Literature Review

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.

Without support, seniors aging in place may elect facility-based care, study finds McKnights Home Care; by Adam Healy; 4/16/25 Older adults aging in place may rethink whether they want to receive care at home if they do not receive certain aging-in-place supports from their care providers and loved ones, according to a new study published in the Journal of the American Geriatrics Society. The researchers interviewed nearly 300 older adults receiving care at home and in long-term care facilities. ... The first theme was participants’ personal health experiences. ... Similarly, loss of health of loved ones and friends may also influence where patients want to receive care. ... The final factor influencing older adults’ aging preferences was time, the study found. 

Palliative care and advanced cardiovascular disease in adults: Not just end-of-life care: A scientific statement from the American Heart Association AHAIASA Journals - American Heart Association; by Lucinda J. Graven, PhD, APRN, FAHA, Lisa Kitko, PhD, RN, FAHA, Martha Abshire Saylor, PhD, MSN, BA, RN, Larry Allen, MD, MHS, FAHA, Angela Durante, PhD, RN, Lorraine S. Evangelista, PhD, RN, CNS, WAN, FAHA, Amy Fiedler, MD, James Kirkpatrick, MD, Lakeisha Mixon, MSW, and Rachel Wells, PhD, MSN, BA on behalf of the American Heart Association Complex Cardiovascular Nursing Care Science Committee of the Council on Cardiovascular and Stroke Nursing; and Council on Cardiovascular Surgery and Anesthesia; 4/17/25  ... This scientific statement (1) discusses the application of effective communication, shared decision-making, age-friendly care, and advance care planning in advanced cardiovascular disease palliative care; (2) provides a summary of recent evidence related to palliative care and symptom management, quality of life, spiritual and psychological support, and bereavement support in individuals with advanced cardiovascular disease and their care partners; (3) discusses issues involving diversity, equity, and inclusion in cardiovascular disease palliative care; (4) highlights the ethical and legal concerns surrounding palliative care and implanted cardiac devices; and (5) provides strategies for palliative care engagement in adults with advanced cardiovascular disease for the care team.

Where bills stand in the Nevada legislature in 2025: ... AB161 - Hospice Care Fox 5 - KU-TV, Las Vegas, NV; by FOX5 Staff; 4/14/25 FOX5 gathered the most high-profile bills moving in the Nevada legislature this year. Here’s where they stand: ...

Hospitalists in a bind when cancer prognosis hasn’t sunk inMedscape; by Jake Remaly; 4/15/25 When a patient with cancer is admitted to the hospital, the reason might not be related to the malignancy. But the hospitalist in charge sometimes becomes aware of a major disconnect: The patient, who they just met, does not grasp the severity of their cancer prognosis. On the one hand, the hospital medicine team and patient have advance directives and goals of care to consider, which may steer the course of the hospitalization and any use of hospice. The cancer prognosis — the patient might only have months to live, for example — could be a key component of those conversations. On the other hand, explaining the cancer situation should fall to the oncologist, right? ...

Community Catalyst leads national response against new rule that threatens health care access Community Catalyst, Boston, MA; by Jack Cardinal; 4/11/25 Today, Community Catalyst organized hundreds of local, state and national partners to submit comments to the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) opposing a new proposed rule from the Trump administration that would make it harder and more expensive for people to buy their own insurance on Affordable Care Act (ACA) Marketplaces and increase their medical debt. ... The administration’s own estimates suggest that as many as 2 million people will lose their coverage under this proposal, ...

VNA Hospice NWI celebrates some of its most dedicated volunteers at Volunteer Appreciation Breakfast NWI.LIFE, Valparaiso, IN; by Philip Bolton; 4/7/25 On the morning of Saturday, April 5, VNA Hospice of Northwest Indiana hosted its annual Volunteer Appreciation Breakfast at Christ Lutheran Church in Valparaiso. Volunteers who assist with VNA’s many services, including hospice and palliative care, the Medical Guardian help button program, the We Honor Veterans program, the Phoenix Center for Grief, and VNA Meals on Wheels of Porter County, were recognized. ... Matthew Naillieux, a VNA Hospice NWI volunteer, has proudly worked with the organization for 20 years. “Everything VNA Hospice NWI does is good for the community,” Naillieux said. ... "Usually, we’re volunteering at different locations at different times, and we aren’t able to get together like this very often." ... During the award presentation segment of the event, volunteers were recognized for milestone achievements. These included awards for achievements like 5, 10, 15, 20, and 25 years of service ... [Continue reading ...]Editor's note: Reminder that April is National Volunteer Month; April 20-26, 2025 is National Volunteer Week.

How housing instability complicates end-of-life take care of growing old unhoused populations Health Medicine Network; by Pilar Ingle; 4/8/25 Research estimates that one-third or more of the unhoused inhabitants within the U.S. is age 50 or older. Unhoused individuals of all ages face high rates of ... severe sickness. They additionally die at younger ages in contrast with people who find themselves not unhoused. Yet, there are few choices for palliative and end-of-life care for unhoused individuals. ... As a health care and aging researcher, ... I interviewed 17 well being care and social service suppliers in Colorado to grasp how they attempt to deal with palliative and end-of-life wants for his or her unhoused shoppers.

Senior living demand hits all-time high: NIC McKnights Senior Living; by Kimberly Bonvissuto; 4/3/25 The demand for senior living is at an all-time high, with the first quarter seeing a record number of occupied units, almost 621,000, the National Investment Center for Seniors Housing & Care said Thursday afternoon [4/3]. Senior living occupancy rates increased 0.3 percentage points to 87.4% in the first quarter, up from 87.1% in the fourth quarter of 2024, according to the latest NIC MAP Senior Housing Market Fundamentals report. Independent living occupancy rose to 89%, up from 88.6% in the fourth quarter, whereas assisted living rates increased to 85.8% compared with 85.5% in the fourth quarter.

Housing instability complicates end-of-life care for aging unhoused populations The Conversation; by Pilar Ingle, University of Denver; 4/7/25 Research estimates that one-third or more of the unhoused population in the U.S. is age 50 or older. Unhoused people of all ages face high rates of chronic and serious illness. They also die at younger ages compared with people who are not unhoused. Yet, there are few options for palliative and end-of-life care for unhoused people. ... In 2024, Colorado saw a 30% increase in the number of people experiencing homelessness from the year before. Nationally, 771,480 people — the highest number ever recorded — experienced homelessness last year. As the number of people experiencing homelessness in the U.S. grows, so too does the need for palliative and end-of-life care for these individuals. ... [Continue reading ...]

What happens when someone passes at home? It depends Bozeman Daily Chronicle, Bozeman, MT; Chris Remely "discussions with a funeral director"; 4/5/25 One of the most common questions we get asked as funeral directors is, “What happens if I pass away at home?” The answer is ... it depends. Home death is fairly common in the context of someone being on hospice care. For many individuals who have been given a difficult medical diagnosis that is terminal, they often prefer to be at home surrounded by loved ones for as long as possible. ... In this scenario, hospice will pronounce the death and work with the funeral home to transfer the individual into their care. ... However, when someone passes away at home and they are not on hospice, this is considered an “unattended death” — meaning a medical professional is not involved. In this case, the coroner’s office is required to investigate the death to determine the cause and manner of death — as well as pronounce the death. ... When someone from the coroner’s office arrives, they will do several things. They will visit with the next of kin and ask them questions about their loved one’s medical history and investigate the scene where the death occurred. Editor's note: Too often, hospices gloss over this all-important information for caregivers and families. Death is traumatic enough. Families are left in a lurch. Conflicts can erupt at the family's most vulnerable moments. Yes, timing and delivery for such sensitive information is important. Our sponsor Composing Life Out of Loss provides empathic, sensitive videos for hospice teams to use with caregivers and families, with interdisciplinary team guides for tending individuals' different readiness for education and preparation.