Literature Review

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.

Home health care: A broken system Business NH Magazine, New Hampshire; by Dave Solomon and Scott Merrill; 12/16/25Amy Moore has strong feelings about the value of home care for patients of all ages because she’s seen what can happen when care isn’t available. She is vice president of external relations at Ascentria Care Alliance and president of the Home Care Hospice and Palliative Care Alliance of NH. 

Medicare's AI prior authorization pilot sparks backlash over incentives to deny care Complete AI Training | Insurance; by Joren Erne; 12/7/25 CMS will pilot AI prior auth in traditional Medicare across AZ, NJ, OH, OK, TX, WA through 2031. Expect tougher reviews, vendor incentives, and pushback on denials and delays. ... For insurance professionals, this is a signal: CMS is importing private-plan utilization tactics into fee-for-service Medicare, with financial incentives tied to denial-driven cost savings. Expect policy, operations, and provider relations to feel it. 

A Place for Mom’s refreshed marketing strategy focused on family stories, thought leadership Hospice News; by Jim Parker; 12/8/25 Upon the 25th anniversary of its founding, the senior services company A Place for Mom is undergoing a rebrand and redesigning its marketing strategy. The company’s name is not changing as part of the rebrand. Rather, A Place for Mom has a new logo and visual identity and has developed a data-driven, tech-enabled approach to marketing that leverages AI, social media and video content. This is coupled with efforts to further establish the company as a thought leader in the senior care space.

The tech-enabled evolution of home-based care: How technology is shifting care from hospital to home THL - Thomas H. Lee Partners, Boston, MA; posted on "Insight & Analysis | Healthcare"; 12/1/25 Key Takeaways:

When Medicare sent patients home sooner, Mary Naylor built the safety net Penn LDI - Leonard Davis Institute of Health Economics; by Liz Seegert; 11/17/25 When Medicare’s diagnosis-related group (DRG) payment system took effect in October 1983, hospitals adapted quickly, discharging patients faster to manage fixed reimbursement rates. Heart failure patients who once stayed eight to 10 days were going home in three to four days. But LDI Senior Fellow Mary Naylor, then a fellow with what was then known as the U.S. Senate Committee on Aging and Finance, realized no one had thought about what happened after discharge. She saw how these shifts created new risks for older adults, as hospitals lacked the infrastructure to support care continuity. ...

Living with dementia report emphasizes that even those with advanced disease have stories to share JAMA Medical News; by Rita Rubin, MA; 10/31/25 As the average age of the US population has risen, so has the number of people living with Alzheimer disease and related dementias. And yet, dementia is still a highly stigmatized condition, a new collection of essays published by the Hastings Center for Bioethics points out. Clinicians, caregivers, and loved ones could improve the lives of the more than 7 million people in the US who are living with dementia if they only recognized that such individuals still have their own stories to tell, even when they can’t express themselves the same way they did before their symptoms appeared. 

Engaging community health workers in Advance Care Planning  Hospice News; by Jim Parker; 10/24/25 Three organizations have developed an advance care planning training program in Illinois for community health workers that could potentially be adapted for other states. The seeds for the project were planted when the Illinois Public Health Association (IPHA) was awarded a grant by the Health Resources & Services Administration (HRSA). IPHA proceeded to engage the Illinois Hospice & Palliative Care Organization (IL-HPCO) and the HAP Foundation as subject matter experts to help develop the curriculum, as well as the education company Hospice Media, which filmed and designed the modules and workbooks.

Traumatic brain injury in late life tied to elevated dementia risk Medscape; by Liz Scherer; 10/13/25 Traumatic brain injury (TBI) in late life is associated with a significant increase in the risk for new-onset dementia. The risk is especially elevated (by as much as 69%) within the first 5 years following the injury, according to newly published study findings. Though TBI, which results from direct impact or indirect force to the head, has long been recognized as a midlife risk factor for dementia, the risk that TBI poses in adults aged 65 years or older has been unclear.

Chesapeake Supportive Care and Southern Maryland House Calls partner to expand access to in-home palliative care in Calvert County Southern Maryland News Net, Chesapeake, MD; 10/16/25 Chesapeake Supportive Care (CSC), the palliative care arm of Hospice of the Chesapeake, is excited to announce a new partnership with Southern Maryland House Calls (SMHC), a trusted leader in home-based geriatric care, to enhance access to palliative care services for residents of Calvert County. ... “Southern Maryland House Calls has been an exceptional partner in caring for our shared patients,” Becky Miller, President and CEO of Hospice of the Chesapeake, said. “Together, we’re building on that relationship to help more people access the kind of care that truly improves quality of life.”

Alzheimer’s Association, Maine Chapter sees largest turnout for annual fundraiser walk WABI-5, Bangor, ME; by Grace Bradley; 10/11/25 For more than two decades, folks have hit the streets of Bangor to help raise money and awareness for Alzheimer’s. On Saturday, Maine’s chapter of the Alzheimer’s Association says they saw the largest crowd yet of about 400 people for their largest annual fundraiser. “We provide free care and support for families and community members walking through this disease, whether it’s Alzheimer’s or other forms of dementia. So what we do enables us to do everything for free. But we also take a portion of that money and put it towards research,” explains Kris Baker, Development Manager of Alzheimer’s Association Maine. Editor's Note: Do you support and partner with the Alzheimer's Association?

Conspiracy of verticals:  Rethinking healthcare models with Peter Benjamin Teleios collaborative Network (TCN); video/podcast hosted by Chris Comeaux with Peter Benjamin; 10/8/25 In this conversation, Peter Benjamin and Chris Comeaux discuss the impact of COVID-19 on mortality rates, particularly the concept of 'death pull forward' and its implications for Hospice Care. Peter highlights the significant role of assisted living facilities in Hospice days and explores macro trends in healthcare, emphasizing the shift from vertical to horizontal care models. The discussion also covers the evolution of Palliative Care, frail elderly practices, and institutional special needs plans (iSNPs), while stressing the importance of measuring quality of care, particularly in pain management. 

Communication surrounding treatment preferences for older adults with dementia during emergency medical services responseJournal of the American Geriatrics Society; by Lauren R. Pollack, Danae G. Dotolo, Anna L. Condella, Whitney A. Kiker, Jamie T. Nomitch, Elizabeth Dzeng, Nicholas J. Johnson, Thomas D. Rea, May J. Reed, Michael R. Sayre, Erin K. Kross; 9/25Emergency Medical Services (EMS) providers, capable of rapidly delivering life-prolonging interventions, are often first to respond to acute health concerns for older adults in the United States. Prior work has shown a preference among many people with dementia for comfort-focused care near end-of-life. EMS providers treating critically ill older adults with dementia face challenges that may hinder their ability to elicit treatment preferences, in particular when responding to calls from professional caregivers. Direct communication with surrogate decision-makers may facilitate goal-concordant care.Assistant Editor's note: Being an RN for over 40 years, I have seen many changes in health care, especially in what is expected now of patients/families. I remember the day when nurses were not permitted to share with the patient his/her own BP reading; instead, we were to tell patients to "ask the doctor". Back then the doctor controlled almost all aspects of the patient's care, as well as the sharing of information with the patient about his/her own medical condition. I am glad those days are gone. Now, patients are expected to engage in ongoing discussions regarding advance care planning, execute written advance directives, and are expected to share their care preferences with health providers and loved ones and/or caregivers. It would be an ideal world where health care providers were continuously aware of evolving patient preferences and could always deliver goal concordant care. I believe we need to keep working toward this goal, but I also understand that this expectation can add burden to patients who are already extremely burdened with the many difficult aspects of serious illness. I believe that, as health care providers, we need to appreciate that some people simply cannot or will not share their preferences; it is simply too scary, too foreign, too difficult to do so.