Advance care planning for patients with hematologic malignancies: A narrative review
American Journal of Hospice & Palliative Medicine; by Olivia M. Seecof; 1/26
Advance care planning (ACP) completion rates are higher in patients with serious illness compared to the general population, however, ACP is overall under-utilized and sub-optimal, especially for patients with hematologic malignancies. This patient population can experience unique and significant physical and psychological symptoms due to their illness and the treatment, resulting in high rates of aggressive end of life care. This high healthcare utilization pattern often triggers ACP conversations and documentation, often facilitated by specialty palliative care clinicians. This review article examines existing literature about ACP for patients with hematologic malignancies with the intent to inform future prospective research to improve values-based patient care.

Understanding advance care planning among young adults: A theory-based examination using the Integrated Behavioral Model and Precaution Adoption Process Model
Journal of Social Work in End-of-Life & Palliative Care; by Colette A. McAfee, Derek Cegelka, Victoria R. Wagner-Greene, Amy Wotring; 1/26
This study examined predictors of ACP [advance care planning] behaviors among U.S. adults aged 18–35 (N = 614) using the Integrated Behavioral Model (IBM) and the Precaution Adoption Process Model (PAPM). ACP engagement was defined as completing a living will, designating a durable power of attorney for health care (DPAHC), and discussing wishes with a loved one. Most participants (68.6%) had not fully engaged in ACP. Regression analyses revealed that direct perceived norms, attitudes, and life experience with serious illness were significant predictors of intention to engage in ACP.  Personal or family experiences with life-threatening illness emerged as key motivators.

Palliative external beam radiation therapy for dysphagia in a 101-year-old man with esophageal adenocarcinoma
Cureus; by Pericles J. Ioannides, Jester M. Odrunia, Gina N. Perez, Morgan Butow, Georg A. Weidlich; 1/26
Esophageal adenocarcinoma in centenarians is rare, and treatment options in this age group are limited. We present the case of a 101-year-old male patient with symptomatic distal gastroesophageal junction (GEJ) adenocarcinoma who presented with progressive dysphagia, aspiration, and weight loss. The patient underwent palliative external beam radiation therapy (EBRT) ... targeting the obstructive esophageal mass with a margin using volumetric-modulated arc therapy (VMAT) technique. The treatment was well tolerated by the patient with no significant acute toxicity. After treatment, the patient reported clinically meaningful improvement in functional status, with improved swallowing, advancing from liquids to a soft diet, weight gain, and improved QoL. Moderate-dose palliative radiation can be a safe and effective treatment in a centenarian with obstructive GEJ adenocarcinoma, particularly when endoscopic interventions are not successful or durable.

Direct care nursing as a career destination-A qualitative exploration of why nurses stay
Nursing Management; by Leach, Catherine T., Whade, Jill J., Horvick, Savannah G.; 1/26
Intent to stay (ITS) is the best predictor of nurse turnover. Interventions aimed at combating turnover may be ineffective if they're developed without getting input from nurses to understand why they stay. A total of 18 clinical nurses were interviewed, and four major themes were identified: organizational culture, sense of belonging, leadership in action, and sustainability of bedside nursing. Conclusions: Integrating organizational culture, sense of belonging, leadership in action, and resources for direct care nursing will strengthen nurses' ITS and encourage nurses to pursue direct care nursing as a career destination.

Presence experiences after loss: Prevalence and relational meaning in a diverse urban sample
Omega; by Claire White, Anna Mathiassen, Ronald Fischer; 1/26
Presence experiences-the sense that a significant person who has died is nearby or perceptible-are common after bereavement but remain underexamined in grief research. This study ... [revealed that] ... over two-thirds of participants reported having ever experienced a presence, with nearly half reporting at least one occurrence in the past two weeks. These experiences were most commonly reported as a general feeling of presence, rated as both significant and welcome. Participants frequently interpreted encounters as meaningful attempts at contact and preferred disclosing these experiences to close social connections rather than institutional figures. These findings highlight presence experiences as common, relationally shaped, and culturally interpreted aspects of bereavement.

Difficult encounters: How to set boundaries in the context of structural inequities
Journal of Pain & Symptom Management; by Carrie C. Wu, Erik K. Fromme; 1/26
Difficult encounters between patients and clinicians impact all areas of medical care, yet how to manage them is not routinely taught in medical training. This paper presents a case of a patient with cancer who struggled with emotional outbursts and impulsive behaviors. In the context of the racial trauma and socioeconomic challenges that the patient also experienced, the team struggled with boundary setting. We will review both traditional and contemporary approaches to the management of difficult clinician-patient interactions, while also addressing some of the limitations of existing frameworks. We will explore the role of bias in boundary setting and make suggestions for individual-, team-, and system-level approaches.

Sociodemographic disparities and impact of palliative care utilization during end-of-life hospitalizations in patients with gastric cancer
Journal of Palliative Medicine; by James Lee, Jasmine Lee, Rahul Tripathi, David Stein, Ballakur Rao, Daniel Jamorabo, Lisa Fisher; 1/26
Gastric cancer is frequently diagnosed at an advanced stage and is associated with high symptom burden. Among 13,435 weighted hospitalizations [among gastric cancer patients who died during hospitalization] ... 57.6% received palliative care. Black patients had 32% lower odds of receiving palliative care than White patients ... Higher palliative care use was associated with greater income, large hospitals, urban teaching hospitals, and private/other insurance. In adjusted analyses, palliative care was linked to a $36,240 reduction in hospital charges ... with no significant difference in LOS [length of stay]. Palliative care was associated with higher odds of DNR status ... and lower odds of CPR, mechanical ventilation, transfusion, and vasopressor use.

The impact of religious and spiritual care on parents or caregivers in pediatrics: A scoping review
Journal of Health Care Chaplaincy; by Salvador Leavitt-Alcántara, Samantha Summers; 1/26
This scoping review examines the literature on the impact of spiritual and religious care on parents or guardians of children admitted to high acuity pediatric hospital units. Results reveal themes of positive impact of spiritual or religious care on several components of parents/caregivers' in the areas of emotional coping, grief and bereavement, positive parental perception of the impact of chaplains in high acuity settings, and outside spiritual/religious guidance and support during the medical decision-making process.

Assistive intelligence: A framework for AI-powered technologies across the dementia continuum
Journal of Ageing & Longevity; by Bijoyaa Mohapatra, Reza Ghaiumy Anaraky; 1/26
While traditional [dementia] care models often focus on symptom management in later stages, emerging artificial intelligence (AI) technologies offer new opportunities for proactive and personalized support across the dementia trajectory. This concept paper presents the Assistive Intelligence framework, which aligns AI-powered interventions with each stage of dementia: preclinical, mild, moderate, and severe. These are mapped across four core domains: cognition, mental health, physical health and independence, and caregiver support. We illustrate how AI applications, including generative AI, natural language processing, and sensor-based monitoring, can enable early detection, cognitive stimulation, emotional support, safe daily functioning, and reduced caregiver burden. The paper also addresses critical implementation considerations such as interoperability, usability, and scalability, and examines ethical challenges related to privacy, fairness, and explainability.

[Republic of Korea] P-1080. Multidrug-resistant organism status and its association with hospice use and end-of-life care patterns in patients with advanced cancer referred palliative care
Open Forum Infectious Diseases; by Jeong-Han Kim, Jiwon Yu, Ye Sul Jeung, Shin Hye Yoo, Jin-ah Sim, Bhumsuk Keam; 1/26
Multidrug-resistant organisms (MDRO) are increasingly prevalent and may contribute to more aggressive healthcare utilization near the end-of-life, particularly among patients with advanced cancer receiving palliative care (PC). MDRO status was associated with significantly lower use of community-based hospice care, including inpatient hospice ... and home hospice ... It was also linked to more frequent deaths in tertiary hospitals ... and higher intensive care unit admissions ... and renal replacement therapy ... Medical costs were consistently higher in the MDRO group across all end-of-life trajectory before death.

[China] Progress in research on alleviating the symptoms associated with advanced cancer using Traditional Chinese Medicine
Pain Research & Management; by Chunmeng Jiao, Ting Zhang, Yachen Yang, Ruofan Zhang, Wenbo Liu, Yanqing Wang, Lei Huang; 1/26
Advanced cancer continues to pose a substantial global challenge, with complex symptom burdens and limited therapeutic options. Traditional Chinese Medicine (TCM), grounded in holistic theory and the principles of syndrome differentiation, employs interventions such as herbal medicine, acupuncture, moxibustion, and acupoint‐based therapies to address both the malignancy and the patient’s overall functional status. Emerging evidence indicates that TCM may alleviate symptom clusters associated with advanced cancer, enhance quality of life, and potentially contribute to improved survival outcomes. This review synthesizes findings from the past decade on the role of TCM in advanced cancer care, with a focus on herbal decoctions, Chinese herbal injections, acupuncture—either alone or in combination with herbal therapy—moxibustion with adjuvant medication, and other external TCM modalities. Evidence is examined regarding their effects on cancer‐related pain, fatigue, gastrointestinal dysfunction, chemotherapy‐ and radiotherapy‐induced toxicities, and immune modulation.

Being loved by someone gives you strength while loving someone deeply gives you courage. ~ Lao Tzu