Literature Review

Home health patients, caregivers lack understanding of palliative care, researchers find McKnights Long-Term Care News; by Adam Healy; 2/25/25 Home healthcare patients, caregivers and clinicians have significant knowledge gaps surrounding palliative care, which are contributing to poorer health outcomes for sick patients, according to a new study published in Home Healthcare Now. ... Healthcare providers, including home care agencies, are partially responsible for this limited public awareness, according to the researchers. The majority of survey participants agreed that it is the responsibility of doctors and nurse practitioners to inform seriously ill patients about palliative care. However, Medicare policy may be at the heart of this issue, Ashley Chastain, the study’s lead author, said.

Forget perks—leadership starts with asking employees what they need Forbes; by Benjamin Laker; 2/25/25 Employee well-being isn’t just a perk—it’s a business imperative. As organizations struggle with high turnover, burnout, and shifting workforce expectations, leaders must rethink how they engage and support employees. Research consistently shows that investing in well-being leads to measurable gains in productivity, retention, and performance. A recent study published by BMJ Leader examined how a structured, data-driven approach to improving workplace culture can yield transformative results—using the well-being initiative at Royal Free Hospital as a case study. ... The program, which was the focus of the BMJ Leader study, incorporated systematic conversations based on the Joy in Work Framework, identifying key challenges and implementing targeted solutions. Following implementation, workplace satisfaction surged by 76%, highlighting the significant impact of addressing staff concerns directly. Employees became more engaged in organizational initiatives, fostering a culture of active participation rather than passive compliance. 

Palliative care’s most disruptive forces in 2025 Hospice News; by Holly Vossel; 2/25/25 Palliative care providers are taking varied routes to address the most disruptive forces they are encountering this year, rising to challenges that have been persistent across the sector. Mounting workforce pressures mark the most significant of concerns for palliative care providers, according to Dr. Martha Twaddle, The Waud Family Medical Directorship’s palliative medicine and supportive care clinical professor of medicine at Northwestern Medicine. The nation lacks a sufficient supply of palliative care professionals amid a swelling population of seriously ill patients, driving up demand. Current reimbursement streams are challenging the staffing issues even further, Twaddle stated. ... Workforce shortages and lack of sustainable reimbursement are indeed the largest obstacles to palliative care growth, according to Center to Advance Palliative Care (CAPC) CEO Brynn Bowman.

WesleyLife at Home expands services with palliative program Hospice News; by Kristin Easterling; 2/26/25 Des Moines, Iowa-based WesleyLife at Home has launched the area’s first home-based palliative care program. The organization is the fourth-largest home health provider in the state, according to Aaron Wheeler, vice president of home and community-based services. While analyzing their home health census, the organization identified a significant number of patients with chronic medical conditions who required an additional level of care.

‘Global problem’: Numerous factors, biases contribute to overtreatment at end of life Healio; by Josh Friedman; 2/26/25 Nathan I. Cherny, MD, has worked all around the world. At every stop — from Australia to Israel, and Memorial Sloan Kettering Cancer Center in between — he has seen people with cancer receive overly aggressive treatment at the end of life. ... In a review published in ESMO Open, Cherny and a cohort of multinational colleagues highlighted numerous reasons why overtreatment occurs among patients approaching the end of life, ... They listed more than 20 contributing factors, including desire for control of the cancer, denial and anger, family pressure and hope preservation. The two factors that contribute most to overtreatment are optimism bias and the “counterphobic determination to treat,” which involves clinicians having a difficult time introducing the suggestion of palliative care revert to offering further treatments, Cherny said. ... Responsibility for decisions does not need to fall solely on oncologists, Cherny added. Palliative care physicians, social workers, chaplains and others can be part of a team to assist patients with their choices. ... The number of patients who are overtreated differs at each institution. “Each institution has its own culture of care,” Cherny said. Editor's note: This article puts forth significant insights for all palliative and hospice clinicians, interdisciplinary teams, and palliative/hospice executive leaders. Apply Cherny's to your referral sources: "Each institution has its own culture of care." Apply these findings to your own palliative and hospice services. 

North Texas doctor helps parents facing infant loss deal with the unimaginableCBS News - Texas; by Andrea Lucia, Lexi Salazar, Katie Standing; 2/25/25[Background story for parents Yvette and Thoms Ngo upon dealing with the news that their in-utero baby girl Zoe was diagnosed with Trisomy 13, would likely miscarry, or die soon after birth. Dr. Terri Weinman, their neonatologist offered rich palliative care interventions and support.] "When we met Dr. Weinman and her team the first time, she would say things like, 'So, what are we going to do when Zoey is here,' which changed my mindset completely," Yvette Ngo said. ... For the first time, the Ngos began to consider what Zoey's life, short as it might be, could look like. "It made us more comfortable with the situation, I mean as comfortable as you can be," Thomas Ngo said. "She just gave us hope." Zoey was born on April 18, 2024. She met her parents, her siblings and her grandparents. She was baptized. "They made us little crafts and mementos for us to take home, like footprints, really ways to help cherish Zoey's life," Yvette Ngo said. "They took her heartbeat and recorded it for us. Little things that we wouldn't necessarily think of." Zoey even had a chance to go home. But after 36 hours of life, Zoey passed away in her father's arms. The perinatal palliative care Zoey received remains rare. But for families like the Ngos, it provides a small sense of control when it's needed most. "Being able to plan so much in advance and think about all the different scenarios and how we wanted it," Yvette Ngo said. " I think, looking back on our time with Zoey..." "We wouldn't have done anything differently," Thomas Ngo said. Editor's note: Pair this with "Improving knowledge, confidence, and skills in perinatal bereavement care through simulation in baccalaureate nursing students," posted 2/24/25.

Keeping cool when debate turns hot: Inaugural global Ethics Center conference features scholarship, presentations on fostering civil, productive dialogue The Harvard Gazette; by Christy DeSmith; 2/24/25 Americans today are wrestling with how to turn down the heat when discussing politically and morally charged topics. Students, professors, and education professionals from around the globe assembled at Harvard this month to chart their way to more productive discussions — and better relations. The inaugural Challenging Barriers to Civil Discourse conference, hosted by the Edmond and Lily Safra Center for Ethics, featured scholarship on fostering open, honest exchanges across deep divides. ... [Dr. Julia] Kolak told of mediating clashes that arose ... when the family of a critically ill patient ... resisted end-of-life care. She works to unearth the principles guiding all parties, without elevating those with medical expertise. “When we treat others as capable of dialogue,” she offered, “it really changes the affective grip of conflict. ... [Jeffrey Dunn] raised the critical question: “What is the long-term goal of this work?” ...

ONA Leadership Column: The next level State Nurses Associations - Oklahoma Nurses Association; by Dean Prentice, DHA, MA, BSN; 2/24/25 What is it going to take to raise the leadership ability of your staff to the next level? One of the many roles you play for your staff is encouraging their professional development. ... The future of nursing will require a well-rounded skill set that goes beyond traditional clinical training. Emotional intelligence, cultural competence, data-driven decision-making, ethical leadership, and resilience are all critical to meeting the challenges of tomorrow’s healthcare landscape. By developing these skills, nurses will not only improve patient outcomes but will also contribute to the evolution of the nursing profession, ensuring it remains relevant, compassionate, and effective in an increasingly complex world. 

Candice Bergen’s caregiving journey and how estate planning can help FindLaw; by Catherine Hodder, Esq.; 2/20/25 Candice Bergen is a movie and television star and comedienne best known for her role as Murphy Brown. ... Bergen’s husband of over 20 years, Marshall Rose, recently passed after battling Parkinson’s disease. Her first husband, director Louis Malle, died from lymphoma. In Bergen’s memoir “A Fine Romance,” she describes the struggle of caregiving for someone who is critically ill. She writes, “It really costs you to take care of someone who is critically ill day after day.” Many caregivers can relate. According to the NIH, 50 million people care for a disabled, older adult, or chronically ill family member or friend. ... However, there are estate planning tools available that can help caregivers manage the health and support of their critically ill loved ones. ... 

[Korea] 9 in 10 Koreans support ending life-prolonging treatment: study The Korea Times; by Kim Hyun-bin; 2/24/25 More than nine out of ten Koreans think that they would opt to forgo life-prolonging treatment if they were terminally ill, a new study has found, highlighting shifting attitudes toward end-of-life care in the country. According to a report released by the Korea Institute for Health and Social Affairs on Sunday, 91.9 percent of respondents expressed they would choose to discontinue life-sustaining treatment if they were diagnosed with a terminal illness or were nearing the end of life, based on a survey conducted last April and May on 1,021 men and women. 8.1 percent stated they would prefer to continue such treatment.

Relaxing licensing, training requirements during pandemic didn’t improve nursing home staffing: study McKnights Long-Term Care News; by Zee Johnson; 2/24/25 A new study of more than 15,000 nursing homes found no link between relaxed certified nurse aide training and licensing protocols during the pandemic and improved staffing levels. During COVID-19, 19 states loosened their training requirements (the “treatment” group), and 31 states did not (“control” group). However, both recorded nearly the same CNA hours per resident per day, according to the study by researchers at the University of Iowa. ... During the pandemic, direct caregivers were at extreme risk for contracting the deadly virus, which killed more than 200,000 nursing home residents and workers. But more often than not, they were left without basic benefits such as paid sick leave, Mehboob said. 

Daughter indicted for killing mother with morphine in Evans The Augusta Press, Augusta, GA; by Greg Rickabaugh; 2/25/25The daughter of a woman who died in an Evans assisted living home from a fatal dose of morphine has been indicted for malice murder. Rachel Elaine Waters, 41, is expected to surrender this week on murder charges in the death of 74-year-old Marsha Sprayberry Foster, according to Columbia County authorities.An indictment says that Waters administered a lethal dose of morphine on July 12, 2023, while her mother was at the Marshall Pines assisted living on North Belair Road. The cause of death was determined in an autopsy, showing that excessive use of the unprescribed morphine was the reason for her death. Foster had Alzheimer’s disease, and the morphine was reportedly left behind by hospice workers and used by the daughter without authorization.