Adtalem experts reveal how hospice and palliative medicine provide dignity, advocacy and essential support, transforming the way we care for older adults in their final chapters.
The United States is experiencing a significant demographic shift as its population ages rapidly. According to the U.S. Census Bureau, the number of Americans aged 65 and older grew from 40.3 million in 2010 to 55.8 million in 2020, marking a 38.6% increase—the fastest rate since the late 19th century.
Projections indicate that by 2050, this age group will reach 82 million, comprising 23% of the total population.
As America's aging population grows, the need for specialized care that prioritizes dignity, comfort and quality of life becomes increasingly urgent. Hospice and palliative medicine play a crucial role for elderly showing signs of end of life, addressing not just the physical symptoms of serious illness but also the emotional, social and spiritual needs of patients and their families.
“Every day, 10,000 or more people are turning 65, and we’re living with chronic illness longer than ever before. It’s unavoidable—we need to rise to the occasion and learn how to care for patients and their families.”
That’s the call to action from Dr. Rachel Jordan, MSN ‘18 from Chamberlain University and director of legislative affairs and advocacy at Hospice of the Chesapeake.
The Critical Role of Hospice and Palliative Medicine
Dr. Jordan has dedicated her career to improving access to end-of-life care, but despite the immense benefits of these services, her experiences as a provider have revealed many patients hesitate to seek the proper care due to misconceptions.
Christopher Paredes, MD ’09, from Ross University School of Medicine, is a geriatrician specializing in home-based primary and palliative care. He emphasizes the need for proactive planning to ensure that patients’ wishes are honored.
“In a perfect world, making sure healthcare proxies are appointed, powers of attorney are in place and finances are sorted out early makes things a lot smoother,” he says. “These measures help alleviate stress for both patients and their families as they navigate serious illnesses.”
Barriers to Hospice and Palliative Medicine Access and the Need for Advocacy
One of the major challenges in hospice and palliative care is the lack of trust and awareness, particularly in underserved communities.
“There is a disproportionate amount of Black and brown communities that underutilize hospice, and it’s not because the service isn’t available to them,” Dr. Jordan says. “It’s because of lack of education, lack of trust, lack of availability. We need to be in their churches, in their kitchen, in schools and nursing homes advocating to bring the care to them.”
For Dr. Paredes, another key issue he sees through his Northwell Health House Calls Program is the inadequate coverage of home-based palliative care by insurance providers.
“We’ve proven for over 10 years that giving high-quality comprehensive care in the home prevents unnecessary hospitalizations and increases patient satisfaction,” he says. “Yet, not all insurances cover this kind of care, making it harder for older adults to receive the services they need where they are most comfortable at the end-of-life timeline.”
This lack of coverage forces many patients into hospital-based care, creating financial and logistical burdens for families who would prefer care at home.
Dr. Paredes advocates for policy reforms that would expand insurance coverage for home-based palliative care. “We need to push for legislative changes that recognize the value of home-based care and ensure that all patients, regardless of their financial situation, have access to the services they need.”
The Need for Early Integration of Palliative Care
A significant barrier to timely care is the reluctance of both patients and healthcare providers to initiate hospice discussions. “We need to work on getting our medical providers comfortable with the thought and idea of referring to hospice,” Dr. Jordan says. “It’s not stripping someone of their dignity. It’s just saying this is the care that’s appropriate for you at this time.”
Dr. Paredes adds that understanding patient goals is critical in making treatment decisions. “We always weigh the pros and cons—if a treatment is just going to cause more suffering, we want to have that discussion with the family and let them know the numbers and the percentages so they can make an educated choice.”
Programs Supporting the Future of Palliative Care
Efforts to improve access to hospice and palliative medicine include workforce development. In 2024, The Adtalem Global Education Foundation began supporting the American Academy of Hospice and Palliative Medicine’s Next Gen Scholars Program.
“The AAHPM Next Gen Scholars for Equity program plays a pivotal role in diversifying and strengthening the palliative care workforce,” says Linda Sterling, program manager at AAHPM. “It not only exposes medical residents to a rewarding career path but also equips them with transferable skills and valuable mentorship, all while contributing to the pursuit of equity and justice in healthcare.”
The program aims to increase diversity in the field by supporting postgraduate medical residents and fellows from underrepresented communities and recognizing that a diverse and inclusive workforce is essential for addressing healthcare disparities and ensuring culturally competent care.
Sterling continued: “By targeting medical residents from underrepresented communities, it addresses a longstanding issue of underrepresentation in this crucial healthcare sector. By actively promoting diversity and inclusion, it works toward rectifying disparities in healthcare access and outcomes. This aligns with the broader goal of creating a more equitable healthcare system for all patients.”
Learn more about how Adtalem is Championing Care.
For more information, email the Adtalem Global Communications Team: adtalemmedia@adtalem.com.
