Literature Review

“I Don’t Know What to Say”-A multimodal educational and environmental intervention to improve bedside nursing communication at end of lifeJournal of Hospice & Palliative Nursing; Wolownik, Gregory DNP, AGPCNP-BC, ACHPN; Wholihan, Dorothy DNP, AGPCNP-BC, ACHPN, FPCN, FAAN; 4/25... research shows inpatient medical-surgical nurses are not adequately trained to deliver end-of-life (EOL) care. This lack of foundational learning leads to gaps when communicating with patients and families and negatively impacts quality of care. A literature review and staff interviews identified barriers to communication, such as lack of formal education and experience; personal, cultural, and emotional challenges; and high workload. A multimodal intervention focusing on improving staff nurse communication skills was designed ...[including] environmental cues, engaging pocket cards, and an education module on communication techniques. Nurses demonstrated increased confidence and competence immediately following the education session, enduring at 4 weeks. Innovative, clinically relevant interventions can positively impact communication skills without requiring increased time commitments or high cost.

Antimicrobials in serious illness and end-of-life care: Lifting the veil of silenceThe Lancet. Infectious Diseases; William E Rosa, Shila Pandey, Renee Wisniewski, Craig Blinderman, Mark Wing Loong Cheong, Juan Esteban Correa-Morales, Diego Alejandro Cubides-Diaz, Sharif Folorunso, Nahla Gafer, Mohja Marhoom, Tiffanny Newman, Christian Ntizimira, Temitope Oyewole Obadare, Cihan Papan, Pedro Emilio Pérez-Cruz, Lukas Radbruch, Giri Shan Rajahram, Tomás Alejandro Reyes-Barros, Naveen Salins, Kavitha Saravu, Donald R Sullivan, Edward Christopher Dee; 3/25Global rates of antimicrobial consumption increased by 65% between 2000 and 2015, by 16% between 2016 and 2023, and are estimated to increase by an additional 52% by 2030. Antimicrobial use and misuse remains high among people with serious illness and at end of life, despite scarce evidence of benefit. In addition, the overuse and misuse of antimicrobials at end of life further exacerbate antimicrobial resistance, which is a substantial public and global health concern. These examples are combined with a case of non-beneficial end-of-life antimicrobial use and clinical guidance for patient and family communication regarding antimicrobial treatment. This Personal View also provides recommendations to improve antimicrobial stewardship with the goal of engaging multidisciplinary stakeholders and decreasing inappropriate antimicrobial use at end of life.

You’ve got a friendtor in me: Innovations in peer mentoring for mid-career palliative care cliniciansAmerican Journal of Hospice and Palliative Medicine; April Zehm, MD; Andrew J. Lawton, MD; Leah B. Rosenberg, MD; Sudha Natarajan, PhD, MSN; Bethany-Rose Daubman, MD; 3/25 Mentoring is crucial to professional success, but little is known about the professional development needs of mid-career hospice and palliative medicine (HPM) clinicians. An interprofessional “friendtor” group of five HPM clinicians from three academic medical centers met monthly and for a year-end focus group. Several themes emerged that highlight the importance of peer support when navigating major life decisions, boundary-setting, and non-clinical practice challenges, celebrating friendtors’ personal and professional milestones, and having a productive space for shared academic pursuits. Given the challenges and vulnerabilities the field of HPM is experiencing with workforce sustainability and burnout, the importance of developing supports outside of traditional mentorship paradigms is a valuable area of focus. Our work suggests that a friendtorship model may be an effective tool for sustaining mid-career HPM clinicians.

[Canada] Care utilization patterns among patients dying with advanced chronic obstructive pulmonary diseaseCanadian Journal of Respiratory, Critical Care, and Sleep Medicine; Aleisha Fernandes, Shuaib Hafid, Anastasia Gayowsky, Tetyana Kendzerska, Aaron Jones, Erin Gallagher, Colleen Webber, James Downar, Sophie Corriveau, Douglas G. Manuel, Sunita Mulpuru, David Da Silva-Krul, Amy Hsu, Peter Tanuseputro, Sarina R. Isenberg, Michelle Howard; 3/25Despite primary care providing majority of outpatient care, inpatient utilization is higher amongst patients who are notaccessing PC [palliative care]. These patients are also more likely to die in an acute setting. This study provides insight into the proportion of care patients are being provided from different specialties as well as the distribution of end-of-life outcomes amongst these patterns of care. Future research will benefit from exploring the association between these different patterns and end-of-life outcomes to identify the most optimal care pattern for improving end-of-life outcomes for patients with ACOPD [advanced chronic obstructive pulmonary disease].

RCT of PC in EDGeriPal podcast; by Eric Widera, Alex Smith, Corita Grudzen, Fernanda Bellolio, Tammie Quest; 4/10/25Today we focus on an intervention, published in JAMA, that gave emergency clinicians basic palliative care knowledge, training, and skills. We talk with Corita Grudzen and Fernanda Bellolio about their cluster stepped wedge randomized trial of a palliative care intervention directed at emergency clinicians... We are fortunate to have Tammie Quest, emergency and palliative trained and long a leader in this space, to help us unpack and contextualize these findings.

Stroke deaths and their racial disparities increased over last 20 years EurekAlert! - American Association for the Advancement of Science (AAAS); by Peer Review Publication; 4/9/25 Over the last two decades, ischemic stroke mortality rates in the U.S. have grown, with almost 3 in 10 deaths occurring at home, and increases particularly among racial minorities and rural residents. These growing disparities were among the findings of a new study publishing April 9, 2025, in the open-access journal PLOS One by Jason Lim of Georgetown University School of Medicine, U.S., and colleagues. ...  The analysis included 237,617 recorded ischemic stroke deaths. The study found that age-adjusted ischemic stroke mortality rates, after years of decline, have increased across all urbanization levels since 2009, with the most pronounced rises in non-metropolitan areas. Additionally, there has been a noticeable shift in the place of death, with more people dying at home instead of in hospitals or other medical facilities. From 1999 to 2020, the percentage of at-home deaths increased from 8.44% to 29.31%.Editor's note: Pair this research with ongoing shut-downs of rural hospitals, rural emergency room access, and more. This ongoing increase is one of many, ongoing alarms. Ethics. Integrity. Mission. It's past time to improve patient care.

Doctors are getting creative with artificial intelligenceMedscape; by Tatum Anderson; 4/7/25Artificial intelligence (AI) is becoming more embedded in the work life of some physicians who are taking the initiative to test its use in various scenarios. “I use [generative AI] all the time,” Mohamed Elsabbagh, MBBCh, endocrinology consultant with Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, England, told Medscape Medical News. “I’m a big fan of it, and it has helped me a lot to find papers, summarize guidelines, or compare protocols.” Mohammad Abdalmohsen, MBBS, a lung cancer fellow at Oxford University Hospitals NHS Foundation Trust, told Medscape Medical News that he also uses generative AI, like ChatGPT, often. “If you give it very specific questions, it comes up with great answers. I just asked ChatGPT for a protocol that I couldn’t find, and it got it for me in 5 seconds.”

Why cameras are popping up in eldercare facilities The New York Times; by Paula Span; 4/7/25 Roughly 20 states now have laws permitting families to place cameras in the rooms of loved ones. Facility operators are often opposed. ... The assisted-living facility in Edina, Minn., where Jean H. Peters and her siblings moved their mother in 2011, looked lovely. “But then you start uncovering things,” Ms. Peters said. Her mother, Jackie Hourigan, widowed and developing memory problems at 82, too often was still in bed when her children came to see her in mid-morning. So Ms. Peters bought an inexpensive camera at Best Buy. She and her sisters installed it atop the refrigerator in her mother’s apartment, ... Monitoring from an app on their phones, the family saw Ms. Hourigan going hours without being changed. They saw and heard an aide loudly berating her and handling her roughly as she helped her dress. ... Though they remain a contentious subject, cameras in care facilities are gaining ground. By 2020, eight states had joined Minnesota in enacting laws allowing them, according to the National Consumer Voice for Quality Long-Term Care: Illinois, Kansas, Louisiana, Missouri, New Mexico, Oklahoma, Texas and Washington. [Continue reading ...]

VNA Hospice NWI celebrates some of its most dedicated volunteers at Volunteer Appreciation Breakfast NWI.LIFE, Valparaiso, IN; by Philip Bolton; 4/7/25 On the morning of Saturday, April 5, VNA Hospice of Northwest Indiana hosted its annual Volunteer Appreciation Breakfast at Christ Lutheran Church in Valparaiso. Volunteers who assist with VNA’s many services, including hospice and palliative care, the Medical Guardian help button program, the We Honor Veterans program, the Phoenix Center for Grief, and VNA Meals on Wheels of Porter County, were recognized. ... Matthew Naillieux, a VNA Hospice NWI volunteer, has proudly worked with the organization for 20 years. “Everything VNA Hospice NWI does is good for the community,” Naillieux said. ... "Usually, we’re volunteering at different locations at different times, and we aren’t able to get together like this very often." ... During the award presentation segment of the event, volunteers were recognized for milestone achievements. These included awards for achievements like 5, 10, 15, 20, and 25 years of service ... [Continue reading ...]Editor's note: Reminder that April is National Volunteer Month; April 20-26, 2025 is National Volunteer Week.

The CEO social media ‘influencer era’ Becker's Hospital Review; by Kristin Kuchno; 4/8/25 LinkedIn has emerged as a particularly influential platform, where healthcare executives share leadership lessons, strategy insights and personal reflections from patient interactions. “There’s a call for more authenticity and transparency, and people now expect to hear directly from their leaders to understand their perspective,” LinkedIn Editor-In-Chief Dan Roth told Fortune. This shift toward more personal communication aligns with a broader push for transparency. Research from FTI Consulting shows 92% of professionals are more likely to trust an organization whose executives use social media. Leaders should embrace the conversational tone of social media and allow their personality — including vulnerabilities — to show, with the aim of sparking dialogue, rather than simply echoing news releases, a senior vice president at H/Advisors Abernathy told Fortune. 

Social Media Watch 4/11/25

Caregiving can test you, body and soul. It can also unlock a new sense of selfNPR; by Kat McGowan; 4/1/25Amanda Cruz took care of her mother, who died of cancer late last year. The experience changed her sense of identity. She is still sorting through what that means. When it was all over, Amanda Cruz felt like a phoenix, a new person rising from what had been. First, though, she had to go through the fire... In 2009, two researchers proposed an explanation for why caregiving for an adult who is ill or disabled can be so profound. Their argument, simply called "caregiver identity theory," is now widely accepted among psychologists and social workers who study and help caregivers.

Our newsletter's "Observances" calendar Hospice & Palliative Care Today; by Joy Berger; 4/9/25 We invite you to use our newsletter's "Observances" calendar, with information for numerous annual observances, like National Volunteer Month (April) and Week (April 20-26), National Nurses Month (May) and Week (May 6-12), National Nursing Assistants Week (June 12-18), and much more. To find at anytime, go to our webpage's "Resources" tab; click on "Observances." Do you have edits to suggest? Freely email me.