Impact of prenatal exposure to maternal stress on infant neurodevelopment.

The aging population in the United States is rapidly increasing. Currently, one in six Americans is aged 65 or older, and this proportion is projected to rise to nearly one in four by 2060 []. Aging is associated with a higher risk of chronic illnesses such as dementia, heart disease, type 2 diabetes, arthritis, and cancer, as well as greater vulnerability to infections like influenza and pneumonia. Many older adults live with multiple chronic illnesses and complex care needs, creating a growing demand for care models that focus on quality of life, symptom relief, and support for patients and families []. Home-based palliative care (HPC) has emerged as a promising solution, offering interdisciplinary, patient-centered care in the home setting. Despite the growing need for supportive care at home, a significant gap exists between older adults’ preferences and actual experiences. Although nearly 70% of older adults prefer to die at home, only about 30% do []. Importantly, these patterns reflect not only healthcare system constraints but also the fact that death is a deeply social experience shaped by family capacity, caregiving relationships, and the broader home environment. These patterns are often driven by the limited availability of home-based palliative and hospice services, inadequate funding, financial hardship for patients and families, as well as the significant caregiver burden placed on unpaid family members and other informal caregivers [–]. Home-based palliative and hospice care encompasses two distinct but related concepts: palliative care and hospice care. Both provide holistic support for serious illness. Palliative care can start anytime, even with treatment; hospice begins when treatment stops []. Palliative care delivers medical care designed for people living with a serious illness, addressing physical, functional, psychological, social, and spiritual needs while emphasizing personalized care for both patients and their families []. Home-based palliative care (HPC) refers to specialized palliative care services delivered in the patient’s home rather than in hospital or clinic settings. HPC is a form of community-based care that brings services directly to the patient’s place of residence, including private homes, assisted living facilities, and nursing homes [, ]. By providing care in the home environment, HPC reduces transportation and mobility barriers and improves access for individuals with advanced illness or functional limitations [–]. HPC programs vary in structure, staffing, and intensity. Depending on patient needs and available resources, care may be delivered by individual clinicians or interdisciplinary teams, with visit frequently tailored to clinical complexity. HPC has been identified as a preferred care model for many older adults due to its ability to support comfort, familiarity, independence, autonomy, and family involvement [, ].