takeaways:

7-year-old Clayton girl battling stage 4 cancer enters hospice care at her home CBS-17 News, Raleigh/Clayton, NC; by Matthew Sockol, Maggie Newland, Greg Funderburg; 4/18/25 A seven-year-old girl battling an aggressive cancer has returned to her home in Clayton, her family said Friday. Noelle Franklin was diagnosed with stage four osteosarcoma less than a year ago and received treatment at UNC Children’s Hospital. In a video post on the Noelle Strong Facebook page, her mother Toni said Noelle is entering hospice care at their home. “The staff of UNC went above and beyond,” Toni Franklin said in a statement. “The care Noelle had was more than we could ask for. “Noelle has touched so many people, not just in our community, but in the hospital too,” she continued in her statement. “Seeing how many people came to celebrate Noelle breaking out overwhelmed me with joy. We paraded three different floors, wouldn’t expect anything less for Noelle. “We are home. We are at peace.”

Demystifying the End: Hospice care impact on the Black community Defender; by Laura Onyeneho; 4/22/25 Monica James has seen firsthand the confusion and emotional strain families face when end-of-life care isn’t discussed early enough. She works for the non-profit organization Houston Hospice as the Community Engagement Coordinator, serving 13 counties across Southeast Texas. ... According to data collected by the National Hospice and Palliative Care Organization, Black Americans on Medicare seek hospice and palliative treatment 13% less than their white counterparts. For African American, Afro-Caribbean and African immigrant families, generational trauma and a lack of trust in the healthcare system often lead to delayed decisions about hospice care. “There’s been a historical gap in access and trust,” said James. “Our goal is to show up consistently, to listen and to let these communities know they have options and that they’re not alone.”

Special team at Norton Children's Hospital focused on giving the gift of life CBS WLKY-32, Louisville, KY; by Jennifer Baileys; 4/21/25 Caring for sick and dying children is a tough and heartbreaking job. One special group at Norton Children's Hospital is focused on helping these children and their families. ... "She's missing the left side of her heart," Kindra Edwards, patient mother, said. ... Edwards said there was one consistent source of strength and encouragement the Norton Pediatric Support Team. "They're always there. You know, coming in, checking on us when in our multiple stays at the hospital," Edwards said. The team is made up of pediatric and palliative care specialists, nurses, social services, therapist and pastoral care. ... [Through two decades,] pediatric palliative care has evolved. At Norton Children's Hospital it has grown into a team of almost a dozen people, specializing in not just treating, but caring for the sickest patients and their families.

Stark disparities in treatment and survival time for people with pancreatic cancer Cancer Health, Plymouth Meeting, PA; by National Comprehensive Cancer Network; 4/22/25 New research in the April 2025 issue of JNCCN—Journal of the National Comprehensive Cancer Network found significant disparities based on race, socioeconomic status, and other factors when it came to quality of care and outcomes for people with metastatic pancreatic adenocarcinoma (mPDAC)—which is associated with very high cancer mortality. The researchers used the Surveillance, Epidemiology, and End Results (SEER)-Medicare database to study 14,147 patients who were diagnosed with mPDAC between 2005–2019.

MedPAC identifies low rates of hospice use among kidney disease patients McKnights Home Care; by Adam Healy; 4/17/25 Patients with end-stage renal disease (ESRD) use hospice at far lower rates than patients with other conditions, according to the Medicare Payment Advisory Commission. In 2023, 31% of Medicare decedents with ESRD used hospice services, compared with 52% of all Medicare decedents. Hospice lifetime length of stay is also lower among decedents with ESRD, at a median of six days compared with 18 for all Medicare decedents, MedPAC commissioners said during their April meeting. ...

Portugal: Government signs contracts for 3,000 palliative care beds MacauBusiness.com; by LUSA; 4/18/25 The government on Thursday [4/17/25] signed 90 financing contracts worth €88 million with the private and social sectors to create 3,300 places in the National Network for Integrated Continuing Care (RNCCI). ... The government on Thursday signed 90 financing contracts worth €88 million with the private and social sectors to create 3,300 places in the National Network for Integrated Continuing Care (RNCCI). ... The minister added that “the government’s determination is not to slow down the pace of implementation of the RRP”, emphasising that another 800 contracts will be signed in the coming weeks, in different areas.

Appropriate deprescribing and payment in hospice dementia careJAMA Internal Medicine; Nathan M. Stall, MD, PhD; Sharon K. Inouye, MD, MPH; Lona Mody, MD, MSc; 3/25People living with dementia are one of the largest growing users of hospice care in the US, with approximately 20% of enrollees having a terminal diagnosis of dementia. In the setting of advanced dementia specifically, guidelines recommend deprescribing cholinesterase inhibitors and memantine as there is insufficient evidence for benefit, and there are risks of adverse events including bradycardia, falls, and gastrointestinal adverse effects. The Centers for Medicare & Medicaid Services specifies that hospices are responsible for covering all medications under the Medicare Part A hospice benefit, but audits have revealed that millions of dollars of prescription drug costs are being inappropriately shifted to Medicare Part D. The study by Hunt et al occurs within a context of growing concerns about shifts in US hospice care where more than 70% of hospice agencies serving patients with terminal illness across all settings now operate on a for-profit basis, with increasing acquisition of hospices by private equity firms and publicly traded corporations. Compared with nonprofit hospices, for-profit hospices have more acute care utilization, provide less direct care, and have poorer caregiver-reported care experiences. For-profit hospices also enroll a higher proportion of persons living with dementia, which may relate to their lower acuity and longer stays, as well as more profitable margins under the per-beneficiary daily payment.

Integrating social determinants into palliative care Hospice News; by Holly Vossel; 4/16/25 Strong staff education and reimbursement are among the keys to successfully integrating social determinants of health within a palliative care program. Screening tools developed by the U.S. Centers for Medicare & Medicaid Services’ (CMS) include five areas of social determinants of health: food and housing insecurity, transportation needs, utility difficulties and interpersonal safety. Supplemental domains include financial stability, employment and family and social support, among others.