1.To understand and appreciate the complexities challenging patients, caregivers, and health care providers alike in preparing frail hospitalized older adults to transition home from an acute hospitalization.2.To gain an appreciation of the paucity of palliative care domains addressed in existing hospital-to-home care transitions literature.3.To challenge all providers invested in the care of hospitalized elderly adults to better incorporate palliative care domains, especially those regarding care of the imminently dying and ethical / legal aspects of care, when designing future hospital-to-home transitional care programs. Transitional care programs focus on providing patients/families with resources/support to regain function post-hospitalization and reduce readmissions. Hospital palliative care teams are often consulted for patients imminently dying. These separate approaches overlook patients going home who aren't imminently dying, but have life-limiting chronic conditions with unmet palliative needs. Review literature on hospital-to-home transitional care programs for elderly to determine extent to which domains of palliative care are addressed. Design: Structured content analysis of studies published 1985-2008 using search terms: progressive patient care, after-care, transitional programs, and related terms. Databases: CINAHL, EMBASE, MEDLINE, EBM Reviews (CCRCT/CDRS/DARE). Inclusion criteria: English, >50% subjects >age 60, studies of hospital-to-home transitions. Strategy: Developed structured scoring tool based on National Consensus Project for Quality Palliative Care “Clinical Practice Guidelines” assessing 8 domains: Structure/Processes; Physical; Psychological/Psychiatric; Social; Spiritual, Religious & Existential; Cultural; Care of Imminently Dying; and Ethical/Legal. Domains scored: 0-content absent; 1-content minimally helpful; 2-content very helpful. Total score: 0-16. Descriptive statistics reported. We identified 1182 titles; 903 were eliminated (not meeting inclusion criteria) after inspection of titles/abstracts. 279 publications were selected for independent review by authors EB/GS. Ultimately 83 articles met inclusion criteria, were analyzed and scored. Domains were identified 340 out of a possible 664 times (51.2%). Physical aspects was identified in all 83 articles and Social aspects in 82 (98.8%). Ethical/Legal aspects was identified in only 9 (10.8%) of all articles reviewed, and Care of Imminently Dying merely 6 (7.2%) times. Physical and Social aspects were scored with mean of 1.771 (SD 0.422) and 1.831 (SD 0.408), respectively.