Literature Review

Reflection on the Potomac River Crash Hospice & Palliative Care Today; by Joy Berger, Editor in Chief; 1/30/25We are absorbing unfolding news about Thursday night’s tragic plane and helicopter crash at the Potomac River. As with many of you, I’m flooded with memories of flying in and out of this same airport: gazing out the plane’s window to delight in DC’s historic sites; delighting in the diversity of my fellow travelers and whatever their stories might be. Many of these Washington DC trips were to be with our hospice and palliative colleagues at the (then) NHPCO Conferences or other related meetings. Today, I’m grateful for our safe journeys then. Today, I hope for renewed connections: the joy of each person’s unique life-journey; the relationships we’ve developed in moments at meetings, meals, and follow-up communications; the sacredness of this profound work we are privileged to share. And—with these current Potomac River tragic deaths—we are reminded of icy currents of own traumatic losses. For me, I’m struck with the pains of a beloved family in my childhood’s home church, whose adult son was killed in the 1982 Potomac River plane crash; with the heart-wrenching death of my grandfather when he was killed by a drunk driver; and more. For you? As news continues to unfold, may we treasure anew the unknown measure of our time on this earth. Of our connections with each other—whatever our differences—profit or nonprofit, political, and more. May we sensitively tune into the life-altering traumas carried within those we serve—and the healing compassion we can give. Humbly, Joy

Palliative care is essential for seriously ill patients—at any ageAMA (American Medical Association); by Kevin B. O'Reilly; 1/27/25 The AMA House of Delegates has adopted new policies outlining physicians’ ethical obligation to provide or seek optimal palliative care for patients with serious illnesses who can benefit from comprehensive management of pain and other distressing symptoms—not only those with terminal illnesses or on the precipice of death. “Physicians have clinical ethical responsibilities to address the pain and suffering occasioned by illness and injury and to respect their patients as whole persons,” says one of the new policies adopted at the latest AMA Interim Meeting, held in Lake Buena Vista, Florida. “These duties require physicians to assure the provision of effective palliative care whenever a patient is experiencing serious, chronic, complex or critical illness, regardless of prognosis.” 

Navigate a smooth transition from hospital to home care Health Medicine Network; 1/17/25 When discharged from hospital, a high proportion of people face emotions such as anxiety and fear, which can make the transition from hospital care to safe and appropriate home care difficult. But it doesn’t have to feel that way if you develop an effective strategy before you leave the hospital. ... 

Advance care planning among diverse U.S. older adults with varied cognition levelsAlzheimer's & Dementia; by Zahra Rahemi, Swann Arp Adams; 1/25Older adults from minority groups often experience elevated rates of chronic diseases and cognitive impairment, coupled with lower rates of engagement in advance care planning (ACP) and comfort care as they approach end of life... Our study revealed that individuals facing cognitive impairments exhibited lower rates of engagement in ACP. Notably, among the variables examined, race, ethnicity, rural residence, education, and age emerged as significant predictors of ACP in a national sample of older adults in the U.S. These findings underscore the importance of incorporating these sociodemographic factors into the design of interventional studies aimed at enhancing ACP and mitigating disparities.

The Alliance on CMS Hospice Special Focus Program Implementation: “Doubling down on a dangerous decision, eager to work with incoming administration to fix” National Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 1/16/25 The National Alliance for Care at Home (the Alliance) issued the following statement in response to the news of hospice providers filing litigation against the Centers for Medicare & Medicaid Services (CMS) over their flawed implementation of the Hospice Special Focus Program (SFP). The Alliance and the broader hospice community, who have been engaged on this program since its inception, have repeatedly shared concerns directly with CMS staff at all levels. They warned that this approach would inflict unnecessary harm to patient care, cause confusion to families when selecting a hospice provider to care for their loved ones at the end of life, and will cause some providers to sustain irreparable damage. These concerns have been echoed by lawmakers, providers, and the leading national hospice trade organizations. “With CMS doubling down on a dangerous course of action by proceeding with the Hospice SFP in its current state—and offering no due process or administrative recourse to address or mitigate its flaws—some hospice providers will suffer irreparable harm and have no choice but to seek justice through the courts on behalf of their patients and mission,” said Dr. Steve Landers, CEO of the Alliance. [Click on the title's link to continue reading.]

Nonprofit opens home-based care facility for hospice patients Fox KNWA-24/KFTA, Lowell, AR; by Justin Trobaugh; 1/17/25 A nonprofit organization introduced a new resource Jan. 17 for those in Northwest Arkansas who need home-based care. Circle of Life provides hospice and in-and-out patient care services, and it opened its Joey Feek Center for Home-Based Care in Lowell. The facility will serve 93% of the non-profit’s patients and was donated by the Willard and Pat Walker Charitable Foundation. 

Transition to hospice: how it impacts the mental health of caregivers of persons with dementiaAlzheimer's & Dementia; by Oonjee Oh, Debra Parker Oliver, Karla Washington, George Demiris; 2024In this study, we aimed to examine caregivers’ mental health indicators and their correlation structure based on the timing of hospice transition... In the context of dementia care, our results highlight that caregivers who just entered hospice are undergoing a challenging transition that often finds them in a mentally vulnerable position. To develop and implement effective strategies for caregivers of persons with dementia, we need to understand the needs and vulnerabilities of caregivers during hospice transition and identify the best timing for the delivery of supportive tools.

‘Those who have made death their life’ Part 2: Family The Daily Yonder - Keep It Rural; by Hannah Clark; 1/16/25 Hannah Clark spent six months riding along with the nurses and certified nursing assistants (CNAs) of Hearth Hospice who provide in-home care to those living in Northwest Georgia and Southeast Tennessee. These hospice workers often drive up to a hundred miles a day to visit a handful of patients scattered across the Appalachian landscape in both rural towns and urban centers. What will follow this introductory essay is her photo reportage in three parts, documenting what she has witnessed accompanying these caregivers. The intimate portraits and vignettes show tender moments at different stages towards the end of one’s life. Their beauty lies in the companionship Clark captured in moments of need and vulnerability. Editor's note: Click here for the Introduction, that we posted 1/16/25, and click here for Part 2: Hospice, that we posted 1/17/25.

Trump freezes HHS communications: report Modern Healthcare Alert; by Bridget Early; 1/22/25 The Health and Human Services Department and its agencies are going silent for now, according to the Washington Post. On Tuesday, the day after President Donald Trump's inauguration, HHS received an order to halt all outbound communications, including health advisories, weekly reports, research, website updates and social media posts, the newspaper reported. The Washington Post reports that the pause has no definitive end date and that the decree does not specify whether exceptions will be made for disease outbreaks or other urgent situations. The directive applies to agencies such as the Centers for Medicare and Medicaid Services, the Food and Drug Administration, the Health Resources and Services Administration, the Centers for Disease Control and Prevention, the National Institutes of Health and the Substance Abuse and Mental Health Services Administration.

Hospice agency changes of ownership: An analysis  of publicly available ownership data Assistant Secretary for Planning and Evaluation: Office of Behavioral Health, Disability, and Aging Policy; 1/10/25 ... Over time, the number of both Medicare enrollees receiving hospice care and hospice providers has grown. Between 2010 and 2022, the number of Medicare enrollees receiving hospice care grew by approximately 50%, while the number of hospice agencies grew by 69%. Growth in the hospice provider market was driven predominantly by a 125% increase in for-profit hospices, which represent a growing share (approximately three-quarters in 2021) of the hospice provider market. The shift toward for-profit ownership in the hospice industry has been driven not only by newly enrolling hospices, but also changes of ownership. For example, acquisitions of nonprofit hospice agencies by publicly traded corporations and private equity firms have contributed to the increase in market share of for-profit hospices.

Hospice of the Chesapeake expands inpatient care with high-flow oxygen therapy Southern Maryland News Net; by Hospice of the Chesapeake; 1/13/25 Hospice of the Chesapeake is proud to announce the addition of high-flow oxygen therapy to its inpatient care centers, enhancing the quality of care for patients with complex respiratory needs. ... High-flow oxygen therapy is designed to deliver precise oxygen levels, improving breathing efficiency and overall comfort for patients. ... “Adding high-flow oxygen therapy to our inpatient care centers represents our commitment to providing comprehensive, patient-centered care,” said Dr. Sonja Richmond, Vice President of Medical Affairs & Hospice Medical Director. “This advancement enables us to better meet the needs of our patients and their families during a challenging time.”

Increasing Medicaid rates: A critical step to support home-based care Association Press, North Salt Lake, UT; by Business Wire; 1/14/25To address the growing challenges facing the healthcare system, the Homecare and Hospice Association of Utah (HHAU) calls for an urgent increase in Medicaid reimbursement rates for Home and Community-Based Services (HCBS) waivers, Private Duty Nursing (PDN), and Home Health. These critical services form the backbone of home-based care, enabling individuals to receive the medical attention and support they need in their homes, while saving tax dollars and alleviating strain on hospitals and long-term care facilities.

Physician engagement in addressing health-related social needs and burnoutJAMA Network Open; Masami Tabata-Kelly, MBA, MA; Xiaochu Hu, PhD; Michael J. Dill, MA; Philip M. Alberti, PhD; Karen Bullock, PhD, LICSW, APHSW-C; William Crown, PhD; Malika Fair, MD, MPH; Peter May, PhD; Pilar Ortega, MD; Jennifer Perloff, PhD; 12/24In this cross-sectional study of 5,447 nationally representative physicians in the US, 34.3% regularly dedicated time to addressing HRSNs [health-related social needs]. The study identified variability in physicians’ engagement in addressing HRSNs and found that higher engagement was associated with a greater likelihood of burnout. The findings suggest the need for thorough assessment of the potential unintended consequences of physicians’ engagement in addressing HRSNs on their well-being.