Literature Review

Reducing family caregiver burden may prevent 30-day ED readmissions among community-dwelling older adults, study finds McKnights Long-Term Care News; by Foster Stubbs; 9/9/25 Alleviating caregiver burden may reduce returns to the emergency department for older adults up to 30 days after a discharge, according to research published in the Journal of the American Medical Association. The study examined 1409 dyads or duos of community-dwelling patients 65 years or older and their family caregivers. ... [Questions] included items about strain in the caregiver’s role and personal life associated with caregiving. ... "We interpret these findings as evidence that caregiver burden may contribute to a negative care transition, associated with 30-day ED revisits, ..."

Shepherd’s Cove adds program The Advertise-Gleam, Albertville, AL, by Anthony Campbell; 9/2/25 Shepherd’s Cove Hospice is proud to announce the launch of Shepherd’s Cove Counseling, a new program that provides professional mental health services for individuals, couples and families. This exciting expansion enhances Shepherd’s Cove’s care offerings by giving the community access to licensed therapy through insurance or private pay, without affecting the organization’s long-standing commitment to maintaining access, at no cost, to grief support. “Shepherd’s Cove Counseling creates space for healing, growth, and support during life’s most challenging seasons,” said Stacey Johnson, LICSW, Community Programs Director. 

[Global] Palliative care for special populations ehospice; by Howard Kinyua; 9/1/25

Hospice was meant to offer dignity in death — but it fails the most marginalized. We need hospice programs that go to the streets, into shelters, behind barsSTAT; by Christopher M. Smith; 8/26/25I’ve spent more than a decade in hospice care, sitting at the bedsides of people facing the final days of their lives. I’ve held hands in hospital rooms, in tents, in prison cells, and in homes that barely qualify as such. And over time, I’ve come to see that dying in America is not just a medical event — it’s a mirror. It reflects everything we’ve failed to do for the living. Hospice was created to bring dignity to the dying — to manage pain, provide emotional and spiritual support, and ease the final passage for people with terminal illness. But the systems surrounding hospice care are riddled with inequity. The very people most in need of compassion — the unhoused, the incarcerated, people of color, LGBTQ+ individuals, and people with disabilities — are systematically excluded, underserved, or erased. Access to a good death is too often reserved for the privileged, while everyone else is left to navigate a system that wasn’t built for them — or worse, actively works against them... The truth is, hospice care cannot achieve its mission unless it actively addresses the inequities built into the structures around it. We need hospice programs that go to the streets, into shelters, behind bars. We need training rooted in cultural humility, in antiracism, in trauma-informed care. We need to reimagine what it means to offer dignity to someone whose life has been defined by abandonment... Because dying is universal. But justice, even at the end of life, is still not.Publisher's note: STAT also references Dr. Ira Byock's article "The hospice industry needs major reforms. It should start with apologies, 8/22/23".

Flu, COVID-19 vaccination rates falling among health care workers WWLP, Springfield, IL, originally Boston, MA; by Alison Kuznitz; 8/14/25 The rate of Massachusetts health care workers vaccinated against the flu and COVID-19 is declining, despite state officials pushing for the vast majority of providers to get their shots in order to stunt the spread of illnesses. The Department of Public Health’s goal is to achieve an annual flu and COVID immunization rate of 90% or higher among eligible health care personnel at all licensed facilities and emergency medical services. ... During the 2024-25 respiratory virus season, an average of 83.5% of providers in acute care hospitals were vaccinated against the flu, ... That compares to ... 52.3% in nursing homes, 68.7% in rest homes, 52.2% in adult day health programs, 21.2% in EMS and 65.4% in hospice. Editor's Note: Is 65.4% high enough for health care workers who consistently tending many of the most vulnerable persons receiving health care? What are the vaccination rates for your organization? 

New report gives healthcare providers fresh guidance on communicating with older adults McKnights Long-Term Care News; by Donna Shryer; 8/7/25 A new report from the Gerontological Society of America reveals critical strategies for healthcare providers to improve communication with older adults, who now represent almost 17% of the US population. The comprehensive guide, titled “Communicating With Older Adults: A Review of What Really Works,” addresses the growing need for effective patient-provider interactions as America ages. Approximately one-third of adults aged 65 or more years have a disability that may affect communication, the report noted. 

How one man’s dying wish was denied by the health care system Synopsi, from MedPage Today; by Caitlin E. Morh, MD; 8/5/25 “This is Dr. Mohr.” I answered a number I didn’t recognize. “It’s Irving,” said the frantic voice. “He collapsed. The paramedics are working on him now.” “They’re doing compressions? Stop! Put the paramedic on the phone!” My father-in-law, Irving, the stoic Danish-American Navy veteran, had been on hospice for 3 months. His POST (physician order for life sustaining treatment) form was on file with the hospice agency and his custodial care facility: DNR/DNI, comfort measures only. ... “I’m Irv’s daughter-in-law. I’m a physician. He’s a DNR, he’s on hospice. Stop doing compressions.” 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 ... I listened to the ACLS algorithm unfold in the background. ...

The heart of transformation: People, purpose and progress at City of Hope Modern Healthcare; by City of Hope; 7/14/25 As chief transformation officer at City of Hope, one of the largest and most advanced cancer research and treatment organizations in the U.S., Debra Fields has spent nearly a decade guiding the organization’s evolution. In this conversation, Fields shares her perspective on what it takes to lead meaningful transformation in healthcare including the power of vision, the importance of culture and the responsibility leaders have to care for both their people and themselves.

Why more seniors are going broke in the last 5 years of life SavingAdvice.com; by Riley Jones; 7/27/25 ... According to recent data, more seniors than ever are entering the last five years of life with little to no savings, and some are accumulating serious debt. Despite years of work, careful budgeting, and modest living, the final chapter of life is becoming one of the most financially devastating. ...

When grief involves trauma − a social worker explains how to support survivors of the recent floods and other devastating losses The Conversation; podcast by Gemma Ware with Dr. Liza Lane; 7/17/25 The July 4, 2025, floods in Kerr County, Texas, swept away children and entire families, leaving horror in their wake. Days later, flash floods struck Ruidoso, New Mexico, killing three people, including two young children. ... When death is sudden, violent, or when a body is never recovered, grief gets tangled up with trauma. In these situations, people don’t only grieve the death. They struggle with the terror of how it happened, the unanswered questions and the shock etched into their bodies. I’m a social work professor, grief researcher and the founder of The Young Widowhood Project, a research initiative aimed at expanding scholarship and public understanding of premature spousal loss. Both my personal loss and professional work have shown me how trauma changes the grieving process and what kind of support actually helps. To understand how trauma can complicate grief, it’s important to first understand how people typically respond to loss.

Caring for a difficult elderly parent during a transitionPsychology Today - Caregiving; "Personal Perspective" by Franne Sippel, EdD, LP; 7/21/25 I am the only child of an only child who lives in an assisted living facility thousands of miles away. I unofficially diagnosed Mom with obsessive-compulsive personality disorder after struggling for years with a relationship fraught with guilt and frustration. ... It’s difficult enough to care for a frail parent when their health is failing. However, the added OCD personality, with its micromanaging, rules, and demands, tests patience beyond compare.  ... A good friend suggested I call hospice to evaluate her. Jim, a hospice RN in his 70s, arrived and instantly assessed the situation with laser-like precision. ... I spend many months going back and forth between South Dakota and Arizona to see my mom. Hospice continues to visit her three to four times a week at the assisted living facility, and a dear family friend also visits her several times a week. ... Editor's Note: Keep reading this article to its end. The insightful, practical, sensitive care from these hospice clinicians generated life-long transformations for this burdened caregiver-daughter. 

Opinion: My health and my politics walk into a doctor’s office … The Washington Post; by Kim Fellner; 7/16/25 [Note: Access is behind a paid firewall, with an option to set up a temporary free account]... My palliative care doctor and I have almost nothing in common. We’re still learning from each other. ... It began simply enough. By October, my sarcoma had moved from possibly curable to definitively terminal, and, since metastasis to the bones can be painful, my anchor oncologist offered to connect me with a palliative care doctor to help with the physical and conceptual aches and pains of dying. Which seemed like a good thing to do. ... I did not anticipate, however, that the personal and the political would collide in my doctor’s office. ... [Descriptions unfold of significant, conflicted dialogue between (1) this Jewish daughter of holocaust survivors whose life-long vocation was social justice and (2) this Christian palliative care physician who asked about mental health and then dismissed this person's primary concerns that were affecting her dying.] ... Clearly, my doctor and I shared some beliefs about the importance of the palliative approach. ... But as the doctor noted, the best palliative care goes beyond the purely physical to address the more cosmic questions of life and death, and I was uncertain we were well matched as partners for this intimate process. ... I had no idea how to proceed. ... [More descriptions.] ... And that’s where the magic happened. Within a few days, my palliative care doctor sent me back a transparent, thoughtful and moving response. ... Her courage and openness, her willingness to risk a forthright response, have precipitated a remarkable dialogue about what each of us brings into the room, and how we can honor the space and each other once we get there. ... Editor's Note: Whatever one's political or religious stance, this article is sure to spark fireworks—of conflict, dissonance, and, hopefully, powerful insight. I encourage readers to engage with it attentively, attuned to three things: