Literature Review

Hospice market expands at 9.6% CAGR, projected to hit USD 182.1 billion Market.Us Media; by Trishita Deb; 10/26/25 The Global Hospice Market is projected to reach USD 182.1 billion by 2033, growing from USD 72.8 billion in 2023 at a CAGR of 9.6%. ... Challenges:

Pulse check: Status update on pediatric palliative and hospice community-based coverageJournal of Palliative Medicine; by Meaghann S Weaver, Alix Ware, Deborah Fisher, Betsy Hawley, Holly Davis, Lisa C Lindley, Steven M Smith, Conrad S P Williams, Tej Chana, Christy Torkildson; 9/25Half (49%) of [the country's surveyed hospice and palliative] organizations reported increasing the number of pediatric patients accepted into their care over the past five years. Programs are less likely to include perinatal (61%) patients compared to infants through young adults (94%). Trauma increased as a reason for pediatric enrollment. Nonmetro geographies are less likely to provide services for children. The pediatric palliative average annual census was 271, and the pediatric hospice average annual census was 74. The pediatric patient's average length of stay for palliative care was 154 days and for hospice was 96 days, [with] Medicaid (47%) [being] ... the most common form of reimbursement. Lack of trained personnel, low referrals, and funding were depicted as the most common barriers.

The pitfalls that derail home health providers’ new palliative care efforts Home Health Care News; by Joyce Famakinwa; 10/14/25 ... Though home health-operated palliative care is a rarity, companies like Visiting Nurse Health System, Contessa Health and Compassus have managed to successfully incorporate these services into their broader care delivery model. When structuring an effective palliative care services program, there are some common pitfalls home health providers should avoid. “One of the biggest ones is positioning palliative care as early hospice,” Nikki Davis, senior vice president of palliative care programs at Contessa, said at Home Health Care News’ FUTURE conference. “And just make sure that there’s also clear eligibility and referral pathways, so that when you’re partnering with your home health and hospice teams, you have those processes in place, so that it’s very clear who’s eligible for palliative care.”

An age-old fear grows more common: 'I'm going to die alone' The Washington Post; by Judith Graham; 10/11/25 As families fracture, people are living long and are more likely to find themselves without close relatives or friends at the end of their lives. [Full access may be limited by a paywall.]

Milton Village Open House builds community to support caregivers of individuals with Alzheimer's, dementia, or other cognitive conditions GreatNews.Life; by Lauren Grasham; 10/6/25 To help healthcare providers better understand the numerous resources available, Milton Village hosted an open house on Tuesday, September 30. Milton Village is a collaborative effort between Milton Adult Day Services (a program of the Center for Hospice Care) and Alzheimer’s & Dementia Services of Northern Indiana (a REAL Services program) to provide comprehensive care and support to individuals living with Alzheimer’s or other cognitive conditions and their caregivers. “Inviting healthcare providers to see our facility and learn more about our programs is a great way to help them understand our unique model,” said Sarah Youngs, director of Milton Adult Day Services. “As providers tour the facility and hear how our guests engage in the programming, it’s so satisfying to see them recognize what this can mean for their patients and the patients’ caregivers.”

[Spain] Mapping palliative care for people living with advanced cancer in phase 1 clinical trials: A scoping reviewPalliative Medicine; by Diego Candelmi, Alazne Belar, Carla Zapata Del Mar, Ana Landa-Magdalena, Anna Vilalta-Lacarra, Mariano Ponz-Sarvisé, Carlos Centeno; 9/25This review highlights the unique needs of patients and caregivers in Phase 1 Cancer Clinical Trials and the complexities of integrating palliative care. Key results revealed patients' limited life expectancy, high symptom burden, distress and unmet spiritual needs [and]... patients were reluctant to seek prognostic information or engage in end-of-life discussions, complicating advance care planning. End-of-life care involved frequent unscheduled hospital admissions, hospital deaths and late hospice-care referrals. Caregivers experienced significant distress, while healthcare professionals faced barriers to integrating palliative care. Palliative care interventions varied widely in approaches, settings and outcomes.Assistant Editor's note: This article discusses how palliative care could benefit patients that are enrolled in phase 1 clinical trials for cancer. Traditionally, it has not been common practice for palliative care programs to serve these kinds of patients and their loved ones. This represents an opportunity for the expansion of much needed palliative care services.  

Living with dementia: To improve lives, we need to change how we think and talk about this experience in aging societies EurekAlert! - AAAS (American Association for the Advancement of Science); peer reviewed publication by The Hastings Center; 9/24/25 To experience or even contemplate dementia raises some of the most profound questions: What does it mean to be a person? How does someone find meaning in life while facing progressive neurological deterioration? ... To improve the lives of our fellow citizens who are living with dementia or providing dementia care, all of us need to pay attention to how we imagine and talk about these interwoven and increasingly common experiences, concludes Living with Dementia: Learning from Cultural Narratives in Aging Societies, a special report published by The Hastings Center for Bioethics. This report responds to calls from health care and social service practitioners for new ways to depict and talk about dementia, a collective term for Alzheimer disease and related dementias. Editor's Note: Click here for free access to multiple articles in this crucial report, such as

Building blocks of hospice family caregiver support Hospice News; by Holly Vossel; 9/24/25 Untapped reimbursement opportunities exist when it comes to developing a sustainable family caregiving infrastructure in the face of rising demand for home-based hospice care. ... Among the payment avenues with potential to improve support for caregivers is the Medicaid-funded Structured Family Caregiving (SFC) program. SFC coverage includes a modest financial stipend to health care providers that offer home- and community-based services for caregivers. ... Roughly 63 million Americans are family caregivers, an increase of nearly 50% since 2015, according to a report from the National Alliance for Caregiving and AARP. About one-in-every-four adults is a caregiver to a family member, with 40% of these individuals providing high-intensity care, the report found. About half of the nation’s caregivers reported negative financial impacts, with one-in-five unable to afford basic needs such as food and 25% taking on debt. Additionally, one-in-five caregivers have poor health outcomes, the report found.Editor's Note: Are you aware that the 2008 CMS Hospice Conditions of Participation identify the "family" 423 times? (Yes, I've searched, counted, and categorized.) Click here for AARP's 2025 edition of Caregiving in the US.

Has human life expectancy already peaked?Vice; by Luis Prada; 9/10/25 For most of the 20th century, human life expectancy skyrocketed. Advancements in hygiene science, a wide variety of medical innovations and discoveries ... have all helped our collective life expectancies tremendously. According to a new study, however, we may have topped out. In the study, published in PNAS and spotted by Science Alert, an international team of researchers crunched the numbers on people born between 1939 and 2000 in 23 high-income countries, using six different forecasting models.Editor's Note: I recall a hospice CE conference around 2005, where a healthcare data statistician presented projections on mortality trends. Based on the previous century’s gains, the data suggested that babies born then could live well past 100—with 120 years as a realistic possibility. This new study raises the provocative question of whether those optimistic forecasts may already have reached their limits.

Raising the standard of Arizona’s dementia care Lovin' Life; by Lin Sue Flood; 9/7/25 Arizona is setting a bold new standard to better support families impacted by dementia. A groundbreaking state mandate requires all memory care facilities to provide up to 12 hours of specialized dementia training to their staff, plus four hours of continuing education each year. This extensive training combines online video modules with hands-on, in-person skills sessions. Hospice of the Valley’s experienced Dementia Team is leading the way as one of the agencies the Arizona Department of Health Services has approved to deliver this comprehensive training. The nonprofit organization is unique in offering it as a free community service.

Do not resuscitate (DNR) emergency medical services (EMS) protocol variation in the United StatesThe American Journal of Emergency Medicine; by Amelia M Breyre, E Jane Merkle-Scotland, David H Yang, Kenneth Hanson, Sameer Jagani, Abe Tolkoff, Satheesh Gunaga; 7/25Do Not Resuscitate (DNR) orders are essential for ensuring that critically ill patients receive care from Emergency Medical Service (EMS) aligned with their preferences. However, significant variations exist in EMS protocols regarding acceptable DNR documentation leading to discordant care, moral distress, and ethical dilemmas. Although most EMS protocols have dedicated DNR protocols, this is not universal and there is significant variability in types of documentation recognized as valid. Documentation that is concise, portable, and designed for EMS use, such as the POLST is preferred. Assistant Editor's note: It is this variability in protocols that personally scares many of us who work in the EOL field. It is not uncommon to hear a hospice/palliative worker joke that they want a "DNR tatoo on their chest"! Perhaps it would be easier (and less painful) to continue to promote POLST, or something similar, in each of our respective workplaces.

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.