Literature Review

Breaking with the status quo in end-of-life care through de-implementation Journal of Internal Medicine; by Chetna Malhotra and Ellie Bostwick Andres; 4/17/25... In the realm of serious illness, many patients undergo interventions that may marginally prolong life but often sacrifice quality of life and entail significant costs. These interventions, categorized as ‘low-value care’, often involve complex procedures, frequent hospitalizations and intense medical management, leading to considerable discomfort, reduced functional ability and overall decreased well-being and calling into question the efficiency and effectiveness of current end-of-life (EOL) care practices. ... How to conduct de-implementation in EOL contexts:

Longmont women celebrate milestone 100th birthdays with community and caregivers Longmont Leader, Longmont, CO; by Tricia Stortz; 4/28/25 Two Longmont women are marking a rare milestone this week as they each celebrate their 100th birthdays surrounded by caregivers, family, and friends who have helped shape their life journeys.Virginia, a palliative care patient at The Peaks Care Center, turned 100 on April 25. Dorothea VanLoo, a hospice patient at McIntosh Skilled Nursing Facility, celebrates her centennial today on April 28. Both women are under the care of TRU Community Care, Colorado’s first hospice organization, which today serves more than 1,300 patients and participants across a range of programs. Their milestone birthdays have inspired a community effort to honor lives richly lived.

Practical advice for physicians seeking joy and well-being [podcast] MedPageToday's KevinMD.com; by KevinMD; 4/27/25 Palliative care physician and author Alen Voskanian discusses his article, “Discover the secrets to regaining joy in medicine,” based on an excerpt from his book. Drawing from his personal experience with burnout where he felt isolated and like a failure within the demanding medical industry, Alen strongly emphasizes that burnout is a common result of a broken health care system, not an individual failing. He offers key advice points for physicians and health care workers:  ...

The intersection of dignity and healing with Dr. Harvey Max Chochinov Practice of the Practice; podcast by Jo Sanok with Dr. Harvey Max Chochinov; 4/22/25 How can we ensure dignity in end-of-life care? What does every therapist need to know about actively incorporating dignity into therapeutic care for their clients? What is the procedure for a practical application of dignity in therapy and healthcare? In this podcast episode, Joe Sanok discusses the intersection of dignity and healing with Dr. Harvey Max Chochinov. 

Palliative care and advanced cardiovascular disease in adults: Not just end-of-life care: A scientific statement from the American Heart Association AHAIASA Journals - American Heart Association; by Lucinda J. Graven, PhD, APRN, FAHA, Lisa Kitko, PhD, RN, FAHA, Martha Abshire Saylor, PhD, MSN, BA, RN, Larry Allen, MD, MHS, FAHA, Angela Durante, PhD, RN, Lorraine S. Evangelista, PhD, RN, CNS, WAN, FAHA, Amy Fiedler, MD, James Kirkpatrick, MD, Lakeisha Mixon, MSW, and Rachel Wells, PhD, MSN, BA on behalf of the American Heart Association Complex Cardiovascular Nursing Care Science Committee of the Council on Cardiovascular and Stroke Nursing; and Council on Cardiovascular Surgery and Anesthesia; 4/17/25  ... This scientific statement (1) discusses the application of effective communication, shared decision-making, age-friendly care, and advance care planning in advanced cardiovascular disease palliative care; (2) provides a summary of recent evidence related to palliative care and symptom management, quality of life, spiritual and psychological support, and bereavement support in individuals with advanced cardiovascular disease and their care partners; (3) discusses issues involving diversity, equity, and inclusion in cardiovascular disease palliative care; (4) highlights the ethical and legal concerns surrounding palliative care and implanted cardiac devices; and (5) provides strategies for palliative care engagement in adults with advanced cardiovascular disease for the care team.

A dying wish: Man with terminal cancer travels to volunteer in all 50 states ABC-7 News, Bay Area, CA; by 4/6/25 When Doug Ruch was told he had just 12 to 18 months to live, he didn't choose to stay home. Instead, he hit the road - on a mission to help as many people as possible while he still can. "I thought to myself, I have two choices. I can sit at home and wait to die, or I can go out and live," he told ABC7 News. [Continue reading ...] Editor's note: For more, visit Doug's website, www.dyingtoserve.com.

Home hacks for geriatric dogs and cats dvm360; by Tyler Carmack, DVM, CVA, CVFT, CHPV, CTPEP, CVPP; 4/4/25 As pets grow older, they encounter mobility, comfort, and overall well-being challenges that can significantly affect their quality of life. Anticipating and addressing these issues early can profoundly impact their later years. As a house call veterinarian dedicated to hospice and palliative care, the first thing I take note of when entering a new home is all the challenges that the patient faces to simply navigate their daily routine. Often, families are aware of some of these difficulties, but others often go overlooked or unnoticed. ... Here are some valuable "home hacks" to share with clients, ensuring their aging dogs and cats enjoy improved day-to-day comfort. ...

Navigating the intersection of heart failure and palliative care: A holistic approach to improving quality of life Cureus; by Awanwosa V. Agho, Fatimot Disu, Efeturi M. Okorigba, Okelue E. Okobi, Safiyya Muhammad, Toheeb Bakare, Chioma Ezuma-Ebong, Nneka Muoghalu; 3/30/25 ... Historically, palliative care has often been perceived as a last-resort option, introduced only when curative treatments have failed, creating a false dichotomy between life-prolonging therapies and symptom management. However, modern palliative care frameworks emphasize its integration throughout the disease trajectory, particularly for chronic, progressive illnesses like heart failure. ... Palliative care should ideally be initiated at diagnosis of advanced heart failure or with early signs of significant symptom burden to ensure timely, patient-centered support, as recommended by ACC, AHA, and HFSA guidelines

Niagara Hospice to offer free community presentation for National Healthcare Decisions Day Niagara Frontier Publications; Press Release; 3/28/25 April 16 is National Healthcare Decisions Day, which is a day set aside to educate and empower individuals to discuss and document their end-of-life health care wishes. Niagara Hospice invites the community to attend the free presentation, “Advance Care Planning: Advance Directives for Health Care,” ... Advance care planning includes advance directives like health care proxies, do not resuscitate (DNR) orders, and living wills. Advance directives help to ensure end-of-life care wishes are followed if one is unable to make necessary decisions for themselves. [Continue reading ...]Editor's note: For more information about National Healthcare Decisions Day (NHDD), explor The Conversation Project, at the Institute for Healthcare Improvement. 

Population-based payments to deliver health care to unhoused individualsJAMA Health Forum; Sudhakar V. Nuti, MD, MSc; Amanda K. Johnson, MD, MBA; Theodore Long, MD, MHS; 3/25The 770,000 people experiencing homelessness in the US have a high prevalence of disease and high health care utilization. Compared to the general population, unhoused individuals in the US have a 3.5 times higher mortality rate and 27-year reduced life expectancy. To this end, we propose population-based payment models (PBPs) as a novel mechanism to provide increased, stable, and predictable funding for health care for unhoused individuals. PBPs are the most advanced category of value-based alternative payment models, where health care organizations are given a prospective payment to care for a population of patients, with the flexibility to tailor care without incentivizes to optimize billable encounters, while being held accountable for improved outcomes and costs. The flexibility in how to invest and earn funding is essential for focused investment in these models, as increased reimbursement alone is insufficient.

Pope Francis was so close to death that doctors considered ending treatment Reuters, Vatican City; by Joshua McElwee; 3/25/25 Pope Francis came so close to death at one point during his 38-day fight in hospital against pneumonia that his doctors considered ending treatment so he could die in peace, the head of the pope's medical team said. After a breathing crisis on February 28 ... "there was a real risk he might not make it," said Sergio Alfieri, a physician at Rome's Gemelli hospital. "We had to choose if we would stop there and let him go, or to go forward and push it with all the drugs and therapies possible, running the highest risk of damaging his other organs," Alfieri told Italy's Corriere della Sera in an interview published on Tuesday [3/25]. "In the end, we took this path," he said. [Continue reading ...]

Hastening death by stopping eating and drinking: Hope Wechkin, Thaddeus Pope, and Josh Briscoe GeriPal Podcasts; by Hope Wechkin, Thaddeus Pope, and Josh Briscoe Eric and Alex have featured discussions about complex bioethical concepts around caring for people at the end of life, including voluntarily stopping eating and drinking (VSED), and multiple episodes about the ethical issues surrounding medical aid in dying (MAID). Recently, discussion has emerged about how these issues intertwine in caring for patients with advancing dementia who have stated that they would not want to continue living in that condition: for those with an advanced directive to stop eating and drinking, how do we balance caring for their rational past self and their experiential current self? Should these patients qualify for medical aid in dying medications? And is there a middle path to provide some degree of comfort while also hastening the end of life?

[Multi-cultural] Honouring traditions: Integrating cultural wisdom into palliative care - Saif Mohammed ehospice; by Saif Mohammed; 3/10/25[Personal Story] ... "Reflecting on this experience, I realize that caregiving is deeply embedded in tradition and culture, a natural extension of communal life." Caregiving is as old as humanity itself. One of the earliest known cases of palliative care dates back 45,000 years to Shanidar 1, a Neanderthal male found in present-day Iraq. His skeletal remains indicated severe injuries, yet he had survived for decades, suggesting that his community had cared for him. This example highlights that palliative care is a deeply human and historical practice, far predating modern medicine. Cultures around the world continue to recognize the importance of caregiving, often embedding it in traditions and religious beliefs. ... In some societies, the emphasis on independence can make caregiving more complex, as patients may refuse assistance to maintain self-sufficiency. ... Palliative care workers must be equipped to understand and respect the cultural traditions of the communities they serve. This requires training in cultural competence, which involves: