A growing body of research has found links between hospice and palliative care delivery and improved quality and cost outcomes.

Reducing end-of-life hospitalizations, costs

Systematic identification of seriously ill individuals in need of greater supportive care could help reduce hospitalizations at the end of life and increase home-based care delivery.

This is according to recent research published in the Journal of Clinical Oncology Practice. The research examined strategies designed to decrease hospital utilization and improve quality among patients with advanced and metastatic cancer.

Decreased hospitalization was associated with fewer aggressive health care treatments and lower end-of-life costs, the research found. Earlier disease identification and access to palliative care interventions were found as leading strategies that reduced end-of-life hospitalizations.

“Research priorities have recently shifted in this field as patient-centered outcomes including good days or days at home and symptom relief have become of paramount importance, compared with more standard oncologic outcomes such as survival,” researchers stated. “This work has broad implications for other areas of cancer research that investigators may build upon, demonstrating the importance of efficient, systematic identification of at-risk individuals; the efficacy of a pragmatic, multifaceted intervention; and the increasing relevance of patient-centered outcomes.”

Successful strategic approaches, according to the research, involved examining patients’ electronic medical records, readmission trends and indicators of declining conditions such as malnutrition, respiratory symptoms, infection and changes in mental health.

Access to palliative care was also associated with improved quality of life as well as less utilization of aggressive and urgent care, particularly at the end of life, the research found.

Respite access a driver of home deaths

Access to respite services that hospices frequently provide to family caregivers can increase the likelihood of patients dying in their homes, according to recent research.

Respite care delivery was the strongest predictor of home-based deaths in a recent McGill University-led study. Serious and terminally ill patients with caregivers who receive respite are 2.7x more likely to die at home compared to others, the study found.

The study examined nearly 6,000 patients receiving home-based palliative care from a Montreal, Canada-based between 2015 and 2024, and included feedback from caregivers and health care decision makers. The research was funded by Quebec’s health ministry and part of its plans to improve quality and equitable access to end-of-life and palliative care and reduce hospitalizations.

The study found that timely access to nursing care, support with hygiene and bathing, as well as services that manage pain and symptoms were significant factors in home-based deaths.

Greater investment in respite services is needed to help seniors age in place and improve access to community-based hospice and palliative care. This is according to the study’s lead author Kelley Kilpatrick, assistant professor and Susan E. French Chair in Nursing Research and Innovative Practice at McGill University’s Ingram School of Nursing.

“An at-home palliative and end-of-life care approach that addresses the physical, psychological, spiritual and social needs of patients and their caregivers enables patients to remain at home longer and to die at home when that is their wish,” Kilpatrick said in a statement.

Spiritual care impacts of psychedelic therapies

Psychedelic-assisted therapies may have the potential to alleviate existential and spiritual distress among patients with a life-limiting condition.

A recent analysis of U.S. six studies published between 2013 and 2023 found that seriously ill patients experienced improved spiritual well-being after receiving psychedelic-assisted therapies.

Psychedelic-assisted therapies such as MDMA and psilocybin were associated with enhanced spirituality and reduced feelings of existential distress among 140 patients, according to the analysis, which was published in ScienceDirect’s Journal of Psychosomatic Research. All but one of the patients examined had a cancer diagnosis.

“Psychedelic-Assisted Therapy (PAT) is gaining traction as a novel approach to addressing the psychological and existential distress experienced by patients,” authors wrote in the analysis. “PAT, especially with psilocybin, demonstrated significant enhancements in spirituality, mystical experiences and [spiritual well-being (SpWB)].”