Literature Review

‘A missed opportunity’ for small systems needing nurse Becker's Clinical Leadership; by Mariah Taylor; 5/8/25  In February, South Dakota officials approved the state’s first registered nursing apprenticeship program through Huron Regional Medical Center. The apprenticeship is designed to attract English-as-a-second language nurses into the field, Sioux Falls Live reported May 7. The program was started by Norma Torres Ortiz, RN, a travel nurse contracted with Avera Health who works part time at the Huron Regional Medical Center. Ms. Ortiz is originally from Puerto Rico where she worked as a nurse. When she moved to the U.S., she found herself struggling to pass the NCLEX and find a nursing job due to language barriers. ... Large systems are building international nursing programs that recruit and hire nurses through work visas; however, smaller systems don’t have the funds to hire large numbers of international nurses through an agency. This is where a nurse apprenticeship program can fill the gap. Huron Regional Medical Center launched its practical nursing apprenticeship in 2018. ...

Primary mental health competencies for hospice and palliative medicine physicians: A Delphi studyJournal of Pain and Symptom Management; by Lisa Podgurski, Danielle Chammas, Keri O Brenner, Leah B Rosenberg, Neha G Goyal, Maria I Lapid, Sue E Morris, William F Pirl, Bridget Sumser, Benjamin W Thompson, Lindsey Wright, and Daniel Shalev; 5/20/25  Objectives: To establish and prioritize 'primary mental health competencies' for specialist hospice and palliative medicine physicians using expert consensus methods. Results: The expert panel proposed 68 competencies divided into: (A) psychological foundations of serious illness care, (B) diagnosis and management of mental health disorders in serious illness, and (C) systems-based practice. After first-round voting, 23 competencies were recirculated for a second vote. Following second-round voting, 32 competencies were included in the final list: 7 from part A, 20 from part B, and 5 from part C.

[Taiwan] Spiritual well-being of terminally ill patients and next-of-kin caregivers in hospice care: A quantitative and qualitative approachPalliative and Supportive Care; Er-Jung Hsueh, Shu-Chun Tsai, Jun-Hung Lai, Chi-Yu Lu, Tsai-Wei Huang, Made Satya Nugraha Gautama; 4/25Terminal cancer patients often endure significant distress, impacting their quality of life. Spiritual well-being provides peace and meaning during this challenging period. This mixed-methods study included 30 terminally ill patients and 17 next-of-kin caregivers in hospice care. Spiritual well-being was assessed using the Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being Scale (FACIT-Sp-12), and symptom distress with the Edmonton Symptom Assessment Scale. Patients showed a significant improvement in spiritual well-being over time, ... [and] symptoms such as shortness of breath ... , drowsiness ... , and anxiety ... were negatively associated with spiritual well-being. Caregiver spiritual well-being positively influenced patient scores, especially with female caregivers ... Qualitative findings supported these results, revealing themes of spiritual adjustment, the impact of physical symptoms on spiritual well-being, and the crucial role of caregivers in providing emotional and spiritual support.

White coats, heavy hearts: What to expect as a med student after your first patient death Medscape; by David Brzostowicki; 5/21/25 The first death of a patient represents a profound emotional turning point that reverberates throughout one’s career as a physician. In that critical moment, the shield of clinical detachment gives way to inevitable self-reflection. Daryl Eber, MD, recalls a jarring case of an intubated patient who extubated himself and quickly died after coding. The incident occurred in 2005 while Eber was doing rounds as a medical student at Shands Jacksonville Medical Center (renamed UF Health Jacksonville) in Jacksonville, Florida. Although the patient was not in his direct care, the swiftness with which death took the man has lingered with Eber for two decades. 

6 ways to successfully implement clinical communication tools Forbes; by Judit Sharon; 5/19/25 In the high-stakes environment of healthcare, communication breakdowns can have life-or-death consequences. Yet too often, hospitals and healthcare systems assume that simply deploying new clinical communication and collaboration (CC&C) tools will solve the problem. The reality is more complex: Successful implementation depends just as much on operational alignment, cultural change and thoughtful execution as it does on the technology itself. To turn communication tools into real transformation, here are six ways to drive successful CC&C adoption.

A narrative review—Characterizing palliative care curriculum aimed at high school adolescents and young adultsIllness, Crisis and Loss; Austin B. Elder; 4/25The aim of this narrative review is to explore the characteristics of palliative care curriculum developed for high school adolescent and young adults (AYAs). Characteristics including a variety of designs, methods, and strategies were all identified to have positive participation, feedback, and experiences from high school AYA being provided palliative care curriculum. Conclusions: The literature indicates that the use of subject matter experts within palliative care curriculum for high school students is a core characteristic in meeting the World Health Organizations recommendation to embed palliative care curriculum into public awareness strategies.

Dementia patient discharged from hospice over Medicare requirement. Here’s why it happened WKMG-6, Deltona, FL; by Erika Briguglio and Louis Bolden; 5/14/25A Volusia County family is left scrambling after their loved one is abruptly dropped from hospice care. To qualify for hospice, patients must have a life expectancy of six months or less. However, for dementia patients, the prognosis can be unpredictable. Hospice care can be extended as long as the patient continues to meet Medicare requirements. Unfortunately, these requirements are why Amy Yates lost coverage for her 91-year-old grandmother. ... “I think it’s she hasn’t died fast enough, and it’s costing them money that they don’t want to spend,” Yates told News 6. ... What Yates’ family is dealing with is what Medicare calls live discharge, and they are not alone. The Hospice Foundation of America reports that 17% of people in 2022 who were admitted to hospice care were discharged; about 6% of the total caseload was discharged because they no longer met Medicare requirements for care under the hospice benefit.Editor's note: What are your hospice stats for live discharges? For Length of Stay (LOS)? This factor--with the face-to-face recertification requirement--is crucial. Unfortunately, many hospices misused President Jimmy Carter's extraordinarily long LOS with misleading information about hospice care. They watered down "end-of-life" care and never mentioned anything about a basic recertification process. Warm, user-friendly language can be used with integrity, authenticity, and patient/caregiver support.

Newly Available: Improving Dying Hospice Foundation of America, Washington, DC; Press Release, contact Lisa Veglahn; 5/7/25 Virtual reality, physical therapy, music therapy, pet care, and even a haircut are therapeutic, innovative, and practical ways to improve the quality of life for people with terminal illness and are profiled in a new book and continuing education course recently released by Hospice Foundation of America (HFA). “End-of-life care providers are doing amazing work that rarely gets the attention it deserves,” said Amy Tucci, HFA’s president and CEO. “With Improving Dying, HFA’s goal is to recognize their efforts and provide models that can be replicated to enhance care for dying and the bereaved.”

Theories and concepts about society, dying, and bereavement commonly discussed in education about death, dying, and bereavementDeath Studies; Charles A Corr, Kenneth J Doka; 4/25This article describes and offers some evaluations of fifteen prominent theories and concepts in the field of death, dying, and bereavement. These theories and concepts range from claims about "death-denying societies" and the concept of "societal death systems" to theories about coping with dying and coping with loss, grief, and bereavement. Also examined are the concept of disenfranchised grief and theories about contrasting grief styles. Because each of these theories and concepts is often discussed in education about death, dying, and bereavement, it is important that instructors and students understand both their strengths and limitations. The goal of this analysis is twofold: (1) To help guide educators as they explain these theories and concepts to their students and readers, and (2) To assist educators in commenting on the soundness and usefulness of these theoretical frameworks.

Did someone call for a chaplain Jewish Journal; by Jonah Sanderson; 5/2/25 I am an interfaith hospice chaplain who on average handles 20 deaths every week; at times I manage 40. This number may sound staggering but it’s not. As people age and society understands death, more people will choose to die with the dignity of hospice. The career of a chaplain is not one of the most appealing for new clergy. Why would someone want to hold the hand of a woman as she goes in and out of consciousness surrounded by her family and friends? ...

Group estimates 7.2M US residents have Alzheimer's disease: Cases rise as Alzheimer's research funds are halted  MedPageToday; by Judy George; 4/29/25 The number of people with Alzheimer's dementia in the U.S. exceeded 7 million for the first time, new data from the Alzheimer's Association showed.An estimated 7.2 million Americans ages 65 and older now have Alzheimer's dementia, up from 6.9 million last year, according to the 2025 Alzheimer's Disease Facts and Figures. Nearly three-fourths (74%) of that group are 75 and older. While prevalence studies of dementia in young people are limited, researchers estimated that approximately 110 of every 100,000 people ages 30 to 64 -- or about 200,000 Americans in total -- have young-onset dementia, the Alzheimer's Association said.

Designing and developing interprofessional learning experiences in palliative care: A collaborative workshop approachPalliative Medicine Reports; Carolyn Kezar, Justine McGiboney, Michael D. Barnett, Richard Taylor, Rebecca Edwards, Ella H. Bowman, Elizabeth McAlister, Moneka A. Thompson, Tara Schapmire, Chao-Hui Sylvia Huang; 4/25Team-based care is vital in palliative care, but there is limited interprofessional education (IPE) among health care providers, leading to siloed learning. We aimed to design, implement, and evaluate an Interprofessional Education Exchange (IPEX) Death and Dying workshop to foster interdisciplinary collaboration and improve participants’ comfort with palliative care competencies. The primary findings of our study support our initial goal of creating an effective and engaging learning experience, as demonstrated by the significant increase in comfort levels across all interprofessional competency domains. The use of a case-based, interdisciplinary approach to PC [palliative care] education was particularly impactful, with improvements of up to 50% in some areas. Notably, 96% of learners agreed that working with peers from other disciplines enhanced their education, suggesting that early collaboration can improve communication and team-based care in clinical practice.

A powerful film chronicles one man’s last days within a loving community for all to witness. Monterey County Now, Seaside, CA; by Pam Marino; 5/1/25 Facing certain death from a brain tumor, Ethan “E3” Sisser adopted a mantra. “I am embodied. I am empowered. I am ecstatic,” the 36-year-old would tell himself, in order to ward off oncoming seizures, carry himself through pain or recite for his many followers on social media. “E3” became his nickname. We see Sisser, looking into the camera, recite the mantra early in the documentary, The Last Ecstatic Days, released in 2024. We also meet his hospice and palliative care physician, Aditi Sethi, who leaves her position to become his death doula and friend. She fulfills his wishes for a peaceful death surrounded by a caring community, filmed for others to learn from. Director Scott Kirschenbaum – who made one of the definitive documentaries about birth, These Are My Hours – spent the last two weeks of Sisser’s life near his side with a camera, capturing each moment.