Insights and Trends from the Palliative Care Field

Benchmarking the 2025 workforce, training needs, and operational pressure points in serious-illness care

Snapshot of the Field in 2025

CAPC’s 2025 Palliative Pulse survey offers a national view of how palliative care teams are doing—clinically, operationally, and emotionally. Respondents include physicians, nurses, social workers, chaplains, administrators, and program leaders in hospitals, home-based care, hospice-linked programs, and community serious-illness services.

Several themes emerged consistently:

• Emotional well-being and morale are still under pressure. Burnout, moral distress, and general emotional fatigue remain high on the list of concerns. Teams continue to report the emotional toll of high-acuity, high-complexity cases without meaningful increases in staffing or time for recovery.
• Clinical demand keeps growing. Many programs are seeing higher consult volume and higher medical complexity, including patients with multiple chronic conditions, advanced dementia, progressive neurologic illness, and serious functional decline. Despite this, most teams report that headcount has stayed flat.
• Confusion about palliative care persists. Respondents report that patients, families, referral sources, and sometimes even internal colleagues still misunderstand palliative care as “hospice only” or “end-of-life only,” rather than supportive, symptom-focused, team-based care delivered alongside curative or life-prolonging treatment.
• Training and upskilling are urgent priorities. Programs say they need stronger clinical skills training not just for specialist palliative clinicians, but also for non-palliative colleagues (hospitalists, primary care, advanced practice, home health nurses, etc.) so that core communication, symptom management, and goals-of-care discussions don’t fall on a single overextended palliative consult team.

Workforce Well-Being Is a Strategic Issue, Not Just an HR Issue

The survey highlights that team morale, emotional health, and burnout risk are still viewed as the most urgent internal threats. These aren’t framed as “soft issues”—leaders increasingly see workforce stability as foundational to program viability.

Respondents point to:

• Emotional load of complex cases without proportional staffing support.
• Limited backup coverage, meaning time off can create additional stress for peers.
• Ongoing grief exposure from working daily with patients and families facing serious illness, loss, and difficult decision-making.

CAPC notes that this is driving demand for tools that support team wellness, debriefing, and resilience—not just clinical education. The signal is clear: retention and well-being are now core to program stability, not optional add-ons.

Training: Clinical Skills and Role Clarity

Clinical skills development was again ranked as the most requested educational need. Programs are looking for:

• Evidence-based symptom management training (pain, dyspnea, agitation, anxiety, delirium, etc.).
• High-quality communication training for goals-of-care discussions, advance care planning, and conflict navigation with families and clinical teams.
• Education for non-specialist clinicians on when and how to involve palliative care, and what questions belong with the primary team vs. specialty palliative consults.

This is notable: teams are not only asking for more tools for themselves; they are asking for system-wide training so that palliative care is not the only “owner” of difficult conversations.

Operational Pressure: High Consult Volume, Flat Staffing

Respondents describe a familiar pattern: referrals and consults continue to increase, but FTEs do not. Many teams report that physician, nurse practitioner, and social work staffing has stayed essentially unchanged in the last year, even as acuity has gone up.

That mismatch carries risk:

• Longer response times to consults, especially in high-demand inpatient settings or in home-based serious-illness programs.
• Less time for proactive goals-of-care work; more “firefighting.”
• Fewer opportunities for longitudinal follow-up once the immediate crisis is addressed.

One area of cautious optimism: compared with 2024, fewer respondents said they believe their entire program is at risk of being cut, merged, or defunded in the near term. Financial stability and reimbursement strategy are still concerns, but not as acute as last year. Leaders report having somewhat more confidence in their ability to justify value—often by pointing to avoidable ED visits, smoother care transitions, and improved patient/family satisfaction.

Palliative Care Still Faces Misunderstanding

The survey continues to show that palliative care is widely misunderstood by patients, families, and even some internal stakeholders. Teams report spending valuable clinical time explaining that:

• Palliative care is not only end-of-life care.
• Palliative care can and should run alongside active treatment, including hospital-at-home models, home health, hospice-supported transitions, and complex chronic care in the community.
• Earlier consult involvement improves symptom control, alignment on goals, and caregiver support.

That educational burden has workforce impact. When every consult starts with “what palliative care is,” it slows the work and contributes to emotional fatigue.

Implications for Home Care, Hospice, and Serious-Illness Programs

For agencies providing home-based palliative or serious-illness management, these findings point to several takeaways:

• Recruitment and retention are fragile. Emotional support and workload balance are now part of core infrastructure. If you lose one experienced clinician, you may destabilize the whole program.
• Cross-training non-specialists is leverage. Giving home health nurses, advanced practice providers, or care coordinators foundational palliative skills can prevent every complex situation from escalating to a short-staffed specialty team.
• Clarity in how you describe your service matters. Misunderstanding of palliative care creates delays in referral and missed opportunities to stabilize symptoms earlier. Your external messaging should make it very clear what you offer, when to call you, and how you differ from hospice.
• Bench strength in billing and reimbursement is part of sustainability. Teams reporting lower anxiety about program viability are often the ones who can articulate value to payers and health systems: avoided readmissions, smoother transitions, patient/family satisfaction, and caregiver support.

In short: the clinical case for palliative care is strong and growing, but the people doing the work are stretched. Organizations will need to invest in both workforce well-being and operational clarity to keep these programs viable.