ABSTRACT Purpose/Objectives: This review of the literature was conducted to determine whether community engagement can help overcome barriers and increase access to the best end-of-life care, particularly hospice care. Method: The authors searched the PubMed database using the following search terms: community engagement OR community outreach OR compassionate communities AND hospice utilization OR hospice use OR hospice enrollment OR access to hospice, for articles published within the last 5 years. Findings/Conclusions: Themes in the literature include the importance of community engagement in designing and planning end-of-life healthcare models. Academic partnerships can help bridge communities and healthcare delivery platforms, and community advocacy can drive policy change and infrastructure investment for older adults. Implications for Case Management Practice: Hospice care, is evidence-based to meet person-centered care goals aligned with strategic intiatives for healthcare systems. Community engagement and academic partnerships are best practices to achieve sustainable outcomes in access to person-centered hospice care in diverse communities which are growing and thriving across these United States.
ABSTRACT Purpose of Study: Frequent emergency department (ED) utilization often reflects complex medical, behavioral, and social needs that extend beyond episodic emergency care. The purpose of this project was to evaluate the implementation of individualized care plans created by a multidisciplinary team and describe changes in ED utilization among high-utilizing patients. Primary Practice Setting(s): Community hospital ED. Methodology and Sample: A retrospective evaluation was conducted among 11 adult patients with 6 or more ED visits within a 12-month period. A team of ED stakeholders developed individualized care plans following a comprehensive assessment of each patient's unique needs. ED utilization during the 6 months before and after application of the care plans was compared, and patient characteristics were described. Results: After patients received care plans tailored to their specific needs, ED visits decreased by 66.5% during the 6-month follow-up period. Most participants were insured through Medicaid (72.7%), had at least 1 chronic medical condition (72.7%), and experienced social challenges such as unemployment (63.6%) and financial instability (45.5%). Implications for Case Management Practice: Individualized care plans were associated with reduced ED visits among high-utilizing patients. Collaboration among clinicians, case managers, social workers, behavioral health providers, and community resources can help address the multifaceted issues that contribute to high ED visits. Health care systems may consider implementing similar care planning approaches for high-utilizing patients.
ABSTRACT Purpose/Objectives: To illustrate a critical paradox: health care professionals, and especially case managers, possess knowledge of regulatory requirements, care processes, and available resources that enable them to navigate complex systems more effectively than patients and families without this expertise. Yet, patients should not need a health care insider, professional credentials, or personal relationships within a health system to receive comprehensive, person-centered case management. Primary Practice Setting(s): Across all settings. Findings/Conclusions: The lived experience illustrates a critical paradox: health care professionals, and especially case managers, possess knowledge of regulatory requirements, care processes, and available resources that enable them to navigate complex systems more effectively than patients and families without this expertise. Yet, patients should not need a health care insider, professional credentials, or personal relationships within a health system to receive comprehensive, person-centered case management. Implications for Case Management Practice: Case managers must recognize that effective care coordination extends beyond completing assessments, arranging services, and facilitating discharge. Professional practice requires sustained attention to the patient's voice, dignity, preferences, psychosocial needs, and understanding of the care plan across every transition. Standardized assessments and regulatory requirements provide an important foundation but are not a substitute for individualized engagement and professional judgment. The standard for case management excellence should be a system that consistently provides informed participation, individualized planning, advocacy, coordination, and respectful communication to every patient.
Introduction: Euthanasia has long been at the center of extensive debate at the social, political, legal, and religious levels, assuming an increasingly significant role within the contemporary end-of-life context. To analyze the attitudes of the Italian population toward euthanasia using the Euthanasia Attitude Scale (EAS) as the primary assessment tool. Methods: An observational, cross-sectional investigation was conducted between December 2025 and February 2026 by sharing the online questionnaire through major social media platforms and messaging applications, including Facebook and Instagram. Results: A total of 4,968 participants agreed to participate. Results indicated that factors such as religion, educational level, and age significantly influenced opinions on euthanasia. In particular, lower levels of religious participation combined with higher educational attainment were associated with greater acceptance of the practice. Women tended to be more involved in caregiving activities and were more frequently exposed to end-of-life issues; these factors could foster greater sensitivity and awareness, and increased participation in studies addressing such topics. Implications for Case Management: Our results highlighted the need for greater informational clarity, as a proportion of the population experienced difficulty in distinguishing between euthanasia, medically assisted suicide, and the withdrawal of life-sustaining treatments. Case managers are in an arena to help move these discussions.
