Literature Review

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.

Implementing the PAR scale in a pediatric concurrent care setting: A quality improvement projectJournal of Hospice & Palliative Nursing; by Taylor Ronne, Andrea Cahill, Kassidy Horst, Leeza Struwe, Kelly Gonzales; 6/26Pediatric patients in concurrent hospice and palliative care often face fragmented communication regarding family goals of care during acute hospitalizations. This quality improvement project evaluated clinician and care coordinator experiences with the implementation of the Preference for Acute Rehospitalization Scale at Children's Nebraska. A pre- and postimplementation survey design ...  assessed awareness of family goals, confidence in decision-making, and perceptions of the tool among an interdisciplinary team. While clinicians expressed general openness to standardized communication tools, results showed no statistically significant differences in survey items, highlighting that successful adoption in complex pediatric settings requires sustained education, seamless workflow integration, and robust interdisciplinary engagement to ensure treatment remains aligned with family preferences.

The effect of palliative care involvement in vascular patients at the end-of-lifeJournal of Vascular Surgery; by Angela McCarthy, Kristy Wrana, Emma Triantafyllou, Ya-Huei Li, Carol Strycharz, Lindsay Lynch, Edward D Gifford; 6/26Vascular surgeons frequently manage critically ill patients and support complex end-of-life decision-making. Despite well-documented benefits of palliative care in serious illness, prior studies report that only 25% of vascular patients near the end of life received such support. Those without a palliative consult were more likely to undergo a code (18.0% vs. 6.6% ... ). After palliative consultation, the proportion of patients with a code status of do-not-resuscitate increased from 50.0% to 77.4%, and the proportion with a full code designation decreased from 50% to 22.6%  ... Patients with the goal of care to allow natural death increased to more than half of the patients from 18.4% after the palliative consultation ... These findings highlight an opportunity for vascular surgeons to proactively integrate palliative care, improving alignment between clinical interventions and patient preferences.

[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.

How would hospice use differ if every Medicare beneficiary were in Medicare Advantage?Journal of Palliative Medicine; by Claire K Ankuda, Karen McKendrick, Melissa Aldridge; 6/26Hospice use is higher in the growing Medicare Advantage (MA) program compared to Traditional Medicare (TM). It is uncertain if this is due to different hospice referral patterns. Among 5153 decedents, 35.3% were in MA at death. Compared to TM decedents, MA decedents were younger, more likely to be Hispanic, less likely to reside in a facility, and less likely to report serious illnesses (dementia, cancer, stroke, heart disease, and lung disease). We estimated that if TM decedents had been enrolled in MA, hospice use would have been 6.1% higher ... This difference was pronounced among those with higher education and serious illnesses in TM: for example, 10.1% higher for those with dementia ... versus without dementia ...

Nursing philosophy: What it is and why it matters in BSN education Nevada State University; by RN to BSN; 7/23/26... A nursing philosophy is a personal statement of the values and motivations that guide a nurse’s practice. It is not a job description or a list of clinical competencies; rather, it is a reflection of what nursing means to the individual practitioner and how that meaning informs the way they show up at work. A well-developed philosophy of nursing typically addresses several core areas:

Sterling Hospice home to close, expected to reopen under new ownership KWQC-6, Sterling, IL; by KWQC Staff; 7/22/26 The Rock River Hospice & Home is closing Aug.1, officials announced Wednesday. The organization, which has been serving people throughout the Sauk Valley area for over 40 years, is closing due to longstanding financial challenges, officials said in a media release. “Changes in healthcare reimbursement, increasing operating costs, and other economic pressures have made it increasingly difficult for standalone hospice providers to remain financially sustainable,” officials said. However, officials said care will continue to be available in the community. 

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.

Minnesota’s first dual-certified green burial funeral home opens News.net, PR Quantum, Saint Paul, MN; by Mueller Memorial; 7/22/26Interra Green Burial has become the first funeral home in Minnesota to earn certification from both the Green Burial Council and the National Funeral Directors Association. The milestone reflects the funeral home’s focus on environmental sustainability and its role in expanding eco-friendly funeral choices for families in the Minneapolis/St. Paul area. The dual certification signals a meaningful commitment to offering end-of-life services that align with values of environmental stewardship. Green Burial Council certification is granted to funeral homes that satisfy rigorous standards for environmentally responsible operations. Requirements include the use of biodegradable materials, participation in carbon offset programs, and the adoption of sustainable practices at every stage of the funeral process.