Literature Review

“I wish to be in the same room as my wife so I can hold her hand”: CalvertHealth grants husband’s final wishThe Baynet, Calvert County, MD; by CalvertHealth; 7/19/26 It was one final wish Phillip “Phil” Pfanschmidt shared after learning he had terminal cancer. Just days earlier, his wife of more than 66 years, Joyce “Joy” Pfanschmidt, had entered hospice care at CalvertHealth Medical Center. Now, Phil had entered hospice as well. When members of the palliative care team asked about his wishes, he didn’t hesitate. He wanted to be with Joy.Caregivers across CalvertHealth worked together to make that wish a reality. Phil was reunited with Joy, and the couple spent precious moments together, hand in hand. Less than two hours later, Joy peacefully passed away with her hand resting on Phil’s arm. ...In his autobiography, Born to Live, Phil reflected on what mattered most. “For the last 64 years [as of 2024], every morning when I wake up and every evening before I go to sleep, I give thanks for the woman sleeping beside me.” ... Phil passed away on Friday, July 10, just nine days after Joy.

Toward home cancer care—Reducing time toxicity for the right patients with prostate cancerJAMA Network Open; by David-Dan Nguyen, Bruce L. Jacobs; 6/26Cancer care imposes a substantial burden, not only through the diagnosis itself and treatment-related adverse effects but also through the time spent traveling to appointments, waiting, and receiving care. Even in advanced stages of prostate cancer, many patients live for years with a chronic disease trajectory that requires ongoing monitoring, repeated visits, and long-term systemic therapy. Bange and colleagues ask whether some of this burden can be alleviated by moving elements of care from the cancer center into patients’ homes through an enhanced telehealth model for patients receiving androgen deprivation therapy. Their intervention is distinctive in combining several strategies that have individually shown promise, including paired telehealth visits with home-based phlebotomy, remote blood pressure monitoring, and at-home injections. Their central finding is encouraging: this model appeared both feasible and highly acceptable to patients and clinicians.

When technology meets its limits: Integrating Medical Aid in Dying with withdrawal of a left ventricular assist deviceCureus; by Yvette Vieira, Paola Reveco; 6/26As outcomes improve and patients [with advanced heart failure] live longer with [surgically implanted left ventricular assist devices], ... clinicians across disciplines are increasingly confronted with the complex clinical, ethical, and practical challenges that arise when life-sustaining therapy is dependent on implanted technology, particularly in the context of end-of-life decision-making. We present a case report of a 76-year-old man with advanced heart failure supported by an implanted cardiac pump [who wanted to pursue] ... medical aid in dying ... [in his own home] ... Deactivating a cardiac assist pump typically occurs in a hospital with intravenous sedation for the abrupt heart failure symptoms that can occur when the pump is turned off. An end-of-life care navigator and a carefully assembled interdisciplinary team providing medical aid in dying in conjunction with pump deactivation achieved the patient’s home death at his selected date. Coordinating implanted cardiac device withdrawal with medical aid in dying is clinically achievable, ethically defensible, and legally sound. Healthcare systems must develop written protocols, train hospice providers, provide anticipatory counseling, fund necessary infrastructure, and support this end-of-life care.

Caring with confidence: A guided approach to end-of-life careJournal of Pain & Symptom Management; Laura Maldoon, Stacy L. Nilsen; 6/26Nurses may face uncertainty when caring for dying patients due to inadequate education and experience. This uncertainty coupled with varying practices for end-of-life care may affect both care quality and nurses’ attitudes. In nurses caring for hospitalized End-of-Life patients, does having a guided End-of-Life template and care resources, compared to current practices, improve registered nurse attitudes in providing individualized end-of-life care? Two inpatient nursing units received a 30-minute End-of-Life educational intervention utilizing the City of Hope’s Comfort, Airway, Restlessness and Delirium, Emotional and Spiritual Support (CARES) toolset as a standard resource to assess and prioritize end-of-life symptom management and family communication. This project suggests improved comfort and confidence among RNs in providing end-of-life care with the use of the CARES toolset. Nurses also demonstrated increased interest in seeking additional education.

Exploring the relationship between usage of a digital mindfulness app and perceived stress among caregivers of persons living with dementiaAging & Mental Health; by Michael P. Williams, Morgan Seward, Elizabeth M. Allen, Raquel G. Tatar, Darby M. Simon, Jennifer Huberty, Ana-Maria Vranceanu, Evan Plys; 6/26Mindfulness digital health interventions (DHIs) can support stress management among caregivers of persons living with dementia (PLWD), yet few studies investigate dose-response relationships. This study is a secondary analysis of a feasibility randomized controlled trial of Healthy Minds Program for Caregivers (HMP-C), a mindfulness DHI to reduce stress among caregivers of PLWD, against an educational podcast control (Wellness App [WA]). Participants were instructed to use HMP-C or WA 10 min per day. Every 10 min of HMP-C usage per week was significantly associated with a decrease in perceived stress by 0.7 ... Higher baseline stress and anxiety were related to lowered usage in active control ... , but not in HMP-C.

[Italy] Fever in a palliative care setting: Clinical insights and implications from a prospective observational cohort studyPalliative Medicine; by Stefania Cheli, Elena Angeli, Oscar Corli, Sofia Dinegro, Agostino Zambelli, Tania Carta, Romina Shazivari, Michaela Smolikova, Paolo Franceschi, Francesco Molà, Yara Silva Cruzeiro, Emilio Clementi, Andrea Gori; 5/26Fever is a frequent but complex symptom in adults with a limited prognosis, arising from multifactorial causes beyond infection. The study was conducted in an inpatient hospice palliative care unit within the Luigi Sacco Hospital in Milan, Italy (January and December 2024). Fever occurred in 40% of patients, with a median onset of 5.5 days after admission. In 39.7% of cases, fever was attributed to infections, mainly catheter-associated urinary tract infection. Its strong association with medical devices highlights the need for proportional, personalised interventions that primarily consider prognosis, symptom relief, and quality of life.

Saturday newsletters focus on headlines and research - enjoy!

Ah, summer--what power you have to make us suffer and like it. ~ Russell Baker

700 rural hospitals at risk of closing, by state Becker's Hospital Review; by Madeline Scheetz; 7/22/26 Seven hundred rural hospitals across the U.S., or about one-third of all rural facilities in the country, are at risk of closing due to severe financial challenges, according to a July 21 Center for Healthcare Quality and Payment Reform analysis. The analysis comprises 264 hospitals that are at immediate risk of closure, according to the report. In almost every state, rural hospitals are at risk of closure. In most states, more than 25% of rural hospitals are at risk and in 11 states, 50% or more are at risk. ... More than 100 rural U.S. hospitals have closed in the past decade, with 110 closing since 2015, according to the report. Fifty-three hospitals have ended inpatient services since the beginning of 2023 to qualify for federal grants only available to rural emergency hospitals.

Only one in five U.S. young adults with advanced cancer receive palliative care as part of treatment, study shows American Cancer Society, Atlanta, GA; Press Release; 7/23/26 Young adults with advanced cancer face unique challenges that make palliative care especially important. This population often experiences physical, emotional, and social needs while undergoing treatment, related to their developmental and life-stage transitions. However, a new study by researchers at the American Cancer Society (ACS) reveals that despite a small increase in use over time, only 18.3% of young adults in the United States with advanced cancer received palliative care as part of treatment in 2023. The study is published today in the Journal of the American Medical Association (JAMA) Network Open.