UNITED STATES — March 23, 2026 —Three new studies examining clinical and public perceptions of hospice and palliative care reveal a system under pressure from multiple directions: a persistent physician shortage, underserved populations shut out of comfort-focused services, and family caregivers whose needs remain systematically overlooked.
Published in peer-reviewed journals this year, the research illuminates both gaps and promising models, with implications for policymakers, healthcare systems, and families navigating serious illness at home.
Workforce Shortage Drives Push for Community-Based Training
A study published in Academic Medicine evaluated the Community Hospice and Palliative Medicine (CHPM) Fellowship Program at the University of Colorado, which launched in 2020 to train mid-career physicians in underserved communities. Researchers analyzed outcomes from 10 participating physicians enrolled in 2023, identifying four major themes among graduates: deeper self-development, a greater sense of professional community, increased confidence and competence in palliative medicine, and a stronger capacity to face complex clinical challenges.
“The CHPM fellowship demonstrates a promising model for addressing the national palliative care workforce shortage by providing accessible, community-based training for midcareer physicians,” the study’s authors concluded.
The program’s significance is hard to separate from the scale of what it is trying to solve. The American Academy of Hospice and Palliative Medicine (AAHPM) estimates that only approximately 360 physicians complete specialty training annually — a fraction of the number required to meet growing demand from an aging population. Modeling published in prior years projected a deepening “workforce valley” through the mid-2030s, with physician numbers not recovering to current levels until 2045 absent policy intervention.
The University of Colorado program, now approved for 12 part-time fellows annually, is designed specifically for mid-career clinicians who cannot relocate or leave their practices. Training occurs online and through distance supervision, allowing physicians to build subspecialty expertise while continuing to serve their existing communities.
Homeless Patients Describe Systemic Barriers to Palliative Care
A qualitative study published Jan. 2 in JAMA Network Open evaluated the Palliative Education and Care for the Homeless (PEACH) program, a Toronto-based outreach initiative that delivers mobile, street, and shelter-based palliative services to people experiencing homelessness and life-limiting illness.
Participants interviewed for the study described severe hardships before encountering PEACH, including incarceration, trauma, bereavement, and repeated dismissal by traditional healthcare settings. Most reported systemic barriers to conventional care: long wait times, limited medication access, stigmatizing treatment, and physical challenges navigating healthcare facilities.
“Participants emphasized the need for an accessible, compassionate approach that addresses both medical and social needs,” the JAMA Network Open authors wrote. They noted that PEACH’s low-barrier referral process — often initiated by allied health professionals or case workers rather than requiring patients to self-navigate the system — was central to its effectiveness.
Researchers recommended that “further research evaluating such programs would strengthen the evidence base and support broader policy and funding decisions.” PEACH, a partnership between Inner City Health Associates, Toronto Central Health at Home, and Kensington Health, has served more than 1,000 clients since its inception.
The study adds to a body of evidence showing that people experiencing homelessness face disproportionately high rates of early mortality and multimorbidity yet remain largely excluded from the palliative care system.
Family Caregivers Report Fatigue, Unmet Needs
A third study, published in the Cureus Journal of Medical Science, examined the experiences of female family caregivers in Portugal supporting seriously ill loved ones receiving palliative care at home. Participants reported widespread fatigue, disrupted sleep, and emotional ambivalence. Valued services included home-based telehealth, care coordination, and practical guidance — but participants also described significant unmet needs, including long referral waiting lists, difficulty balancing caregiving with employment, insufficient respite care access, and inadequate social support.
“Improving caregivers’ experiences and safeguarding their well-being requires strengthening early palliative care involvement and expanding formal social support mechanisms,” researchers concluded.
The Portuguese findings align with a growing body of international literature. A November 2025 systematic review published in Nursing Open found that informal caregiver unmet needs in palliative care remain poorly understood across disease types and care settings, and called for a unified synthesis of evidence spanning beyond cancer-specific research. A separate BMC Palliative Care analysis published the same month found that caregivers routinely neglect their own physical and emotional health, leading to escalating caregiving burden that goes largely unaddressed by clinical teams.
A narrative review in Annals of Palliative Medicine (March 2025) characterized caregiver needs as “diverse, yet invisible” — noting that as patient care takes precedence in clinical encounters, caregivers’ own needs are consistently deprioritized, leaving them overwhelmed and unsupported.
Why This Matters for Home Care
For families arranging hospice or palliative care at home, these studies underscore a consistent reality: the burden of coordination, comfort, and caregiving increasingly falls on family members who receive inadequate support from the systems meant to help them. Families seeking to create a dignified, medically appropriate home environment — including proper positioning equipment — can find guidance at sondercare.com/beds/.
Sources: Hospice News (March 23, 2026); Academic Medicine / AAMC; JAMA Network Open (Vol. 9, Issue 1, Jan. 2, 2026, DOI: 10.1001/jamanetworkopen.2025.52434); Cureus Journal of Medical Science; Nursing Open (Nov. 2025); BMC Palliative Care (Nov. 2025); Annals of Palliative Medicine (March 2025); AAHPM Workforce Resources.
