Literature Review

“I’m as mad as hell and I’m not going to take this anymore!”JAMA Neurology; David N. Korones, MD; 4/25So shouted news broadcaster Howard Beale in the iconic 1976 film “Network” as he decried pollution, unemployment, inflation, crime, and all that was wrong in the world back then. And so shouted I, as I slammed down the phone after yet another denial from an insurance company—this time denial of treatment for an 8-year-old little girl with a brain tumor.Every day the phone, email, and text messages mount: an antinausea medication is not approved, oral chemotherapy is denied to a child because it is in liquid form, and only tablets are approved, brain surgery is denied because the patient has the misfortune of not living in the same state as the neurosurgeon who has the unique skill set to remove it, an insurance company that had previously approved an essential therapy for one of my patients now, for inexplicable reasons, denies refills half way through her prescribed course of treatment. Perhaps the more we push back, send them bills for our time, follow that up with bill collectors, call our congressional representatives, and summon our hospital leadership, we can gather a chorus of physicians, patients, hospital leaders, and politicians who all open their windows and, following Howard Beale’s lead, scream in unison that they, too, are mad as hell, and it is long past time to change this unjust system of care. To paraphrase Howard Beale, “our children, our patients are human beings, goddammit, their lives have value!”

The pharmacology of aid in dying: From database analyses to evidence-based best practicesJournal of Palliative Medicine; by Patrick Macmillan, Susan Hughes, Angelique Loscar, Lonny Shavelson; 4/25We investigated the efficacy of four commonly used aid-in-dying medication protocols-using the time to sleep and time to death as proxies for efficacy. This first-time analysis of aid-in-dying medication protocols showed that while a sedative alone had the best median time to death, the most recent sedative/cardiotoxin protocol had an acceptable median time to death of 0.8 hours, but with fewer prolonged-death outliers.

Drivers of palliative care and hospice use among patients with advanced lung cancerCancer Medicine; by Megan C Edmonds, Melissa Mazor, Mayuri Jain, Lihua Li, Marsha Augustin, José Morillo, Olivia S Allen, Amina Avril, Juan P Wisnivesky, Cardinale B Smith; 1/25Despite rigorous evidence of improved quality of life and longer survival, disparities in the utilization of palliative and hospice care persist for racial and ethnic minority patients with cancer. This study evaluated the impact of psychosocial factors on utilization of these services. Minority patients with advanced lung cancer were more likely to receive a palliative care referral and specialty level consultation when compared to non-minority patients. Our work highlights the importance of proactive referral processes in facilitating access to palliative and hospice services, particularly among younger patients.

Top ten tips palliative care clinicians should know about diagnosing, categorizing, and addressing fatigueJournal of Palliative Medicine; by Gregg A Robbins-Welty, Danielle Chammas, Ethan J Silverman, Maria Felton Lowry, Elizabeth Hale, Corina Martinez, Morgan M Nakatani, Daniel Shalev, Paul Noufi, Paul A Riordan, Keri O Brenner, William E Rosa, Christopher A Jones; 3/25Fatigue is a multifactorial symptom that is commonly faced by patients with cancer, chronic disease, and other serious illnesses. Fatigue causes suffering across biopsychosocial domains and affects patients and their loved ones. In this article, a consortium of professionals across cancer care, physical therapy, exercise, pharmacy, psychiatry, and palliative medicine offers tips and insights on evaluating, categorizing, and addressing fatigue in the setting of serious illness. The comprehensive approach to managing fatigue underscores the importance of collaborative efforts characteristic of interdisciplinary palliative care. Prioritizing screening, diagnosing, and treating fatigue is crucial for enhancing patients' and families' overall quality of life.

Advancing the primary palliative workforce: Pilot results of the Educating Social Workers in Palliative and End-of-Life Care (ESPEC) self-study programJournal of Palliative Medicine; Myra Glajchen, Cathy Berkman, Shirley Otis-Green, Russell K Portenoy; 4/25Health social workers caring for the seriously ill may lack preparation in the primary palliative skills needed for this complex task. An evidence-based, nationally scalable, multimodality training program-Educating Social Workers in Palliative and End-of-Life Care (ESPEC)-was developed to address the training needs of health social workers. Prior to completing the online training, 21.6%-50.0% of participants rated themselves as "very confident" in the clinical practice skills central to the role of the social worker in serious illness care. After completing the modules, 58.8%-81.4% rated themselves as "very confident" in both clinical and professional skills, with significant changes in nine clinical practices and four professional practices. This pilot supports the feasibility, acceptability, and educational potential of the ESPEC self-study training in increasing confidence in key practices of primary palliative care for health social workers.

Systemic functioning of Puerto Rican families with a cancer patient: A qualitative-oriented mixed-methods studyJournal of Health Psychology; Nicole M. Vélez Agosto; 4/25Puerto Ricans are part of marginalized communities that are impacted by health disparities, such as lifestyles, health behaviors and access to care (Simmons et al., 2011). The purpose of study was to assess systemic functioning in Puerto Rican families with a cancer patient using the Spanish translated version of the Family Genogram Interview (FGI) that measures Bowen’s four emotional processes in nuclear family and family of origin. Results suggested an acceptable reliability for the FGI-Spanish and higher presence of symptoms in a spouse or partner, symptoms in family of origin, focus on a child and emotional cutoff in family of origin. Qualitative findings suggested that main concerns for participants were related to family changes surrounding illness and familial roles, consistent with Bowen’s theory and clinical implications for designing systemic interventions for Puerto Rican families.

Video: Holes and Wholeness - Mother's Day 2025, Finding peace in the pieces, Wholeness in the holes Composing Life Out of Loss; by Joy Berger; 2018, updated 5/8/25Holidays, birthdays and anniversaries. They’re supposed to bring celebration, fun, food, gifts, rituals, and rich meanings. But, when our loved one is seriously ill, or has died, these same days of joy can become … holes of grief. It's already hard enough, but with the holidays,  we fear that emotions will flood us, that memories will trigger us, like ...                                                                                                                                                                                                                                    

How to survive Mother’s Day when your mom is gone Psychology Today - Dementia; by Deborah Carr, PhD; 5/8/25 ... By age 50, about half of us have mourned the death of our mother. More than 4 million older women in the U.S. have dementia, and most have children who are witnessing their cognitive declines. Whether your mother has died or slipped into the grip of late-stage dementia, Mother's Day can be hard, although the sharp pangs of sadness tend to fade with time after a mom's death. So, how do you survive Mother’s Day when your mom isn't here to celebrate with you?

Becoming time rich with physician moms: Sarah Wittry [hospice] and Nicole Perrotte MarketScale - Ripple of Change; by Todd Otten; 7/30/24  In today’s high-stress healthcare environment, physician mothers face the formidable challenge of balancing demanding careers with their personal lives. The conversation on work-life balance is more relevant than ever, with more women in medicine seeking ways to manage these dual responsibilities effectively. How can physician moms navigate this landscape to reclaim time for themselves without guilt? What strategies can physician moms employ to achieve a healthier work-life balance? This pressing question lies at the heart of today’s discussion on the Ripple of Change podcast. ... Key points of discussion:

We prepare for Mother's Day with today's Special Edition, giving you time to reflect on and share articles with others before Sunday. 

Listen to what your mother tells you, especially near the end News+ Membership; by Jerry Davich; 5/7/25If your mother is no longer alive, what were her last words to you? My mom passed away two years ago and I’ve been asking myself this question since her last breath, which took place in my presence. I had just placed a yellow tulip next to her pillow on a bed inside her hospice room. It was an early Mother’s Day gift, continuing a tradition I started as a child with a stolen tulip from a neighbor’s yard. I knew my mother would not be around a month later for her special holiday. In fact, she wouldn’t be around just a minute later. While pondering that stolen moment, I looked over to my mom and noticed her left index finger moving. It was just a twitch, but until that time she had made no movements since she was admitted into a local hospice near my home. ...... Though I can’t recall my mom’s final words, I deeply feel her lasting legacy of love for my family. We continue to talk about her every day. We think of her every moment. We share photos and memories of her on a family group text thread. Some make us laugh. Some make us cry. This is the beauty and the heartbreak of losing a mother or a father. My mom may be gone, but her gentle voice can be heard in my head any time I want or need it. ...

HOSPICE: Children’s book written by Manheim Township mother finally published 3 years after she died of cancer LNP Lancaster Online, Lancaster, PA; by John Walk; 1/27/25  As she battled a rare sarcoma cancer over the last two years of her life, Manheim Township resident Ginny McCreary struggled to find a children’s book she could read to her two young daughters to help them better understand what she was going through. So McCreary wrote the book herself, sometimes on a smartphone while laying in bed late at night, ... McCreary died Aug. 15, 2021. She was 34. She left behind a self-published manuscript of the children’s book that sat idle for about two years but was not forgotten. ... The book has also made its way inside four Hospice & Community Care locations in Lancaster as well as Penn Medicine’s Ann B. Barshinger Cancer Institute in East Hempfield Township. [Video with Ginny's mother] "I'd love to get it to some cancer centers and hospice centers ..."