Literature Review

Ketamine for depression in serious illness: Evidence, safety, and practical approachesJournal of Pain & Symptom Management; by Paul Noufi, Joshua B. Borris, Danielle Chammas, Cara L. McDermott, Nneka N. Ufere, Jason A. Webb, Daniel Shalev; 4/26Patients with serious illness and short prognoses often experience depression and suicidal ideation. Traditional antidepressants are limited by delayed onset, creating a need for rapidly acting therapies. Ketamine and esketamine [nasal spray] offer the strongest evidence among rapid-acting antidepressants and may be preferred when urgent symptom relief is needed. However, rigorous psychiatric trials in serious illness are lacking. Clinicians should consider prognosis, access to Risk Evaluation and Mitigation Strategies-certified esketamine programs or equivalent regulatory frameworks outside the US, and the need for an appropriate maintenance regimen when integrating ketamine into palliative care depression management.

"Taps" Bugle Call: USMC Drum & Bugle Corps [YouTube]YouTube, filmed at the National Mall, Washington DC, retrieved from the internet 5/22/25Editor's note: We invite you to start this Memorial Day with this reflective playing of "Taps," with backdrops of the Washington Memorial, the Vietnam Veterans Memorial, the Korean War Veterans Memorial, and more. Ongoing, we share with you these resources below for the veterans and their families whom you serve.

Second-generation antipsychotics for depression in serious illness: A first-line augmentation strategyJournal of Pain & Symptom Management; by Gregg Robbins-Welty, Mia Pattillo, Danielle Chammas, Karolina Sadowska, Cara L McDermott, Nneka Ufere, Jason A Webb, Daniel Shalev; 3/26Depression in serious illness is common, disabling, and often requires rapid improvement. In the psychiatric literature, SGA [second-generation antipsychotics] augmentation improves response and remission rates ... , with onset of improvement within 1-2 weeks. Monotherapy is less well tolerated and not guideline-recommended. No RCTs have evaluated SGAs specifically for depression in serious illness, but numerous cancer trials support their safety for nausea, appetite, and other symptoms. Despite the absence of serious illness-specific psychiatric trials, SGAs have the strongest evidence base among augmentation options and may offer meaningful benefits when prognosis or symptom severity necessitates rapid improvement. Low-dose augmentation should be considered early, rather than only after multiple failed antidepressants, particularly when SGAs can also target co-occurring physical symptoms relevant to palliative care.

Challenges in the end-of-Life care for patients with severe persistent mental illness: a case series Psychogeriatrics; by Kaushadh Jayakody, Isha Bajaj, Doug Blomeley; 4/7/26 Conclusions: ... This study emphasises the importance of improved clinician training, clearer referral pathways and integrated care models in addressing this disparity. Implementing these measures will aid in addressing longstanding inequalities and ensure individuals with SPMI receive appropriate and timely palliative and EOL care.

What caring for elderly parents really feels like and what people don’t talk about Sassy Sister Stuff; by Victoria Cornell; 3/29/26 A simple Reddit prompt, “What’s something people don’t realize about taking care of elderly parents?”, turned into a raw, candid conversation in r/AskReddit.  ... Readers shared specific, sometimes heartbreaking stories and blunt advice, and the result is a clear picture of how caregiving is far messier than the Hallmark version we imagine.

Feasibility and acceptability of a self-written, tele-delivered, LGBTQ+-affirming adaptation of dignity therapy for LGBTQ+ women with advanced cancerAmerican Journal of Hospice & Palliative Medicine; by Lexie Wille, Kristie A. Wood, Mike C. Parent; 2/26Dignity therapy (DT) is effective in addressing dignity-related existential distress in people with advanced cancer, but the traditional protocol assumes supportive family structures, uses heteronormative language, and requires synchronous clinician facilitation. These features may limit accessibility for LGBTQ+ individuals. This pilot demonstrated that a self-written, tele-delivered LGBTQ+-affirming DT adaptation was feasible and acceptable for LGBTQ+ women with advanced cancer.

End-of-life care planning for individuals with special needsJD Supra; by Chamblis, Bahner & Stphel, P.C.; 3/23/26 Takeaways

How "The Pitt" can prepare you for the end of lifeKatie Couric Media; by Maggie Parker; 3/20/26 If you're sensitive to seeing death on screen, you shouldn't watch The Pitt. Set in a major city's emergency room, on the hit medical procedural, death is inevitable, and frequent. ... The way end-of-life issues are addressed on the show was carefully thought out and intentionally diverse. ... Unfortunately, it's rare for the media to portray death and dying authentically, according to Dr. Underleider's analysis of more than 141,000 scripted TV episodes from 2010 to 2020. ... This season, The Pitt takes its quest to realistically depict death to another level, with the introduction of a terminal cancer patient, Roxie, who knows what's coming and doesn't want to go home to face it. We spoke to Dr. Ungerleider about her reaction to Roxie's final moments, her experience working with the creators, what they get right about end of life, and why it matters. ...Editor's Note: Pair this with our previous posts, "HBO’s ‘The Pitt’ inspires viewers to consider organ donation, end-of-life planning" and "How ‘The Pitt' gets death right."

Thyme Care launches Integrated Social Support model, bringing proactive oncology social work to 8 million Americans upon diagnosis PR Newswire, Nashville, TN; by Thyme Care; 3/5/26 Thyme Care today announced the public launch of its Integrated Social Support (ISS) model, a redesigned approach to oncology navigation that positions licensed master's-level social workers as the first to intervene when members experience barriers to navigating their cancer. The announcement coincides with National Social Work Month in March, recognizing the essential role social workers play in improving health outcomes. An estimated 44% of individuals affected by cancer experience psychosocial burdens, which are associated with poorer health, clinical, and economic outcomes for patients and caregivers. Thyme Care's ISS model flips the approach by making licensed social workers one of the first points of contact for social, emotional, and practical needs, assessing members from day one and throughout their journey ...